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Combo ablative and profractional lasering - my experience


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#1 Ava_Maria

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Posted 21 June 2011 - 05:43 PM

(Can't figure out why my photos aren't working...sorry! Any advice?)

My background:
I was on Accutane for a loooooong time - continuously for about 30 months, and on 80-100mg daily for the majority of that time. I came off Accutane in July 2010, so it's been about 11 months - and mostly it's been good and acne free!

While I didn't have a lot of deep, all-over scarring, I had pretty uneven skin texture and tone. It seemed silly to go through so much on Accutane, and not follow up with scar removal.

In November of last year, I had profractional laser resurfacing on both of my cheeks, and it worked well, but there were still a few marks. (I wish I'd taken photos! Silly me. Learned this time around.) If anything, I was more conscious of the few marks that were left when I had fewer scars!

So last week, I went back for another round.
In my pre-laser consult with my dermatologist, he asked if I could afford more that the four days off work that profractional lasering required... "well, no, not really," says I, "but I don't really care what my co-workers think of me, so what's the offer, doc?"

His suggestion was a combo effort of ablative lasering (frying off good and bad skin), and then spot-attack deeper scars with profractional. Cons - 10 days of looking like hell rather than four, more painful, more risk of infection, more expensive. Pros - much better results so I won't need another round, and because I've been such a long term patient he'd do me a good bargain! So I'm a sucker for a bargain, and I'm chasing top results, I don't care about down time - so, beam me up, Scotty.

Once the lasers came out:
A topical numbing cream was applied to my cheeks, and I was left to numb for 30 minutes. My dermatologist then gave me with 10 shots of local anaesthetic, 6 to the right cheek, 4 to the left. The numbing cream did nothing to stop the pain of the shots, but I would not have had it done without anaesthetic, no way, no how. (I'm also a wimp!)

The lasering machine is loud. And the smell of your own burning flesh is hardly a pleasant one. For the most part (thank you anaesthetic) it was painless, except for a few sweet spots close to my nose and close to my mouth, on my jawline, and under my eyes. And those spots hurt enough that I did go into mild shock by the end of it (shaking uncontrollably, sweats, crying). The pain was like...well, burning, obviously. The only thing I can compare it to is spilling boiling water on your hand.

The actual lasering took about 20 minutes all up.

The nurse slathered on some vaseline, strapped gauze to my face, and gave me some painkillers. For a couple of hours after the lasering, it feels like you're suffering pretty bad sunburn; hot, tingly, you can feel your pulse through it. It's pretty uncomfortable, but I haven't found this part of it terribly unbearable either time.

Once the bandages come off:
The worst part of post treatment is the first two days aftercare. It's disgusting, not for the weak of stomach. I found the hardest part touching the treated areas to keep them covered in vaseline :\

Posted Image

For about 24 hours post-treatment, you're a mess of blood, vaseline, and serous fluid. Keep plenty of tissues on hand, because you will have to wipe various fluids up before they drip off your chin. You have to sleep on your back, with a towel under your head, because there will be night-time drippage. And drink plenty of water. I woke up the morning after this round really, really dehydrated - another problem I didn't want to deal with!

But after those 24 hours, things get pretty good! For me, it was painless enough to wash (with lots of water, trying not to touch it too much, gentle cleansers only, maybe a very soft face-washer, and definitely a soft towel), all of the bleeding had stopped, and the wounds had stopped weeping serous fluid. It does take a bit of guts to touch the treatment sites, especially enough to apply the vaseline - I was definitely scared of hurting myself. After 24 hours, it was still pretty manky, but a lot better.

Posted Image


And four days after treatment, this is how I looked:

Posted Image


My treatment sites are still very pink, my skin is very dry and crusty without vaseline on it, but that's it! No pain, no bleeding, no obvious individual wounds. I will have to wear vaseline on the treatment sites for at least the next three days, but that should be it. It's pretty strange going to work, with gooey vaseline slathered over pink and peeling skin, but I am lucky to work with nice people and with no public relations!


Lasering gets pretty bad press, so I just wanted to share my experience.

Did it hurt? Yes.
Is it expensive? Yes. ($750AU for each treatment, and that was with a discount!)
Is it gross? Yes.
Would I do it again? Without question.


For me, it has been worth it all, but no one should go ahead with any procedure until they've done their own research and their own risk/benefit analysis. You should only go with someone you know is qualified, someone you trust completely.


If anyone has any questions, I'd be more than happy to answer them smile.gif

Edited by Ava_Maria, 21 June 2011 - 05:47 PM.


#2 hellohellohello

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Posted 22 June 2011 - 12:49 PM

Thanks for sharing your experiences. I'm interested in the fact that you are able to have ablative laser just for specific areas of your face, i.e. the cheeks. I was under the impression that you had to have it for the whole face if you had it done in order for the texture and color to be the same. Did your doctor have any comments about that? My daughter has quite deep scarring on one cheek and the other cheek has fairly light scarring and I'm curious if laser spot treatments can be done.

Thanks for any information you can share. It would be great if you could continue to post updates as your healing progresses. smile.gif

#3 Ava_Maria

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Posted 22 June 2011 - 05:13 PM

QUOTE (hellohellohello @ Jun 23 2011, 04:49 AM) <{POST_SNAPBACK}>
I was under the impression that you had to have it for the whole face if you had it done in order for the texture and color to be the same. Did your doctor have any comments about that?


Hi Hellohellohello smile.gif

I think there are a number of factors involved, like how well you heal, your skin texture prior to treatment, and how pale you are to begin with - I am a pretty fast healer, and I am very, very fair. My dermatologist commented that it is easier to treat fair patients, and it reduces healing time. I'm not sure if my treatment would have differed otherwise.

He did say that I will have pink patches (a rosy-cheeked look!) for a while - perhaps six or so months, but I am lucky that it was fairly even treatment on both cheeks, so it doesn't look too artificial while it does return to a 'normal' skin tone. The pinkness has already faded significantly to my normal skin colour on the edges of the treated areas.

Good luck to your daughter smile.gif

#4 hellohellohello

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Posted 23 June 2011 - 09:23 PM

Thanks for the good luck Ava Maria. I'm hoping that we end up with some decent results.

My daughter also has very fair skin, so I guess she has that going for her. Her skin is very delicate and sensitive though, so I'm a bit nervous on any treatments for her. She has an appointment with a highly regarded laser acne scar specialist at the end of the summer, so I guess I will see what he has to say. I'm not going to rush into anything though. Each dermatologist she goes to recommends something different, so it's hard to figure out what to do. Maybe I'll end up just waiting another year and see if she has any more healing of her scars while using Retin-A.

I'm glad to hear you're getting good results from the laser treatments, please keep us posted!

#5 Panic!!

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Posted 23 July 2011 - 10:57 PM

Great post Ava.

I wanted to get your opinion of just the profractional laser in your November treatment?

I have some shallow scars on both my cheeks that I f-in hate and after going on several consults, I finally found a derm I trust and like. He suggested one session of the Erbium Profractional Laser and said it will likely be all I need to get me to a point where I'm very pleased with my skin.

However, I've read lots of horror stories on lasers in general as well as some saying this particular laser doesn't work.

Of course I know it depends on the depth of the scars you have, the person doing the procedure and your expectations.

For me the doc said I have a 3-4/10 on a scar severity scale. Said I should see great results, but not to expect perfection. Which I realize and am completely okay with...

Was your scarring deep? Bad? Mild? Shallow?

Anyways, would love your feedback and also an update on how your healing and looking.

#6 Gerb00

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Posted 24 July 2011 - 11:41 AM

Hi there~

If you click on the "Browse" and then "Upload" links below the box to reply, you can upload the images. Then, if you click on the spot where the image uploaded, choose the first box. It is the option to insert the photo into the text area. I don't know if this is what you did or not, but this is what I do and it works.

I would love to see the pics~

Thanks for the post. Glad your treatment worked out well!~

Donna



QUOTE (Ava_Maria @ Jun 21 2011, 06:43 PM) <{POST_SNAPBACK}>
(Can't figure out why my photos aren't working...sorry! Any advice?)

My background:
I was on Accutane for a loooooong time - continuously for about 30 months, and on 80-100mg daily for the majority of that time. I came off Accutane in July 2010, so it's been about 11 months - and mostly it's been good and acne free!

While I didn't have a lot of deep, all-over scarring, I had pretty uneven skin texture and tone. It seemed silly to go through so much on Accutane, and not follow up with scar removal.

In November of last year, I had profractional laser resurfacing on both of my cheeks, and it worked well, but there were still a few marks. (I wish I'd taken photos! Silly me. Learned this time around.) If anything, I was more conscious of the few marks that were left when I had fewer scars!

So last week, I went back for another round.
In my pre-laser consult with my dermatologist, he asked if I could afford more that the four days off work that profractional lasering required... "well, no, not really," says I, "but I don't really care what my co-workers think of me, so what's the offer, doc?"

His suggestion was a combo effort of ablative lasering (frying off good and bad skin), and then spot-attack deeper scars with profractional. Cons - 10 days of looking like hell rather than four, more painful, more risk of infection, more expensive. Pros - much better results so I won't need another round, and because I've been such a long term patient he'd do me a good bargain! So I'm a sucker for a bargain, and I'm chasing top results, I don't care about down time - so, beam me up, Scotty.

Once the lasers came out:
A topical numbing cream was applied to my cheeks, and I was left to numb for 30 minutes. My dermatologist then gave me with 10 shots of local anaesthetic, 6 to the right cheek, 4 to the left. The numbing cream did nothing to stop the pain of the shots, but I would not have had it done without anaesthetic, no way, no how. (I'm also a wimp!)

The lasering machine is loud. And the smell of your own burning flesh is hardly a pleasant one. For the most part (thank you anaesthetic) it was painless, except for a few sweet spots close to my nose and close to my mouth, on my jawline, and under my eyes. And those spots hurt enough that I did go into mild shock by the end of it (shaking uncontrollably, sweats, crying). The pain was like...well, burning, obviously. The only thing I can compare it to is spilling boiling water on your hand.

The actual lasering took about 20 minutes all up.

The nurse slathered on some vaseline, strapped gauze to my face, and gave me some painkillers. For a couple of hours after the lasering, it feels like you're suffering pretty bad sunburn; hot, tingly, you can feel your pulse through it. It's pretty uncomfortable, but I haven't found this part of it terribly unbearable either time.

Once the bandages come off:
The worst part of post treatment is the first two days aftercare. It's disgusting, not for the weak of stomach. I found the hardest part touching the treated areas to keep them covered in vaseline :\

Posted Image

For about 24 hours post-treatment, you're a mess of blood, vaseline, and serous fluid. Keep plenty of tissues on hand, because you will have to wipe various fluids up before they drip off your chin. You have to sleep on your back, with a towel under your head, because there will be night-time drippage. And drink plenty of water. I woke up the morning after this round really, really dehydrated - another problem I didn't want to deal with!

But after those 24 hours, things get pretty good! For me, it was painless enough to wash (with lots of water, trying not to touch it too much, gentle cleansers only, maybe a very soft face-washer, and definitely a soft towel), all of the bleeding had stopped, and the wounds had stopped weeping serous fluid. It does take a bit of guts to touch the treatment sites, especially enough to apply the vaseline - I was definitely scared of hurting myself. After 24 hours, it was still pretty manky, but a lot better.

Posted Image


And four days after treatment, this is how I looked:

Posted Image


My treatment sites are still very pink, my skin is very dry and crusty without vaseline on it, but that's it! No pain, no bleeding, no obvious individual wounds. I will have to wear vaseline on the treatment sites for at least the next three days, but that should be it. It's pretty strange going to work, with gooey vaseline slathered over pink and peeling skin, but I am lucky to work with nice people and with no public relations!


Lasering gets pretty bad press, so I just wanted to share my experience.

Did it hurt? Yes.
Is it expensive? Yes. ($750AU for each treatment, and that was with a discount!)
Is it gross? Yes.
Would I do it again? Without question.


For me, it has been worth it all, but no one should go ahead with any procedure until they've done their own research and their own risk/benefit analysis. You should only go with someone you know is qualified, someone you trust completely.


If anyone has any questions, I'd be more than happy to answer them smile.gif






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