I am 50 and have been having acne scars for 30 years. I recently had Fraxel re:store, 3 times , 6 weeks apart, and don't see the improvement. I bought a package of 4 times, so I'll have one more Fraxel re:store. My doctor recommended to have subcision after the 4th Fraxel. My question is: Should I have subcision after the 4th Fraxel or before? Or 4th Fraxel, subcision and another Fraxel? Should I consider other treatment like TCA cross, silicone injection?
Subcision for Acne Scars? Done Fraxel Restore 3 Times and No Improvement. (photo)
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Doctor Answers 1
Subcision Works well for Depressed Acne Scars in conjunction with Laser Resurfacing
With the significant acne scarring present in these photos, I have found a three fold approach to be most beneficial. Before beginning any treatment, control outbreaks and clear up skin with oral and topical antibiotics and hormones if necessary.
First I have found subcision works well the day of the laser procedure.
Secondly I have found injecting filler (my favorite is your own Fat or Radiesse) to help raise the depressed area. In the case of Fat Grafting, there are also a number of Growth Factors and Stem Cells that will stimulate Collagenesis.
Thirdly I have found setting the Fractional laser (I prefer CO2 over 1540nm) on a small spot size to reduce the "Shoulders of the Scars", followed by a larger spot size over the entire face including the subcisioned site for best color and texture match.
There is some extra bruising and swelling with the healing time elongated to a week vs the 4 to 5 days we usually see with just Fractionsl CO2. We have also helped patients with the use of "Copper Cream" by Procyte as a topical to accelerate healing. Good Luck, M.Lyons,MD