Is Restylane the best option for a depressed scar? I'd like to try microneedle with PRP, Infini, subcision if necessary? (Photo)

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

this type of scarring needs submission, fillers and lasers. it can be done independently or like me you should have halo treatments done every 2-3 months for Antiaging and treat scarring and irregular texture and have spot treatment of stronger laser like pro fractional or co2 on that individual scar for the texture. fillers long term like Bellafill will be better or even silicone as compared to Restylane which will metabolize over time.  see an expert in scars!
Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we alreayd pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer. 

Restylane, a hyaluronic acid filler from Galderma, as well as other dermal fillers would be a good option for lifting the base of the scar in order to help minimize its appearance.  Filler would provide immediate but temporary improvement in the appearance.
Occasionally scars adhere to the underlying tissues and the filler alone is unable to lift the skin.  Subcision, using a needle to undermine the scar and release it temporarily from the underlying tissue, can be helpful.  Subcision is more commonly required for scars that are deeper than they wide.  Subcision can be combined with filler in the same sitting.
For a more permanent improvement in the appearance of the scar, resurfacing the skin and encouraging the skin to build new collagen would be needed.  Microneedling with PRP and Infini, a device that delivers microneedling with radio frequency, are two good options.  Fractional CO2 laser would be a more aggressive treatment option.
Thank you for your question.  Good luck.
-Dr. Z.
De Luz Medical Aesthetics