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sh2os

Subcision without filler?

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Hi guys,

I have some pretty bad atrophic (mainly rolling) acne scarring on my cheeks left behind by cystic acne I had 5-6 years ago. In the past year I’ve decided I wanted to do something to treat it, and in December and January I had two erbium laser treatments done by a doctor who insisted laser could be the solution to my problems. 
 

Now, I feel like I can’t see any real improvement in the depth of my rolling scars (though overall redness level and texture has improved) and I want to try subcision. I finally found a doctor in my country (Norway) who performs subcision, and after a very nice email conversation with him where he even offered to take a look at a photo of my scars, I have scheduled an appointment 3 weeks from now. 

During the email conversation I asked him whether he recommends the use of a temporary filler to keep the scars from re-tethering in the days and weeks following treatment. He said it might help in the short term, but also cited a study that says temporary filler does not make any long term difference in the healing of these type of scars. 
 

I was just curious what your thoughts are? Has anyone had good results from subcision without filler? How many sessions did you need? Any other techniques or products I should try to keep the scars from re anchoring? Cupping?

I’ve attached a photo of my left cheek (where the worst of the scarring is) before and after the two laser treatments. 

2E3B5589-B5BD-48DE-AA90-3813CBE09426.jpeg

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This is interesting topic, subc with or without I d like to know too .

https://www.realself.com/question/los-angeles-ca-subcision-without-filler

https://www.doctorxdentist.com/questions/how-effective-is-subcision-without-fillers

"I usually combine subcision with bio-stimulatory / collagen boosting fillers for best results.

This is because studies have shown that there is 20% chance that the fibrous scar tissue might "re-form" during the recovery process after subcision. Fillers help to decrease this risk. "

Well 20% is not that much imho, dont know if its worth money, fillers help to decrease the risk of scars rethetering  but they wont prevent it 100% . 

I must say I personally had 4 subcisions , 2 with filler, 2 without filler but combined with Genius RF on same session, i have very nice improvements.

One deeper scar however didnt improve without filler after first subc, it retheterd after 1 week and no improvement whatsoever  ( problematic zone for filler so i didnt want to take risk ), so 2nd subcision with filler dr used filler as spacer even for that problematic scar,  and it improved quite nicely, so it probably really depends on what your dr prefers as method and on type of scar, your healing abilities and so on.

 

I d like to know what other people here think about filler as a spacer ( not creating volume ) used after subcision.

I know f.e. Prof Chu in England said filler prevents formation of collagen, and after it dissolves scars show very little improvement so he didnt use filler after subc.

Also I must say i spaced 1st and 2nd subc 4 months,  2nd 3rd 6 months, 3rd and 4th 6 months, and while filler still present scars rethetered to some extent so dr had to cut it again , so....

I also red 1 study, but cant find it just now, that they compared results subcision with and without filler, and in long term subcision with filler didnt give superior results compared to subc without filler.

You probably gonna listen to ur dr and trust him.

https://www.joochiatcomplex.com/subcision-fillers-the-best-atrophic-scar-removal-method/

Here u have subc + filler folowed in 2 weeks with CO2 , 165 patients 

https://onlinelibrary.wiley.com/doi/abs/10.1002/der2.53

Edited by Miro
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11 hours ago, sh2os said:

I was just curious what your thoughts are? Has anyone had good results from subcision without filler? How many sessions did you need? Any other techniques or products I should try to keep the scars from re anchoring? Cupping?

 

Yes, get filler, but not as a spacer but volumizer. 

First, get the subcision. Then wait 2 weeks or until the swelling is completely gone. Then get Sculptra with either RF Microneedling or Fractional CO2. Studies have shown when you couple Sculptra with energy devices, it enhances collagen remodeling.

Edited by Sirius Lee
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Don't do Erbium lasers for your scars. Erbium is too weak and you are just giving away your money to the doctor. I've only seen Dr. Lim do aggressive Erbium treatments, but CO2 is the laser you want - after you have tried manual methods like subcision and TCA Cross.

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On 2/27/2021 at 10:52 AM, sh2os said:

He said it might help in the short term, but also cited a study that says temporary filler does not make any long term difference in the healing of these type of scars. 

 

I was just curious what your thoughts are? Has anyone had good results from subcision without filler? How many sessions did you need? Any other techniques or products I should try to keep the scars from re anchoring? Cupping?

Do you happen to still have the study? I'd be curious to take a look. May I ask, who your doctor in Norway is? We are being told there aren't many doctors who treat scars in Europe, but there actually are. Some of them have years of experience and very skilled in the standard treatments, they just don't advertise or get promoted heavily. 

To answer your question, subcision has recently been offered in combination with tumescent anaesthesia, which is supposed to prevent re-tethering as well as provide better pain control during the procedures. You literally don't feel a thing even during otherwise very painful co2 or rfm treatments. It comes with a pricetag, though.

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11 hours ago, Marumi said:

Do you happen to still have the study? I'd be curious to take a look. May I ask, who your doctor in Norway is? We are being told there aren't many doctors who treat scars in Europe, but there actually are. Some of them have years of experience and very skilled in the standard treatments, they just don't advertise or get promoted heavily. 

To answer your question, subcision has recently been offered in combination with tumescent anaesthesia, which is supposed to prevent re-tethering as well as provide better pain control during the procedures. You literally don't feel a thing even during otherwise very painful co2 or rfm treatments. It comes with a pricetag, though.

Here is the study:

study on subcision with/without fillers.

The doctor is doctor Wenus in Drammen (near Oslo). He is mainly a mole removal specialist and an ear nose and throat doctor but he also has lots of experience with cosmetic procedures - just doesn’t advertise it so much. Norway has kind of a complicated relationship with cosmetic surgeries, which is why many doctors who perform them don’t advertise so much. I had a great experience with this doctor :)

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23 hours ago, sh2os said:

Here is the study:

study on subcision with/without fillers.

The doctor is doctor Wenus in Drammen (near Oslo). He is mainly a mole removal specialist and an ear nose and throat doctor but he also has lots of experience with cosmetic procedures - just doesn’t advertise it so much. Norway has kind of a complicated relationship with cosmetic surgeries, which is why many doctors who perform them don’t advertise so much. I had a great experience with this doctor :)

Thanks for sharing. :)

You've had very good improvements so far, by the way. I'm looking forward to seeing even more results from the upcoming treatments!

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