I think it really comes down to the skill of the doctor. I think most of the hyaluronic acid fillers are like Coke and Pepsi, meaning there's nothing inherently special about a particular one. Just make sure you have the doctor use severe angled lighting to really highlight the indentation. Belotero is thinner and so it may be less lumpy than something like Restylane, which can feel a little hard when used superficially in acne scars.
I've had cortisone dents before and yes they have filled in. There might have been one or two that never recovered fully, but they all seemed to resolve to varying degrees. I understand your concern though that you feel your skin is prone to scarring after any kind of trauma. But there's no way a temporary filler will do any damage.
Thanks for the clear pictures. I'd classify them as mostly rolling scars with volume loss, especially on the left cheek area. For this, I think the most effective thing to start with would be possibly multiple subcisions and suctioning. Fillers would also work to restore some of the lost cheek volume. For that you have options that are temporary or permanent. Temporary fillers include Voluma, Restylane. Permanent fillers include Bellafill and a small minority of doctors use liquid silicone, although that is very controversial and always used off-label (meaning that it is not approved for dermal injections, but it can be used that way). Permanent fillers in general are considered controversial, and there are some doctors who think they should never be used, and others who think that they have a place if used only in specific indications like for scars. The risks include granulomas (lumps in the areas injected), rejection of the material, and poor technique which may be difficult to reverse because of it's permanent nature.
This video is of a patient getting injected with Bellafill and he has pretty deep scars with volume loss.
FYI, usually cortisone atrophy does correct itself, but it could take many many months. There was a girl here who started a super long thread detailing her botched cortisone injections. The indentation on her chin area was significant, but I think it ultimately filled in for her. So don't lose hope yet.
I'm not sure what your doctor means by saying you have too much scar tissue for subcision.
I've had a few resurfacing procedures done including both laser and dermabrasion, and it always looks nearly flawless with the microswelling. Then once that starts to dissipate, the scars will reappear. The true results are only appreciable after several months.
I think it might work well for your scars, but always have realistic expectations because it comes down to the doctor's technique. What I notice is that the scarring is causing volume loss in your cheek area, which gives the face a more sunken appearance. I think injecting some of the filler a little deeper to give the cheek volume and structure will help with the overall look of your face and reduce shadowing. This is something I find that a lot of doctors don't understand. They just try to inject the indentations, which don't get me wrong is very important, but they forget that deeper acne scarring can cause volume loss, which makes the overall appearance of the scars and face more pronounced.
So I'd say use some filler to add a little bit of volume to the cheek area directly beneath the area of fat loss, but don't use too much or you might look too full in the mid face. We don't want to look like a real housewife. Then you can inject the individual scars.
The other option is just to do subcision alone and add suctioning and see how much improvement you get from that. This route might take longer although the results will probably be more permanent. If you have money to burn and want to get improvement right away then subcision and filler would accomplish that. Again, it really depends on the skill of your doctor.
AND MARK YOUR SCARS YOURSELF. Bring a marker or eyeliner to mark them because doctors don't see the scars the way you do. Be sure to have them use a strong angled light to really highlight those scars. Flat office lighting makes scars look less prominent.
Really? Sorry if you already explained, but I'm assuming you are in Europe? That filler is not approved here in the US, so I was curious. That's the first time I've ever heard about a doctor just giving the patient the syringe to take home.
I don't think the filler can seep out. It might be possible that the needles and pressure may shift the filler out of place.
Vbeam is the best way to quickly get rid of red marks.
Accutane may impair wound healing due to it's ability to dramatically shrink sebaceous glands. I agree, however, that it is more likely that the people who use Accutane are the ones with the most severe scarring forms of Acne. It is also possible that people with severe acne also have a genetic defect in the way they heal, which is why they scar so badly to begin with and it's being incorrectly attributed to the Accutane. Correlation does not mean causation. That said, I believe the fear over Accutane is often WAY overblown and irrational. Personally, Accutane saved my skin from getting even more scarred than it already was.
I'll admit, I do get frustrated easily with people on here who post pictures of their minor scarring and claim that it has upended their lives. I think most of them know it's not bad, but are seeking validation (albeit in a very disingenuous, childish way). I agree with Factoid, after a certain threshold of acne scarring, it is hard to simply "get over it." FaultlessFire, I know you stated that because of your own acne scarring, you are actually more scrutinizing of scarring than the average person. Actually, I think that because all of us here suffer from acne scars we have a more realistic and nuanced view of what constitutes mild vs. severe scarring. We have all done so much research and seen so many pictures of acne scarring, that we know what TRULY severe acne scarring looks like. It's become normalized for us to see these levels of scarring. The average person on the street does not have this nuanced view, so to them TempleofDoom's scarring might very well be considered severe, even though to us we know that it isn't even anywhere near the pictures above. The average person who does not suffer acne scars would never even think of searching for such shocking pictures like the ones above to begin with.
I don't think it's self-pitying to discuss out in the open things that we know are the truth. People do comment and bully people for visible differences. Think of how many times we've heard people slam someone for being fat, short, bald, or whatever. AND all of those things are extremely COMMONPLACE. If people have the capacity to be cruel over things like that, why is it so hard to believe that people can be especially cruel about a condition like acne scarring (which is actually not common at all).
I for one, can relate to TempleofDoom's feelings. If we only had to deal with the occasional asshole here and there who makes a rude comment, I think most of us could brush it off. That said, if one's scarring is severe enough that people stare and comment everywhere, even the strongest person gets worn down over time. And remember, our metric for what's severe is not the same as the general public. We're only human.
What do you mean when you say he gave it to you? Did he give you the actual syringe? Is the second subcision going to be done on untreated scars or the same scars? I would think that another subcision in an area just recently injected would shift and displace the filler already injected.
Lucas, I didn't start this topic, and I certainly am not self-pitying. First of all, the clear difference is that I've expended an incredible amount of my own resources learning, and failed multiple times through trial and error with countless treatments. I've read and learned from others on this board. I didn't start this thread, and what I was doing was simply commiserating with the OP because I thought he made a good observation. I thought it was important to let him know that he's not alone in those observations, and that people do judge harshly sometimes. If I sat around and did nothing, then perhaps you might have a point. I think in your situation, many people have tried to give you constructive advice, but you have shot down everything others suggest and then got into some diatribe about how classist and elitist it was to assume that everyone could afford medical treatment. Your tone was aggressive towards people simply telling you what worked for them. What I was trying to say in the other thread, perhaps not very elegantly, is that it's fine to vent but you need to take some action and don't be so defensive when others try to help. They've walked down the road before.