Your question presupposes that fillers are necessarily the ideal treatment for box car acne scars. While longer-lasting fillers, like Radiesse and Restalyft in small amounts (my choices in my Upper East Side Manhattan practice) can be helpful for elevating depressed scars, more often than not the central depressions of these kinds of scars are so fibrotically bound down that the filler cannot lift it up sufficiently; instead, there is a risk that the filler can spread to the sides and around the bound-down portions of the scars and result in something of a donut type appearance (with the surrounding area being elevated above the hole giving rise to this unwanted result). (In my Israel satellite facility where a far greater number of regulatory agency approved fillers and volumizers are available, I typically opt for Sub Q or Hyaluronica 2 for this purpose).In most cases, donut hole problem can be avoided, if subcision, a quick, simple, and inexpensive procedure is performed before the addition of the filler, either immediately before or about a month before the filler is injected. For more information on subcision and on other possible acne scar treatments, check out the archives of Realself.com. And be sure to consult with a board certified aesthetic physician with experience and expertise in all facets of acne scar treatment.
