Single session of combined microfat and subcision in the treatment of Grade 4 atrophic acne scars

Severe atrophic acne scars (AAS) remain the "Achilles's heel" of AAS treatment. The combination of microfat and subcision treatment is a potential solution for severe AAS.This study aimed to evaluate the efficacy and safety of combined microfat and subcision treatment for severe (Grade 4) AAS.Data of patients with Grade 4 AAS who underwent combined microfat and subcision treatment between September 2016 and December 2020 were reviewed. Post-treatment evaluation was performed at least 3 months postoperatively. The severity of AAS was graded based on Goodman's qualitative classification. The volume of concavities was measured using an Antera 3D camera. Complications were documented.A total of 42 patients received a single treatment session. Excellent response was observed in 5 (11.9%) patients, very good in 13 (31.0%), good in 22 (52.4%), and poor response in 2 (4.7%). The average reduction of the total volume of concavities was 28.0%. The most common minor side effects were mild swelling and bruising. No major complications were observed.Combined microfat and subcision treatment is a safe and effective treatment for severe AAS. The approach will be a significant treatment for severe AAS.