Would I benefit from subcision and filler? (photos)

Question

Hi I have done multiple co2 and dermabrasion sessions. Went to a new doctor and was suggested subscision and fillers. Will it help.

Nelson Lee Novick, MD · Answer

Unfortunately, I am not surprised by the lack of success with the prior treatments. From the photo, the predominant issues are deep ice pick scars and dilated pores. TCA CROSS, which I have been performing for over twenty-three years, is my treatment of choice, in all skin types, for ice pick scars and dilated pores because the acid goes deep down the shafts of these scars and pores and closes them off as part of the healing process. By contrast, ablative therapies, like C)2 laser and dermabrasion, although aggressive on the surface do not get down to the depth of the scars. Following TCA CROSS, professionally performed manual microneedling (no need for the added risks and expense of RF micronreedling) can be sued to improve and blend better with the surrounding normal skin any residual surface, textural irregularities. You would be wise to consult an experienced, board certified cosmetic dermatologist scar treatment specialist. Best of luck.

Randal Haworth, MD, FACS · Answer

Based on your picture and IME, it should definitely help with your issue.

I hope this helps,
best of luck !

Mats Hagstrom, MD (license on probation) · Answer

I don’t think and fillers are going to fix the ice pic, acne scars on your nose.
Before moving forward, I suggest you ask the provider to show you an ample selection of before, and after pictures of previous cases they have treated.
Direct surgical excision may be a legitimate option for single select areas of defect. 
These are inherently difficult.
Best,
Mats Hagstrom, MD

Raffy Karamanoukian, MD, FACS - Account Suspended · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Would I benefit from subcision and filler? (photos)

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