Chance of Acne Scars Getting Deeper After Radiesse?

Question

I have cystic acne scars and I am thinking of getting Radiesse as per doctor's recommendation. Do I have a big chance of getting more and deeper indentations than my existing deep acne scars?

Michael A. Persky, MD · Answer

Hi Thanks,
Your welcome.
No, you should not be at risk of deepening or worsening acne scars by having Radiesse injections. 
Steroid injections are known to make some scars indent more if too much is used or if the solution gets outside of the cyst.
Enjoy your Radiesse.
Dr. P

Farbod Esmailian, MD · Answer

It will not make the scars look worse if done correctly.  The scar needs to be released from below the skin and then the filler can be placed.  It can potentially get worse if the filler is placed more around the periphery of the scar than just beneath it.
Other than that, you should be okay.  Good luck.

David Shafer, MD, FACS · Answer

If you have contracted scars which are tethered down to the underlying tissue, then injecting a fill will just make the pit or scar look worse as the tissue surrounding the pit will be inflated with the filler. If the doctor is able to subcise the contraction by percutaneously releasing the attachments, then the filler may work better. This is true for any filler such as Juvederm, Restylane, Evolence, Perlane, not just Radiesee. Good luck with your treatments.

Stephen A. Goldstein, MD · Answer

Thanks so much for your question. In general, Radiesse should improve the contour deformities of your acne scarring. Radiesse serves to “volumize” the injected area, thereby tightening the skin. In some areas, undermining or subscision of the deeper acne scars may be necessary. There may be additional modalities available to improve the appearance of your skin. I would advise you to see a board certified/eligible plastic surgeon or dermatologist that is experienced in skin care.

Christopher L. Hess, MD · Answer

Radiesse is an excellent filler made of hydroxyapatite. It is designed to be injected into the very deep tissues, on top of the bone. I find it great for tear trough deformities and nasolabial folds, particularly around the nose as well as the mandibular deformities created by the jowls. None or these areas typically are affected by acne or acne scarring. If your surgeon wants to use the Radiesse in the cheek then yes the appearance of the acne scars can be made worse.

Bryan K. Chen, MD · Answer

I agree that the tethering collagen fibers should be released with subcision prior to injection of any filler.  Radiesse would last longer and a lot of my colleagues seem to have good results with it, although a hyaluronic acid filler such as Restylane would be more forgiving in the sense that if the material were to migrate to an undesirable location or nodules were to occur, the material could be dissolved with hyaluronidase.
Good luck.

Eugene Mandrea, MD (retired) · Answer

If the scars are shallow and small, Radiesse may help, simply by the fact that the skin is slightly stretched.
If the scars are deep, Radiesse will neither help nor harm.
If the scars are large and deep and attached to the subcutaneous tissue by fibrotic bands, the latter will have to be broken by subcision before Radiesse is injected.
I hope this helps.

Richard P. Rand, MD, FACS (retired) · Answer

An acne scar is what is left after the infected pustule heals. These are scars that go into the fat below the skin and act like thumb tacks anchoring the skin down at the point of the scar. When injections are done to improve these, the injector must release the thumb tack element of the scar so that the material can be placed properly under the middle of the scar and thus plump it up and minimize the indentation of the scar. If the scar is not released, the material just plumps the tissue around the scar and can make the scar look deeper.

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