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DudleyDoRight

Subdermal Minimum Surgery

Subdermal Minimal Surgery for Acne Scars

Researchers used this new, needleless technology to inject hyaluronic acid into acne scars and improve their appearance.

Subdermal minimal surgery technology makes use of an industrial-strength, needleless hypodermic inoculator that delivers medication into the skin through a high-pressure jet. One shot covers a 1-cm2 area in the dermal and subdermal planes. In a pilot study from South Korea, investigators evaluated the efficacy of this technology for treating acne scars.

Ten patients with facial acne scars underwent a series of three subdermal minimal surgery treatments, 4 weeks apart, under topical EMLA anesthesia (lidocaine, prilocaine topical cream). Hyaluronic acid (HA) was infiltrated into the area of the scar, at 0.15 mL/scar. The HA used in this trial was 90% cross-linked with butanediol diglycidyl ether; according to the authors, it remains active for 6 to 8 weeks.

At follow-up 3 months after the last treatment, two independent observers found mean scar improvement of 51% to 75%; in patient assessments, the mean rating was 25% to 50% improvement. The authors note that the benefit seemed to last for at least 6 months and that ice pick scars improved more than rolling or boxcar-type scars. Pain was described as none to mild, and no complications were noted.

Comment: Subdermal minimal surgery technology has interesting potential for delivering filler materials and medications into the skin. It is not clear whether the observed benefit was related to the fleeting presence of HA or to the trauma of infiltration and resulting wound healing and collagen remodeling. The authors state that the HA is dispersed within the dermis, but given the density of the dermis, it is much more likely that the material is dispersed in the subdermal plane (as denoted by the name of the technique).

— George J. Hruza, MD

Published in Journal Watch Dermatology October 1, 2010

Citation(s):

Lee JW et al. Treatment of acne scars using subdermal minimal surgery technology. Dermatol Surg 2010 Aug; 36:1281.

Medline abstract (Free)

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oh thank you - as always dudley, you have found us useful information. im happy to hear it works well on ice pick scars - until now the possibilites have been rather limited! :dance:

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Cartwheeling, I have never used injectibles, and I do not have icepick, but I thought this would be an interesting method that would improve on the old needle procedures. Good Luck!

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ToBe, as I mentioned I have not done this, and I am posting this for those who are trying fillers.

tobe - from my reading they would last about as long as normal fillers, maybe a bit less if the scars are in postions that are constantly moving.

its an idea, but for people with widespread scarring like myself, it seems like an extremely expensive option, for just a temporary improvement. there also appears to be little to no long term benefit of using it.

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ToBe, as I mentioned I have not done this, and I am posting this for those who are trying fillers.

tobe - from my reading they would last about as long as normal fillers, maybe a bit less if the scars are in postions that are constantly moving.

its an idea, but for people with widespread scarring like myself, it seems like an extremely expensive option, for just a temporary improvement. there also appears to be little to no long term benefit of using it.

hey guys, lets give this more thought. it basically seems similar to airgent, which is used commonly for rolling scars, but its probably perfect for ice picks.

i realise it may take a few treatments to get the desired results and then treatments need to be undertaken on an ongoing basis to keep them refilling.

would the actual act of pushing through the skin, actiually cause any collagen growth within itself?

lets have an active debate on this :)

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any puncture/damage to skin will force collagen production

and hyalouronic acid definitely increase collagen.

many derms notice that people who get fillers for acne scars ends up needing less and less injection on the scarred areas because of their improvement.

they're not too sure if most of the improvement comes from the needle or the hyalouronic acid (filler).

Edited by chee6119

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any puncture/damage to skin will force collagen production

and hyalouronic acid definitely increase collagen.

many derms notice that people who get fillers for acne scars ends up needing less and less injection on the scarred areas because of their improvement.

they're not too sure if most of the improvement comes from the needle or the hyalouronic acid (filler).

oh thanks chee. that does sound like good news. so not only will the scars look nice whilstever using it, but there would also be the long term actual improvement.

i know i keep ranting on about tca crosses and all that, but this might just be better. has here anyone had the airgent done?

theres only two places in australia that have the equipment and they are in another city....i wouldnt mind flying down every 6 weeks for it if they were willing to do it on the ice pick scars.... :)

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in an attempt to be proactive, ive researched this further. there seems to be a general consensus it might lead to long term dermal thickening...im not sure if this is due to a real thickening, or whether its purely because its still plumped up after a period of time.

there have been some studies conducted with a small number of people who did them for eye treatments. they found there was still a small amount of plumping six months after the last procedure. whether this is due to fleeting levels of HA, or actual new collagen growth, no one seems to be certain of.

there is a much wider study currently being conducted in Israel for "skin problems". they are currently calling for test subjects. i believe the aim is to see if there is any long term dermal thickening, instead of just a temporary plumping. given they havent started yet and will be waiting a long time to see the results, this seems like more long term study.

i've contacted the two airgent providers here in australia that i know of and have both an email. ive asked whether they would consider using it for ice pick scars and and whether they have seen any ongoing dermal thickening as a result.

im waiting for their replies (hopefully be today). once i get them, ill post them up here for everyone to read.

all the best.

Edited by gimme gimme gimme

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Awesome! Thanks, Gimme, for all the research. Those of us w/ ice pick scarring are always in need of solutions that can work for us!

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Awesome! Thanks, Gimme, for all the research. Those of us w/ ice pick scarring are always in need of solutions that can work for us!

we sure do. neither responded to my email...i cant believe it !

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Is this the same thing as Airgent that someone else posted in a different thread?

It is Airgent. The study referenced by Dudley is cited as a clinical study on their site:

http://www.airgent.com/

Edited by TokyoGirl

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Is this the same thing as Airgent that someone else posted in a different thread?

yup this is the same as airgent. this could possibly be the start in the turning curve in cosmetic surgery history for acne scarring we have all been waiting for !!

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