Asian Doing Mixto For Acne Scars On Cheeks

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Hello,

I posted on these boards before regarding my acne scar treatments. I was doing Lux 1540, but I will be heading back into school this fall and, thus, will have much less time for treatments, thus I wanted to try something faster.

As such, I turned to the Mixto laser as done by Dr. David Rahimi in Beverly Hills, CA. He proposed a Mixto + minor subcision followed by a touch-up after healing. He warned that I would not get rid of all of my scars, that the scars would mostly return by the end of the first month but then get better by around the third or fourth month, at which point he'd do the touch-up.

I am posting this as a blog for my progress and to answer any questions people may have about the procedure itself.

By the way, Dr. Rahimi is probably the most honest doctor I have ever met. When I told him I was already undergoing Lux 1540 procedures, he encouraged me to actually keep going with those procedures at my older dermatologist. But, when I told him about my upcoming schedule, he understood and immediately gave me a bunch of options, out of which I chose Mixto.

His process, as he explained to me, was a little different than others, because he uses a different head on the Mixto laser to "shave down the edges" of the ridges of the scars as well as the Mixto itself. He also did a subcision immediately after the procedure to raise some bound-down scars, which I think was very necessary on the left side of my face.

Also, btw, when I say "harshest lighting I could find," I mean that, each time I took a picture, I went out of my way to find the worst lighting possible for my scars at that particular time with a light coming down from straight above. My bathroom has a single 120 watt pure-white light bulb, which is kind of like a weaker version of the side lights that dermatologists use to find acne scars. This does mean that the angles are possibly off with each picture, but this is the most objective way I can figure to do it, since there is no way the scars can actually look "worse" than they are with the angles I took them.

April 27, 2012:

Day before procedure. Had to take some sort of Doxycyclin the night before in order to prevent infections. I was also given two microdermabrasions each spread a week apart before this point in order to prep my face for the procedure.

I took these pictures under the harshest lighting I could find.

post-157705-0-57622600-1337015175_thumb.

post-157705-0-28959200-1337015203_thumb.

April 29, 2012:

One day after post-op. Here is what it looks like with Aquaphor and crap slathered on. And yeah, it's a ghastly red, I know, haha.

gallery_157705_12317_21784.jpg

gallery_157705_12317_156808.jpg

gallery_157705_12317_283041.jpg

May 9, 2012:

About five days after stopping applying Aquaphor, which means it's been 11 days since the procedure. I've mostly finished peeling. The scars look better, especially on the left side of my face, but they are still pretty evident in the right. It is difficult to wait for the full three or four months to see how these scars will develop.

Some acne broke out, and I was given an oral antibiotic to treat it, but it hasn't worked too well (I've always been pretty resistant to antibiotics). Forutnately, the outbreaks are pretty minor, nothing even approaching the levels that caused the scarring in the first place.

Again, harshest lighting I could find. The left side really is much better.

post-157705-0-30471200-1337015522_thumb.

post-157705-0-11357900-1337015548_thumb.

I should add, it LOOKS like there is no redness, but there is. The automatic color-corrector on the camera kicked in for the second picture. The first picture is a better indication of the redness.

May 28, 2012: Happy Memorial Day!

It's been exactly a month to the day since I had my procedure done, here's how it looks so far:

First my left, reflected in a mirror as always.

gallery_157705_12315_238495.jpg

yeeeeeeah, check out that grody acne. Seriously, though, not much has changed here.

Here's the real interesting side, the right side (again, reflected in a mirror):

gallery_157705_12315_272235.jpg

This is the WORST angle I could find for my scars. I tried moving in and out, side to side, shifting my head, etc., this is the worst angle I could get.

Now, it LOOKS like there has been a lot of improvement, and there has, but really, it's not as much as it looks compared to my older picture. My older picture was a little blurred, made the scars look worse than they actually were. What you can REALLY notice is the bridge of skin between my two scars clusters, that was not really there before. Exciting stuff.

Anyway, in case you were wondering, this is has been my post-op treatment routine:

Morning:

Shower.

Wash face with cold water and glycolic cleanser. Pat dry.

Sunblock.

Spot treat any acne with Acanya (2.5% benzoyl peroxide/1.2% clindamycin mix).

Night:

Wash face with cold water and glycolic cleanser. Pat dry.

Acanya all over face.

Kojic acid all over face.

Neocutis Bio-Gel all over face (this is my moisturizer, essentially).

Every week, I will forego all of my topicals in the night treatment for a treatment with Atralin (topical tretinoin .05%)

So yeah. Steady as she goes, but there is definitely improvement. Also, the redness is much more noticeable in these pictures because I took off the color correction.

Hope ya'll had a great long weekend.

June 28, 2012

Pretty much exactly two months since I had the treatment. I took these photos last night, when my scars are at their worst after a long day:

Left side (reflected in mirror):

gallery_157705_12387_273920.jpg

Right side (reflected in mirror):

gallery_157705_12387_372516.jpg

As you can see, left side still pretty much the same (I'm still wondering why the left side resolved so damn well) whereas there is still room for improvement on the right, but it's definitely getting a bit better. I also have a bit of active acne still ongoing, but it appears to be on its way out, as far as I can tell.

There are some days where they look worse. For instance, on the left side of my face, a slight crater may show up at the end of the day, and on the right it'll look a bit messier, but overall this is generally how they look at their worst.

I scheduled my touch-up for July 28. After consulting with Dr. Rahimi some more, I have confirmed that it is, indeed, basically another regular Mixto treatment (in fact, he said he would be going more aggressively on my right side than last time), except he'll be attacking only the scars and not the entire face. He also said any subsequent treatments, if I would want any, would be $500 each. However, considering that I'll be starting grad school, I don't think I'll have time for more treatments until at LEAST winter vacation, so yeah.

August 11, 2012

Had my second procedure exactly two weeks ago. It was a TCA Peel + Mixto + Subcision, and it was free. Check it out.

(pictures deletes to make room for new pictures)

August 28, 2012

A month after my second Mixto:

gallery_157705_12483_200476.jpg

gallery_157705_12483_197064.jpg

Edited by DRaGZ
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If that's 11 days out your results are looking very good so far. Micro swelling should be pretty much gone by now. Looks like you had a little bit of active acne before which is making the after pics look a bit better, but overall solid improvement.

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If that's 11 days out your results are looking very good so far. Micro swelling should be pretty much gone by now. Looks like you had a little bit of active acne before which is making the after pics look a bit better, but overall solid improvement.

Yeah, I still have active acne. The two dermatologists who've treated me were willing to treat me while my acne was still ongoing because it wasn't as severe as it used to be and I was on a regiment to control it. The treatment itself seems to have exacerbated it a bit, though, especially the Aquaphor I had to slather on for five days.

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your skin looks much better, hopefully some of that improvement will be permanent. Keep us posted.

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Yeah, I'm gonna take another set of pictures at exactly one month, then two, then three, then four, then after my touch-up, and more from there.

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Huh, so apparently my doctor said I could do my touch-up at two months, which matches up with what some other people have been saying about maximum downtime required for a fractional ablative procedure.

So, that's what I'll do, I guess.

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Good for you. Go on the attack, this is your life. You have not reached final results, and you do still have some microswelling, so you will need multiple laser treatments.

Edited by DudleyDoRight

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Good for you. Go on the attack, this is your life. You have not reached final results, and you do still have some microswelling, so you will need multiple laser treatments.

Yeah, that's what I suspect if I want most of them to go away, but, really, I don't mind if SOME of them are there, I would just rather it didn't look as "intensely dirty" as it does right now, if you know what I mean.

I also suspect that some of the results on the left side of my face are primarily due to the subcision he did. He did subcision on both sides, but he did it way more on the left than the right, and the left, so far, looks exactly the same as it does in the "after" picture I've posted above.

I'm gonna post anothe pair of picture on the 28th, just for comparison.

EDIT: Oh, and here's an interesting tidbit I learned from my dermatologist:

If you ever have acne, and it eventually bursts and turns into an open wound, DO NOT apply benzoyl peroxide on it. Usually, the course of treatment is to apply BP to kill the acne, but if BP is applied on an open wound it prevent the fibroblasts which form collagen from coming together, which means that it'll increase the likelihood of the wound becoming an acne scar. Thinking back with this information in mind, I think this is a big reason as to why the right side of my face ended up so scarred, because I used to apply BP right on top of the open wound anyway, thinking it would help.

Edited by DRaGZ
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Good for you. Go on the attack, this is your life. You have not reached final results, and you do still have some microswelling, so you will need multiple laser treatments.

Yeah, that's what I suspect if I want most of them to go away, but, really, I don't mind if SOME of them are there, I would just rather it didn't look as "intensely dirty" as it does right now, if you know what I mean.

I also suspect that some of the results on the left side of my face are primarily due to the subcision he did. He did subcision on both sides, but he did it way more on the left than the right, and the left, so far, looks exactly the same as it does in the "after" picture I've posted above.

I'm gonna post anothe pair of picture on the 28th, just for comparison.

EDIT: Oh, and here's an interesting tidbit I learned from my dermatologist:

If you ever have acne, and it eventually bursts and turns into an open wound, DO NOT apply benzoyl peroxide on it. Usually, the course of treatment is to apply BP to kill the acne, but if BP is applied on an open wound it prevent the fibroblasts which form collagen from coming together, which means that it'll increase the likelihood of the wound becoming an acne scar. Thinking back with this information in mind, I think this is a big reason as to why the right side of my face ended up so scarred, because I used to apply BP right on top of the open wound anyway, thinking it would help.

That is some very good info for people with active acne, and you should post that on those forums also.

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It looks like you have found a good doctor, and you will end up very satisfied when you are done. The subcision-Mixto combo seems to be very good. I hope everybody is watching this thread. You ought to let people know where this doctor is, I hear a lot of people spinning their wheels looking for the right treatment.

Edited by DudleyDoRight

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I'll update the main post when I get on a computer with less crappy input problems, but basically, he is Dr. A. David Rahimi. His practice is "Forever Young" out of Beverly Hills, CA. He is board-certified in both dermatology and plastic surgery, which I think is somewhat of a rarity. He also has a book called "Please Don't Die Trying to Become Beautiful" where he outlines a lot of different reasons as to why plastic surgery or any cosmetic dermatological procedures may not necessarily be for you, which is an interesting stance for a dermatologist/plastic surgeon.

He also has pretty excellent office hours, he takes off only Sundays and Mondays, and Sundays he is still available by appointment. After the procedure, he gave me his direct cell phone line, in case I needed to contact him for any reason, but I've never had to use it because, so far, everything he said would happen has happened, so nothing unpredictable. He's a pretty nice guy overall.

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*sigh*

I don't know why I bothered posting that information in the acne treatment forums, now I'm stuck arguing with this idiot who thinks Manuka honey is the wave of the future for acne treatment and that BP causes cancer.

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Hello,

I posted on these boards before regarding my acne scar treatments. I was doing Lux 1540, but I will be heading back into school this fall and, thus, will have much less time for treatments, thus I wanted to try something faster.

As such, I turned to the Mixto laser as done by Dr. David Rahimi in Beverly Hills, CA. He proposed a Mixto + minor subcision followed by a touch-up after healing. He warned that I would not get rid of all of my scars, that the scars would mostly return by the end of the first month but then get better by around the third or fourth month, at which point he'd do the touch-up.

I am posting this as a blog for my progress and to answer any questions people may have about the procedure itself.

By the way, Dr. Rahimi is probably the most honest doctor I have ever met. When I told him I was already undergoing Lux 1540 procedures, he encouraged me to actually keep going with those procedures at my older dermatologist. But, when I told him about my upcoming schedule, he understood and immediately gave me a bunch of options, out of which I chose Mixto.

His process, as he explained to me, was a little different than others, because he uses a different head on the Mixto laser to "shave down the edges" of the ridges of the scars as well as the Mixto itself. He also did a subcision immediately after the procedure to raise some bound-down scars, which I think was very necessary on the left side of my face.

Also, btw, when I say "harshest lighting I could find," I mean that, each time I took a picture, I went out of my way to find the worst lighting possible for my scars at that particular time with a light coming down from straight above. My bathroom has a single 120 watt pure-white light bulb, which is kind of like a weaker version of the side lights that dermatologists use to find acne scars. This does mean that the angles are possibly off with each picture, but this is the most objective way I can figure to do it, since there is no way the scars can actually look "worse" than they are with the angles I took them.

April 27, 2012:

Day before procedure. Had to take some sort of Doxycyclin the night before in order to prevent infections. I was also given two microdermabrasions each spread a week apart before this point in order to prep my face for the procedure.

I took these pictures under the harshest lighting I could find.

post-157705-0-57622600-1337015175_thumb.

post-157705-0-28959200-1337015203_thumb.

May 9, 2012:

About five days after stopping applying Aquaphor, which means it's been 11 days since the procedure. I've mostly finished peeling. The scars look better, especially on the left side of my face, but they are still pretty evident in the right. It is difficult to wait for the full three or four months to see how these scars will develop.

Some acne broke out, and I was given an oral antibiotic to treat it, but it hasn't worked too well (I've always been pretty resistant to antibiotics). Forutnately, the outbreaks are pretty minor, nothing even approaching the levels that caused the scarring in the first place.

Again, harshest lighting I could find. The left side really is much better.

post-157705-0-30471200-1337015522_thumb.

post-157705-0-11357900-1337015548_thumb.

I should add, it LOOKS like there is no redness, but there is. The automatic color-corrector on the camera kicked in for the second picture. The first picture is a better indication of the redness.

hey man how much did the procedure cost you and do you have your doctors emails i have a few questions id like to ask him please pm me with answer, your results look amazing

Edited by Syn1122

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Hello,

I posted on these boards before regarding my acne scar treatments. I was doing Lux 1540, but I will be heading back into school this fall and, thus, will have much less time for treatments, thus I wanted to try something faster.

As such, I turned to the Mixto laser as done by Dr. David Rahimi in Beverly Hills, CA. He proposed a Mixto + minor subcision followed by a touch-up after healing. He warned that I would not get rid of all of my scars, that the scars would mostly return by the end of the first month but then get better by around the third or fourth month, at which point he'd do the touch-up.

I am posting this as a blog for my progress and to answer any questions people may have about the procedure itself.

By the way, Dr. Rahimi is probably the most honest doctor I have ever met. When I told him I was already undergoing Lux 1540 procedures, he encouraged me to actually keep going with those procedures at my older dermatologist. But, when I told him about my upcoming schedule, he understood and immediately gave me a bunch of options, out of which I chose Mixto.

His process, as he explained to me, was a little different than others, because he uses a different head on the Mixto laser to "shave down the edges" of the ridges of the scars as well as the Mixto itself. He also did a subcision immediately after the procedure to raise some bound-down scars, which I think was very necessary on the left side of my face.

Also, btw, when I say "harshest lighting I could find," I mean that, each time I took a picture, I went out of my way to find the worst lighting possible for my scars at that particular time with a light coming down from straight above. My bathroom has a single 120 watt pure-white light bulb, which is kind of like a weaker version of the side lights that dermatologists use to find acne scars. This does mean that the angles are possibly off with each picture, but this is the most objective way I can figure to do it, since there is no way the scars can actually look "worse" than they are with the angles I took them.

April 27, 2012:

Day before procedure. Had to take some sort of Doxycyclin the night before in order to prevent infections. I was also given two microdermabrasions each spread a week apart before this point in order to prep my face for the procedure.

I took these pictures under the harshest lighting I could find.

post-157705-0-57622600-1337015175_thumb.

post-157705-0-28959200-1337015203_thumb.

May 9, 2012:

About five days after stopping applying Aquaphor, which means it's been 11 days since the procedure. I've mostly finished peeling. The scars look better, especially on the left side of my face, but they are still pretty evident in the right. It is difficult to wait for the full three or four months to see how these scars will develop.

Some acne broke out, and I was given an oral antibiotic to treat it, but it hasn't worked too well (I've always been pretty resistant to antibiotics). Forutnately, the outbreaks are pretty minor, nothing even approaching the levels that caused the scarring in the first place.

Again, harshest lighting I could find. The left side really is much better.

post-157705-0-30471200-1337015522_thumb.

post-157705-0-11357900-1337015548_thumb.

I should add, it LOOKS like there is no redness, but there is. The automatic color-corrector on the camera kicked in for the second picture. The first picture is a better indication of the redness.

hey man how much did the procedure cost you and do you have your doctors emails i have a few questions id like to ask him please pm me with answer, your results look amazing

Dr. A. David Rahimi, in Beverly Hills, CA.

http://www.foreveryo...t/practice.html

It was $3000 for the procedure plus the touch-up follow-up.

He's a hella busy guy, so he doesn't give out his e-mail or private number to anyone but patients, but if you go in for a consultation he spends as much time with you as you need.

Edited by DRaGZ

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did you notice any improvements with your scars? i seem to had gotten rid of the active acne but how was it on the scars any improvements?

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did you notice any improvements with your scars? i seem to had gotten rid of the active acne but how was it on the scars any improvements?

Check for yourself in those pictures I posted. I took them in as HARSH lighting as I possibly could in each example. And I just rechecked my face since I rewashed it just now, and they look pretty much exactly the same as in the 11 days after picture I posted (a little bit better in the right side, actually, there's an island of smooth skin now between the two larger scars).

The laser didn't do anything for my acne, in fact, the Aquaphor I had to put on afterward actually EXACERBATED my acne condition and caused a little more, but it wasn't anything I couldn't handle, and not nearly as bad as the acne I used to have.

Mind you, I've also been doing a LOT of aftercare. I've been using topical tretinoin (.05%) twice a week (which increases cell turnover), applying Neo-Cutis Bio-Gel (which encourages faster healing [at least it does in burn victims, not entirely sure how they react to collagen remodeling]), and been using glycolic cleanser twice a day (which also increases cell turnover). I've also been using a sunBLOCK (this is different from a sunSCREEN) to keep my skin from getting any more damage, since all of the treatment makes it very sensitive, and I've been spot-treating any acne with Acanya, which is a 2.5% benzoyl peroxide/1.2% clindamycin mix. Oh, and kojioc acid, once nightly, to fight off any potential hyperpigmentation (though I haven't really had any, in fact, I've had less hyper-pigmentation from the ablative Mixto procedure than the non-ablative Lux 1540 procedure, for some reason).

So...yeah, aftercare is pretty important.

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Your skin looks so much better. How many treatments have you had in total? Also, I don't know much about lasers but was it ablative or non ablative. I just want to clarify. (But I did read that the Mixto was ablative and the Lux was non ablative). Sorry, but I just want to know in detail. Thanks.

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*sigh*

I don't know why I bothered posting that information in the acne treatment forums, now I'm stuck arguing with this idiot who thinks Manuka honey is the wave of the future for acne treatment and that BP causes cancer.

LOL those people crack me up. They belong in medieval times. Look at how many people listened to Jenny McCarthy and Oprah Winfrey and didn't innoculate their babies. A few years back there was a huge increase in Whooping Cough in california because of her nonsense. The doctor who faked the study that Jenny and Oprah used as the basis of endangering millions of babies, has been banned from practicing medicine in England, but he is still touring the US spreading his lies.

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Your skin looks so much better. How many treatments have you had in total? Also, I don't know much about lasers but was it ablative or non ablative. I just want to clarify. (But I did read that the Mixto was ablative and the Lux was non ablative). Sorry, but I just want to know in detail. Thanks.

"Ablative" simply means that some actual skin is removed (literally vaporized away). "Non-ablative," obviously means that it does not.

These days, both ablative and non-ablative procedures generally refer to fractionated lasers, in which columns of skin are affected instead of entire patches. Here's an easy chart that illustrates what this means:

fractional_co2_laser_skin_resurfacing.png

The two examples at the left are older models of laser (though full ablative CO2 resurfacing is still done in some places). The two examples on the right are the lasers that most doctors use today, mainly because they have much less downtime than the traditional lasers and because they penetrate deeper.

I had two Lux 1540s done, which are non-ablative, and one Mixto, which is ablative.

*sigh*

I don't know why I bothered posting that information in the acne treatment forums, now I'm stuck arguing with this idiot who thinks Manuka honey is the wave of the future for acne treatment and that BP causes cancer.

LOL those people crack me up. They belong in medieval times. Look at how many people listened to Jenny McCarthy and Oprah Winfrey and didn't innoculate their babies. A few years back there was a huge increase in Whooping Cough in california because of her nonsense. The doctor who faked the study that Jenny and Oprah used as the basis of endangering millions of babies, has been banned from practicing medicine in England, but he is still touring the US spreading his lies.

I don't understand why people still believe that study when it's been revealed that he MADE UP all of the data.

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Your skin looks so much better. How many treatments have you had in total? Also, I don't know much about lasers but was it ablative or non ablative. I just want to clarify. (But I did read that the Mixto was ablative and the Lux was non ablative). Sorry, but I just want to know in detail. Thanks.

"Ablative" simply means that some actual skin is removed (literally vaporized away). "Non-ablative," obviously means that it does not.

These days, both ablative and non-ablative procedures generally refer to fractionated lasers, in which columns of skin are affected instead of entire patches. Here's an easy chart that illustrates what this means:

fractional_co2_laser_skin_resurfacing.png

The two examples at the left are older models of laser (though full ablative CO2 resurfacing is still done in some places). The two examples on the right are the lasers that most doctors use today, mainly because they have much less downtime than the traditional lasers and because they penetrate deeper.

I had two Lux 1540s done, which are non-ablative, and one Mixto, which is ablative.

Hi there, thanks for replying. It sounds like it was worth it. I am also Asian, but Filipino (Philippines). I hope it's okay if you can just enlighten me with a few details regarding your procedure.

1. What were the settings on each laser?

2. How many times can you have these procedures? I understand that 30% improvement is considered a success, but hypothetically speaking, is money were not an issue how many times can you have a laser procedure done to raise the likelihood of improvement?

Thanks, so much. By the way, I'm really happy that you were able to treat your scars. It gives everyone here hope.

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I don't know what the settings were. I asked beforehand what his settings would be, but he told me that he would change the settings around as he saw fit. So, in patches of skin without scars (but with, say, red spots or sun damage) he would use a low setting, but over scarred areas he would use higher settings and do multiple passes.

More important than the settings, I think, was his technique. This is his technique as he described it to me:

1. Made a single pass around the entire face.

2. Used a sculpting head on the laser to shave down the edges of more prominent scars.

3. Used a precision head on the laser to stimulate extra growth in specifically pockmarked areas.

4. Did another pass over more heavily scarred areas.

5. Did subcision on rolling scars.

And he did all this while using a side light, so he could see exactly where all of my scars were at all times.

As far as the research is considered, you can have these lasers done...as many times as you want. As long as you don't have them performed very close to each other. The minimum time needed per procedure, as I understand it, is two months, but if you're going to do it a LOT, somewhere down the line, you're probably going to want to rest your skin a little more.

Edited by DRaGZ

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Your skin looks much improved bro.

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wow nice results, especailly your right side looks scar free,

did your results stick after swelling went down? and have you had to deal with any hyperpigmentation?

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wow nice results, especailly your right side looks scar free,

did your results stick after swelling went down? and have you had to deal with any hyperpigmentation?

Technically my left, since it's reflected in a mirror.

Yes, they are still more or less the same. In fact, my right side actually looks better, it looks like some of the healing that Dr. Rahimi said would happen is starting to slowly happen (slow being the key word, here).

I am still planning to post updated pictures on the 28th, but I got this weird...line of zits on the left side of my face this morning which came outta nowhere, hoping that'll clear up before then, haha.

I'm honestly more self conscious about the acne than the scars.

Oh, and there is veeeeery minor hyper-pigmentation. I was treating with kojic acid for two weeks before the procedure and had been doing microdermabrasions, which Dr. Rahimi said would help prevent hyper-pigmentation. I've honestly had less hyper-pigmentation from this ABLATIVE procedures than from the two non-ablative procedures I had done before.

Edited by DRaGZ

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