Acne Scar Rewind
(Subcision & Fat Grafting)
Rolling acne scars that are held down tightly cannot be treated wiht injections alone. This type of acne scarring requires a more aggressive approach, like Subcision. At The Acne Scar Center, we call this our Rewind procedure and it is the best option for these severe cases.
Rolling Scar Rewind Treatment Before & After
What is Subcision?
EX-cise means to remove something by cutting around it. IN-cise means to cut into something. To SUB-cise is to cut below something.
The Acne Scar Rewind procedure subcises a broad area of the face, like the cheeks, through a small hidden scar placed in the hairline and/or corner of the mouth where it will not be visible after healing. Once the tiny incisions are made, special needles are passed below the skin to cut the tethered scar from below.
When the underlying scar is released, the skin needs to be supported from below to smooth out the surface texture. A special blend of the patient’s own fat and PRP/Stem cells is injected into the released space, helping to “push” the skin back up. This is required in order to prevent the upper skin from returning to its previously depressed shape.
This type of broad subcision should not be confused with limited subcision offered by some dermatologists. Limited subcision treats individual scars, one at a time. For patients with more severe or widespread acne scarring, this would require numerous treatments and yield more limited results.
With the skill and experience of a plastic surgeon like Dr.Richard Sadove, the issue can be treated more aggressively with the Acne Scar Rewind technique and most patients achieve their desired result with a single visit.
Fat Grafting for Depressed Scars
Fat cell grafting, also known as fat transfer, is a procedure that involves transferring fat cells from one area of the body to another.
As a preliminary step of the Rewind procedure, fat cell transfer involves a small amount of liposuction. Therefore, the procedure is best performed by a trained Plastic Surgeon. A low pressure hand held liposuction technique is used to extract the desired volume of adipose fat cells from the patient’s hip area. The small amount of fat removed, generally 10-20 cc, is not evident in the donor area afterwards.
The fat is then processed for purification. Blood is drawn from the patient’s arm and the platelet rich plasma (PRP) is separated out. Adding the PRP with the purified fat cells prior to injection increases the survival of the cells after transfer.
Since the 1990’s, Plastic Surgeons like Dr Sadove have extensively employed fat grafting to enhance the cosmetic appearance of breasts, buttocks, face, hands, and hips. Many publications have been written about the clinical applicability, therapeutic and reconstructive benefits of fat grafting procedures in wound healing, and scar treatment. This is why we choose to combine auto fat transfer with our Rewind procedure, rather than any other filler material.
Anesthesia Used for Acne Scar Rewind
Acne Scar Rewind procedure is performed with a variety of local anesthetic drugs that can be administered by Dr Sadove in an outpatient office setting. The choice of anesthetic drug depends on the volume of fat that needs extraction by liposuction technique.
Local anesthesia administration does not change your level of consciousness. You are comfortable but awake during the procedure. Under the influence of local anesthesia, small volumes of fat can be harvested and the subcision procedure performed safely and comfortably.
If a patient is nervous or apprehensive about their procedure, a light sedative such as Valium can be administered as long as the patient has a ride home.
After Acne Scar Rewind, patients will experience swelling and numbness in the subcised area. Local anesthetic and the transferred fat will cause the treated area(s) to look “overfilled” for the first 48-72 hours. Moderate swelling will persist for a period of about 2 weeks. Patients may continue to experience mild swelling for the next couple of months while the transferred fat settles.
There is usually little to no bruising on the face, but some bruising and soreness may be evident in the fat transfer donor site. Patients usually report that they are more aware of pain at the donor site than the subcised area.
Pain medication may be prescribed but patients usually switch to Tylenol after the first couple of days.
As with any other procedure or treatment, results may vary from patient to patient. Many factors, such as severity and age of scarring, will play a role in the degree of improvement a patient will experience after subcision with auto fat transfer.
Our patients typically report significant improvement in the texture and appearance of their acne scars compared to other treatments they may have tried in the past such as laser, peels and microneedling.
We expect most patients to have at least 50% improvement with one Acne Scar Rewind treatment. However, many patients report that they feel their acne scars were improved by 70% or more.
Additional treatments may be advised if further improvement can be achieved.