Subcision for acne scars best alone or with a filler? (photos)

A combination approach will give the most improvement and most treatments can be performed on the same day. These types of scars need a combination of subcision, fillers with Cosmelan, lasers,  and microneedling/prp. It may take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

In my opinion there are many protocols for subcision. Some like to add fillers at the same time of subcision others like to wait. Some Physicians like permanent fillers, other like temporary fillers. Our personal favorite is to combine subcision with PRP and let a matrix form underneath the subsized area. This is an all natural process and permanent .We combine this with a suction device to be used post-operatively.

i always prefer to do subcision and add autologous fat at the same sitting as it is advantageous and gives better results

Many combinations are possible. I am making a video about subcsion and the various combinations. The answer depends on the type of tethering and extent. I do this as a stand alone procedure, in other situation I use a 'spacer' filler, or even saline, other times fat, other times PRP. It depend on the anchored scar. Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments and not just one device. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help.

For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars.

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best,

Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.