Best options for acne scar treatment? (Photo)

First, let me say that I am not surprised by the lack of success with the laser treatments, as I have been cautioning readers of RealSelf for years already that the science to support relatively expensive "bells and whistles" lasers (and other so-called energy-based treatments, for that matter) lags well behind the intense marketing hype to promote them. I have likewise cautioned readers against the use of permanent fillers, such as silicone and Bellafil, since permanent fillers can translate down the road into permanent filler complications that can be provoked by manipulation of the injected areas--not just immediately, but even five, ten or twenty+ years later. So, this segues to the problem here. Ordinarily, I would suggest subcision as the treatment of choice for tightly-bound down, tethered boxcar scars. However, my concern here is that since these areas have already been injected with silicone, the very manipulation of the skin by a subcision could in fact become a trigger for the development of difficult-to-treat lumps and granulomas. I suggest you consult with a board certified cosmetic dermatologist with extensive experience in performing subcisions and one who also has experience in treating the complications of permanent fillers. Perhaps he/she will opt to try one scar first as a test to determine your particular response to treatment before going ahead and treating all potential sites . Wishing you the best of luck.

A series of micro-needling treatments with PRP, plasma rich platelets, would probably be very helpful. I would suggest finding a medical spa and discussing your concerns.