Hi, everyone. I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My focus is on helping patients with acne scars, pigmentation issues, and facial balancing. Over the years, I’ve treated countless individuals who’ve struggled with their skin, and my goal has always been to provide them with safe, effective, and long-lasting solutions. Today, I want to share some insights into my approach to treating acne scars and other skin concerns. Whether you’re dealing with stubborn boxcar scars, hyperpigmentation, or even questions about fillers or subcision, I’ll walk you through everything you need to know.
Why Personalized Treatment Plans Matter
In my practice, no two patients are the same. Each individual comes to me with unique skin concerns, skin types, and expectations. That’s why I take a highly personalized approach to treatment. For example, when it comes to addressing acne scars, I often combine multiple modalities—like subcision, TCA CROSS, CO2 laser resurfacing, and fillers—to achieve optimal results. Take one of my recent patients, for instance. He had deep boxcar scars and volume loss in his cheeks. After six months of treatment, including subcision, laser treatments, and Bellafill injections, the improvement was truly remarkable. His skin looked smoother, more balanced, and youthful.
The key takeaway here is that scar treatment isn’t a one-size-fits-all solution. It requires careful assessment, a tailored treatment plan, and sometimes even patience as we work through multiple sessions. Let’s dive deeper into some of the techniques and products I use.
The Role of Fillers in Scar Treatment
One question I often get is, “Which kind of filler is the best option for scars?” The answer depends on several factors, including the type of scar, the location, and the patient’s goals. Here’s how I decide:
- Bellafill : This is my go-to for patients with boxcar scars and volume loss. Bellafill contains polymethyl methacrylate (PMMA) microspheres, which stimulate collagen production over time. Unlike hyaluronic acid fillers, Bellafill provides long-term support for the skin.
- Sculptra : If the patient has more diffuse scarring or needs collagen stimulation across a larger area, Sculptra is an excellent choice. It works by gradually building collagen, making it ideal for areas like the temples and cheeks.
- Radiesse : For patients with skin laxity, Radiesse can be beneficial because it stimulates elastin production. However, I typically reserve it for specific areas where contraction and tightening are needed.
Each product has its strengths, and I choose based on what will deliver the best outcome for the patient’s unique needs.
Why I Avoid Certain Products Like Juvederm
Another common question is whether I use Botox or Juvederm. The short answer is no. While these products are widely used in the industry, I’ve found that they often lead to complications like shifting, swelling, or unsatisfactory results. Instead, I prefer products from the Galderma line, such as Restylane and Dysport. These alternatives tend to integrate better with the skin and provide more natural-looking results.
Subcision: A Game-Changer for Indented Scars
Subcision is one of the most effective treatments for indented scars like rolling or boxcar scars. By breaking up the fibrous tissue beneath the scar, we allow the skin to heal more evenly. Patients often ask, “How much does subcision cost?” The price varies depending on the complexity of the case, but it typically ranges from $800 to $1,200 per session.
Some areas, like the jawline, can be trickier to treat due to their sensitivity to heat and energy-based devices. However, subcision remains a reliable option for improving the appearance of scars in these regions.
Treating Different Skin Types and Concerns
As someone who treats predominantly Fitzpatrick 4+ skin tones, I understand the unique challenges that come with darker skin types. Hyperpigmentation, keloids, and scarring require a cautious and strategic approach. Here’s how I ensure safe and effective treatments:
- Pigmentation Concerns : For patients worried about post-inflammatory hyperpigmentation, I emphasize sun protection, melanocyte suppressants, and gentle treatments. I also avoid aggressive heating or bulk energy delivery, which can exacerbate pigmentation issues.
- Keloid Prevention : When performing subcision on patients prone to hypertrophic scars, I use tumescent fluid (a mix of lidocaine and epinephrine) to minimize inflammation and reduce the risk of keloid formation.
Questions Answered: Your Most Pressing Concerns
Here are answers to some of the questions I received during the live session:
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Question: Which kind of filler is the best option for scars?
Dr. Qazi: It depends on the type of scar and the patient’s goals. Bellafill is great for boxcar scars and volume loss, Sculptra works well for collagen stimulation, and Radiesse is ideal for areas needing elastin production. -
Question: Do you do Botox or Juvederm?
Dr. Qazi: No, I prefer Galderma products like Restylane and Dysport. They integrate better with the skin and provide more natural results. -
Question: How much is your subcision treatment?
Dr. Qazi: Subcision typically costs between 800and1,200, depending on the complexity of the case. -
Question: Is the jawline hard to work on?
Dr. Qazi: Yes, the jawline can be challenging because it doesn’t respond well to excessive heat or energy. Subcision and phenol peels are often better options for this area. -
Question: How many times does one usually need subcision?
Dr. Qazi: In the mid-cheek area, one session is usually sufficient. However, the lower part of the face may require repeat treatments. -
Question: Does older skin require anything different?
Dr. Qazi: Older skin may take slightly longer to respond to collagen-stimulating treatments, but the overall approach remains similar. -
Question: How does treatment work for out-of-state or international patients?
Dr. Qazi: I offer virtual consultations to create a detailed treatment plan. Patients can then visit for in-person treatments, and I provide remote aftercare support. -
Question: What side effects should I expect with Bellafill after CO2 and subcision?
Dr. Qazi: Bellafill is generally safe, but it requires patience as collagen builds gradually. On average, patients need four to six syringes spread over multiple sessions. -
Question: Does Pico laser help with acne scars?
Dr. Qazi: Pico lasers can improve scars to some extent, but they’re not a first-line treatment. Subcision and CO2 lasers tend to yield better results. -
Question: Is it smart to do subcision in an area that already has filler or Sculptra?
Dr. Qazi: Yes, it’s possible, but it depends on how the previous treatment was performed. Sometimes, subcision is still needed to break up remaining scar tissue. -
Question: What do you recommend for pore size reduction?
Dr. Qazi: Controlling oil production with topical retinoids, oral medications like isotretinoin, and treatments like CO2 laser can help reduce pore size. -
Question: As a person of color, I’m worried about pigmentation. How do treatments pan out for brown skin?
Dr. Qazi: I take extra precautions with darker skin types, avoiding excessive heat and energy. With proper protocols, treatments are safe and effective. -
Question: Isn’t hyperpigmentation easier to get rid of?
Dr. Qazi: Yes, hyperpigmentation is generally easier to treat than scars. However, it’s important to manage expectations and discuss risk tolerance beforehand. -
Question: Can subcision cause keloids if I’m prone to hypertrophic scars?
Dr. Qazi: It’s unlikely if subcision is performed correctly with tumescent fluid to minimize inflammation. -
Question: What’s the difference between Juvederm and Bellafill?
Dr. Qazi: Juvederm is a temporary hyaluronic acid filler, while Bellafill provides long-term collagen stimulation. They serve very different purposes. -
Question: What’s your opinion on phenol peels? Would this patient be a good candidate?
Dr. Qazi: Phenol peels are reserved for severe cases and require significant downtime. This patient could be a candidate if he’s willing to commit to recovery. -
Question: Will these scars be prominent after weight loss?
Dr. Qazi: Rapid weight loss can make scars more visible. Supporting the skin with fillers like Bellafill can help mitigate this issue.
Final Thoughts
Treating acne scars and achieving skin restoration is both an art and a science. By combining advanced techniques with personalized care, I strive to help my patients feel confident in their skin. If you’re considering treatment, don’t hesitate to reach out. Together, we can create a plan that works for you.
Thank you for reading, and I look forward to helping you on your journey to flawless skin.
