Hi everyone, I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My focus is on treating acne scars, pigmentation issues, and collagen stimulation. Today, I want to share an exciting case study with you—a patient who experienced significant improvement in their skin after dealing with severe volume loss and fat destruction. This result showcases the power of combining treatments like subcision, collagen-stimulating products, and more. Let’s dive into how we achieved this transformation and explore some common questions patients have about skin restoration.
The Case That Excites Me: Restoring Volume and Confidence
I recently treated a patient in his 40s who had suffered from acne and scarring for years. His skin type posed challenges, and he was turned away by multiple clinics before coming to me. The issue wasn’t just the scars—it was the extensive fat loss that made his skin appear sunken and aged. Many people overlook the importance of addressing volume loss when treating scars, but it’s absolutely critical.
For this patient, we used a multi-step approach:
- Taylor Liberator Subcision: This technique breaks up tethered scar tissue, allowing the skin to lift naturally.
- Ablative CO2 Laser: We targeted thicker scars and areas needing resurfacing.
- Sculptra: Since there was significant fat loss, Sculptra helped restore volume while stimulating natural collagen production.
After just one month, the results were stunning. The skin quality improved dramatically, and the volume loss was visibly corrected. But here’s the best part: we’re not done yet. Over time, these treatments will continue to improve as collagen production ramps up. It’s incredibly rewarding to see someone regain confidence in their appearance after struggling for so long.
Understanding Fat Loss and Its Impact on Scar Treatment
One of the most overlooked aspects of scar treatment is fat loss. When cystic acne occurs, your body's immune system often destroys surrounding tissue, including fat cells, in its fight against bacteria. This means even if you gain weight later, the fat won’t return to those damaged areas. For my patients, recognizing this fact is crucial because it affects the treatment plan significantly.
In cases of severe fat loss, traditional fillers may provide temporary relief, but they don’t address the root cause. That’s where biostimulatory products like Sculptra and Bellafill come into play. These treatments stimulate your body’s natural collagen production over time, offering a more permanent solution.
For example, Sculptra typically lasts around two years, though some patients maintain results longer. On the other hand, Bellafill offers a more lasting effect, which appeals to certain individuals. In the case of the patient mentioned earlier, Sculptra was instrumental in restoring volume and improving overall skin quality.
The Importance of a Multi-Step Approach. Subcision, Laser and Volume Replacement
Treating complex skin issues requires a comprehensive strategy rather than relying on a single procedure. Here’s why:
- Combining Techniques for Optimal Results:Subcision: Breaks up fibrotic scar tissue, allowing the skin to lift.Laser Resurfacing: Targets surface irregularities and stimulates collagen.Volume Replacement: Addresses underlying fat loss with products like Sculptra or Bellafill.
Each step plays a vital role in achieving the desired outcome. For instance, while subcision addresses tethered scars, laser resurfacing smooths out the skin’s texture. Meanwhile, volume replacement ensures the face regains its youthful contours.
- Tailoring Treatments to Individual Needs: Every patient’s skin is unique, necessitating personalized treatment plans. Factors such as skin type, severity of scarring, and individual goals influence the choice of procedures. For darker skin tones, aggressive treatments might risk hyperpigmentation, requiring gentler approaches.
By combining various techniques thoughtfully, we can achieve remarkable improvements in skin quality and appearance. This holistic method ensures that each aspect of the skin’s condition is addressed effectively.
Questions Answered
Live Questions From The Session:
Question: How long will Sculptra last?
Dr. Qazi: Sculptra generally provides volume replacement for about two years. However, its effects can vary depending on individual factors. Some patients still notice good volume years later, while others may require touch-ups sooner.
Question: Are procedures for acne scars usually out-of-pocket and not covered by insurance?
Dr. Qazi: Yes, unfortunately, procedures specifically targeting acne scars are considered cosmetic and are rarely covered by insurance. While some acne treatments might be partially covered, scars themselves fall outside that scope.
Question: How long after Bellafill can you do microneedling?
Dr. Qazi: You can perform microneedling immediately after Bellafill without any issues. The two treatments complement each other beautifully.
Question: What is the best treatment for stretch marks?
Dr. Qazi: Stretch mark treatment depends on severity. For mild cases, lasers like Erbium or diluted Radiesse can help. In extreme cases involving significant skin laxity, surgical removal may be necessary.
Question: Any options for chronic-term eye bag discoloration?
Dr. Qazi: First, determine whether the discoloration stems from true pigmentation, shadowing due to volume loss, or visible vessels. Lasers like Excel V target underlying vessels effectively, while fillers address volume-related shadows.
Question: Big pores and scars—can you minimize them?
Dr. Qazi: Pores are trickier to treat, but controlling oil production through topical retinoids or procedures like Accure laser can reduce their appearance. As for scars, combining subcision, lasers, and volume restoration yields excellent results.
Question: The best serum to help with ice pick scars?
Dr. Qazi: Topical serums alone won’t significantly improve ice pick scars. Instead, consider TCA Cross or excisions for deeper scars. Retinoids may help shrink pore size slightly but won’t fully resolve the issue.
Question: If I play sports and sweat a lot, how do I prevent breakouts and oil buildup?
Dr. Qazi: Sweat and oil production spike during exercise, especially if testosterone levels rise. Using hypochlorous acid spray before and after workouts keeps bacteria at bay. Additionally, managing oil production with low-dose Accutane or Accure laser can make a big difference.
Question: Thoughts on thread lifts combined with subcision/PDO threads in place of filler?
Dr. Qazi: Thread lifts aren’t my go-to solution because they offer only temporary effects and can complicate future treatments. Instead, I prefer methods like Sculptra, Bellafill, or fat transfer for lasting volume restoration.
Question: Ice pick scars for the nose?
Dr. Qazi: Treating ice pick scars on the nose requires caution due to limited space. TCA Cross works well here, but concentrations must remain low to avoid excessive widening of the scar.
Question: How about Rejuran?
Dr. Qazi: Rejuran has gained popularity in Korea, but feedback from my patients suggests it doesn’t significantly improve scars. It might enhance overall skin texture but isn’t a game-changer for deep scars.
Question: Can I do low-dose Accutane and subcision?
Dr. Qazi: Absolutely! Low-dose Accutane supports healing and reduces inflammation post-subcision. It’s an underutilized yet effective option.
Question: Is superficial scars easier to treat, and what is the best treatment for it and for boxcar scars?
Dr. Qazi: Superficial scars seem simpler but often require patience. Patients with darker skin tones need careful treatment to avoid hyperpigmentation. Boxcar scars respond well to subcision, lasers, and volume restoration.
Question: What would you recommend as the best procedure to diminish smile lines that isn’t filler?
Dr. Qazi: Smile lines often stem from volume loss, making non-filler solutions challenging. Silicone tape post-Bellafill helps protect treated areas, but achieving optimal results typically involves some form of volumization.
Question: Can you explain the difference between Sculptra versus hyaluronic acid filler?
Dr. Qazi: Hyaluronic acid fillers provide immediate volume, whereas Sculptra stimulates collagen production over time. They serve different purposes and cater to varying patient needs.
Question: What about under eyes—I’ve been thinking about filler, Sculptra, or microneedling with PRP?
Dr. Qazi: Avoid Sculptra under the eyes due to the risk of lumps. Filler and microneedling with PRP are safer options, provided they’re administered carefully.
Question: Is there a solution for hormonal acne?
Dr. Qazi: Hormonal acne responds well to oral contraceptives containing estrogen and progesterone, along with medications like Spironolactone. These regulate oil production and hormonal fluctuations.
Final Thoughts: Trust and Patience Are Key
Skin restoration is both an art and a science. Every patient’s journey is unique, requiring personalized care and realistic expectations. Whether you’re dealing with acne scars, volume loss, or pigmentation issues, trust that modern treatments can deliver transformative results.
If you’d like to learn more about your options, schedule a consultation here. Together, we’ll create a plan tailored to your goals. Remember, consistency and commitment are crucial, your skin deserves nothing less than the best!
