@Eric NHi there this is severe scarring. Mainly Box cars, Icepicks, and rolling scars.

Chemical peel alone will do nothing for your acne type, you need many subcisions, I can tell they were not aggressive enough, and dermapen would be worthless in your scar type because of severity by itself as a main treatment. Sorry you spent so much money but the treatments were not done properly, perhaps your dermatologist was not aware of how to treat.

TCA Cross and TCA paint on(multi - layer of TCA put into the bed of the scar and the walls are not touched). This raises the floor of the smaller boxcars and icepicks. You will need several of these. Be aware they can widen with treatment but you will resurface the skin towards the end.

I would do multiple subcisions(4 of them). Lots of tethering going on there.

RF Needling is needed 3-4 sessions. Lots of fibrosis on your cheeks, this may not be enough.

CO2 angled to the border walls of the box cars. Few Drs do this besides Lim but see if you can find someone, otherwise do Erbium profractional or low density co2(Several sessions).

Picosure laser is great for your skin type for the hyperpigmentation(redness) and collagen production.

Several TCA Peels or Fully ablative Erbium resurfacing by someone familiar with your ethnic skin type, otherwise this can have side effects. This step of treatment is used for texture, once you lift the scars as much as possible.

I don't know your location but perhaps travel to Dr Lim as you have a harder case to treat.

Please use a retin-a/tretinorin/differin cream every night and a konjac arbtuin cream for hyperpigmentation with it nightly. Stop when you have your Treatments.

You may do at home dermastamping or microneedling as well between Dr treatments once per month. All Dr treatments should be 3 months apart. Everything is optional. Treat as you have time and money, many take 3 years to treat as the body is slow to heal. Yes it's expensive but is affordable if spread out and done by a Dr who knows what they are doing.

BA

@beautifulambition

Thanks for the asnwer for my acne scar problem.
i've done subcision for 1x treatment and only give little improvement.The treatment itself give a red spot on my cheek wheres the needle injected. I search for subcision, its say that subcision works for rolling scar or can it work for boxscar too?

I live in indonesia and theres a few clinic that perform subcision. I cant afford to australia cause its will cost a lot of money. I think i will find the treatment in indonesia.

@Eric NI am sorry it caused you redness. Subcision must be done multiple times at least 3 months apart to work. You need filler after the subcision, see the atrophy in the cheek. A red are can be normal in a sensitive person, discuss this with the Dr they may be able to use a vascular laser on the area. Without filler and without aggressive cannular subcsion(less marks on the skin as it reaches a wider area) you won't see improvement form subcision.... also if the practitioner is bad at doing it. Yes subcision would be done in your case you have a huge amount of fat loss on the left cheek. I am not just talking about treating on higher planes individual scars but putting volume there - raise the skin even if you do not raise the individual pits.

Your box cars are very atrophic, ... I suggested the rf needling and laser treatments above for them as well.

It's a long journey lots of work to do still.

You don't need to goto AUS, sure treat locally in Indonesia.

BA

@beautifulambition

Thanks for the suggestion.
The filler you talked about , do you mean dermal filler? Dermal filler doesn't give permanent result right? . I think my clinic dont use cannula. they just use a normal needle.

I gonna do another subcision treatment as you suggested.

@Eric NThat is the problem, you are not going to get results with your scar severity with normal needles. This is bad subcision skill. Find a Dr who does subcision. Normal needle subcision will do nothing here. Find someone else.

We don't use filler to be permanent, if you want permanent - Bellafill PMMA you get that after the 4th treatment of subcision. Your subcisions have not been done properly here. Find another practitioner for this. Regarding the filler again if you only knew how many messages I get from people with complications from permanent fillers which manifest months to years later after injection, they must have them surgically removed. You have to like the results from a HA filler to even consider this. According to your pictures above I have seen no benefit from filler yet in your case. We use filler as a spacer not for aesthetics. We want your body to replace with new collagen in the subcision process. Your scarring is very severe and we need to break up the scarring as well as it looks fibrotic. Start by finding another subcision provider. You would see a difference if they were good. I would also see a lifting of the whole cheek with HA filler done afterwards.