Would subcision + filler & TCA CROSS be a good treatment for my acne scars? (Photo)

Question

I'm a 32 year old male, I suffered from acne since I was 13, and it left some pretty bad scars on both my cheeks and chin, luckily nothing on my nose, forehead and temples. I have been able to make peace with the scars at times but often being under direct lighting reminds of the harsh reality. I did some research but got confused with the different options available. I'm sharing my pictures here hoping that I could get some insights on what could be the best course of action for me.

Nelson Lee Novick, MD · Answer

There appears to be significant acne-related atrophy (volume depletion) in the cheeks, which is no doubt increasing the shadowing (craters of the moon effect) of the overlying scars. So, a Field Subcision to elevate and smooth the cheeks would be a very reasonable first step. This alone would likely effect a significant cosmetic improvement. Following that, for further improvement,individual subcisions can be used to treat any residual boxcar & rolling scars. TCA CROSS can be used to treat the numerous ice pick scars that appear to be present. Both procedures have decades' long records for both safety and efficacy in all skin types. The expensive, faddish, here-today-gone-tomorrow light and energy-based gizmos, such as fraxel lasers and RF devices, are backed far more by marketing hype than hard science. Make sure that you consult with an experienced, board certified cosmetic dermatologist and exercise a healthy dose of buyer beware when being hawked the aforementioned "bells and whistles" gizmos. Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

James G. Wu, MD, FAAD · Answer

Based on the appearance of your scars on your photos, the two most effective treatments for you would be deep subcision and TCA cross. Deep subcision using the taylor liberator would improve the large depressed areas of your skin that look like they are scarred and bound down to the underlying facial fascia. TCA cross would be useful for the ice pick scars.

Would subcision + filler & TCA CROSS be a good treatment for my acne scars? (Photo)

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Would subcision + filler & TCA CROSS be a good treatment for my acne scars? (Photo)

Answers (3)

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Everything you need to know about Subcision

Our mission is to create a world where every investment in modern beauty is Worth It.