Swelling from scar tissue after subcision - advice? (photos)

Question

Had Taylor liberator subcision in March 2021 for acne scarring and have scar tissue which has caused inflammation and swelling in both cheeks. Dr has tried steroid injections. Had MRI which says oedema and scar tissue and I just have to wait for it to heal. No improvement so at a loss. Any suggestions?

Nelson Lee Novick, MD · Answer

Sorry you are having this problem. The Taylor Liberator field subcision is a a very aggressive subcision tissue with the obvious potential to elicit a very extensive, excessive fibrous tissue response. I have been performing subcisions since 1994, but I do not personally perform this procedure out of concerns for provoking this kind of reaction, but have encountered patients treated elsewhere who have experienced similar problems that I have treated with a varying concentrations and amounts of triamcinolone+/-the additonal use of varying concentrations and amounts of 5-FU to shrink the firbrous tissue mass. Make sure that you consult with an experienced, board certified cosmetic dermatologist and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

Swelling from scar tissue after subcision - advice? (photos)

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Swelling from scar tissue after subcision - advice? (photos)

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Everything you need to know about Subcision

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