Is subcision an option for me? Depressed scar on forehead. (photo)

Question

I have a depressed scar on my forehead due to an injury a while back. I fear doing injections since I've been told this is a sensitive area of the forehead and fillers could potentially block nerves leading to blindness. I'm also very pale and prone to hyperpigmentation so I'm weary about laser treatments as well. Is subcision an option for a scar like this? Thank you!

Raffy Karamanoukian, MD, FACS · 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

Jason Emer, MD · Answer

this type of scarring needs fillers, botox, and lasers. subcision can "help" but wont ultimately treat the problem. at home dermarolling relaly improves the outcome.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly) should be started now.  visit emeragecosmetics.com where we ship medical grade skincare all over the world AND do free virtual skincare consults daily.

if you have post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we already pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Benjamin Barankin, MD, FRCPC · Answer

I think subcision with a bit of filler will likely be helpful ; yes, there are most certainly risks involved, especially in this location, and that's why you go to an expert physician injector such as a dermatologist and not a salon/spa etc.

Steven F. Weiner, MD · Answer

I would treat your scar with subcision and fillers. I don't think lasers are going to adequately help this scar. There is additional risk in this area with filler such as vascular occlusion and blindness, so these procedures need to be done by someone who is an expert in this area.

Michele S. Green, MD · Answer

A scar like yours would benefit from subcision. However, I typically inject a small amount of filler at the same time in a scar such as yours. You would benefit from some laser treatment as well and the fact that you are so pale will help you with these types of procedures since you don't risk the same type of hyperpigmentation. Please consult an expert in acne scars and see the attached link. Best, Dr. Green

Is subcision an option for me? Depressed scar on forehead. (photo)

Answers (6)

Answer: Forehead scar - subcision candidate?

Answer: Forehead scar - subcision candidate?

Answer: Subcision plus filler for indented scar with laser treatment

Answer: Subcision plus filler for indented scar with laser treatment

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Is subcision an option for me? Depressed scar on forehead. (photo)

Answers (6)

Answer: Forehead scar - subcision candidate?

Answer: Forehead scar - subcision candidate?

Answer: Subcision plus filler for indented scar with laser treatment

Answer: Subcision plus filler for indented scar with laser treatment

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Recommended reading

Everything you need to know about Subcision

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