Just about every skin rejuvenation treatment will happily advertise that they can reduce acne scars, from chemical peels and Réjuvapen® microneedling to laser skin resurfacing. It’s often true, though the only treatments with results that we can stand by with certainty are the ones we’ve chosen to offer at Dermatology Associates of Atlanta. The treatments we most often use for mild acne scars include laser skin resurfacing (either non-ablative like Fraxel®, fractionally ablative like DOT™, or fully ablative like CO2 or erbium), procedures that combine microneedling with radio frequency energy (like Infini™ and Fractora™), and even pulsed dye lasers like the Vbeam Perfecta to reduce scar redness. However, the reality is that they’ll only make a noticeable difference for small, shallow scars, and many acne scars are simply too deep and prominent to be addressed in this way. Here’s the good news: people with deeper types of acne scars do have an effective option – minimally invasive acne scar surgery.
Don’t let the word “surgery” scare you. In reality, the procedure is done in our convenient in-office surgical suite, so you still have the comfort of our own dermatology office rather than an intimidating operating room. The procedure is also minimally invasive, meaning that you won’t have extensive incisions or significant scarring, and you can go home the same day to heal at home. Depending on the type of acne scars you have, there are a number of potential techniques our board-certified dermatologists can use to provide optimal results.
Punch Grafting or Punch Floating
The punch grafting technique uses a circular surgical tool to selectively remove the scar tissue and replace it with a graft of healthy skin from an inconspicuous area. This is generally the best option for “ice pick scars” – deep scars that are narrow at the top, sometimes being so narrow and deep that they look like very large pores. Punch grafts typically heal with a very smooth and natural look.
For depressed acne scars, the appearance of an indent comes from a loss of underlying tissue and from rigid scar tissue pulling down on the surface skin (similar to the way rigid connective tissue pulling skin down can contribute to the dimpled look of cellulite). The goal of subcision is to free that scar tissue to allow the skin to look smoother from the surface. In many cases, subcision is paired with injecting a filler or another material into the area to replace the lost underlying tissue.
One exciting advance of modern medicine is the ability to remove unwanted or unneeded fat with liposuction, process it, and then inject it into an area that needs more volume. Acne scar surgery is one of the many uses for fat transfer which we’ve been using for 20 years, because your own natural fat is used to fill in depressed acne scars. To help your body rebuild skin-smoother and firming collagen, the fat is often combined with natural growth factors, a component of your own blood, and it can be used alongside subcision for a comprehensive and natural result.
For people with just a few acne scars that are very deep, excision can be used to remove the scar tissue and damaged skin, stitching together the skin at the surface and allowing the body to heal in a smoother, more controlled way. Excision alone is only generally used for very deep and irregularly-shaped scars in areas that are difficult to treat with other methods.
The word “surgery” has a way of making patients nervous, but acne scar surgery is actually a very manageable procedure that we perform in our well-prepared, in-office surgical suite, so it doesn’t truly feel like a “surgical” experience. If you want to resolve your acne scarring and get back to a complexion that makes you feel confident, schedule an acne scar consultation at Dermatology Associates of Atlanta. If you want to find out the many nonsurgical treatments we offer for mild acne scarring, follow us on Facebook, Twitter, and Google+.