Acne scar, tip of nose, over two years - I have tried Juvederm and profractional laser. What other options will help? (Photos)

Question

I have had this acne scar on my nose for a little over two years now, have tried juvederm to raise the scar (seems to get absorbed fast) and at least 6 profractional laser treatments to improve the depth with little progress. Would there be any way to perform some kind of subscision/excision/scar reconstruction that would fill in the depression left? I don't really care that much about the coloration, I am so insecure due to the indent left even when wearing makeup. I would be willing to do anything surgical including rhinoplasty/skin graft, I am young and this has impacted me to point where I have almost entirely stopped dating and am too insecure to get professional headshots done for my job. Last picture shows scar immediately after last juvederm fill, but the depressed part of the scar is still noticeable

Nelson Lee Novick, MD · Answer

For thirty years, I have personally been performing subcision for elevating and smoothing all kinds of Indented scars, whether from acne, chickenpox, surgery, or trauma, with very gratifying results
As you have unfortunately have already learned the hard way, unlike all the expensive, bells and whistles, light and energy-based gizmos out there (whose supposed benefits are backed up far more by heavy marketing hype and social media buzz than hard science), simple and relatively inexpensive subcision has a long and proven track record for both safety and efficacy and for yielding long-term to permanent results. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment expert and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience—scars on the nose can be especially challenging to treat due to the thicker skin, sebaceous nature, and limited subcutaneous tissue in this area. Since you have already tried dermal filler (Juvederm) and multiple profractional laser sessions with limited improvement, other procedural approaches may be considered:

Subcision: This involves releasing tethered scar tissue beneath the depression. On the nose, it can be technically more difficult due to limited skin mobility, but in select cases it may provide improvement.

Excision and closure: For well-defined, deep scars, a small surgical excision with precise closure can replace the depressed area with a fine-line scar that may be less noticeable.

Punch grafting or punch excision: Particularly useful for small, resistant scars, where the scarred tissue is removed and either closed or replaced with a tiny skin graft.

Cartilage or dermal grafting: For more pronounced depressions, tissue support from a graft can help elevate and smooth the surface.

Combination approach: Often, best results come from combining surgical revision with resurfacing (laser, microneedling, or dermabrasion) after healing.

It’s important to understand that while significant improvement is possible, achieving a perfectly smooth nasal contour can be very difficult due to the nature of nasal skin. That said, surgical options such as excision or grafting may offer more improvement than fillers or repeated lasers alone.

Acne scar, tip of nose, over two years - I have tried Juvederm and profractional laser. What other options will help? (Photos)

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Acne scar, tip of nose, over two years - I have tried Juvederm and profractional laser. What other options will help? (Photos)

Answers (2)

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Everything you need to know about Scar Removal

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