Is dermabrasion the right treatment for my nose scar? (Photos)

Question

I have an atrophic acne scar on my nose, so far have undergone three surgical dermabrasion procedures done by my facial plastic surgeons. I am wondering if any improvement is visible so far (from a provider’s perspective) and if this is the right course of action to take with this type of scar. initially planned for 3-4 dermabrasions and then fat grafting in the area, but i am starting to question if this is the right course of action due to seeing minimal visible improvement to the skin texture, and I am uncertain i will feel satisfied with the final result if i go through with the fat grafting. Any suggestions from those who have done scar revisions on how to best treat this scar would be appreciated, i feel like every time i go back to my facial plastic surgeon they tell me it is looking much improved, but comparing before and after photos it seems as though the area looks almost the same/more volume loss.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience and for being so thoughtful about your treatment plan. Scars on the nose—especially atrophic acne scars—can be particularly challenging to treat because the skin in this area is thicker, tightly attached to underlying structures, and heals differently compared with other parts of the face.

Dermabrasion is a well-established treatment for certain types of scars because it works by removing layers of skin to stimulate new collagen formation and smoother resurfacing. In some patients it can gradually soften the edges of depressed scars and improve texture. However, the results are often incremental and subtle, especially with deeper atrophic scars where there is true volume loss beneath the skin.

From a dermatologic perspective, it’s not uncommon for improvement after dermabrasion to be difficult to appreciate early on, particularly if the scar is deeper. Sometimes physicians notice small changes in scar edge blending or surface texture, while patients understandably focus more on the overall indentation or contour difference.

Your observation that the area may look similar or even slightly more hollow can also occur. Dermabrasion improves the skin surface, but it does not replace lost volume, which is often the primary issue with atrophic scars.

That’s likely why your surgeon mentioned fat grafting as the next step. Fat grafting works differently from dermabrasion—it restores structural volume beneath the scar, which can elevate the depression and create a smoother contour. In many cases of deeper atrophic scars, a combination approach is used:

• Surface resurfacing (dermabrasion or laser) to soften edges and texture
• Volume restoration (fat grafting or filler) to lift the depression

That said, it is completely reasonable to reassess the plan if you feel the improvement so far has been minimal. Other scar-revision strategies dermatologists often consider for this type of scar include:

• Subcision, which releases the fibrous bands tethering the scar downward
• Fractional laser resurfacing to stimulate collagen remodeling
• Microneedling with radiofrequency for gradual collagen buildup
• Temporary hyaluronic acid filler as a diagnostic step to see how much improvement volume restoration could provide

Sometimes performing subcision before volume restoration can significantly improve the result, because it frees the scar from the deeper attachments.

It’s also important to remember that scar treatments often require multiple modalities rather than a single technique, and improvement tends to occur gradually over time rather than all at once.

Your concern about whether you will ultimately feel satisfied with the outcome is very valid. When there is uncertainty about the next step, it can be helpful to carefully review standardized before-and-after photos taken in the same lighting and angle, as subtle improvements can sometimes be easier to appreciate that way.

Overall, dermabrasion can play a role in treating certain scars, but for deeper atrophic scars on the nose, combining surface treatments with methods that restore or release the underlying tissue often provides the most meaningful improvement.

Is dermabrasion the right treatment for my nose scar? (Photos)

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