Does the combination of subcision and HA fillers give a permanent improvement in atrophic/rolling acne scars?

Subcision is an excellent treatment to break up shallow or atrophic scars that are tethered. In my opinion, the combination of subcision with PRP is superior to that of subcision with hyaluronic acid.. PRP has the ability establish a fibrin matrix that can act as a form for the collagen deposition. Hyaluronic acid is a space filler, and can temporarily keep the shape, however it may not encourge as much new collagen formation and wound healing. Find an acne scar expert. Ask to see 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

Acne scars are treated most effectively with a combination of treatments including lasers, microneedling, fillers, chemical peels, subcision, punch excision, at home skin care, etc. Usually multiple treatment sessions are needed. It is an ongoing process and commitment is key. The goal should be improvement and not total elimination. Make sure you find an experienced provider to minimize complications. Best wishes.

Yes, acne scars need a combination of subcision and fillers combined with lasers, microneedling/prp, and Cosmelan to get the most improvement. It will take a series of treatments and will need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

The primary role of subcision is to disrupt the tethers binding down rolling acne scars.  It secondarily creates a space that blood will occupy supporting neocollagenosis as your skin heals.  Subcision is working towards long term improvement of your scars.  PRP promotes healing.  Hyaluronic acid fillers used for acne scars are biodegradable and therefore provide short term improvement.  Hope that helps