Would I see results if I user filler for deep acne scars on my cheeks? (Photo)

Question

Hi, I have deep acne scars on my cheeks that I would like to treat. Would I see results using fillers? I know it would not erase it but would it lessen them?

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Filler can help reduce the appearance of acne scarring.  Another option would potentially be a CO2 laser.  The laser helps resurface the skin an encourages collagen production.  I would suggest speaking to a Board Certified Plastic Surgeon and or Board Certified Dermatologist who has experience with injecting and CO2 lasers.  Best of luck to you.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. Placing filler (Restylane) into the scars will lesson their appearance, but not completely hide them. Combination of laser resurfacing followed by filler might further help. See an experienced oculofacial surgeon with expertise in fillers and lasers. Good luck!

Nelson Lee Novick, MD · Answer

From the photo, there is quite a significant amount of acne scarring-related cheek atrophy. When this is the case, the overlying scars, because they are so indented as a result of this, can become so shadowed that they stand out even further. By performing a Field Subcision, accompanied by the injection of a robust HA filler, the underlying atrophic cheeks can be elevated and smoothed to such a degree that the overlying scars are considerably less deep and thus demonstrate much less shadowing. The results of this technique, when performed by an experienced board certified cosmetic dermatologist typically give rise to an immediate and often dramatic overall improvement. Wishing you the best of luck.

Camille Cash, MD · Answer

From your photo it appears you would have the best results from a combination of treatments.  In addition to fillers you could also consider Morpheus8 or laser treatments.  Morpheus8 combines microneedling with RF technology to improve skin tone and texture.  See a board certified plastic surgeon near you to learn more.

Jo Herzog, MD · Answer

My best guess is that you would see some improvement of your scars after using fillers. If you were my patient I would first subsize the scars and inject some saline under them to see how well they surfaced. You might also benefit from a laser treatment after getting started with fillers.