I have a depressed scar. Could I benefit from subcision? (Photo)

Question

Following a facial tightening treatment an area at the top of my nasolabial fold became infected and took some skin away, creating a groove after healing. At first I thought this was just an exaggerating tightening effect. I attempted filler after this photo which settled outside of the indentation which further solidified my belief that it is actually a depressed scar. Could I benefit from subcision? Is there something else that could help (injectable), selphyll for example? Thanks!

Jason Emer, MD · Answer

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

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

Jeff Rapaport, MD · Answer

In my opinion, a depressed scar that is bound down should respond to subcision with PRP and possibly microneedle radio frequency. The tethers that are holding the scar down need to be transected and something to keep the scar lifted such as PRP or a filler inserted. Depending upon the nature of the scar tissue, microneedle radio frequency may be of assistance. Good luck.Jeff Rapaport MD FAADRealself All-star

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