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Man in the Mirror: Pre and Post Subcision Photos

subcision tca

Best Answer alex13, 07 June 2013 - 06:09 PM

Hey guys, I have had a pretty nasty acne since age 14 (the worst - cystic acne) and now it seems I managed to reduce it to one or two pimples (no milk, no cow products, no sugar or spicy foods) :(. I am 22 now I got a few nasty scars and dont know how to get rid of them. I didn`t read all your thread but I want some expert advice from you !

 

In my country - romania - we don`t have lots of options for acne scar treatments and the one that are available are very expensive, but I want to try one of these :

 

1. Microdermabrasion with cristals

2. Microdermabrasion with diamonds

 

They say it would help a lot, the one with diamonds seems to be better. What do you guys think ? should I give money for something like that ? and also, is there any cream that I should search for ? or maybe some natural stuff that I can eat ? however the scars are pretty old , 7 years old and i don`t know if anything internally would change them. Please respond with your info ! I really need it.

 

I aprecciate a lot, Alex

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#21 KnicksRock

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Posted 22 April 2009 - 01:54 PM

Thanks for the fast replies Matt. I appreciate it.

As I am 23 and still a bit acne prone this will be purely a consult. I have a better idea of what I can ask him now.

As my scars are particularly deeper and I have depressed and icepicks only really on my right cheek I have come to the conclusion that I need surgical procedures such as subcision or punch grafting done on my right cheek.


I think the best treatment for myself will likely be subcision followed by a TCA cross in the future after it heals or microdermabrasion or some form of laser to even it all out...or just a deep chemical peel.

My left cheek oddly is great. I have pretty much no indents there and my skin is pretty resilient to acne scarring. My right cheek it seems is weaker towards it and I have 1 particular depressed scar about a CM in length that is fairly deep and is the mains car I want to get fixed, then I have 1 that is a little smaller and 3 smaller than those that I would like to get fixed.

I think subcision followed by something to smooth out the overall appearance of my skin would be effective. Or a punch graft.

Not sure which yet.

I see that you did TCA cross only on select areas.... at first I was under the impression that you did it to your whole face after or before subcision which is why I was confused because TCA cross seems like something pretty powerful and it wouldn't make much sense to do it on an area you are having a surgical procedure on the same day.


BTW did you go under local anesthesia? How does that work? Were you awake?

As results in the first week are usually amplified and 2nd week look worse.


You find your results to be optimal the 4th week?

I will likely take off a week from work when I decide to finally do this.


QUOTE (just another1 @ Apr 22 2009, 12:28 AM) <{POST_SNAPBACK}>
Your results are impressive Matt! I hope your next couple sessions work even better for ya.



#22 mr. matt

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Posted 22 April 2009 - 05:10 PM

QUOTE (KnicksRock @ Apr 22 2009, 02:54 PM) <{POST_SNAPBACK}>
Thanks for the fast replies Matt. I appreciate it.

As I am 23 and still a bit acne prone this will be purely a consult. I have a better idea of what I can ask him now.

As my scars are particularly deeper and I have depressed and icepicks only really on my right cheek I have come to the conclusion that I need surgical procedures such as subcision or punch grafting done on my right cheek.


I think the best treatment for myself will likely be subcision followed by a TCA cross in the future after it heals or microdermabrasion or some form of laser to even it all out...or just a deep chemical peel.

My left cheek oddly is great. I have pretty much no indents there and my skin is pretty resilient to acne scarring. My right cheek it seems is weaker towards it and I have 1 particular depressed scar about a CM in length that is fairly deep and is the mains car I want to get fixed, then I have 1 that is a little smaller and 3 smaller than those that I would like to get fixed.

I think subcision followed by something to smooth out the overall appearance of my skin would be effective. Or a punch graft.

Not sure which yet.

I see that you did TCA cross only on select areas.... at first I was under the impression that you did it to your whole face after or before subcision which is why I was confused because TCA cross seems like something pretty powerful and it wouldn't make much sense to do it on an area you are having a surgical procedure on the same day.


BTW did you go under local anesthesia? How does that work? Were you awake?

As results in the first week are usually amplified and 2nd week look worse.


You find your results to be optimal the 4th week?

I will likely take off a week from work when I decide to finally do this.


QUOTE (just another1 @ Apr 22 2009, 12:28 AM) <{POST_SNAPBACK}>
Your results are impressive Matt! I hope your next couple sessions work even better for ya.



I think that you're really wise to have your procedure done while you are young and you are fortunate that you scarring is limited to only one side of your face.

If you have icepick scars, TCA Cross Method is definitely something you should discuss with your doctor.

My dermatologist did inject the areas surrounding my scars with anesthesia and I was awake and talked with my doctor throughout the procedure. The shots themselves were more painful than either the Cross or subcision procedures.

The first week my skin did look perfect. By week two, the swelling had subsided and the scars began to re-appear. I knew to expect this based upon photos I had seen on the internet and from others' comments. Between weeks three and four, my scars began to fill in from underneath.

I could feel a "tingling" sensation which I believe was the collagen remodeling. In fact, I still feel it from time to time.

I just got an LED unit last Saturday and have been using it everyday for five to ten minutes. I hope that this will help promote collagen remodeling in my right cheek. Only time will tell.

My right cheek still needs a lot more improvement, but the scars are somewhat flatter than they were. My left cheek, however, has improved tremendously and for that, I am grateful. biggrin.gif \

Hope this helps.

#23 Emhfali

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Posted 23 April 2009 - 12:00 PM

hey mr. matt
really great results, your story has convinced me to perform subcision on my scars.
some of my scars are a little bit deeper than yours, do you think there's a limit in treating deep acne scars with subcision? can be acne scars too deep to treat with subcision?
i'm 18 and i'm still on accutane. how long i have to wait till i can go to a dermatologist or an surgeon who performs subcision? if i chose laser treatment i would wait 6 months after accutane. the same at subcision?



#24 KnicksRock

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Posted 23 April 2009 - 12:06 PM

Matt,


I just thought I'd let you know how my consult went. The doctor and the nurse didn't think subcision would be the best idea for me even for the couple of deeper ones on my right cheek. From everything I read in my research I thought those would be the best two options.

For now they said for me to continue use of tazorac until acne is completely clear and everything and they also said that tazorac can remodel skin with 12-24 months of use. I agree that I should stay on Tazorac until all redness and acne are completely gone and perhaps it can even improve scarring.

The doc and the nurse seemed to think that subcision would leave behind a worse scar than the ones I currently had. I know the subcision leaves something behind, but do you agree with this assessment? He described my scars on my right cheek as rolling scars. He performs a laser surgery at his place but he said my skin was too young for that type of laser...but he recommended a doctor with Fraxel and said it would probably take me 5 or 6 treatsments to get where I want to be.

I asked him about subcising the scars first but he didn't think it was necessary. I don't really know what to think or do. I agree that for now I'll stay on my current regiment but am not sure what my next step would be. The nurse seemed to think that a series of facial peels would probably help me significantly.

What do you think?

#25 mr. matt

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Posted 23 April 2009 - 12:57 PM

QUOTE (Emhfali @ Apr 23 2009, 01:00 PM) <{POST_SNAPBACK}>
hey mr. matt
really great results, your story has convinced me to perform subcision on my scars.
some of my scars are a little bit deeper than yours, do you think there's a limit in treating deep acne scars with subcision? can be acne scars too deep to treat with subcision?
i'm 18 and i'm still on accutane. how long i have to wait till i can go to a dermatologist or an surgeon who performs subcision? if i chose laser treatment i would wait 6 months after accutane. the same at subcision?


Hey, I'm glad to hear that you were inspired by my story. I know that I have been greatly encouraged and inspired by some of the other posts and pictures of other readers.

Six treatments with subcision is the maximum number of times that I have heard that most doctors will do on rolling scars. However, I am sure that depends upon each individual and his/her unique scars.

As far as acne scars being too deep to treat with subcision, I honestly don't know. But, you should keep in mind that it's the fibrous bands that hold down the epidermis to the underlying tissue. So, if these are cut, then the epidermis is free to be released from the "tethers" that are holding it down and the skin can raise itself with the collagen production that is induced by the procedure.

The scars on my right cheek are very deep. However, I have noticed that they have flattened out since my initial treatment with subcision.

You will need to wait for approximately six months after you've completed Accutane before anything can and/or should be done surgically to your skin due to the increased risk of scarring.

However, I think that it is important to talk to your doctor now about what type of scars you have. If you have rolling scars, then subcision may be a good option for you and I would go ahead and get the appointment(s) scheduled for the procedure. It took me three months after my initial consult with my doctor to get it scheduled due to his busy schedule. You would be wise to go ahead and get at least two sessions scheduled now. One in about seven months after you've finished Accutane and one two months after that. You skin will need some downtime after the first procedure in order for the collagen to remodel.

I have two more rounds scheduled. One in May and one in July.

If you do have rolling scars, I would suggest a round of subcision followed by laser and another round of subcision followed by laser.

I'm going to have a Pearl Laser treatment either in July to replace the subcision treatment I have scheduled or I'll have it done in December. I've been told it takes seven to ten days to recover from this type of laser treatment.

Keep us all posted on your progress.

#26 mr. matt

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Posted 23 April 2009 - 01:13 PM

QUOTE (KnicksRock @ Apr 23 2009, 12:06 PM) <{POST_SNAPBACK}>
Matt,


I just thought I'd let you know how my consult went. The doctor and the nurse didn't think subcision would be the best idea for me even for the couple of deeper ones on my right cheek. From everything I read in my research I thought those would be the best two options.

For now they said for me to continue use of tazorac until acne is completely clear and everything and they also said that tazorac can remodel skin with 12-24 months of use. I agree that I should stay on Tazorac until all redness and acne are completely gone and perhaps it can even improve scarring.

The doc and the nurse seemed to think that subcision would leave behind a worse scar than the ones I currently had. I know the subcision leaves something behind, but do you agree with this assessment? He described my scars on my right cheek as rolling scars. He performs a laser surgery at his place but he said my skin was too young for that type of laser...but he recommended a doctor with Fraxel and said it would probably take me 5 or 6 treatsments to get where I want to be.

I asked him about subcising the scars first but he didn't think it was necessary. I don't really know what to think or do. I agree that for now I'll stay on my current regiment but am not sure what my next step would be. The nurse seemed to think that a series of facial peels would probably help me significantly.

What do you think?


I'm surprised that he advised against subcision for your rolling scars. Honestly, I think it makes more sense to subcise rolling scars BEFORE they are treated with any type of laser as subcision deals with the root cause of the rolling scar: fibrous bands holding down the epidermis.

If you still have active acne, the chemical peels may actually help reduce your acne. I've used Glycolic and Lactic Acid as chemical peels. The Glycolic Acid is actually a harsher acid and will cause peeling. The Lactic Acid is not as harsh and the downtime is significantly less.

I would suggest that you look at buying 20-30% Lactic Acid off of
E-bay and try this every other week. It should help your overall skin tone and may help with any outbreaks.

Based upon what I've read on the internet so far, I'm not real impressed with Fraxel. My doctor recommends the Pearl Laser as if he feels that it is more effective in producing collagen remodeling than the Fraxel. I'll be getting a Pearl Laser treatment either in July or December of this year.

You may want to ask your doctor if he has performed subcision before. Most dermatologists I've gone to were not familiar with the procedure. That could be why he is recommending against the procedure.

Hopefully, you'll find the course of treatment that works best for both your acne and your scarring.

Matt


#27 uofababy

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Posted 23 April 2009 - 07:07 PM

Hey Knicksrock- I've had the same problem finding a doctor willing to preform subcision even though most doctors know that the patient will see improvement! My best guess is why should they suggest subcision which is relatively cheap when they can suggest lasers for thousands? I'm going in to see a new doctor next week and I'm going to try a new approach I'm not going to ask about subcision I'm gonna TELL him I want it done and thats it....We will see how that plays out By the way my scars are exactly like Mr. Matts so I know for a fact it would help me!

#28 carmusen

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Posted 26 April 2009 - 11:40 PM

How much did you pay in total?

#29 mr. matt

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Posted 27 April 2009 - 05:03 AM

Because I've been a long-time patient of my dermatologist, he gave me a substantial discount.

I only paid $200 for my subcision and TCA Cross (Chemical Reconstruction of Scarred Skin) Method treatments.

Of all of the things that I have done to help improve my scars, this has been the only thing that has actually worked.

I had three Laser Genesis laser treatments two years ago with absolutely no results, I've had more than 50 chemical peels and cryrotherapy and none of these treatments did anything to improve my scarring.

Ninety percent of my scarring was due to rolling scars. So, subcision was the right treatment option for me. I'm going back for round two in May.

I would encourage you to talk to your dermatologist/surgeon and see what the best option for your scarring might be.

Matt

#30 KnicksRock

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Posted 27 April 2009 - 02:38 PM

it sucks because it says he performs subcision and he even said that he could do it...but they seemed to think that it could make the scar look worse rather than better??

I don't know if his opinion is good or not yet, am still debating...because he didn't try to sell me on his laser, but he referred me to a guy that does fraxel and said 4-6 treatments to get where I'd want to be, if he wouldn't be benefitting from the sale of the treatment is it possible he is telling the truth?

I agree I should continue to really look and find someone that is capable of doing this right.

As far as my active acne it is almost pretty much gone for a month now, tazorac has pretty much cleared me up.

He also recommended that I stay on the tazorac for at least 12 months- 24 months before doing anything for scarring because of "it's ability to remodel skin".

So I agree with him on staying on the tazorac for at least 6-9 months more and then slowly trying to find the right doc to do the procedure. I certainly don't want subcision to make it worse...but I feel that it is probably one of the better options.

#31 KnicksRock

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Posted 30 April 2009 - 11:54 AM

matt,

question:

what did your doc say about risk to make the scarring worse: that seemed to be the main reason they didn't want to perform the procedure on me or warned me about it.

Any further info on this topic would be very helpful. I think subcision definitely needs to be done on my deeper ones and do not see how any laser treatment can bring it up to level. It simply doesn't make sense! I don't have the worst scars in the world but I mean it is there and I notice it and it upsets me so I need to do something about it.

My acne is pretty much almost clear now on a ligher note. Have you ever used any retinoids like retin A or tazorac btw? Just wondering.

YOu had over 50 peels? That is a lot of peels. Were they strong peels?

TCA cross is basically a peel just concentrated at a higher percentage right?

How bad were the scars the subcision left behind?

Honestly if I found a doctor that could do this in a different state and was skilled at it I would probably fly out.

#32 mr. matt

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Posted 30 April 2009 - 04:04 PM

QUOTE (KnicksRock @ Apr 30 2009, 12:54 PM) <{POST_SNAPBACK}>
matt,

question:

what did your doc say about risk to make the scarring worse: that seemed to be the main reason they didn't want to perform the procedure on me or warned me about it.

Any further info on this topic would be very helpful. I think subcision definitely needs to be done on my deeper ones and do not see how any laser treatment can bring it up to level. It simply doesn't make sense! I don't have the worst scars in the world but I mean it is there and I notice it and it upsets me so I need to do something about it.

My acne is pretty much almost clear now on a ligher note. Have you ever used any retinoids like retin A or tazorac btw? Just wondering.

YOu had over 50 peels? That is a lot of peels. Were they strong peels?

TCA cross is basically a peel just concentrated at a higher percentage right?

How bad were the scars the subcision left behind?

Honestly if I found a doctor that could do this in a different state and was skilled at it I would probably fly out.

My doctor had me sign a release that the procedure(s) could result in scarring. I think that most doctors are going to require this to protect them from liability.

If you truly have rolling scars, I would seek out a second and/or third opinion. I do think that subcision is the best option for people followed by laser treatment to help the collagen remodeling.

I'm going for round two of subcision on May 8, 2009 and hoping that I'll see continued improvement.

I have been using Retin A .10% since March of this year. I think that it does help with collagen development and I say that based upon my baseline and post procedure photos.

I've been doing at home peels for the past two years and using 70% glycolic acid or 70% salycilic acid. However, these chemical peels did not appear to have impacted my scars much because they are deeper rolling scars.

However, I do think that chemical peels help with your overall skin tone and complexion and think they do help with some collagen remodeling.

Please take a look at a photo I took this evening and just posted in my album. Today marks the 45th day since my subcision procedure. My scars appear much, much flatter than they did in my baseline photo. The 18g Nokor needle improved my rolling scars more than any chemical peel ever did, the three Laser Genesis treatments I had, and all of the cryotheraphy sessions I had years ago. I think that the chemical peels and Retin A have improved my complexion overall.

TCA Cross (Chemical Reconstruction of Scarred Skin) Method is a treatment whereby the physician dips a sharpened wooden applicator in TCA and inserts it into a scar. This approach actually creates a wound and the skin responds by creating collagen and the scar fills in. TCA Cross Method should not be confused with a TCA peel. They are two very different and separate procedures.

You sound as if you are really motivated to see improvement in your scarring. I wish you a lot of success on your journey to healing.

#33 mr. matt

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Posted 08 May 2009 - 07:52 PM

QUOTE (mr. matt @ Apr 30 2009, 04:04 PM) <{POST_SNAPBACK}>
QUOTE (KnicksRock @ Apr 30 2009, 12:54 PM) <{POST_SNAPBACK}>
matt,

question:

what did your doc say about risk to make the scarring worse: that seemed to be the main reason they didn't want to perform the procedure on me or warned me about it.

Any further info on this topic would be very helpful. I think subcision definitely needs to be done on my deeper ones and do not see how any laser treatment can bring it up to level. It simply doesn't make sense! I don't have the worst scars in the world but I mean it is there and I notice it and it upsets me so I need to do something about it.

My acne is pretty much almost clear now on a ligher note. Have you ever used any retinoids like retin A or tazorac btw? Just wondering.

YOu had over 50 peels? That is a lot of peels. Were they strong peels?

TCA cross is basically a peel just concentrated at a higher percentage right?

How bad were the scars the subcision left behind?

Honestly if I found a doctor that could do this in a different state and was skilled at it I would probably fly out.

My doctor had me sign a release that the procedure(s) could result in scarring. I think that most doctors are going to require this to protect them from liability.

If you truly have rolling scars, I would seek out a second and/or third opinion. I do think that subcision is the best option for people followed by laser treatment to help the collagen remodeling.

I'm going for round two of subcision on May 8, 2009 and hoping that I'll see continued improvement.

I have been using Retin A .10% since March of this year. I think that it does help with collagen development and I say that based upon my baseline and post procedure photos.

I've been doing at home peels for the past two years and using 70% glycolic acid or 70% salycilic acid. However, these chemical peels did not appear to have impacted my scars much because they are deeper rolling scars.

However, I do think that chemical peels help with your overall skin tone and complexion and think they do help with some collagen remodeling.

Please take a look at a photo I took this evening and just posted in my album. Today marks the 45th day since my subcision procedure. My scars appear much, much flatter than they did in my baseline photo. The 18g Nokor needle improved my rolling scars more than any chemical peel ever did, the three Laser Genesis treatments I had, and all of the cryotheraphy sessions I had years ago. I think that the chemical peels and Retin A have improved my complexion overall.

TCA Cross (Chemical Reconstruction of Scarred Skin) Method is a treatment whereby the physician dips a sharpened wooden applicator in TCA and inserts it into a scar. This approach actually creates a wound and the skin responds by creating collagen and the scar fills in. TCA Cross Method should not be confused with a TCA peel. They are two very different and separate procedures.

You sound as if you are really motivated to see improvement in your scarring. I wish you a lot of success on your journey to healing.

ROUND TWO SUBCISION AND TCA CR0SS METHOD MAY 8, 2009

This afternoon, I went to my dermatologist's office for my second round of subcision and TCA Cross (Chemical Reconstruction of Scarred Skin).

He and his assistant were very pleased with the results that I had with my first treatment. They both said they noticed a difference in my skin the moment they first saw me.

My dermatologist said he thought that I would need multiple treatments based upon his first evaluation of my scarring. Today, he told me that he thought that I would only need today's session plus one session of Pearl Fractional and I should be finished. eusa_clap.gif

Round two began with me washing my face with an antibacterial soap. Then, my doctor gave me a mirror and asked me to point out which areas I wanted to be treated.

Much to my surprise, he said that he was going to treat the three large boxscars on my left cheek that he had not touched during my first treatment. smile.gif

He then used a sterile pen and marked the "margins" of all of my scars and marked where my icepick scars were. He told me he was doing this now because once he began injecting my face with anesthesia, my skin would begin to swell and he would no longer be able to see the scars.

The assistant took several pictures and another assistant came in to the room to videotape the procedure (my request).

This time, I held a handheld mirror and actually watched both procedures. My dermatologist inserted a wooden applicator into 80% TCA and inserted the applicator into several icepick scars on my nose, chin, temples, and forehead. The areas he touched immediately frosted over.

Then, he took an 18 gauge Nokor needle and inserted it into the marked areas and began to use a "fanning" motion back and forth. I could hear the fibrous bands "pop" as they were being released. He also showed me how he had marked the needle so that he wouldn't lose the proper orientation of the needle during the procedure. Apparently, losing the proper orientation of the needle can prevent the beveled edge of the needle from cutting the fibrous bands properly.

For those of you who have had subcision and have not had good results, I think that the proper orientation of the needle is important. Throughout both subcision procedures, I heard the "popping"sound of the fibrous bands being broken.

During the procedure, the assistant placed ice packs on my face to reduce the bleeding, bruising, and swelling.

After one hour, the doctor and his assistant bandaged about 75% of my face with cotton balls and tape. I've been home four about four hours and I look like The Mummy. I'm going to upload a picture my wife took when I got home with all of my bandages into my album.

I talked to my doctor about having one session of Pearl Fractional done in July before I went on vacation and he advised that I not do it before going on a family vacation. After I saw photos of patients who had had the procedure, I saw why. They had very red and swollen faces and that's not how I want to be remembered on my family vacation. So, I will try to schedule it for another time.

I have an appointment scheduled in July and we'll see if I need a third round of subcision and TCA Cross.

I think that I had about 70-80% improvement with the rolling scars on my left cheek and about 40% improvement with the deeper rolling scars on my right cheek.

I cannot believe that I finally found a treatment that has actually helped my scars. As you may have read earlier in this thread, I have tried multiple sessions of Chryotherapy, three sessions of Laser Genesis, and over 40 chemical peels with no visible results.

If you have rolling scars, I strongly encourage you do to your research and find a good doctor who can help you. I've suffered for years with these rolling scars and to now see them going away is truly a blessing and a huge relief.

You need to keep in mind that it takes time for the collagen remodeling to occur. I noticed the biggest changes during weeks three and four after my scars had begun to resurface after the initial swelling had subsided. There were several times where I could feel my skin "tingling" and I knew that something was growing under the top layer of my skin; it was actually collagen developing. It is kind of like watching a swimming pool being filled with a garden hose. It takes a while for the pool to fill up, but eventually it does. It is the same way with subcision and rolling scars. It takes a while for the collagen to remodel itself, but eventually it does.

In fact, my doctor made a comment about how he was surprised at the amount of collagen remodeling that had occurred especially in my left cheek. (I'm in my forties and didn't think I could get these type of results because of my age).

I just bought an LED device and Vitamin C serum. I'm hoping that these two things will also help my scars to heal and will "jump start" the collagen remodeling.

I will post my "before and after" photos in 30 days.

In the meantime, hang in there and let's all continue to encourage one another on our individual journeys to healing.

Matt

#34 unfortunate1y

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Posted 09 May 2009 - 10:31 AM

goodluck. your testimony is giving me hope, im 24 and actively seeking some sort of treatment. Again, good luck i hope all goes well and im glad you are posting detailed results. Very inspirational. Thank you for sharing.

#35 demaguil

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Posted 09 May 2009 - 10:38 AM

sir,your skin has improved a lot congratulation..

#36 MellowFellow

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Posted 09 May 2009 - 07:05 PM

your results are incredible matt. i've really enjoyed your updates.

for me i tried cross and subcision by rapaport and it backfired on me. after the procedure i got these huge black cysts that left deeper scars as well as pinkish/brown hyperpigmentation on my face that's still evident after 4 years.

this is counter to alot of peoples experience with both modalities. i'm still confused as to what the hell happened.

#37 newtrix

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Posted 10 May 2009 - 06:17 PM

Very nice improvement. Congrats whistling.gif)

#38 Daniel :D

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Posted 11 May 2009 - 01:15 PM

Mr.Matt, I have just sent you a PM.

#39 KnicksRock

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Posted 13 May 2009 - 09:50 AM

where is your doc again Matt? I wonder if it's worth flying out to a doctor in a different state if you cannot find one in your own state. Good luck with the healing.

#40 xXx~Gothic_Gurl~

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Posted 13 May 2009 - 03:53 PM

i dont think you skin was bad in the first place.

you really cant compare though, when in the before pics youve done it with a shadow on your face which makes it look worse. then on the after pics youve done it, in good light




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