Can subcision alone improve an atrophic scar?

Question

I have deep acne scarring on my cheeks. I'm just curious if subcision alone would raise an atrophic scar, or at least show a slight improvement. Isn't it that when you break the fibrous band it can stimulate collagen, so can i incorporate Suction Method instead of filler? Or it really need to have a filler to plump it up after subcision? Thank you very much!

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

In my opinion, subcision alone is a effective method of treating depressed acne scars. It works especially well for saucer-shaped scars. We have found that pre-treating with Aspirin for one week or combining with Toradol at the time of treatment is also advantageous. We use a suction device postoperatively to  assist in the correction.Multiple sessions may be necessary. Hope this helps. Good luck.

Michele S. Green, MD · Answer

A combination approach is best used for these type of scars with lasers such as eMatrix or Fraxel and fillers as well.  Please consult an expert.  Best, Dr. Green

Davin Lim, MBBS, FACD - Account Suspended · Answer

Absolutely the procedure can be a stand alone one, or combined with fillers- autologous blood. Scars that respond best to subcision are ones that move with animation. See the video link below for a way to examine scars. Often multiple sessions are needed. There are numerous methods to perform their procedure using everything from small needle to special sharp edge needles. The video below also shows how I perform standard subcision using both filler needles for small tethered scars, then a larger 21 and 23 g. needle for larger, deeper and more severe scars. A combination of surgical, filler and energy devices targeted at specific scar types will give you the very best results. All the best, Dr Davin Lim Laser and aesthetic dermatologistBrisbane Australia.

Can subcision alone improve an atrophic scar?

Answers (4)

Answer: Yes, subcision alone can improve depressed, and anchored scars

Answer: Yes, subcision alone can improve depressed, and anchored scars

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Can subcision alone improve an atrophic scar?

Answers (4)

Answer: Yes, subcision alone can improve depressed, and anchored scars

Answer: Yes, subcision alone can improve depressed, and anchored scars

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Recommended reading

Everything you need to know about Subcision

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