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Subcision Done & Sharing The Rest Of The Journey.

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#1 19lee

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Posted 29 May 2013 - 09:31 AM

I am 32 year old with acne problem for a long time. Acne had settled down and left me with rolling scars that I have been trying to fight for years. I did microdermabrasion, and two years ago started Fractional Laser CO2 but it did nothing to help with my rolling scars. 

 

Thanks to this community that I begin to relook my options and special mention to Mr. Matt, Greg and many others that took the effort to share their experiences and give hope to many. 

 

I just had my subcision done exactly 2 weeks ago - with suctioning done from the 3rd day till today. Procedure is much the same as what everyone had mentioned, however I didn't have much bruising. It swelled up on the very day, turned slightly purplish the next day and 3rd day onwards was just yellow patches and I was able to see my depressed scars pretty much the same as before. My doctor did mention that the bruising should only be slight. I told him that I often see comments that the more bruises you see the better it is. However he said that some bruises are bad because it is 'overdone' Well I hope so and shall wait and see, since it has just been two weeks and hopefully the work of the collagen does it job soon. Once in a while I did feel some aching/throbbing reaction.

 

During these two weeks, I have also been applying vit c serum once to twice a day, unfortunately it gave me some rashes - Doc says it is because it is drying out my skin. Now I am not sure if I should continue this. Additionally, I am also taking Meiji Amino Collagen Supplement.  

 

Will be updating this post again on the outcome to share with all my experience in this long journey that I will continue to fight. And to everyone who is in this journey too, don't give up!



#2 michi31

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Posted 29 May 2013 - 10:08 AM

Thank you so much for sharing! I am a 32 year old female also, and I have my first subcision appointment in 3 weeks and I'm really scared to be honest. Can I ask where on your face your scars are, and also where your doctor is? Did he recommend suction or was it just something you decided to do on your own?


Edited by michi31, 29 May 2013 - 10:11 AM.


#3 19lee

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Posted 29 May 2013 - 10:35 AM

Thank you so much for sharing! I am a 32 year old female also, and I have my first subcision appointment in 3 weeks and I'm really scared to be honest. Can I ask where on your face your scars are, and also where your doctor is? Did he recommend suction or was it just something you decided to do on your own?

 

Hi michi31

 

You have nothing to worry! I am actually very comfortable with subcision in comparison to lasers. You would only feel the pain from the injections, and its nothing much really. As for the bruises, mine didn't turn out bad and it was not exactly noticeable the next day, just looked like you have some fresh acne. My depressed scars are both my mid cheeks. Suction was something I decided to do and it made complete sense to me after some readings and some of the posts I read here. No harm trying anyway. I am actually based in Singapore and did my subcision here. 

 

I'll post up some photos probably a week later when theres changes to the scars, hopefully! 

 

Good luck to you, and let me know how did it go. We can do this!



#4 michi31

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Posted 29 May 2013 - 11:01 AM

I'm more scared that it will somehow make the scar worse. It is on the side of my chin, and I have read worse results for this area of the face. Good luck - keep us posted!



#5 austra

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Posted 29 May 2013 - 03:39 PM

Good luck to both of you and please keep us posted! :)



#6 lisaw

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Posted 29 May 2013 - 05:48 PM

Thank you so much for sharing! I am a 32 year old female also, and I have my first subcision appointment in 3 weeks and I'm really scared to be honest. Can I ask where on your face your scars are, and also where your doctor is? Did he recommend suction or was it just something you decided to do on your own?

 

Hi 

 

 

You have nothing to worry! I am actually very comfortable with subcision in comparison to lasers. You would only feel the pain from the injections, and its nothing much really. As for the bruises, mine didn't turn out bad and it was not exactly noticeable the next day, just looked like you have some fresh acne. My depressed scars are both my mid cheeks. Suction was something I decided to do and it made complete sense to me after some readings and some of the posts I read here. No harm trying anyway. I am actually based in Singapore and did my subcision here. 

 

I'll post up some photos probably a week later when theres changes to the scars, hopefully! 

 

Good luck to you, and let me know how did it go. We can do this!

 

Hi all,

 

I am very interested to find out how your procedure went, 19lee. Do you mind posting pictures? Like michi31, I am very anxious about the procedure.

 

I have an indented scar from surgery on my cheek and I am having a hard time finding any doctor who does it.

 

The facial plastic surgeon I consulted asked me what it is, and I had to explain subcision to him! 

 

I finally found one doctor who says he has done over 50 subcisions and is very comfortable with it. He thinks subcision + filler is a conservative approach.

 

Any information or experiences you feel comfortable to share would be much appreciated!

 

Thanks, 

LisaW

   

#7 ughhhhh

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Posted 29 May 2013 - 06:14 PM

I'm more scared that it will somehow make the scar worse. It is on the side of my chin, and I have read worse results for this area of the face. Good luck - keep us posted!


Maybe I missed it but did you find out why exactly that the chin area is worse? The amount if muscle and movement? Most derms recommend subscision to me so I definitely haven't heard it. I'm excited for you! I hope it goes well.

And OP post pics please!

#8 19lee

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Posted 29 May 2013 - 08:41 PM

 


 


Thank you so much for sharing! I am a 32 year old female also, and I have my first subcision appointment in 3 weeks and I'm really scared to be honest. Can I ask where on your face your scars are, and also where your doctor is? Did he recommend suction or was it just something you decided to do on your own?

 

Hi 

 

 

You have nothing to worry! I am actually very comfortable with subcision in comparison to lasers. You would only feel the pain from the injections, and its nothing much really. As for the bruises, mine didn't turn out bad and it was not exactly noticeable the next day, just looked like you have some fresh acne. My depressed scars are both my mid cheeks. Suction was something I decided to do and it made complete sense to me after some readings and some of the posts I read here. No harm trying anyway. I am actually based in Singapore and did my subcision here. 

 

I'll post up some photos probably a week later when theres changes to the scars, hopefully! 

 

Good luck to you, and let me know how did it go. We can do this!

 

Hi all,

 

I am very interested to find out how your procedure went, 19lee. Do you mind posting pictures? Like michi31, I am very anxious about the procedure.

 

I have an indented scar from surgery on my cheek and I am having a hard time finding any doctor who does it.

 

The facial plastic surgeon I consulted asked me what it is, and I had to explain subcision to him! 

 

I finally found one doctor who says he has done over 50 subcisions and is very comfortable with it. He thinks subcision + filler is a conservative approach.

 

Any information or experiences you feel comfortable to share would be much appreciated!

 

Thanks, 

LisaW

   

 

Hi Lisa

 

I am comfortable to share anything that you like to know. I said pretty much about what was after the procedure. As for the procedure itself, I was numbed with elma cream for about 45mins to 1hr then went in to an operating room kind of environment. The next thing was to inject local anaesthesia about 3-4 shots on a side of my cheek, that hurts a little but bearable and then I didnt feel much when he subcised the scars. I didn't hear much popping sound as mostly described maybe because of the calming background music that was put on and my doctor was also talking to me and making sure I was feeling fine. I only know he was doing the fanning motion up and down the area, with the nurse pressing down my cheek throughout. The procedure itself was about 20-30 minutes. I looked at myself in the mirror and it was really red, but it was because of the pressure pressed onto my cheek for the whole 20-30 minutes. 

 

Here are the pictures I took, Day 1 was taken one hour after the procedure and the redness went away just about another hour later which you can see how it look like in Day 2. 

 

Day 1

Day1.jpg

 

Day 2

Day2.jpg


Good luck to both of you and please keep us posted! smile.png

 

Thank you austra and I will. :)



#9 lisaw

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Posted 29 May 2013 - 09:22 PM

19lee - thanks for sharing the pictures!

 

So you should be at around the 2 week mark? Can you post a pic of how that looks like? I hope it has just improved day by day. Has the scar improved? Does it continue to be plumped up after the swelling goes away? Did you use a filler?  I am considering subcision +filler.

 

Thanks again and good luck! 



#10 19lee

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Posted 30 May 2013 - 01:02 AM

lisaw - No worries! Today marked the 17th day actually, honestly I don't know. It didn't seems to me it has improved but most results I read, should only be obvious after 3 weeks so I am keeping my fingers crossed. Will post up another picture on the 21st day.



lisaw - Oops sorry missed your questions. It did plump up abit on the 3rd and 4th day and thats it. After, it looks all the same but it does seem to me the indents seems to have some redness inside them, like hollow red flesh. Sorry that I can't describe it well enough. But well on harsh lightings, the scars look just as depressed. So now its the waiting...

 

As for fillers, not yet but I plan to discuss this with my doctor when I see him for my follow up on 20th June. Will share with you what he thinks about it.



#11 lisaw

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Posted 30 May 2013 - 01:12 AM

19lee - thanks for sharing. i have heard that the first week always looks better because of the swelling. definitely, talk to your doctor about augmenting it with a filler. here's some research i found, hope it helps. my best wishes for you - hang in there as you wait. ~ lisa

________________

 

 
 
Subcision with Fillers
Injecting acne scars with fillers can be a very satisfying procedure with relatively minimal downtime.  However, because acne scars may tether down the skin, some of these indented scars can not be smoothed out with filler alone.  Because the center portion of the indented acne scar is tethered down with collagen fibers, the filler tends to extrude around the tethered area to create a “doughnut effect.” In other words, the indentation barely improves, and the edges of the acne scar become filled and rise up higher, worsening the overall appearance.
In these cases, some subcision is helpful in untethering the collagen fibers to allow the filler to lift up the central portion of the indented scar.   Without subcision, the filler does not have enough “hydraulic” pressure to push out the indentation.  Typically Dr. Yang will attempt to conservatively fill the indented acne scars, and if the scar does not lift easily, Dr. Yang will perform some light subcision with the same small needle used to inject the filler to release the collagen fibers before adding more filler.  This helps avoid the “doughnut effect.”
Because the subcised area is much smaller and a smaller needle is used, the amount of bruising is greatly reduced.  Furthermore, the filler that is pushing out the indentation also acts to compress the subcised area.  This effectively reduces the amount of bleeding and subsequent bruising compared to a traditional subcision.  This technique allows patients to experience the benefits of subcision with relatively little recovery time.


#12 Helton

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Posted 30 May 2013 - 01:46 AM

Good luck on your procedure! I can see improvements already in the day 2 photo. :)



#13 austra

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Posted 30 May 2013 - 05:08 AM

19lee - thanks for sharing. i have heard that the first week always looks better because of the swelling. definitely, talk to your doctor about augmenting it with a filler. here's some research i found, hope it helps. my best wishes for you - hang in there as you wait. ~ lisa

________________

 

These were great, thanks. :)

I wish Dr. Yang lived in my country, he seems like a really good doctor for treating acne scars.  I'm going to ask a facial (/skin cancer) plastic surgeon about subcising my one large rolling scar (I have some smaller shallow ones too, but they don't really bother me), but I'm prepared she won't have heard of it or even if she has, doesn't have any experience.



#14 michi31

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Posted 30 May 2013 - 07:41 AM

I'm more scared that it will somehow make the scar worse. It is on the side of my chin, and I have read worse results for this area of the face. Good luck - keep us posted!


Maybe I missed it but did you find out why exactly that the chin area is worse? The amount if muscle and movement? Most derms recommend subscision to me so I definitely haven't heard it. I'm excited for you! I hope it goes well.

And OP post pics please!

 

I don't think I know exactly the reason - whether it's muscle movement or just the skin is less fatty there. It is more that I have read several reviews where people have said it didn't work on the chin, whereas it did on the cheek. I have read a couple where they said it made it worse. I think yours is more on your cheek though so you should be ok.



19lee - thanks for sharing. i have heard that the first week always looks better because of the swelling. definitely, talk to your doctor about augmenting it with a filler. here's some research i found, hope it helps. my best wishes for you - hang in there as you wait. ~ lisa

________________

 

 
 
Subcision with Fillers
Injecting acne scars with fillers can be a very satisfying procedure with relatively minimal downtime.  However, because acne scars may tether down the skin, some of these indented scars can not be smoothed out with filler alone.  Because the center portion of the indented acne scar is tethered down with collagen fibers, the filler tends to extrude around the tethered area to create a “doughnut effect.” In other words, the indentation barely improves, and the edges of the acne scar become filled and rise up higher, worsening the overall appearance.
In these cases, some subcision is helpful in untethering the collagen fibers to allow the filler to lift up the central portion of the indented scar.   Without subcision, the filler does not have enough “hydraulic” pressure to push out the indentation.  Typically Dr. Yang will attempt to conservatively fill the indented acne scars, and if the scar does not lift easily, Dr. Yang will perform some light subcision with the same small needle used to inject the filler to release the collagen fibers before adding more filler.  This helps avoid the “doughnut effect.”
Because the subcised area is much smaller and a smaller needle is used, the amount of bruising is greatly reduced.  Furthermore, the filler that is pushing out the indentation also acts to compress the subcised area.  This effectively reduces the amount of bleeding and subsequent bruising compared to a traditional subcision.  This technique allows patients to experience the benefits of subcision with relatively little recovery time.

 

I had a consultation with Dr. Yang and he explained this technique to me. He spends a lot of time talking to his patients, and potential patients, and I liked him the best of any doctor in terms of being personal and honest with you. I considered doing the filler with the subcision, but I want to start with subcision alone to see where that gets me in terms of a permanent solution. I didn't choose Dr. Yang just because I would have to take the train into Manhattan which is an added expense, whereas I can drive to the other doc I chose. Is this your doctor, lisaw?



#15 lisaw

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Posted 30 May 2013 - 09:52 AM

michi31 - thanks, glad to know that Dr. Yang was good. His article is very helpful. I did ping him but did not set up a consult yet. I am on the other side of the coast so I can't use him. I had a hard time finding anyone who does subcision where I live so I did seriously consider flying out to New York if that is what it takes.

 

For those who are considering Dr. Yang, he consults by skype and charges US$125. 



#16 ughhhhh

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Posted 30 May 2013 - 11:19 AM

 

I'm more scared that it will somehow make the scar worse. It is on the side of my chin, and I have read worse results for this area of the face. Good luck - keep us posted!


Maybe I missed it but did you find out why exactly that the chin area is worse? The amount if muscle and movement? Most derms recommend subscision to me so I definitely haven't heard it. I'm excited for you! I hope it goes well.

And OP post pics please!

 

I don't think I know exactly the reason - whether it's muscle movement or just the skin is less fatty there. It is more that I have read several reviews where people have said it didn't work on the chin, whereas it did on the cheek. I have read a couple where they said it made it worse. I think yours is more on your cheek though so you should be ok.



19lee - thanks for sharing. i have heard that the first week always looks better because of the swelling. definitely, talk to your doctor about augmenting it with a filler. here's some research i found, hope it helps. my best wishes for you - hang in there as you wait. ~ lisa

________________

 

 
 
Subcision with Fillers
Injecting acne scars with fillers can be a very satisfying procedure with relatively minimal downtime.  However, because acne scars may tether down the skin, some of these indented scars can not be smoothed out with filler alone.  Because the center portion of the indented acne scar is tethered down with collagen fibers, the filler tends to extrude around the tethered area to create a “doughnut effect.” In other words, the indentation barely improves, and the edges of the acne scar become filled and rise up higher, worsening the overall appearance.
In these cases, some subcision is helpful in untethering the collagen fibers to allow the filler to lift up the central portion of the indented scar.   Without subcision, the filler does not have enough “hydraulic” pressure to push out the indentation.  Typically Dr. Yang will attempt to conservatively fill the indented acne scars, and if the scar does not lift easily, Dr. Yang will perform some light subcision with the same small needle used to inject the filler to release the collagen fibers before adding more filler.  This helps avoid the “doughnut effect.”
Because the subcised area is much smaller and a smaller needle is used, the amount of bruising is greatly reduced.  Furthermore, the filler that is pushing out the indentation also acts to compress the subcised area.  This effectively reduces the amount of bleeding and subsequent bruising compared to a traditional subcision.  This technique allows patients to experience the benefits of subcision with relatively little recovery time.

 

I had a consultation with Dr. Yang and he explained this technique to me. He spends a lot of time talking to his patients, and potential patients, and I liked him the best of any doctor in terms of being personal and honest with you. I considered doing the filler with the subcision, but I want to start with subcision alone to see where that gets me in terms of a permanent solution. I didn't choose Dr. Yang just because I would have to take the train into Manhattan which is an added expense, whereas I can drive to the other doc I chose. Is this your doctor, lisaw?

 

I just read a study last night that said there was no difference in improvement between subcision and fillers and subcision alone. So I think you're going the right way for now.

And you would be surprised how much fat is on the chin, on the one thats going under my jawline, if I tilt my head forward I can see how much fat is missing compared to the other side, it looks like someone is pulling it in. $%^# I hate these.



#17 michi31

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Posted 30 May 2013 - 11:49 AM

 

 

Oh that's interesting about that study - and surprising. In my relentless google searching I just came across something else interesting - a new method for surgeons where they ensure the needle is at a 90 degree angle so it doesn't dip down and damage the dermis. This made me think that maybe this is the problem for people whose scarring got worse from subcision. It would be a good question to ask in a consulation - how they keep the needle level and ensure there is no further damage. 


Edited by michi31, 30 May 2013 - 11:50 AM.


#18 19lee

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Posted 02 June 2013 - 09:14 PM

Today is the 21st day since my first subcision procedure and no I do not see any result yet - or optimistically, the scar has not been filled. Some see results in 3 weeks some in 4 weeks or even 6 weeks, so I shall be patient. I do feel some aching on both my cheeks once in a while. I will also proceed with my first home dermarolling later today to help boost up the collagen production. Will only do it minimally at 1.0mm since it is my first dermaroll.

 

An additional info that my doctor plan to only have 2 subcision procedure and followed by 2 mixto laser. I see that most people do subcision for at least 4 times, and I have no idea why he only suggested 2. I will ask him again in my next consultation on the 20th. When asked on improvements, he said to be 30-40% from the subcision treatments. 

 

I will update again on my 28th day or as soon as I see any result.



19lee - thanks for sharing. i have heard that the first week always looks better because of the swelling. definitely, talk to your doctor about augmenting it with a filler. here's some research i found, hope it helps. my best wishes for you - hang in there as you wait. ~ lisa

________________

 

 
 
Subcision with Fillers
Injecting acne scars with fillers can be a very satisfying procedure with relatively minimal downtime.  However, because acne scars may tether down the skin, some of these indented scars can not be smoothed out with filler alone.  Because the center portion of the indented acne scar is tethered down with collagen fibers, the filler tends to extrude around the tethered area to create a “doughnut effect.” In other words, the indentation barely improves, and the edges of the acne scar become filled and rise up higher, worsening the overall appearance.
In these cases, some subcision is helpful in untethering the collagen fibers to allow the filler to lift up the central portion of the indented scar.   Without subcision, the filler does not have enough “hydraulic” pressure to push out the indentation.  Typically Dr. Yang will attempt to conservatively fill the indented acne scars, and if the scar does not lift easily, Dr. Yang will perform some light subcision with the same small needle used to inject the filler to release the collagen fibers before adding more filler.  This helps avoid the “doughnut effect.”
Because the subcised area is much smaller and a smaller needle is used, the amount of bruising is greatly reduced.  Furthermore, the filler that is pushing out the indentation also acts to compress the subcised area.  This effectively reduces the amount of bleeding and subsequent bruising compared to a traditional subcision.  This technique allows patients to experience the benefits of subcision with relatively little recovery time.

 

 

Thanks lisaw for this article. It is very encouraging to get help and advise from others who understand. Will look into this and discuss with my doctor :)


Edited by 19lee, 02 June 2013 - 09:09 PM.


#19 19lee

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Posted 19 June 2013 - 11:08 PM

It is almost 6 weeks since my first subcision. Had not been updating as I do not see much improvement. Just few days ago I noticed some improvements, with my boxscars starting to raise and the overall appearance starts to smoothen a little though not significant enough. However I am plagued by some skin irritations/dryness as well, I have stopped my vit c serum for a while and now I am starting to suspect it may be my collagen supplement. So I am not sure if this hinders the overall appearance over my subcision area.

 

Will continue to update if any, and I should be getting my 2nd subcision in another month.



#20 19lee

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Posted 07 July 2013 - 09:50 AM

Today is 8th week since my first subcision and also did a follow up with my doctor few days ago. He compared the photo that was taken at his clinic before treatment and I do agree with him that there are improvement. (I actually forgot to take a photo on my own before my treatment) 

 

Some are filled in some are filled a little and some are not but overall he said the improvement is positive and I will continue to see improvement. Here is a photo of what it looks like now but sorry I do not have a photo before treatment. This is on my left cheek which is much worse than my right so I guess I will just be updating this area. There are still some pink skin irritation from my vit c serum/supplement. In terms of the depth of scar, I would say some are filled in 50%, some are 20%. There are also some smaller scars that looks like enlarged pores which he recommends laser which is something that I lost faith on. But well, one step at a time and we'll see.

 

For now he recommends another round of subcision since I do have positive response from the first treatment. I'll give it another 2 weeks before I go for the 2nd and will be doing my 2nd home dermaroll tonight. 

 

 

 

 

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