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Absorbable suture thread as filler for acne scars (i.e. Vicryl)

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Hi to all!

I suffer from severe acne scaring and I've been coming to this board for a while but only recently had the courage to post.

I remember reading an article where the author mentioned the use of absorbable suture as a filler for subcision but can't find the article because it was a brief mention. This got me into thinking about the idea. After subcision, inserting the suture thread through the "needled hole" into the subcided space could create a sort of grid structure to support tissue/scar tissue formation without there being depression and ultimately level the skin (permanent?). The beauty is that the Vicryl would slowly be absorbed and leave no trace behind. (this is not that farfetched really as vicryl and sculptra are the same substance)

The main issue here is that being an external agent a bacterial infection could form along with biofilm and abscess.
Theoretically, I think, it makes sense, but the risk is really scary.

I remembered this because I'm in a dark place now, looking at everyone's posts about not being happy with any "orthodox" treatment is making me hopeless about overcoming this nightmare.

Don't discard this idea immediately, just give it some thought. I went to "ask a doc" on RealSelf about this and I'm waiting for the question to be approved, but was hoping to hear from the community as well.

Thanks for reading, all the best! :new_smiley_0:

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It's sad though:

"Our idea of using catgut as filler, which is known for its immunologic reaction and risk of granuloma, to produce a fibrous reaction is original. There may be different reasons why no difference was observed between the sub- cision and the subcision catgut. The location of this filler, dermis or hypodermis, may have some effect. The nature of catgut suture not to create significant fibrosis seems to be imperative. In the literature review, no conclusions were found that even when there is prolonged inflamma- tory reaction that fibrosis will result in conjunction with catgut suture. In this regard, further comparative con- trolled studies with use of other recognized filler could be helpful to answer this paradox.

Subcision seems to be a safe, simple, well-tolerated and valuable surgical procedure for some types of acne scars and for patient unwilling to undergo more complex procedure. In this regard, it is a useful tool for dermato- logists who perform scar revision with considerable rate of improvement and patients’ satisfaction. However, more controlled studies to assess the efficacy and safety of this procedure and additional effect of the subdermal implant would be fruitful in this regard. "

I wonder, their pacient number was rather limited...

P.S.: thanks for pointing the article
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Another similar procedure is dermal grafting.  This is a subcision procedure where a dermal graft is placed under the scar.  There dermal graft is harvested from the patient I believe usually from behind the ear.  There is a doctor out west somewhere who treats many acne scar patients with this procedure.  I can't remember his name.  If you search this scar forum you should be able to find his name.  From what I remember his reviews on this site were not good.  And I believe the incision requires more than just a needle hole.  

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Dermal grafting, that thing sounds like it'll leave an even bigger scar, I don't know... Honestly I'd be willing to try the absorbable suture but I'm going through a course of accutane at the moment so that's a big NO for any procedures. Either way, the infection risk really scares me from trying, but seing as a lot of people have previously and successfully performed subcision on themselves, maybe I'll try this technique in a near future. Like I said, that case study consisted of a mere 22 subject of which only half had the "implant" done and they don't even explain this implant technique, just that they had it done. It's just so sad that with all the misleading laser treatments things like subcision with proven results for a great number of people lose interest for investigation and technique improvement.

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That's true, but sculptra stays for longer than 1 year as oposed to vicryl which would last for about 40-60 days, serving only as a structure for tissue growth and prevention from rethetering. What I imagine is like permanent "suction" which according to an article is beneficial, but this way, instead of suctioning sessions each day it would remain there the whole time creating that space between the released skin and the thetering scar tissue. By the way, the doctors already answered at realself:



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I wished all the doctors on realself would be honest about Bellafill.  They keep saying that it lasts for at least 5 years, which is legally true since that is when the studies were ended.  What it implies is that it is not permanent, just long-lasting.  In reality, the plexiglass beads are indeed permanent.  They work precisely by creating a granulomatous reaction, which causes the beads to be encapsulated in scar tissue / collagen.  Not saying it doesn't work, but I don't like how they're not shooting straight with people.

Also, Dr. Emer really does come off like a smarmy used car salesman.  A girl posted on realself asking for advice about her mild acne scars, and Dr. Emer says "NO, those are not mild."  Clearly they're very mild, but it seems like he wants to sell her on lasers, fillers, microneedling, the works.   I asked this guy a question before, and he comes off condescending.

Do these look severe to you?  It's unsettling how some doctors are shameless in their self-promotion. 

Edited by blahblah82
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