subcision, excision and auto fat grafting for acne scars/craters

Gainesville Plastic Surgeon
4.9 out of 5 stars 27 reviews
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Dr. Sadove is truly an artist and i respect his technique. He made sure that the procedure was PAINLESS. It was PAINLESS! Even the area where he did lipo on the hip to take that fat and bring it under my facial scars. He recommended fat since fillers don't last...WHY DON'T OTHER SURGEONS TELL YOU THIS?! I felt comfortable in his care and i felt like I could trust being in his hands because of his knowledge and confidence in this procedure. I am 35 y/o and have been suffering for years with trying to get rid of acne scarring from high school. It's been a frustrating process with little improvements and lots of money spent. I got this procedure two days ago and am still healing so I can't speak of the outcome yet but I can speak on the actual surgery. He made sure I didn't feel anything...He even had the staff massage my feet to calm me down during the procedure with relaxing music, distracting conversation, positive affirmations and soft touches of the hand every now and then. He even numbed me before numbing me so i didn't even feel the needles!!! Dr. Sadove is very professional, confident in his work and highly skilled with his technique. He spent 3 hours on me when we were only supposed to do 1 hour...He told his next appointment they had to wait since i changed my mind at not getting CO2 laser and this treatment instead at the last minute. The Dr was even gracious enough NOT TO CHARGE ME EXTRA for a more intense procedure. I am thankful to have found him because he seems to be more informed, experienced and advanced with his technique in some areas than other surgeons but allows you to decide in the end on what is best for you personally. In the end, I chose what he felt was best for my acne scars since I still had acne scars after 2 intense CO2 LASER treatments and have been tired of the same old results. Any other surgeon would recommend CO2 LASER but he was clear on the fact that CO2 LASER is not the best solution at getting rid of craters from acne. Thousands of dollars later I wish someone would have said so sooner. I watched YouTube videos after my surgery (I went in not knowing what it was exactly) and realized patients were complaining of pain during the Subcision process. I had no pain with Dr. Sadove. I also saw how some surgeons went in through all areas of the face which you'd think would leave scars but Dr Sadove went in through the corners of the mouth...brilliant!!! Hopefully the outcome is as brilliant as Dr Sadove's technique and skill level during the surgery. I will keep everyone updated on on my progress under "acnescarringprincess." I will also have more details by the end of this month!!


Here are photos following my progress from the day of the procedure. I realized that i can't find anything online showing the healing process for this particular procedure so i figured i would help someone else by documenting my journey of the subcision with fat transfer combination that was done by Dr Richard Sadove in Gainesville, Florida.

Day 5 post op

A little less swollen. Had post op appt & Dr Sadove said it's normal to have swelling for at least 2 weeks & to not monitor it until bruising goes away on my hip where he took the fat cells.

6-8 days post op of excision marks and swelling

Not too sure about the last 3 photos. I know i still have abnormal volume in my face but the two marks on the right side seem to be sunken in more than the ones on the left side. On the left they are pretty flat, just red. The left side is more swollen still so hard to tell.

Subcision/excision with auto fat grafting for acne scars update

2 weeks post op and the excision scars are not to my liking yet but i went for a 2 week post op check and Dr Sadove says that they are healing nicely and it will take a while longer until i see the excision marks lighten and fill in. He recommended that purchase silicone scar repair adhesives from CVS (generic or not brand...I got the CVS brand) and to wear these on clean and dry skin directly on the excision marks, to flatten and reduce redness, for at least 1-2 weeks all day. The overall appearance of my skin looks to be better (minus my slight rosacea breakout this week from the temperature change but Rose Hip and Coconut oil has helped that to calm down a lot). There is still some swelling that the Dr says will eventually go down. The swelling that i am concerned about is around my lateral chin area because it brings out frown lines...AND NO ONE WANTS FROWN LINES unless you are a sad clown! It looks like a frown line especially around the right side of my chin where there is the excision. Overall, Dr Sadove has been great and i trust him completely. My skin is in his hands...Literally. I will update again in two weeks after my 1 month post op appt. It has been quite humbling to walk around town and at work with a red, swollen face with marks all over it.

25 days post subcision/excision and auto fat grafting for acne scars/craters

I went to my 4 week post op appt and i like to results so far with hope that the right side will continue to catch up with the left side as far as skin texture goes. I am still wearing the silicone adhesives during the day at work and at night. I only take them off for a special occasion or to clean my face in the morning and at night. I am also trying to keep my skin calm at the moment as i have been breaking out with little white heads that easily pop and my skin is red and dry. A homemade turmeric/honey mask helps clear my breakouts and i purchased hyaluric acid which helps with the dryness instantly...Love those two things. For the redness, apple cider vinegar has been helping to balance my skins PH. Other than that, the swelling is almost completely gone and the excision marks are lightening and filling in nicely. The first three weeks are scary. I started seeing a huge improvement the last couple of days. My right side is still not what i want exactly but it's a huge improvement and the Dr says that it will continue to get better since the auto fat stem cells are under my skin and collagen is still producing for the next few months. Will update in 6 weeks after my next post op followup.

10 weeks post-op of subcision and excision with fat transfer.

Scarring from incisions are still red and left a bit of an indent but i am still hopeful that overtime they will look better. I am not wearing silicone patches anymore and just my Aveda concealer makeup and keeping my face out of the sun. I see my cheeks continue to go down in volume and some craters are still left but i see some improvement. As the swelling subsides i see a bit of what was left behind around my smile crease area especially on the right side which i wanted to be gone. I am hoping that in time it will get better. I will keep you updated. ANY SUGGESTIONS ON WHETHER I SHOULD GET A CHEMICAL PEEL OR NOT? I am not 100% satisfied just yet on my skin's texture and color. Even though Dr Sadove did a great job, i feel like there should have been more change after such an intense procedure. Maybe in time it will get better. I am still pretty sure that it would have came out fine with just subcision.

3 months post subcision with excision and auto fat grafting

I am well pleased with how my skin continues to get better and better. It is true what they say, you have to wait 3-4 months post-op to really see the results you are looking for. However, I am still concerned about the right lower side (around my mouth) of my face and i expressed my concerns with Dr Sadove during my 2 month post-op check up and he wants me to be especially satisfied in the end result so he is doing subcision with auto fat transfer to that the areas that still have craters from the excision again for no charge at all! I am very pleased with the results except for that area which was the worst area and the most of my focus when getting this procedure. I believe the excision wasn't as good as the subcision for me in particular so what he will do in a couple months is go back in with only subcision and more auto fat transfer to the areas of concern. The swelling is almost completely gone and my skin looks smooth and without blemishes as i have been using just baking soda to wash my face and drinking lots of MSM with freshly squeezed orange juice as well as spirulina daily which i feel personally helps my skin tremendously. I truly feel that subcision with auto fat transfer is the way to go with getting rid of craters. Dr Sadove is highly skilled in this. If i did not have excision, i believe one procedure would have been enough. Since a couple of the excisions didn't heal flat, and the area to the right is still scarred, he will do subcision and auto fat transfer to those excision areas for free. FOR FREE because he wants it to look great and for me to be 100% happy with the results. He is amazing!! I highly recommend him. Very happy with the left side of my face! I will post after my second procedure to keep you all updated!

Post second subcision with auto fat graft transfer and NO EXCISION.

Dr Sadove filled in my hip where he initially took out fat for the first procedure since i was concerned about it's indent appearance. He did a great job at evening it out FOR FREE! Then he went and did the second subcision on my right side in two spots. One of the spots was made from the excision so we decided to not do excision again and just try subcision with auto fat grafting. The two crators you can see to the right of my smile crease and right side of my chin. I will post more updated photos as it heals. I have learned from the first procedure that it takes 3 months for the fat and inflammation to settle.
Gainesville Plastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
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