7 replies to this topic

[tricia]

Since I recently moved and there is this top doc plastic surgeon nearby I went in for a consult on anything and everything he does for acne scars. I have to say he is one the most honest doctors I've ever talked to. He told me right off the bat I probably won't be satisfied with any of his treatments and they are all very costly.  We talked about subcision and how I've had two other doctors tell me I wasn't a great candidate for it, perhaps my scars aren't tethered much.  Well he said ALL scarring is tethered to some degree or it wouldn't be scarred, but the one's with the deepest scarring are the one's who see the greatest improvement from subcision.  He said at most I could hope for 50% improvement and to be honest that is pushing it, from one subcision. And get this, he would charge me $2000 for just a few spots!  That is too much $$ for me but I understand he is in demand because of his great reputation. I would give his name but they make you sign a confidentiality agreement so I'd rather not. But I have nothing negative to say about him so it probably wouldn't matter, if you are interested pm me.

 

So then we were talking about fillers, he said fillers will help some after subcision, but on their own they are pretty worthless. I asked him if he'd read the subcision suction method, I said I saw the document from a medical journal online and he goes on to tell me he has edited journals before and a lot of these studies are not done properly, etc. and you can't just look at any study online. 

 

He says lasers are pretty much crap for scarring.  He said he can get rid of sun damage, wrinkles, everything else but scars.  He said the improvement he has seen in acne scars from laser in his experience, (and he has done a lot of erbium fraxel and full resurfacing procedures) shows only little improvement and his patients are generally unsatisfied, but sure if I want him to laser a spot he will do it, but later I learned the prices are astronomical for even a few spots, like $3500!!

 

I asked him in theory what he thought about silicone microdroplet (I didn't tell him I'd had a little put in before without much improvement) he said he doesn't do it, never would do it and has seen bad complications from it. He said Priscilla Presley had it done in microdroplet form (I had thought she'd got a lot in at once) but he said no they've been doing microdroplet, and her face is horrible, she has granulomas. Well that got me depressed I may have complications one day again.

 

So, I will probably continue on with my dermastamping or single needling as this whole business about going to the doctors seem a waste.  He did tell me I should feel good my scarring is not worse.  I asked him about excision and he said he would only do scalpel excision on me if I was worse, because the scars it leaves would ultimately be worse.

 

Hope this helps someone!

Edited by tricia, 25 January 2013 - 12:25 PM.

[ForeverAndPatience]

I can agree that in the best case, those with worse scarring see more remarkable improvement with one treatment or another. But that doesn't mean that those with more mild scarring will never be happy, or see great improvement.

I have to disagree with excision making scars worse. You're replacing a wide scar with a thin one, if its done right, and taken care of properly. Though, I have never had one, and few posts on here document... its basically the same thing as having a mole cut out and stiched up. Which I've seen plenty of pictures showing a hardly noticeable mark.

Edited by ForeverAndPatience, 25 January 2013 - 12:42 PM.

[mammasay]

Kinda depressing but very helpful! Thanks so much for sharing this with us. My skin is recovering from the most severe acne I've ever had, and I'm noticing a few scars. Does the needling help you? And have you ever tried chemical peels?

[tricia]

I did try chemical peels but as this doctor stated he thinks the best chemical peel for me to get any results would be the Baker-Gordon peel.  It is a phenol peel.  I have read those can be pretty risky, but he said he's done it before with no bad results but I would probably not want to do a big area.  But then we started talking about other things so I never got the price. I think it is an option from a well experienced doctor.

 

Dermastamping in combo with my 12.5% TCA peels I do to myself have helped somewhat.  I want to go with more aggresive single needling now from owndoc.com website. It can be similar to a professional subcision I think, it you do it on a regular basis, and is pretty much all I can afford right now. But subcision does seem a pretty good place to start if you have the money.

 

Concerning excision, if your scars aren't severe good luck talking a doctor into performing it on you.  And we all think our scars are pretty severe but I guess the doctor didn't think mine were bad enough.  He wouldn't have done it even if I would have asked and paid.  Two other doctors have told me the same.  So really excision is out of the question, unless I come down with skin cancer or this silicone flares up pretty bad... then maybe they would excise.  But I agree I think a line scar would look better.

[ForeverAndPatience]

I did try chemical peels but as this doctor stated he thinks the best chemical peel for me to get any results would be the Baker-Gordon peel.  It is a phenol peel.  I have read those can be pretty risky, but he said he's done it before with no bad results but I would probably not want to do a big area.  But then we started talking about other things so I never got the price. I think it is an option from a well experienced doctor.
 
Dermastamping in combo with my 12.5% TCA peels I do to myself have helped somewhat.  I want to go with more aggresive single needling now from owndoc.com website. It can be similar to a professional subcision I think, it you do it on a regular basis, and is pretty much all I can afford right now. But subcision does seem a pretty good place to start if you have the money.
 
Concerning excision, if your scars aren't severe good luck talking a doctor into performing it on you.  And we all think our scars are pretty severe but I guess the doctor didn't think mine were bad enough.  He wouldn't have done it even if I would have asked and paid.  Two other doctors have told me the same.  So really excision is out of the question, unless I come down with skin cancer or this silicone flares up pretty bad... then maybe they would excise.  But I agree I think a line scar would look better.

Yeah. I suppose so; but you never know until you try. I've seen scar revisions on scars similar to mine. Maybe not excision and a straight stitch. They have other techniques. We'll see. Thanks for the info

[michi31]

Well this is depressing. Thank you for letting us know though, it's helpful.

[kidrock29520]

I'd say about 50% of what that doc said is pretty much what you're going to hear from any Derm/PS. On the other hand those prices are absolutely ridiculous and wayyyy out of the norm. Most docs offer subcision for around $500 and most lasers won't cost over $3000-3500 for a full face treatment.

Edited by kidrock29520, 28 January 2013 - 06:46 AM.

[austra]

Thank you for sharing, Tricia.

 

50% improvement from one subcision sounds pretty good to me, actually. But the price is ridiculous! Surely there are doctors performing it for much less!

 

It's true that I wouldn't place too much value on only one study when it comes to scar treatments. E.g. the famous Korean TCA cross study seems fairly unbelievable to me, and I do suspect how objective it was. So the jury on the suction method is still out, definitely. However, at least Mr. Matt seemed to get excellent results with it. And since it doesn't seem that risky, I don't see why not give it a try, if you are having subcision treatments.

 

What the doctor said about laser treatments does sound pretty disappointing. :/ I hope he was actually talking about other lasers than the fractional ablative kind, which really aren't that good for scarring, but who knows.

 

I'm a little bit disappointed by what he said about excision. Perhaps he meant that if you were to excise every scar, the result with one's face having several line scars would look worse than having several acne scars. And also, it does depend on the scar as well - small ice picks or boxcars would probably be more suitable than e.g. shallow but bigger rolling scars. But I don't know. I'm impatient to consult a plastic surgeon about it myself.

 

I'd say dermarolling sounds like a good plan for your scars, and subcision if you can find a doctor who does it for a better price. Good luck!

 

 

I have to disagree with excision making scars worse. You're replacing a wide scar with a thin one, if its done right, and taken care of properly. Though, I have never had one, and few posts on here document... its basically the same thing as having a mole cut out and stiched up. Which I've seen plenty of pictures showing a hardly noticeable mark.

 

 

Actually, my dad has had a mole cut out from his cheek in his early twenties or so, and yet to this day, I haven't been able to locate where exactly the mole was removed. I haven't noticed any scars, and was actually surprised to hear about the mole removal since I could see no sign whatsoever. Maybe you could see a mark if you knew the exact location and were looking at it closely, but still this is pretty much a completely invisible excision scar. Maybe it's rare to have such a good outcome, but I really hope not! Surgeons would probably know best though, so I'm really looking forward to consulting one.

Edited by austra, 28 January 2013 - 11:12 AM.