Subcision and fat transfer longevity?

I'm thinking of having a subcision and fat transfer procedure done on my forehead to correct acne scarring followed by ablative CO2 lasering. I have mostly rolling scars. I keep hearing that fat fillers last only a few months. Will I have to have this procedure repeated often?

Doctor Answers 5

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

Likely you will need a series of treatments for improvement and then other treatments for maintenance and further improvement for the rest of your life.  Please see an acne scarring expert.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Forget The Lasers; Be Cautious About Fat Transfer: Subcision Works Well For Depressed Acne Scars

As I have emphasized in many of my previous responses on RealSelf, regarding the treatment of acne scarring with lasers, fraxels in particular, they appear to be far more backed by device manufacturer supported marketing hype and little hard science. Enough said. As to fat transfer, I have also repeatedly pointed out that very often the durability of the response from this approach is much shorter-lived than fat transfer proponents assert, perhaps lasting no more than conventional, off-the-shelf volumizing fillers. Furthermore, fat transfer is generally relatively more expensive, since it is a two step procedure (drawing fat from one area of the body and reinjecting into another), and is more invasive (typically requires larger cannulas for both wound sites). Subcision, which I have been performing for 22 years, on the other hand, is a simple, relatively inexpensive method for elevating indented scars, and since it depends upon promoting new, native collagen and elastic fiber synthesis (neocollagenesis, neoelastogenesis), its results tend to be long-lasting to permanent. For immediate elevation and for additional biostimulation, I often inject a small amount of Restylane Lyft (in my Upper East Side Manhattan office) or Hyaluronica 2 (in my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available). Make sure you seek consultation and treatment by a board certified aesthetic physician with experience and expertise in acne scar treatments. Best of luck.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 22 reviews

Subcision and fat transfer

Great question.First it would help to see photos. Many forehead scars are best treated with excision and placement of the scar in a forehead wrinkle.Longevity of the transferred fat is an area of very active research. It is sure that we do a better job now of cleaning, preparing the fat along with stem cells so that the survival is assured.The subcision by itself is very helpful.I do not think there is anything better for rolling scars than subcision and fat stem cell grafting. The laser is probably a waste of time and money.

Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 18 reviews

Acne scar treatments in Los Angeles

I would use a combination of fractional laser, skin resurfacing, fractional RF, Yag laser, and subcision for most forehead acne scars. The forehead is an excellent area for acne scar removal. Best, Dr. KaramanoukianLos Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 93 reviews

Treatment of acne scars on the forehead.

Unlike the cheeks, the forehead does not have a layer of fat beneath the skin. Therefore, subdermal injections with Radiesse, Juvederm, Restylane, or fat are rarely necessary. Deeper scars can be elevated, by punch elevation, or excised. This is often followed by dermabrasion or laser resurfacing. Ice pick scars are usually surgically removed.  More superficial scars can be treated by dermabrasion or laser resurfacing. Some providers use micro-needling, which is far less effective.

Robert S. Bader, MD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

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