If you have very severe acne scars on your face, you may be a candidate for a more aggressive acne scar surgery to improve the appearance of your skin. Dr. Raffy Karamanoukian at Kare Plastic Surgery and Skin Health Center in Santa Monica offers the most comprehensive approaches to acne scar treatment in Los Angeles.
There are several types of acne scars that are visible on the skin, and these are related to how deep the scars are on your face. Atrophic acne scars refer to scars that are formed from cystic acne and pimples with destruction of the collagen in the dermis. These atrophic and indented acne scars include valley scars, boxcar scars, and ice pick acne scars.
It is important to choose a plastic surgeon who understands the complexities and options for laser resurfacing for acne scars and acne scars surgery. If you have undergone chemical peels and laser resurfacing with minimal improvement in your scars, then our Los Angeles plastic surgery practice may be the ideal option for your scar treatment. Dr. Karamanoukian is board-certified in plastic surgery and has a comprehensive cosmetic dermatology and plastic surgery center in Los Angeles.
Acne Scar Facelift: An acne scar facelift is an ideal option for patients who have severe acne scarring that is diffusely distributed on the face. By undermining and tightening the skin below the level of the dermis, we are able to pull the skin tighter in a natural way in order to improve the contour of the skin and release scar tethering and fibrosis that is causing some of the indented scars. After treatment, we will recommend a combination of laser skin resurfacing and TCA cross chemical peels to further improve skin contour, skin texture, and deep acne scars. Dr. Karamanoukian performs a specific type of acne scar facelift that allows us to achieve impressive results by our top Los Angeles plastic surgeon.
Laser Resurfacing for Acne Scars: For patients who wish to undergo a more conservative treatment but understand that they have severe acne scars on the face, we recommend a combination protocol that involves laser skin resurfacing, subcision, and TCA cross in our Los Angeles office. We evaluate your skin type first and determine whether you are a good candidate for skin undermining and laser resurfacing. The goal is to further improve skin tightness and contour using less invasive techniques that are non-surgical.
TCA Cross for Acne Scars in Los Angeles
Atrophic acne scars form when inflammatory acne destroys collagen and adipose tissue within the dermis, leaving a structural deficit beneath the skin surface. The dermis — a dense connective tissue layer composed primarily of type I and III collagen fibers, fibroblasts, and ground substance — is responsible for skin's firmness and volume. When dermal collagen is degraded during active acne, the overlying epidermis loses its scaffolding and collapses inward, producing the characteristic pitted appearance of ice pick, boxcar, and rolling scar subtypes.
TCA CROSS (Chemical Reconstruction of Skin Scars) exploits the wound-healing capacity of this dermal architecture. A high-concentration trichloroacetic acid solution (65–100%) is applied focally to the base of individual scars using a fine-tipped applicator. The acid causes immediate protein coagulation and controlled focal necrosis within the scar base, penetrating deep into the reticular dermis.
This targeted injury triggers a robust wound-healing cascade: fibroblasts are recruited and activated, stimulating the synthesis of new collagen and ground substance. Over several weeks, this neocollagenesis physically elevates the scar floor from within, gradually reducing scar depth and improving surface contour. Multiple treatment sessions are typically required for optimal results.
Recovery after Acne Scar Treatment in Los Angeles
Recovery after acne scar removal depends on the type of procedure you have performed at our Los Angeles plastic surgery practice. The Acne Scar protocols at Kare Plastic surgery vary in terms of downtime and recovery. For example, treatment of hyperpigmentation usually has minimal downtime and involves the application of topical creams such as Melarase AM and Melarase PM followed by Melapeel depigmentation peels in clinic. Acne scar subcision or TCA Cross, on the other hand, may have several weeks of healing and involve scabbing and crusting of the skin scars.
Dr. Raffy Karamanoukian is an experienced plastic surgeon with years of experience in the management of acne scars. His combination approach may include invasive lasers, subcision, acne scar surgery, and TCA Cross technique. If you have limited tolerance for downtime, we can design a specific protocol to marry the needs of your acne scars with the limitations of healing and recovery.
Proper post-treatment care is also very important after your acne scar treatment in Los Angeles. Many of our patients seek treatment from across the country, so we have mechanisms to temper their recovery and aftercare. Dr. Karamanoukian and his staff will provide you with specific guidelines for recovery.
Avoiding hyperpigmentation after acne scar removal depends on your specific skin type and preventative measures you take after treatment. Avoid direct sunlight, unless instructed to go in the sun for hypopigmentation. Our approach may include Melarase AM and Melarase PM depigmentation protcols.
Kare Plastic Surgery & Skin Health Center
804 7
th Street
Santa Monica, CA 90403
Consultations: (310) 998-5533
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