Should you do subcision with filler before or after Morpheus8 for acne scar treatment?

Question

I am looking to improve my acne scars and am wondering if morpheus8 will work better once the scars have been lifted? Or will it make the filler dissolve more quickly?

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

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Subcision, which I have been performing since 1994, has a proven track record of safety and efficacy for elevating and smoothing all kinds of of indented scars. On the other hand, relatively expensive "bells and whistles" fraxel laser and RF devices are far more backed by heavy marketing hype than hard science. For residual, superficial, surface color and textural abnormalities, professionally performed, conventional microneedling, which I have been employing for about twenty-three years, has a proven track record for safety and efficacy in all skin types. Hope this helps. Best of luck.

Should you do subcision with filler before or after Morpheus8 for acne scar treatment?

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