What would be the best treatment plan for my acne scar? (Photo)

Question

My acne scar has been with me since high school, in which I had years of constant breakout. Because of the severity of my breakout, my entire cheek is depressed, which can be seen in the third photo. I have done two fraxel laser a few years ago and one subcision two months ago. What is the best procedure for my acne scars? Also, is there any procedure I can do to make the sunken part of my cheek gain back fat so cheek looks smooth from the side? Thank you so much!

Nelson Lee Novick, MD · Answer

You would be wise to consult an experienced, board certified cosmetic dermatologist acne scar specialist to discuss a Field Subcision for elevating and smoothing the acne atrophy-related sunken cheek. TCA CROSS can be used for the ice pick scars and individual subcisions for boxcar and rolling scars. However, there is likely to be significant improvement overall just from the Field Subcision. All of the foregoing procedures have a track record of decades for safety and efficacy in all skin types. Expensive fraxel lasers, like RF gizmos, on the other hand, while surrounded by loads of marketing and advertising hype and social media buzz unfortunately woefully lack hard science to support their use. .So, I am not surprised that despite the two prior fraxel treatments you are still searching for real improvement. I hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Laura A. Katz, MD · Answer

The morpheus8 radiofrequency microneedling device both in standard and resurfacing mode would be excellent for your type of scarring.  The morpheus device transmits energy into the skin at various controlled depths which promotes collagen production, scar filling and reduction, skin tightening and muscle contraction.  It does great things for evening out the skin surface as well.  These procedure are done easily in the office setting with minimal downtime or restrictions.

What would be the best treatment plan for my acne scar? (Photo)

Answers (3)

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