Options for Reducing Facial Scars - Restylane or Subcision?

I have a couple trauma and chickenpock scars on my forehead and two on my cheeks. I recently visited a dermatologist in the Atlanta area and he recommended doing a subcision with fascia lata. I'm very skeptical about the fascia lata as it donated by someone through American Red Cross.

Although he mentioned another option was to use Restylane as filler instead of the fascia lata, I'm looking for a permanent fix. I also looked into Fraxel, but the doctor told me that I could get hyperpigmentation because of my Indian skin color. I'm not sure what to do now.

Should I choose the subcision with fascia lata or Restylane, or could there be other options?

Doctor Answers 7

Indented facial scars may be improved with a combination of subcision and filler injection.

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Indented facial scars may be improved with a combination of subcision and filler injection. This combination gives superior results to either one performed exclusively.

Subcision alone for a scar is effective, and Restylane adds to benefit.

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Depending on the depth and size of your scar, another option may be subcision alone, or subcision with some saline injected. Irritation and trauma to the tissue beneath the scar, even without filler, can promote collagen building and it may heal less depressed than before. Subcision can be repeated, and material ranging from saline solution to Restylane can be used to additionally stretch the underlying skin pocket created by subcision, and signal the stretched fibroblasts to start creating more collagen. I recommend that there is no harm in giving one of these methods a try before going to something like fascia lata, with its higher risk profile.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Fixing facial scars with Restylane

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Restylane is a powerful and effective dermal filler that can be used safely throughout the face. One of the most effective applications is the correction of scars. Restylane may be injected underneath a depression or scar to help fill out and level this area of the skin. Restylane may be a good solution for chickenpox scars. Your best bet is to work with a board-certified plastic surgeon with a great deal of experience with dermal fillers and scar revision. They will be able to determine if you will best be served by having these areas filled or by transacting the underlying tissue that is pulling the surface of your skin downward and causing a noticeable scar.

Chicken Pox scar treatments

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If you are interested in a "permanent fix" then Restylane is not your choice. Subcision or excision are definitely options and laser resurfacing may be depending on how dark you are.

If your skin is too dark for laser resurfacing (get an opinion or two), then punch excision and subcision are probably better options than Restylane because of the permanent nature of the procedures. Dermatologic surgery is a very specialized field, so I would probably get at least three different opinions including surgical procedures (excision, subcision) and lasers (fractional, Erbium, non-ablative).

Only consider injection procedures such as Restylane if you want a temporary solution.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Resylane is helpful for treating scars but isn't a long term solution

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The other options you mentioned are more permament although they each have their pros and cons. It sounds like the physician that you saw gave you excellent and comprehensive discussion of the treatment options for scarring. 

Patricia Farris, MD
Metairie Dermatologic Surgeon

Facial scar revisions

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Both subcision and fillers can be good options for improving the appearance of facial scars. Fillers only provide a temporary result. Other options include excision of scar and repair as well fractional laser resurfacing. This could cause hyperpigmentation but a test spot could be done in hidden area.

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
4.3 out of 5 stars 14 reviews

Scars and fillers

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No treatment for scars is perfect.  However releasing of the scar if it is depressed and placing a filler underneath may be a nice solution.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.