8 hours ago, Ccmeow said:

What do you suggest for these acne scars? I have had 4 professional microneedling which did next to nothing.  
next step im thinking subcision? Filler? Punch excision? I have no idea.  
suggestions?

I don™t think punch excision is good for these scars as the area is large. You should focus more into smoothing the edges with full ablative erbium and fillers at the end. Again these are not very deep in the first place. It™s just that it has slight depression but due to the area being large it is noticeable. You should definitely consider fillers, subcision. To be honest I think the edges are smooth but you can give it a shot with full ablative on the edges. I think for immediate improvement subcision and fillers shoUld give you a good satisfaction 

17 hours ago, getsmart121 said:

I dont think punch excision is good for these scars as the area is large. You should focus moreinto smoothing the edges with full ablative erbium and fillers at the end. Again these are not very deep in the first place. Its just that it has slight depression but due to the area being large it is noticeable. You should definitely consider fillers, subcision. To be honest I think the edges are smooth but you can give it a shot with full ablative on the edges. I think for immediate improvement subcision and fillers shoUld give you a good satisfaction

Thank you. I think the microneedling helped smooth the edges a tiny bit. I was thinking subcision and filler as well for the next step. Filler just kind of sucks you have to do it over and over and theres risks with filler too

Filler sucks indeed because it's ineffective and the longer ones are risky. But that seems to be the only option for scars like that. They are quite shallow and you look quite good to be honest.

Also I'm not a fan of needling at all. And there's just no way needling will generate or stimulate tissue needed to fill gaps imo.

18 hours ago, harmlessboy1441 said:

Filler sucks indeed because it's ineffective and the longer ones are risky. But that seems to be the only option for scars like that. They are quite shallow and you look quite good to be honest.

Also I'm not a fan of needling at all. And there's just no way needling will generate or stimulate tissue needed to fill gaps imo.

Thank you your comment means alot!! I know my scarring is not as severe as others, but I have a few deep, nasty ones as seen from bad cystic acne I had. I have a few on the other cheek as well and thats all it takes to completely destroy my self esteem. Needling definitely has not done enough and wont for these type of scars. I am going to give filler and subcision a shot as my next step and see how that goes.

1 hour ago, Ccmeow said:

Thank you your comment means alot!! I know my scarring is not as severe as others, but I have a few deep, nasty ones as seen from bad cystic acne I had. I have a few on the other cheek as well and thats all it takes to completely destroy my self esteem. Needling definitely has not done enough and wont for these type of scars. I am going to give filler and subcision a shot as my next step and see how that goes.

If you do the subscision find a good doctor. Anything you subtract really does permanently fiddle with the anatomy that's how I always view things.At least that's how I look at it. The skin is a very complicated organ, and all 3 layers are complicated. But that's probably your best bet since your scars appear to just be a few surrounded by mostly normal skin.

Well either way, good luck. Also I always suggest people try to do a test first on ONE and see how it goes. Whatever you do always try one first and see if you like it, any side effects, how it looks etc. Just my opinion.

5 hours ago, harmlessboy1441 said:

If you do the subscision find a good doctor. Anything you subtract really does permanently fiddle with the anatomy that's how I always view things.At least that's how I look at it. The skin is a very complicated organ, and all 3 layers are complicated. But that's probably your best bet since your scars appear to just be a few surrounded by mostly normal skin.

Well either way, good luck. Also I always suggest people try to do a test first on ONE and see how it goes. Whatever you do always try one first and see if you like it, any side effects, how it looks etc. Just my opinion.

Thank you for your response. Is subcision that risky? What are the possible bad side effects? I havent seen anything too negative about it. Do you think its worth it for me to try it

14 hours ago, Ccmeow said:

Thank you for your response. Is subcision that risky? What are the possible bad side effects? I havent seen anything too negative about it. Do you think its worth it for me to try it

I might be thinking of excision actually my apologies. I always confused the two. Excision is the one that actually removes and subscision (I think) is the one that breaks up the tethering. I think the hope is that plus filler generates some growth but I never really bought that in any meaningful magnitude. I don't know much about the risks generally if any.

9 hours ago, harmlessboy1441 said:

I might be thinking of excision actually my apologies. I always confused the two. Excision is the one that actually removes and subscision (I think) is the one that breaks up the tethering. I think the hope is that plus filler generates some growth but I never really bought that in any meaningful magnitude. I don't know much about the risks generally if any.

Oh okay that makes alot more sense!haha. Yes excision is cutting the scar out, subcision is breaking the tethers. Excision i think would be my very last resort if ever. It kinda scares me. But, subcision i think there isnt much risk besides it doing nothing to help from what i understand.

13 hours ago, Ccmeow said:

Oh okay that makes alot more sense!haha. Yes excision is cutting the scar out, subcision is breaking the tethers. Excision i think would be my very last resort if ever. It kinda scares me. But, subcision i think there isnt much risk besides it doing nothing to help from what i understand.

Probably not much risk but honestly I never studied it very closely. Any needle that fiddles any area (constantly) in damaged layers after acne scars though is always something you should just be overly cautious about, including say injecting juvederm every 3-6 months after untethering. That's why I don't love short term fillers, because the action of the needle has to be harsh over and over to the layers.

I myself had a botched excision about half an inch I'd say currently. It was about 50% smaller prior (quarter inch), and the only benefit is the edges aremore roundthan sharp or steep yet the depression is deeper. Still, the very procedure of taking an extra quarter inch of material out, sort of screwed up some of the anatomy near the spot (color/circulation maybe). That's why I always just be wary about testing a spot or that or being careful in general. But I agree subscision seems less risky than most things and realistically that's probably the only treatment for certain scars. My old scar must have been too sharp to properly subscise perhaps.

On 1/7/2022 at 2:01 PM, harmlessboy1441 said:

Probably not much risk but honestly I never studied it very closely. Any needle that fiddles any area (constantly) in damaged layers after acne scars though is always something you should just be overly cautious about, including say injecting juvederm every 3-6 months after untethering. That's why I don't love short term fillers, because the action of the needle has to be harsh over and over to the layers.

I myself had a botched excision about half an inch I'd say currently. It was about 50% smaller prior (quarter inch), and the only benefit is the edges aremore roundthan sharp or steep yet the depression is deeper. Still, the very procedure of taking an extra quarter inch of material out, sort of screwed up some of the anatomy near the spot (color/circulation maybe). That's why I always just be wary about testing a spot or that or being careful in general. But I agree subscision seems less risky than most things and realistically that's probably the only treatment for certain scars. My old scar must have been too sharp to properly subscise perhaps.

Im sorry you had that experience. Thats whats scary about excision to me. You might not be happy with the results after. Yeah, thats why the thought of fillers kind of suck, but i think if i saw a good difference after it would make me super hopeful and happy and then maybe think about a permanent filler. The only one i know of is bellafill, and the thought of a permanent filler is scary because what if something goes wrong? Theres no way to remove it