Subcision - deep or superficial?

I have been performing subcisions since 1994 for all kinds of problems, ranging from acne scars, chicken pox scars, surgical scars, tramautic scars and even cellulite. Each kind of problem requires different size needles and different depths (for deeper scars, usually more than one depth).  If your doctor is a board certified, aesthetic physician, he/she will be best for determining what needles to use for subcision and what depth(s) are necessary to get the job done and whether a biostimulatory filler should be added to the treatment. Best of luck.

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HIDEF 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 acne 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 acne scars and indented acne 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 been 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 laser 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.

Subcision works well alone and in combination with other laser and RF platforms, including fillers and air subcision. TCA Cross can be combined with subcision. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne 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

This is difficult to answer without pictures and will vary due to the severity of the scarring. Keep in mind, a combination approach is needed to give the most improvement. Acne scars need a combination of lasers, microneedling/prp, subcision and fillers. It will 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