Will subcision, fillers and TCA cross help with my type of scars? (Photos)

Question

Hi. I'm a 30 year old female and my esthetician recommended subcision or punch excision with fillers and TCA cross for my scars. I'd like to ask doctors if those treatments will help, and how many treatments I need? Thank you.

Eric M. Joseph, MD · Answer

If your acne scars are not bound down to deep tissues, microdroplet Silikon1000 may be considered for permanent improvement. This may be excellent for people with darker skin types that are not candidates for resurfacing procedures. Hope this helps. Dr Joseph

Hung William Song, MD · Answer

Hi unfortunately there is no single treatment available for treating your scars. However, there are many treatment options available including all the treatments you mentioned. I typically start with subcision combined with laser or RF micro needling. I would re-evaluate after a couple of months and possibly repeat the process or use Bellafill to fill in some of the rolling scars. If there are any "ice pick" type of scars I might do punch excisions. A fat transfer and or PRP may also be helpful. A series of Microneedling can continue to improve on the results from the more aggressive treatments. The bottom line is that these type of scars require a series of customized treatments but it is possible to get some very good results.

Jason Emer, MD · Answer

Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars.- Subcision for depressed, tethered scars.- Vascular lasers like Yellow laser, Aerolase, excel V, or IPL for redness or thick acne scars.- Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, Intensif microneedling RF) for textural issues and superficial scarring.- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.
All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Shelby K. Brantley, Jr. MD · Answer

Hey there and good afternoon.  I see that you have asked what could be done about the acne scars on your face.  You would be a good candidate for dermabrasion.  Unfortunately, any filler, or TCA would not make an impact for the results you are probably looking for.  Some of your scars would do well with punch excision but that is something that would need to be evaluated in person.  Good luck.

Robert T. Buchanan, MD (retired) · Answer

If you had only one or two scars, then dealing with each with subcision and fill would be reasonable. It is not reasonable, however, when you have as diffuse scarring as you have. Over many years, I have learned the best treatment for the scars you have is to lower the surface, instead of propping up the depressed scar, and then rebuilding collagen. To do this, I start everyone on hydroquinone and tretinoin. This starts rebuilding collagen, which you, at 30, are no longer doing, and controls the pigment cells so they do not react to the laser resurfacing done after about 6 weeks on the prep. I then continue the tretinoin.

Will subcision, fillers and TCA cross help with my type of scars? (Photos)

Answers (5)

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