The MOST important skill set for the treatment of acne scars is surgical subcision & dermal fillers. Deep scars including rolling acne scars will usually have elements of tethering. The extent can be guessed on examination, but only confirmed intra-operatively . . 🔬Science: All things being equal (procedure, skill level, equipment level) the end result in the context of scar revision is largely based upon one’s ability to remodel scar tissue & regenerate dermal matrix. Everyone lies on a bell curve. Subcision beaks attached scars in the dermis but mostly the hypodermis. I subcise in 2 sometimes 3 levels . . 👀👉Scar types: Superficial #acne scars include boxcar scars, pick scars, isolated #icepickscars, & mild rolling scars. These can be treated with the usual #microneedling, #lasers, #RFmicroneedling, TCA, & phenol peels, those scars respond predictably to treatment . . 👉Deep Scars include rolling scars, atrophic scars & tethered acne scars. With significant atrophy, in some cases your immune system can not stimulate enough #collagen (& or adipose tissue) to replace the divots & undulations, namely rolling + atrophic scars. We can use many techniques to ASSIST YOUR IMMUNE SYSTEM such as energy devices & manual methods. If atrophy persists, you are left with 3 choices, filler, fat or dermal grafts. The later is only suitable for low volume deficits . . 🗡🔪Subcision is important, the needle technique is outdated, cannula, modified instrumentation subcision or limited NOKOR blades yield much better results. Pros & cons or each to be discussed with your #dermatologist or plastic surgeon . . 😎Dr Davin Lim, Dermatologist Brisbane, Australia🇦🇺 @drdavinlim . #nomorescars #dermatologistbrisbane #scarrevision #brisbanedermatologist #acnescartreatments #brisbaneskin #brisbanedermatologist #rollingscars #skinscience #scareraser (at Brisbane, Queensland, Australia) https://www.instagram.com/p/CKA3SxoD2Pj/?igshid=1fcf27bd4glw5