Are fillers or subcision enough for sunken cheek due to acne scars

subcision for acne scars

Dealing with a pimple can be a frustration, especially if one is suffering from severe cystic acne. This condition heals and leaves behind textural changes in the skin, in the form of pits or depressions in various sizes and depths. However, there is a wide range of treatments available to temporarily improve your facial appearance, ranging from soft tissue fillers to a more invasive subcision for acne scars.

Soft- tissue fillers for acne scars

In this method of treatment, fillers used can be made up of hyaluronic acid, Poly-l-lactic acid, and calcium hydroxylapatite, silicone etc. depending on the duration of effect. Most commonly used fillers are hyaluronic as it is one of the components of the naturally occurring collagen in the dermal layer. The injection will then help to plump and lift the area resulting in a more even finish. It is more useful in localized scars and broad, rolling scars are round in shape as compared to widespread scars and icepick type of scars. Since the effect can wear off, the injections can be repeated at an interval of 6 months to 2 years and are relatively painless.

The advantage of fillers is that procedure time is short, minimally invasive and it’s only for a temporary period of time whereas the drawbacks are related to its potential of causing hypersensitive reaction towards hyaluronic acid. Therefore, prior to the procedure allegy testing needs to be done on the patient. Its adverse effects are non-life-threatening, mainly mild transitory erythema and mild-to-moderate pain during injection.

Subcision of acne scars

For patients who wish to permanently reduce the appearance of their acne scars, subcision is one of their options. This procedure involves inserting a needle in the dermis layer to break up the fibrotic band that is tethering the scar to the underlying tissue, giving its pitted scars. After the surgery, the wound will heal with the deposition of new collagen forming a cosmetically improved scar appearance.

Subcision is safely performed in the outpatient setting and is usually well tolerated. For better outcome, surgeons will also combine with other modes of treatment. Choices for consideration include:

  • Topical retinoids
  • Microneedling
  • Chemical peels, e.g .15% trichloracetic acid
  • Laser therapy

Despite its many benefits, this minor surgery is indicated only in certain types of acne scars particularly depressed distensible scars, depressed bound down scars, depressed skin grafts even wrinkles and cellulite dimples. Moreover, patients are required to adhere to several post-surgical instructions to ensure satisfactory results by applying pressure and ice to the operated site to reduce the risk of bleeding and to avoid direct sun exposure in case of temporary post-inflammatory hyperpigmentation turning permanent.

Clearly, this procedure is more complex and post-treatment care is quite elaborate. Due to concerns of developing hypertrophic scars, the number and intensity of subcisions should be limited on the first treatment to review the patient’s response before the subsequent session in a month’s time. Once completed, there’s no need for repeat treatment.

Both of the acne treatment above post their own risks and complications. Therefore, always ensure thorough research and consultation with medical- board certified doctors before going under the needle.

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