Can a fat transfer improve the appearance of atrophic acne scars? Should this be addressed before my facelift? (photo)

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Before jumping into expensive, aggressive facelift surgery that engenders risks and considerable post-treatment downtime, you might wish to consider a Field Subcision. At least from the one photo provided (which shows quite a bit of volume deficit in the cheeks aging the face and also making the overlying scars more prominent), a Field Subcision would not only elevate and smooth the overlying scars, but would very likely rejuvenate the face in one treatment session in the hands of an experienced injector to the extent that you will likely exclaim "Wow!" immediately following treatment. I gave up using injectable fat years ago. For one thing, it is a relatively expensive two-step minimally invasive procedure that engenders downtime. And, despite the promise of permanence, much of the fat, separated from its original blood supply in the donor area, does not survive. And, that fat that does survive retains the characteristics of the area from which it is derived--meaning that when belly or buttock fat experiences a midlfe midriff bulge, the fat that was transferred into the face may also do so. Before jumping into surgery, you would be wise to consult an experienced, board certified cosmetic dermatologist. Best of luck.