Atrophic acne scar, going for autologous fat filler. Will it be helpful? (Photo)

I have atrophic acne scar on my cheek ... my surgeon advised me to have autologous fat filler ... will it be helpful ?

Doctor Answers 3

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

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I find that a combiantion of subcision, laser, microneedling and filler/bellafill do well for this.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 204 reviews

Atrophic Scars and Treatment

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The best treatment would be a combination of fillers and lasers such as eMatrix.  Other treatments such as micro needling with PRP are also effective.  Please consult an expert with experience in treating scars.  Best, Dr. Green

Atrophic Scars May Be Elevated Via Subcision & Appropriate Fillers

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There is no substitute for a close up examination and palpation of scars to determine their suitability for certain scar treatment procedures.

Having said this, the photos suggest the presence of boxcar scars, as well as rolling scars. The rigid walls of boxcar scars typically do not easily elevate from the injection of fillers. In fact, not uncommonly, the fillers, unable to budge the rigid scar walls, spill over into the surrounding normal tissue actually making the appearance worse.

Autologous fat, which I stopped using back in 1994 for a variety of reasons, being very thick is even more likely to give rise to this kind of unwanted situation if used alone.

In appropriately selected cases I typically perform subcision prior to the injection of any filler, in order to break up the bundles of tethering scar collagen responsible for the indentation (depression) of the scars. Once done, I then opt for a lifting volumizing filler. My choice in my Upper East Side Manhattan practice is Restylane Lyft. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available Hyaluronica 2). Although tempting, I do not use permanent, foreign-to-the-body fillers, such as Bellafill (or silicon or bioalcamid), since if short term or long term problems develop with these, it is extremely difficult to treat. 

Following the above treatments, fractional microneedle resurfacing (aka medical microneedling) may be used to blend the tone and texture of the treated areas with the surrounding normal skin. Relatively expensive fraxel lasers and radiofrequency treatments, much hyped these days device manufacturers, have been showing themselves to yield underwhelming variable and subtle benefits.

Make sure you are being evaluated and treated by a board certified aesthetic physician with specific experience in acne scar treatments. Good luck.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

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