How long until I see improvement for indented acne scar from deep Microneedling PRP and TCA Cross? (Photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

I'm a bit confused by your pictures since it appears that you photoshopped the right nasolabial fold area.  Perhaps repost with untouched photos and circle the area of interest.  In general, most of the results that you are going to see should be already evident, but a minor amount of further change is possible over the next few months.

TCA cross takes 6-10 treatments in general and Microneedling RF will do very little for ice pick scars. you likely will need TCA plus halo or Fraxel lasers, even a co2 would help speed up the process.  you may never get full clearance but will get improvement.
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 alreayd pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer. 

Microneedling for acne scars is recommended monthly for 6-8 months.  PRP or TCA CROSS will enhance.  A more effective treatment would be resurfacing with radiofrequency series of 5 monthly treatments with PRP.  Bellafill injections are another option.

Deep acne scarring will need injections of PRP to get deeper then microneedling and will also benefit from a PracaSil-Plus, a scar cream offered by many compounding pharmacies.

This is a specialized treatment for Acne and to find out what you expectations should be, please speak with the doctor who performed the process