Regular subcision vs. subcision with fillers? Use suction method for both approaches? (Photos)

The deeper scars need to have filler. My choice is Bellafill. I don't think that microneedling will touch this. I feel that microneedling is about 1/10th the effectiveness of Infini. Infini with Bellafill is clearly needed. Some of the ice pick scarring can be treated with TCA cross. Subcision is done in conjunction with the Bellafill. In regards to Infini: it has insulated needles which are important to deliver the RF energy deep into the dermis and protect the epidermis. This energy causes coagulation of the tissues which leads to maximal collagen remodeling and proliferation. Don't be mislead that noninsulated needles are more robust. The energy for these devices must be less or there would be significant downtime, wound care, and risks of hyperpigmentation/scarring. Heat/power is not the limiting factor with the Infini, it is the skin's tolerance to the energy that limits the settings..

I agree with the Surgeons below, microneedling itself, given the severity and depth will do very little. My first method will be Infini RF combined with PRP in an over and under method. The under method of PRP will provide some subcision. 3 sessions one month apart, followed by filler and subcision. The later is technique dependent. Bellafill or HA filler will give you a good result. You will require 3-4 sessions of this combination. Expect up to 70% improvement with 7-8 sessions, as you have one of the hardest types of scarring to treat, the good news is that they can be improved with realistic expectations. Dr Davin Lim. Brisbane. Australia.