Subcision and Infini for acne scars - which order?

In my  opinion, if one is using hyaluronic acid fillers, the infini has to be done first. Recent studies show that infini reaches and effects the hyaluronic gel. Find an acne scar expert. Ask to see photos.

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

Infini should be done prior to filler injection. It is best to see the results from the miconeedling before adding filler. New collagen forms over several weeks. At this time subcision and fillers could be added. Subcision will release tethered scars and the filler will elevate these depressed areas.

Filler is usually the final step in my scar treatment programme, unless the patient has absolutely no down-time to undergo an energy based solution like RF or laser.  Infini will help break down your scars and promote your own body to remodel the scars, and promote collagen and elastin to form in a more normal pattern.  Subscion will provide a release of the tethered scarring and can be performed in combination with Infini, Laser or filler in the same session.  So in short, Infini first, then fill - subcise with both.  Best wishes, Shobhan.

Infini should be done before subcision and filler. In the long run, Infini can permanently correct acne scarring, but this takes many months. Filler can be used to temporize while your dermis remodels itself. HA fillers are a temporary solution.

Logically Infini first, then filler. Reason being is that if Infini can break down scars and stimulate more collagen, the likelihood of needing more filler or other procedures is less. Many of us combine subcision with microneedling. (essentially one is vertical one is horizontal). Filler with microneedling can lead to an increased risk of infection. All the best, Dr Davin S. Lim.