Can you have fillers after subcision?

Question

I have rolling, boxcar and ice pick scars in concentrated areas of the cheeks, I have been going through a whole treatment plan with my doctors that include chemical peel, derma pen with prp, and laser. Now the doctors are thinking about doing subcision and fillers next. Can the fillers be injected right after the subcision or would I have to wait? Also does subcision only work with certain type of scars, or all? And if so which?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HIDEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be been improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional laser such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone.

Subcision works well alone and in combination with other laser and RF platforms, including fillers and air subcision. TCA Cross can be combined with subcision. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian

Michael I. Echavez, MD · Answer

Fillers are normally done immediately after subcision of acne scars.  The subcision releases the attachments of the scar and the filler is used to allow the skin to lift up and prevent the skin from becoming depressed again.  Subcision does not usually work on ice pick scars.  It can help with certain types of rolling and boxcar scars.

David Z. Gay, MD · Answer

Thanks for your question. Since the subcision breaks scar tissue tethering the surface skin to the deeper layers this is an excellent time to do filler. By placing filler at the same time I feel that it reduces the chance of the scar forming an indented area again.

Liliana Marcu Awan, MD, FAAFP - Account Suspended · Answer

Yes most subcision are followed by fillers These is done to prevent further scaring from the acne scar removed

Can you have fillers after subcision?

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Answer: Fillers after subcision

Answer: Fillers after subcision

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Can you have fillers after subcision?

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Answer: Fillers after subcision

Answer: Fillers after subcision

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.