What Can Be Done For the Big Acne Scar On My Face?
Q: Dr. Eppley, I am interested in surgical scar revision for my box car acne scar. I have undergone microdermabrasion, fractional laser resurfacing, and TCA peel to the area but none of them have had any beneficial effect. It seems like something deeper will need to be done or perhaps just cutting it out. I don’t know as I am not a doctor but none of these other doctors seems to know either.
A: As you have discovered, none of these superficial treatments are going to work for your type of facial acne scar. This is a problem of tissue atrophy/loss not one of just a more simple surface contour irregularity. Your acne scar surgery options include either excision and geometric scar rearrangement or scar adhesion release and injectable fat grafting. You can first test out how well fat grafting may work by having some injectable filler or even a trial of saline injections done to see if the scarred area will lift up by adding volume by injection underneath it.
Give its size, total excision and a geometric closure is also a consideration. What needs to consider how much tolerance one has for the healing and maturity of a scar on one’s face vs. whether one wants to first try an injection approach before embarking on a ‘bolder’ excisional approach.
Dr. Barry Eppley