Can subcision with PRP/saline solve this issue or PDO sugar threads? (Photo)

Question

I have skin irregularities due to acne scars and bumps remained after subcision with hyaluron filler done more than a year ago. I would appreciate your suggestion how to solve skin irregularities due to acne scars and bumps remained after subcision with hyaluron filler done more than a year ago. Can subcision with PRP/saline solve this issue or PDO sugar threads? Or something else?

Nelson Lee Novick, MD · Answer

The bumps in the photo may be related to too much filler injected and/or an overproduction of collagen in response to the subcision. In either case a tiny amount of hyaluronidase injected at each site may help to shrink the bumps. Occasionally a small amount of antiinflammatory agent, such as triamcinolone, can also be helpful for flattening any excess collagen proliferation. Both agents may be needed, although I would opt for starting with the hyaluronidase. Subcision with saline are usually reserved for  elevating steroid induced atrophy (dents), rather than for bumps; so, I would not be inclined to go this route out of concern for worsening the bumps. Likewise, although not consistently effective, PRP may in fact stimulate more collagen and worsen the bumps. Make sure to consult a board certified aesthetic physician. Best of luck.

Jason Emer, MD · Answer

this needs more than threads you need a combination of skin tighteing when morpheus or fractora, lasers like halo, and sculptra to build collagen. at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly) should be started now.

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.

Steven F. Weiner, MD · Answer

I would treat your scars with subcision and RFM. It will take 2-3 treatments and won't improve the skin 100%. If still not to your satisfaction after those treatments, consider one CO2 laser treatment. It hard to make recommendations with just one picture and not seeing you in person but that's my best recommendation from what I see.

Can subcision with PRP/saline solve this issue or PDO sugar threads? (Photo)

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Can subcision with PRP/saline solve this issue or PDO sugar threads? (Photo)

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