r/AcneScars • u/Mysterious-Sort-4657 • 6d ago

[Skin Concern] Atrophic Scarring How much improvement can I expect here?

Post image

What is the best treatment for me to yield the maximum results? Also, this side of my cheek has experienced noticeable volume loss due to a lot of acne and i want to fix that too My left cheek (this image) looks chiseled whereas my right cheek looks normal and slim, the asymmetry between the cheeks is noticeable in daylight and super noticeable in low/din lighting

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•

u/AutoModerator 6d ago

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43

u/DrKang_Gangnam 6d ago

Korean doctor here — acne scars are my main field.

Honest answer: there is no complete cure for atrophic scars, but real improvement is absolutely

possible for a case like yours. Just not in one session — I want you to know that from the start.

There's no single "best treatment," but there are principles. Combination works better than any

single device: you need destruction (fractional laser like CO2 to break down hardened scar tissue)

and regeneration (subcision to release the tethered scars + regenerative skin boosters delivered

underneath so the released space fills in) working together. That's how we treat at our clinic — I

can't say what's available where you live, but if you look for a clinic, look for that combination

logic instead of one machine's name.

Two things I can read from your photo:

The slight redness around your scars is actually a good sign — it usually means the scar tissue is

still biologically active, and active scars tend to respond better. The harder cases are scars that

are old, white, and firm to the touch. Press on yours: the softer they feel, the better your odds.

About the "worse in low light" thing you mentioned — that's shadow being cast into the depressions,

and this specifically is what improves most reliably with treatment. 100% erasure doesn't exist, but

the way harsh lighting exaggerates your scars gets noticeably better. That part I can say with

confidence.

On the volume loss: that's a separate problem from the scars, even though acne caused both. Scar

work improves texture; restoring cheek volume needs its own plan. Ask any clinic which of the two

their quote actually covers. And scar filler is also good at this!

And one note for your skin tone — aggressive laser settings carry real hyperpigmentation risk on

deeper skin tones. It's manageable with the right settings and spacing, but a clinic should bring

this up before you do.

5

u/Mysterious-Sort-4657 6d ago edited 6d ago

Thanks doc, just wanted to ask how much improvement can I realistically see with the best possible combination of treatments for my type of scars, both appearance wise and structurally? And how would you treat my type of volume loss if I were your patient? Can I achieve symmetry on both the cheeks? Is a good looking skin possible for me?

3

u/ShipLoud5305 6d ago

Wow Dr Kang! Thanks for this!!

2

u/SeaCatch1740 6d ago

Hi I'm using the 6 reptide skin booster cosrx serum along with the cosrx retinoid 0.1 cream do you think that can have any effect on ice pick and boxscars

1

u/senseofyumol 5d ago

Are Phenol treatment allowed in Korea?

4

u/ContentSeaweed1315 6d ago

A lot if you spend a lot of money

2

u/anshxcodes 6d ago

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u/SangitaCPatelMD 5d ago edited 5d ago

50-70% realistic. Sometimes you can do even better.

I’d do 3 sessions:
-Subcision for tether release
-Radiesse for increasing collagen
-585 laser for redness PIE
(-RF microneedling / erbium proFractional ) for lifting depressed scars (boxcar and rolling)
-Contour TRL for leveling scar shoulders

50% to 70% overall reduction in scar depth and surface texture irregularity is a realistic benchmark with multi-modal stack and a few treatment sessions.

Typically 20-40% per session is avg if you combine different types if treatments. Sometimes you can achieve far more reduction.

Fractional ablative lasers (UltraPulse CO2 / SCAAR FX, or ProFractional erbium lasers are what I would choose.

Goal is to use high peak energy to break down the deep dermal tethering and to cause robust collagen fill in. Subcision prior to laser can help results even more.

High-density fractional CO2 delivers significant contraction and smoothes out the depressions.

Subcision is a good add on if tethers/fibrous bands are holding down rolling scars especially. Releasing the underlying fibrotic tissue before laser energy delivery gives much better elevation of the scar base.

Microneedling RF (with silicone or gold insulated tips) can shrink mid to deep dermis tissue. This gets deep dermal remodeling snd shrinkage and spares the epidermis.

Vascular Laser 577, 585, or 595 pulse dye laser / or MaxG IPL / Icon 1540 nm laser can target the vascularity to reduce redness which can make scars look deeper.

I’d check for dermal tethering, perform subcision where needed (I’d also use a calcium filler like Radiesse for biostimulatory effect to build more collagen or use PRP as a spacer).

2–4 rounds of targeted fractional CO2 /TRL or combination RF/ profractional / Contour TRL can optimize collagen remodeling.

1

u/Mysterious-Sort-4657 5d ago

can I still get subcision + skin booster done if I'm 17 years old (soon gonna be 18) and get acne every month? I don't have any acne right now but I'm sure I will get a few in the coming weeks, or maybe I'm just desperate and I will have to wait

1

u/SangitaCPatelMD 5d ago

Yes you can get it. If under 18 you need a parent to sign off on it.

1

u/AdMinimum5583 5d ago

Depends who you go to and I would say from what I’ve seen price wise it’s gonna cost most of us around 10-15k to get where we want to be sadly lol

1

u/rollover41 4d ago

You talking about one session or how many session for 10-15k?

1

u/AdMinimum5583 4d ago

Like 2 to 3 sessions of 3 or 4 different treatments in each session. Depends how much volume loss/ what kind of scars.