Can subcision be done on the entire face? Hoping to treat rilling scars (photos)

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

Severe acne can result in such a degree of generalized atrophy in the cheeks, temples, and chin regions as to make individual overlying acne scars appear even more prominent by virtue of the "craters of the moon" effect worsened by the widespread underlying skin sinking. A Field Subcision can help to elevate and smooth these larger areas and thus improve the appearance of the individual rolling and boxcar scars above. I have been performing subcisions since 1995 and have performed numerous Field Subcisions on the cheeks, temples and forehead. So, yes, subcision can be done. But, in this day and age, with so many venues hawking their expensive, supposedly "next big thing" fraxel laser or RF device, finding practitioners who are willing and able to perform subcisions has become increasingly difficult. Make sure to consult with a board certified cosmetic dermatologist with expertise in acne scar treatments and best of luck.

In my opinion, the entire face can be treated with subcision. In this situation, It is helpful to add a field subcision to the Nokor individual lesion subcision. When treating around the jawline, special care is necessary to prevent keloid formation. We recommend suction in the post-operative period. Find an acne scar expert.
Jeff Rapaport MD FAAD
Realself Hall of Fame

Yes, subcision can be done on the entire face and is the most effective treatment for rolling scars. I've found nokor needle subcision to be superior to cannula based subcision techniques, and I think would work well in your case.