Q: Dr. Eppley, I need acne scar revision surgery. I have large deep acne scars. I have tried four sessions of Ematrix…a waste of a lot of money. Didn’t even remove some red blotching which they said it would remove. Have been to other plastic surgeons and they wanted to either fill or sent me to some other laser type skin care people. Subcision seem to be my only hope. I understand you perform this kind of acne scar revision procedure. Please contact me with any info on this procedure.
A: Acne scars can be difficult scar improvement problems but it is important to match the acne scar type with the most appropriate procedure to have any hope for a visible change. Subcision works best in those acne scars that are deep but broad-based. Using a fine needle, the skin under the depression is cut or released. Some simply let blood fill in space that was released or one can place injected fat into it. I am of the injected fat approach as a spacer is ultimately needed to prevent the skin from just scarring back down as it heals. Deep acne scars that have a more narrow base (ice-pick type) are better treated by complete excision of the total scar and then closed to level it out. Many acne scar patients need a combination of excision and subcision/fat injections as their acne scar types are variable. When the acne scar revisions are more than just a few, the entire procedure is best done in the operating room under some form of anesthesia.
Dr. Barry Eppley