Thank you for your question. Acne scars can be tricky to treat as these are chronic scars that have been acquired over many years and they can be deep or pigmented. I always tell patients that there will be improvement but the scars will not be eliminated. There are no "miracle cures" although marketing and media may lead you to believe so.
Successful treatment of such scars will often require patience from both the patient and doctor and a combined approach of lasers, subcision and fillers to the underlying scar. There are many procedures and options that have be discussed by my aesthetic colleagues regarding lasers, Rejuran and fillers so I will not repeat those.The current guidelines suggest a multimodal approach to treating scars but there is no gold standard for treatment. However, there is exciting therapeutic potential for the use of autologous fat grafting where functional and aesthetic improvements of the scar quality have been reported.
Personally, something that I have found to be useful for treatment of difficult scars over the years is subcision of the scars and injection of structural fat grafts as well as nano fat to the scar. Subcision of the scar is done to release the scar band from the underlying tissue so that it can be lifted. This is then followed by plumping of the space with some form of a filler, in this case your own fat. The structural fat grafts serve to plump up the scar and prevent the scar from adhering to the underlying tissue after the subcision. (This is what gives the puckered appearance.) As the autologous fat grafts are your own tissue, once it engrafts and heals it will be permanent. The most difficult cases are what we consider "ice pick scars." They are very deep and narrow. I have on occasion placed a small skin graft from behind the ear into these types of scars for best results.
Finally, nano-fat (processed from your own fat) which contains growth factors are injected into the area of the scar to stimulate wound healing and overall skin texture improvement.
I hope this answers your questions!
