What is the downtime like for subcision of forehead and temples?

Question

What is the recovery/downtime for subcision of the forehead and temples for acne scarring thanks

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

Nelson Lee Novick, MD · Answer

I have been performing subcisions for boxcar and rolling acne since 1995, Subcision, as the name implies, is cutting below the skin surface. Hence there is no significant surface cutting and no sutures are placed. As a result, there is typically little to no discomfort or significant downtime and I typically permit patients to apply makeup and resume there regular facial routines right away. Because, by intent, a small pocket of blood is created under each scar (it's the blood that contains the growth factors and wound healing factors that give rise to the desired improvement), a small black and blue mark may appear on the surface of the skin. But this can be easily covered up if so desired. Please note: the above applies to subcisions anywhere on the face, not just the temples and forehead. Hope this helps and best of luck. 
You would be wise to make sure to oonsult with a board certified cosmetic dermatologist with extensive experience in subcisions, since these days many venues rarely perform them, since so many are into heavy marketing and sales of expensive fraxel laser and RF treatments whose hard science to support their use unfortunately lags well behind the heavy marketing hype to promote them. Hope this helps and best of luck.

Mats Hagstrom, MD (license on probation) · Answer

I suppose it all depends on your definition of downtime.
Personally, I wouldn’t consider a small facial procedure as having any downtime in regards to doing daily activities.
If you’re talking about looking your best for studio photographs, then maybe three months in order. 
Personally, I don’t believe in subcision. Releasing scar tissue that’s pulling down on the skin is simply going to just create more scar tissue.
The contour irregularities inevitably return without any long-term benefit.
The textbook answer for acne scar is selective individual direct excision. This often seems too excessive by both providers and patients, so it is rarely done, even though it is far more successful.Keeping the procedure small and risk free may seem like a better option but if it doesn’t get the job done then is it really?
If you’ve had good experience with these procedures in the past, then maybe it’s worth continuing.
Small facial procedures should heal quickly with some scab formation lasting 4 to 7 days.
There may be some inflammation with redness that lasts a few weeks afterwards.
It would be helpful to know some point of reference to what you consider recovered.
Recovery doesn’t happen all of a sudden. It’s a gradual process.
Best,
Mats Hagstrom MD

What is the downtime like for subcision of forehead and temples?

Answers (3)

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