Scar tissue can be hard to eradicate and clear off, especially in people with persistent acne problems. Treatments and products have flooded the Singapore market and various solutions for dealing with acne marks and scars can be confusing too. Dermal fillers can be effective for facial sculpting, but how well do they actually work for scarring?
Dr Chin Yee Choong is the medical director of Dermclear Aesthetic & Laser Clinic. He responded to a couple of DoctorxDentist reader questions about the differences between the many fillers available in Singapore, and whether or not they are effective solutions for scars. Here is his advice.
What are fillers and how do they work?
Injectable fillers can be best described as soft tissue fillers that are inserted into the skin to help fill in facial inconsistencies like wrinkles and scars. This helps restore the skin, making it appear smoother and clearer. In some cases, more than one filler injection may be required for optimal results. 
Bellafill fillers are effective permanent filler implantations
This FDA-approved dermal filler functions as a permanent solution for the correction of nasolabial folds (or smile lines). It is inserted into the skin and, unlike many other dermal fillers, is considered non-resorbable. This means that Bellafill will not be absorbed and will not require reinjection.  
Can silicone as a dermal filler work just as well?
Medical-grade silicone can be used as a filler as it also yields permanent results. It’s generally used to smoothen lines and remove wrinkles. However, many doctors think that silicone can be unpredictable when used as a dermal filler and there are some complications that can arise. These complications include bruising, swelling, and pain or more severe problems such as infection, allergic reactions, or skin necrosis. 
What about Sculptra facial dermal fillers?
Sculptra facial dermal fillers are unique as alternatives to hyaluronic acid fillers because they can help stimulate the skin's own natural collagen production, restoring its inner structure and increasing volume in order to fight ageing. 
Fillers may not be the best option for some scars
In some cases, Dr Chin noted that dermal fillers may not work very well against certain types of scars such as rolling scars or other depressed (atrophic) scars. This is because atrophic scars are often caused by a pull on the skin's surface by fibrous scar tissue. As a result, these scars are non-stretchable and results may not be good. 
Hyaluronic acid might be slightly better for scars
As a dermal filler that elevates rolling scars, hyaluronic acid may be a better choice as the substance can be injected beneath the rolling scar to lift it temporarily. Even then, final results may not be ideal. 
There are other treatments that may be more effective
Rolling or atrophic scars may improve with much better results possible through procedures that release the underlying scar tissue. These procedures include subcision (manual release using an inserted needle) or fractional energy devices such as fractional CO2 laser.
Ultimately, dermal fillers differ greatly in composition, longevity, placement level and approved indications. They might not be the best treatment for all scars. Patients should consult their doctors and get a proper evaluation as well as accurate suggestions regarding the treatment choices that could work best . 
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