Subcision After Fillers?

I have one depressed scar from a skin lesion excision. I have had dermal fillers (Restylane/Perlane) placed under the scar. Intially, there were good results, then the scar came back like I never had the treatment.

I was wondering, how deep does a scar have to be before you can have subcision? Can a subcision be performed after fillers have been injected into a depressed scar? I don't mean straight away, like, give it a month.

Doctor Answers 2

Subcision is a good start

Most depressed scars can be treated by subcision as a first step, or as a later step. Often fillers such as Juvederm, Restylane, or Perlane have trouble lifting up the scarred tissue. Subcsion alone can improve a depressed scar, or adding a filler after subcsion can be an excellent option. Doing subcision after Restylane or Perlane is reasonable also. You may need some supplemental filler after the subcision. It is also possible to inject fat or dermis (skin structure) under a scar to provide lift.

Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Subcision after fillers can be done

Subcision may be safely performed after fillers and lead to an improved appearance, although it is best done prior to consideration of filler use. Subcision works very well for some scars, particularly "delled" or "boxcar" acne scars, but is not the treatment of choice for all scars. Depending on the appearance of the scar, re-excision may also be a great choice for scar improvement rather than subcision.

If the scar was a good candidate for subcision in the first place, then it should respond well even after hyaluronic acid fillers. A good plan might be to allow 6 months for fillers to remain active, consider subcision after that +/- dermal grafts at that time, then consider fillers again after allowing 2 months for the subcision and dermal grafts to stabilize.

Chad L. Prather, MD
Baton Rouge Dermatologic Surgeon

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