Dr. Sam Lam Plastic Surgery Forum

Dear Dr Lam. i would like to know your opinion on dermal pocket grafting treatment. i have had acne scars for many years, as i am now in my early 30thies they started to be more prominent. last year and half ive had number of different treatments: subcision dermaroller and chemical peels all for very little effect. recently i have decided (mainly to see if it works) to try hyaluronic acid based filler and it has made huge difference. its anyway fading very fast and i am now looking for more permanent correction. there are only two treatment options i am considering at this stage and thats silicone microdroplets and dermal pocket grafting. i know you yourself prefer silicone but still, what do you think about dermal grafting as with regards to precision and longevity of correction and would you recommend this treatment? I have some smaller boxcar scars and some larger broader contour defects. and i know you have been asked this before but is silicone compatible with afterprocedures like scar revision surgery? i know CO laser is not advisable after having silicone injected does this affect dermabrasion or fraxel laser treatment as well? thank you very much for your help.

i simply do not have enough experience with dermal grafting to speak intelligently about the results. i assume there are incisions to do the grafting. if so, i always believe any incisions create risk of further visible scarring. i find that in my hands for certain types of acne scarring that it is the best treatment i have ever seen. with the caveat that there is no miracle per se just incremental improvements. i don't have a problem with using silicone in many circumstances even after co2, scar revision, etc. that is my opinion. hope that helps as a start for you.
best,
sml

dear Dr Lam, thank you very much for your response. i have made up my mind towards silicone as i had the incision aditional scarring issue with dermal pocket grafting as well plus its permanency which is questionable. i live in england and have just found specialist who will do silicone for me here, hopefully with as gratifing results as are the onces you deliver to your patients every day.
yours sincerely,
askin

best wishes. always ask to see his/her work before deciding on jumping in. also just make sure he or she is using Silikon 1000 and not a cheaper version. in addition, just make sure the doctor understands microdroplet technique. stay safe.
best,
sml