I asked for subcision/filler to prevent tethering and to get less subcision followups. Both were done alone on certain scars?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Not all scars are the same.  You need a cosmetic dermatologist who specializes in acne scarring/pigmentation and does a combination of treatments including: surgery/punch excision, subcision, or TCA cross for deep or pitted "ice pick" scars; fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars; Eclipse Micropen for all types of scars and improvement in texture and tone; lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Sublative or Viva to improve the scars and give long term collagen production. There are many options but you want someone who can customize a regimen for your short and long term goals based on your individual situation.  Without photos there is no way for us to tell you what combination is best. Good luck, Dr. Emer!

Thank you for your question.It is difficult to assess the situation without any photographs. A variety of names are used to describe the kind of acne scars on the face, and not all of them are tethered. This can only be evaluated on actual physical examination and treated accordingly.All The Best!