I'm doing my research now, and one of the nearby doctors for me is Dr. Rapaport. I haven't had a consultation yet, I'm hoping to go before the end of winter. Anyway, there is a bunch of good basic info on his website and his Youtube channel:
For example: "Lasers don't lift the skin". In other words, if you have pock marks, lasers will not change that (!!!) Good to know!
He also recommends the suction technique after subcision, and tells his patients to take a baby aspirin for 7 days before the procedure. I think he also recommends an herbal supplement for collagen formation (but I can't remember which one - I might be mistaken).
He says TCA Cross requires two to five passes, to get results.
It seems like ALL procedures require multiple sessions to get the best results. In my case, I am anticipating Dr. Rapaport recommends 1 to 3 subcisions, probably 5 TCA Crosses, and 5 or more Fraxel sessions (my skin has multiple types of scarring). Maybe it won't be that bad. But with subcision, for someone with my scarring, I don't think it's realistic to expect that every scar will be addressed in one session. I figure some medium scars won't even be noticed, until the worst ones are improved (kind of like how I didn't notice how bad my acne scarring was until after Accutane got rid of my inflammation. You need to clear the visual field a little first, in order to get a better overview. And you notice the worst problems first). The amount of work required (for me) might be a lot. And it's important to do things in the right order (laser would be last priority, I think, while subcision would be first).
The second video on his Youtube acne scarring channel shows the different types of scars, and how he would address them. I believe this is what he says (correct me if I'm wrong - he uses multiple terms for the same thing, so it's confusing):
acne.tiff 88.23K 37 downloads
Box Scars: TCA Cross, Fraxel Laser
Shallow Rolling: Subcision, Fillers, Fraxel
Deep Rolling: Subcision, Fillers
Ice Pick Deep: Excision, TCA Cross
Ice Pick Shallow: Fraxel Restore, TCA Cross
I think what is implied here though, is that once you improve a scar, then you can use additional methods (example: use TCA Cross on a deep icepick, then if it improves to a shallow icepick, you can use Fraxel too. Subcision on a deep rolling scar, and when it improves to shallow rolling, then add Fraxel)
There is no "one & done" treatment, if you have scarring to begin with. And yes, this is probably hella expensive - maybe too expensive for many. (But since it's a series of treatments, maybe get them once in a while, as you can afford it).
Anyway, it's made me wonder about peoples' comments here, when I see people say "Lasers don't work" (etc) I wonder if they were misled by their clinic about what lasers can achieve, or maybe weren't given the correct treatment (maybe they needed subcision first, and never got it) and of course I fully believe that not everybody will get amazing results even if the doctor does everything right. Most people are average and will get average results (the Bell curve of grading, most people are in the middle).
I'm not promoting Dr. Rapaport, I searched his name and saw that some people here didn't like him. Fair enough. I'm also interested in Dr. George Yang in Manhattan. I don't feel like I'm committed to a doctor if I don't like their style - I'll find somebody else. But I'm also aware that it might require many sessions, and results might be slow. I reserve the right to pick different doctors to do different things.
Anyway, I see a lot of posts with patients making recommendations, so I thought it would be interesting to talk about what the doctors recommend (without inviting them to post here - I'm glad this is a patient's forum!)
Edited by KB2000, 14 January 2014 - 08:50 AM.