Fat Grafting for Acne Scars in Pune: Lifting Scars from Underneath

What is fat grafting for acne scars?

Fat grafting for acne scars is a form of fat grafting aimed at depressed acne scars. Severe acne can destroy fat and collagen under the skin and leave fibrous bands that pull the skin down. The result is a dent or a wave-like surface that no cream can fill.

The procedure works in two ways:

• Volume: fine fat placed under the scar lifts the dent.
• Skin quality: fat contains cells and growth factors that may improve the texture and softness of the scarred skin. Very finely processed fat (nanofat) is sometimes used for this.

A summary of the main scar types and every treatment option is in acne scars treatment options.

Who may benefit, and how is suitability assessed?

You may benefit if you have:

• rolling or tethered scars that look like soft dents or waves;
• broad, shallow depressed scars or a hollow look in the cheeks;
• acne that has been under control for several months;
• enough donor fat, stable weight and good general health.

The doctor will examine the scars in different lighting, stretch the skin to see which scars lift (these usually respond well), and ask about current acne treatment, isotretinoin use, keloids, smoking and medicines. Narrow ice-pick scars and sharp boxcar scars usually need other methods.

What are the options for depressed acne scars?

Option	What it can do	Limitations
Subcision with fat grafting	Releases tethered scars and fills them with your own tissue	Swelling; some fat reabsorbs; a donor site
Fractional CO2 laser	Improves surface texture and shallow scars	Several sessions; redness and downtime
Dermabrasion	Smooths raised edges and the surface	Downtime; pigment changes in darker skin
Microneedling, with or without PRP	Gradual texture improvement	Several sessions; modest change
Hyaluronic acid fillers	Quick, temporary lift of rolling scars	Lasts months
Punch excision or elevation	Treats deep ice-pick and boxcar scars	Small stitches; individual scars only

Combining two or three methods usually gives more improvement than any one alone.

How is fat grafting for acne scars performed?

1. Marking: the scars are marked in good light, with you sitting up.
2. Anaesthesia: local anaesthetic, with or without sedation.
3. Fat harvest: a small amount of fat is taken from the abdomen or thighs through a tiny opening with a thin cannula.
4. Processing: the fat is cleaned and, for fine work under the skin, made smoother by passing it between syringes.
5. Subcision: a fine needle or blade is passed under tethered scars to cut the bands holding them down.
6. Injection: the fat is placed in tiny amounts under each scar and across the area, through small needle openings.
7. Dressings: small dressings are placed, and a light garment may be worn on the donor area.

How should you prepare, and what should you ask?

• Make sure active acne is controlled; ask your dermatologist how long to wait after isotretinoin.
• Stop smoking, which reduces fat survival.
• Keep your weight stable.
• Plan a week or two away from important events.

Questions to ask:

• Which of my scars are likely to respond to fat, and which need another method?
• Will I need laser or a second session?
• What will the donor area look like?

What is recovery like?

Time	What to expect for most patients
Days 1-3	Swelling and bruising of the face and donor site; tightness
Week 1	Bruising fades; many return to desk work; avoid pressing or massaging the face
Weeks 2-4	Most swelling settles; the area may look slightly overfilled at first
Months 3-6	Reabsorption is complete and the lasting improvement is clear

What are the risks?

• Swelling and bruising, expected.
• Reabsorption, so less improvement than hoped, sometimes needing another session.
• Lumps or unevenness, more likely where the skin is thin.
• Infection, uncommon.
• Donor-site problems, such as a small dent or numbness.
• Fat entering a blood vessel: very rare but serious, with reports of vision loss or stroke after facial fat injection. Blunt cannulas and small amounts lower this risk.

Seek urgent help for sudden vision change, severe pain or skin colour change in the treated area. Contact the clinic for fever, spreading redness or a growing lump.

What results can you expect?

Most people see softer, shallower scars and a smoother contour, rather than scars that disappear. Published reviews report improvement in most patients, with variable fat survival. Results are usually better when combined with surface treatments.

What affects the cost of fat grafting for acne scars in Pune?

• Extent of scarring and areas treated.
• Combined treatments, such as laser or subcision.
• Number of sessions.
• Anaesthesia and facility.
• Follow-up visits.

Acne scar treatment is usually considered cosmetic and not covered by insurance.