Should doctor have done TCA Cross before subcision?

Question

A doctor told me she won't do TCA Cross on the scars I am planning to have subcision done on. Was this the correct thing to do? Should I have not had the TCA Cross done before the subcision?

Jason Emer, MD · Answer

Acne scars need a combination approach for improvement. For the best results, we always target each acne scar type. Subcision is typically used for depressed, tethered scars and atrophic, indented scars in combination with fillers like Bellafill and Sculptra. TCA CROSS and punch excision are best for deep ice pick scars and narrow box car scars. The majority of patients will have a collection of different scar types, so a tailored treatment plan is best.It's never about the laser or product that gives the results. It's about the expert behind the equipment that gets you the best outcome. I would recommend seeing an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HIDEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be been improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional laser such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone.

Subcision works well alone and in combination with other laser and RF platforms, including fillers and air subcision. TCA Cross can be combined with subcision. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian

Jeff Rapaport, MD · Answer

We usually perform TCA cross prior to subcision. At times, we will perform them at the same session. Occasionally, some box cars are broader and the need for subcision after TCA cross cannot be determined until  the TCA cross heals. There's no downside employing  the procedures on separate days.It  usually takes two to three weeks to determine the effects of the TCA cross. Find a scar expert. Good luck.Jeff Rapaport MDRealself All-star

Steven F. Weiner, MD · Answer

We routinely do both of these procedures on the same day in our office. TCA Cross is mainly used for icepick scarring and small boxcar scars. Subcision is best for treatment of atrophic and tethered scars. It might be that the scars weren't needing both treatments.

Davin Lim, MBBS, FACD - Account Suspended · Answer

No idea, what is your scar type? If they are pick, ice pick, narrow or linear box car scars- sure, TCA is an option. The level of injury is different from subcision (usually sub cuttenous or lower dermal). All specialist will conduct both procedures in the same sitting IF appropriate. Dr Davin S. Lim. Brisbane. AU

Should doctor have done TCA Cross before subcision?

Answers (5)

Answer: TCA Cross at same time as subcision

Answer: TCA Cross at same time as subcision

Answer: TCA and subcision

Answer: TCA and subcision

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Everything you need to know about Subcision

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Should doctor have done TCA Cross before subcision?

Answers (5)

Answer: TCA Cross at same time as subcision

Answer: TCA Cross at same time as subcision

Answer: TCA and subcision

Answer: TCA and subcision

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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.