Can I do subcision without filler and use laser instead? (Photo)

Question

I had sculptra done 7 months ago and initially I was scared my face was going to look lop sided since one side looks slightly more puffy than the other. It isn't too noticeable so I'm not all that stressed but my derm is considering injecting another vial for my acne scars. I don't feel comfortable having more sculptra since I feel got spared this time from overcorrection. I desperately don't want to use filler because of overcorrection issues. Will i still see results if I do subcision again but this time without filler? I've already seen improvements but this time I'd much rater just use laser as an alternative to filler.

Nelson Lee Novick, MD · Answer

I have been performing subcision for acne scars since 1994. For over two decades, subcision was traditionally performed without the addition of a filler; it worked by breaking the tethering fibrous bands that held boxcar and rolling scars down and by secondarily stimulating new collagen and elastic fiber synthesis (neocollagenesis and neoelastogenesis)-- a process that takes between four to six weeks. More recently, subcision is accompanied by the use of filler to provide more immediate elevation and smoothing and for supplementing the stimulation of new collagen and elastic fiber production. So, the short answer to your question is that subcision can most certainly be performed without adding filler, since that is the way it was traditionally and successfully performed for many years. Hope this helps. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Can I do subcision without filler and use laser instead? (Photo)

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Can I do subcision without filler and use laser instead? (Photo)

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Everything you need to know about Subcision

Our mission is to create a world where every investment in modern beauty is Worth It.