The use of the Sterimedix GTI Cannula® (Amar) in the management of facial scars and contour defects

Facial scarring, whether it is caused by trauma, surgery or acne, can lead to considerable psychological sequelae to patients. The size of the scar, as well as the cause of it, have been shown to lead to increased levels of anxiety and self-consciousness (Tebble et al, 2004). In the modern age of social media, patients are more aware of the presence of any facial scars and irregularities, and often seek treatment to improve the appearance and quality of the scars. World-wide, acne has been estimated to affect up to 90% of adolescents (Stathakis et al, 1997), and in specialist acne clinics, some degree of acne scars have been identified in more than 95% of patients (Layton et al, 1994).

Scarring is a physiological process and any injury to the deeper reticular layer of the dermis results in the formation of scars. These can be broadly categorised into hypertrophic scars, keloid scars and atrophic scars (Gu et al, 2018), with abnormal accumulation of extracellular matrix, mainly abnormal collagen, being the main cause of keloid and hypertrophic scars (Gu et al, 2018). An atrophic scar is sunken, pigmented or hypopigmented, and is often associated with facial acne (Gozali and Zhou, 2015). The inflammation that is associated with moderate to severe acne leads to dermal collagen and fat loss, resulting in the appearance of an atrophic scar (Fabbrocini et al, 2010). Histologically, the loss of collagen, elastin and dermal fat results in the downward pull of the epidermis, creating the sunken appearance of the scar (Yug et al, 2006).