Looking for doctors who do subcision for acne scars in the St. Louis, Mo area?

There is no one treatment that helps acne scars. I find multiple minimally invasive treatments help, each partially. I try to avoid the more aggressive treatments such as laser resurfacing which can leave discoloration, have a higher cost, and still dont completely improve.I find subcision helps, filler injections, microneedling, and sometimes direct excision of a larger depression. Even spot TCA treatment can help.

Subcsion was first reported in 1995. Since then this technique has taken many pathways. Most dermatologist and plastics still perform the old method- using sideways motion to break scars down. In the original papers this took 6-10 sessions using a needle. This still can be effective, but its OUTDATED. Since then other methods have evolved including-



The use of other size needles
The use of NOKOR or cutting needles
The use of cannula techniques


Of all these techniques, cannula stands out. The most recent paper this year shows that it has the best rate of scar breakdown with much less side effects than with NOKOR. Namely less bruising and ‘lumps’ from bleeding. 



The results of subcision is extremely variable and will depend on the technique and experience of your Plastics or Dermatologist. Ensure they can perform all techniques competently. This is especially important with dermal fillers (or fat transfer). If one subcises a depressed scar and find it has NOT got significant tethering, a filler is needed. In this situation filler or fat is needed to elevate the scar. Subcision is my preferred method for scar revision, as I can feel how many scars I am breaking with my 3 level cannula technique. This is now considered the Gold Standard in subcsion as reviewed by peer papers. All other modalities including lasers, energy devices and peels are considered ‘instruments’ in the way I practice acne scar revision. Remember treat the scar type with a method, and you will achieve the desired outcomes. Subcsion releases and remodels acne scarring from underneath. Needless to say this just a method, the results you will achieve is 90% dependent on the skill sets of your Plastic surgeon or Dermatologist.  



All the best, Dr Davin Lim 

Acne Scar Specialist. Brisbane. Australia.