AbstractBackgroundAcne scarring remains a difficult problem for patients and physicians. Often it is treated as a two‐dimensional disease with lasers and similar devices, whereas it is really a three‐dimensional problem. Fillers have been used for many years but recently fillers with more lifting potential have been made available and serve the purpose of the selective elevation of atrophic scars, adding the third dimension to treatment.MethodsFive patients with atrophic acne scarring were selected in this pilot study. Each patient was treated twice with a 3‐month follow up from the second treatment. A vertical modified tower technique was used with a hyaluronic acid filler to lift each scar and support the skin to adopt a more flattened appearance.ResultsThe mean scar count declined from 48.8 scars to 15.4 visible after the second session. The mean volume to total correction with filler of all scars declined from 1.144 mL to 0.525 mL from the first to second session. Global subjective improvement was assessed at 5.4 and 5.5 (−3 to +10 scale). The static objective grading scale showed an improvement from 3.2 at time of first treatment to 3.0 at the second, to 2.6 at final review.ConclusionsThe relative speed, accuracy and efficacy of high lift hyaluronic acid is shown in this small case series with subjective and objective measurement.