Acne scars - disappear with lifting. How can I improve these? (Photos)

Question

Hello , I have this Acnes scar on my cheeks I’ve struggled a lot. Tried fillers, currently doing micro needling , wanna try subcissions But I feel the only way to make them go is with a lifting, cause when I lift my face with my hands they disappears. I need an advice , on how I can effectively get rid of them or at least make them disappear a little bit more than that!

Anna Chacon, MD, FAAD · Answer

Dealing with acne scars can be challenging, but there are several effective treatments available that may help improve their appearance. Since you've already tried fillers and are currently undergoing microneedling, here are a few additional options to consider:

Subcision: As you've mentioned, subcision is a technique that can be effective for treating certain types of acne scars, especially those that are tethered down. It involves breaking the fibrotic strands beneath the scars, allowing them to lift and improve in appearance. This procedure can be done in conjunction with other treatments for optimal results.

Laser Resurfacing: Fractional laser treatments, such as CO2 or erbium lasers, can help resurface the skin and reduce the appearance of scars by promoting collagen production and skin remodeling.

Chemical Peels: Medium to deep chemical peels can help improve the texture of the skin and reduce scar visibility. However, these should be performed by a qualified dermatologist to ensure safety and effectiveness.

Radiofrequency Microneedling: This combines microneedling with radiofrequency energy to enhance collagen production and improve skin texture. It can be particularly useful for atrophic scars.

Surgical Options: In some cases, surgical options like a facelift or mini-lift might be considered if the skin laxity is significant and lifting the skin manually improves the appearance of scars. Consulting with a dermatologist or plastic surgeon can provide more insight into whether this is a viable option for you.

Skincare Products: Incorporating retinoids, vitamin C, and other collagen-boosting ingredients in your skincare routine can support the treatments and improve overall skin health.

It's important to consult with a board-certified dermatologist or plastic surgeon to discuss these options and determine the best treatment plan tailored to your skin type and scar severity. They can provide a comprehensive approach that may include a combination of treatments for the best results.

Best of luck on your journey to improving your skin!

Nelson Lee Novick, MD · Answer

From your description, you would be wise to investigate a "Field Subcision." This procedure essentially performs a subcision covering the entire area of the cheeks. The lift achieved in this manner typically elevates and smooths the skin, much the way you see it improve by physically lifting your skin. Although Field Subcisions, which I have been performing for several decades, can be performed without the use of a supplemental filler. However, if so desired, a robust HA lifting filler can be used additionally, not only for its temporary lifting effects, but for its more long-term benefits from enhancing new native collagen production. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist acne scar treatment specialist. Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

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