Thinking about getting subcision and RF microneedling (Photo)

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

Depressed scars can be improved with vascular lasers like Yellow laser or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer​

You have rolling, saucer-shaped scars. Your idea of subcision combined with RF microneedling is a good one. You may need to follow this up with a filler to lift the deep contours of cheek fat that has been eroded by the scarring.
Find an Acne Scar expert.
Jeff Rapaport MD FAAD
Realself Hall of Fame

Consider a "Field Subcision" to address the apparent widespread cheek atrophy due to the acne scarring. By lifting and smoothing the cheek in this fashion, the overlying scars will be immediately made more superfiical and will have much better light reflectivity and much less 'craters of the moon" shadowing. Once this is done, then individual subcisions can be performed, if still needed. Professionally performed manual microneedling (no need for the extra expense and extra risk of adverse reactions with added RF) can be performed to better blend the treated areas in both color and texture with the surrounding normal skin. Hope this helps and best of luck.