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Hi. Short background info: i've old (over 10 years old) and new (under 1 year) acne scars. Right now i am 28 years old male. About 10 years ago i was on accuttane, about 9-10 months, it helped for my acne but i am left with some deep scars. Occasionally i still get couple zits/pimples, but after quitting dairy it's just because stress/hormones, i think. But feels like every pimple i now get, leaves a scar... Whatever i do to them, or don't do, there is a small pit left, except if that pimple have been veryvery superficial. Maybe i am just too conscious about that and observe them too much... But it's weird because the problem (scars) is only in my cheeks (not forehead for example). Ofc, i have old scars in my back but they are hypertrophic and i don't care them that much.
Anyway, i think my scars are both rolling scars and boxcar scars? Also, i think there is hypertrophic scarring and/or scarred pores... I also think i have some volume/fat loss in my cheeks because of the most deepest scars.
I haven't really treated these scars. For what i think is light hypertrophic scarring, in my cheeks, i've tried silicon scar gel. I have applied it 2 times in a day and i see there is minor changes, ofc it doesn't do anything for atrophic/pitted scars. Also i have done some very light peels, like mandelic acid, and it just brightens the texture a bit. But for that, i didn't have any expectations for bigger changes in the first place. So, i haven't done anything major for these.
What are the best treatments for these scars? I tried to take pictures in the worst lightining, especially those two, under direct light. What i've read, probably subcision with filler would be good option, but wanted to hear other thoughts. Thank you.
Can subcision be performed with the same needle what is used to add filler? So if Dr. uses cannulla full of filler first to break bands, and then applies the filler.
I remember someone here wrote something like that long time ago, that his/her derm did that, but haven't heard about that anything more. I am also asking because where i am living, no one performs subcision, so i would have to travel abroad. Lots of people offering fillers. If my atrophic scars are not anchored, would just filler be enough to lift them?
Yes Sub could be performed with the same needle injecting the filler at the same time. I had it done with my Dr. But I had first Sub with the cannula first. So if the fibrosis is hard so the usual needle would not probably break it. The filler on its own without Sub might be enough but also could lead to a Button effect when the filler spreads around the scar not under it due to unbroken tethers.