Is subcision for rolling acne scars permanent? Results improved with a filler? How long after initial treatment to see results?

I have moderate rolling acne scars on my cheeks. I have done 4 fraxel lasers, 1 mlp, 1 laser genesis, with a 30% improvement. (Fraxel didn't really help) I have decided on subcision now,to break fibers beneath scars.I had first treatment about 1.5 weeks ago, but no visible improvement. I know it takes a few sessions, but wonder how long to see results? I am worried that the fibers re-attached because skin looks the same. Does collagen fill in after some time? Does a filler help with appearance?

Doctor Answers 2

Treating Acne Scars on Face

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Treating acne scars can best be accomplished by a combination of Fraxel lasers and fillers for injections.  You may need more Fraxel lasers or deeper treatments with the laser.  New collagen is forming several months later and takes a while to see the ultimate results.  For the best cosmetic results in treating acne scars please consult a board certified dermatologist with a great deal of experience with Fraxel laser.

Subcision for Acne Scars

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Hi Rose.  Subcision is a great procedure for acne scars, but generally works best in situations where the acne scar depression is wider than 1/4".  If the depressions are not wide, then it's not likely to work well for you.  

In addition, just because Fraxel did not work out well for you, does not mean that fractional laser resurfacing is the wrong option.  If you did not have deep bleeding during the Fraxel and if they only used facial numbing cream, then you had a very superficial resurfacing procedure.  This means that the results are limited because the procedure did not reach the bottom of the scars.  Our deep resurfacing is still only 7 days recovery but can be 3-10x deeper than a fractional resurfacing, which leads to better results.

To see an example of a good candidate for subcision with Restylane, take a look at the before and after picture at the link below.  You can see that the scar is wide and in general these types of scars respond better to subcision.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.