10/17/2026
This patient is one month out from elliptical excision, where we removed his scar and narrowed it into a more superficial scar. The result is already looking excellent.
Today we assessed the next layer of the problem. His boxcar scars show significant fat loss with tethered, pulled-down tissue. This is a pattern we see often: the scar pulls the skin down in some spots while the surrounding skin thickens from constant tension as the tissue fights to stay in place. You can see this clearly when he smiles, the tethered areas pull downward while the skin around the edges bulges slightly.
The treatment plan addresses each component. Subcision will release the bound-down scar tissue from beneath, freeing the skin to lift back up. TCA Cross will be placed precisely into each scar to stimulate collagen production so the base rises over time. Bellafill will be placed in the areas of fat loss, with bovine collagen for immediate support and PMMA microspheres for long-term scaffolding. Finally, lasers will resurface the thickened edges and sand everything down to a smooth, even finish.
His post-inflammatory erythema, the red marks left behind from inflammation, will largely fade as the acne improves, but a laser can also target them directly if they persist.
Every scar pattern demands its own roadmap. No single treatment fixes everything, which is why we treat the depth, the tethering, the volume loss, and the surface as separate problems with separate solutions.
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skinrestoration