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Scar Info From Dr. Rapaport

boxscars rolling scars icepick

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#1 KB2000

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Posted 14 January 2014 - 08:47 AM

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:

 

https://www.youtube....F_PiL5K8nGbCxXK

 

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):

 

Attached File  acne.tiff   88.23K   30 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.


#2 LeadingForce

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Posted 14 January 2014 - 12:48 PM

noone knows for sure alll these doctors with different answers so confusing 

 

but i think the only option that sounds logically is subcision because youre cutting out the hole completely


Edited by LeadingForce, 14 January 2014 - 01:28 PM.


#3 Robertitoo

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Posted 14 January 2014 - 03:23 PM

noone knows for sure alll these doctors with different answers so confusing 

 

but i think the only option that sounds logically is subcision because youre cutting out the hole completely

differn't doctors have differn't techniques, remember that.

 

It's pretty obvious..I think if a derm/surgeon immediately pushes lasers to 'treat' your scarring that should be an automatic red flag...

 

subcision for rolling scars MAKES SO MUCH SENSE..


Edited by Robertitoo, 14 January 2014 - 03:27 PM.


#4 LeadingForce

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Posted 14 January 2014 - 06:50 PM

i think excision is when you cut out the scar opps wrong one



#5 FreshStart2014

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Posted 15 January 2014 - 01:42 PM

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've thought this myself many times.  I recently had a consultation at a popular laser clinic in my city.  The client representative (read SALES rep) suggested that I could see a minimum of 80% improvement on my scars after 4 Fraxel Restore treatments.  She even offered me an additional 10% off if I signed up that day.  Thankfully I knew that my scars were too bound down for any laser to make any difference yet.  I also wasn't feeling particularly depressed about my scarring (that day anyway) so I didn't let emotions get the better of me.  I think people get taken advantage of all the time and it's shameful. But as they say, caveat emptor!


Edited by FreshStart2014, 15 January 2014 - 01:43 PM.


#6 KB2000

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Posted 23 January 2014 - 05:39 AM

 

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've thought this myself many times.  I recently had a consultation at a popular laser clinic in my city.  The client representative (read SALES rep) suggested that I could see a minimum of 80% improvement on my scars after 4 Fraxel Restore treatments.  She even offered me an additional 10% off if I signed up that day.  Thankfully I knew that my scars were too bound down for any laser to make any difference yet.  I also wasn't feeling particularly depressed about my scarring (that day anyway) so I didn't let emotions get the better of me.  I think people get taken advantage of all the time and it's shameful. But as they say, caveat emptor!

I agree, and I would not choose a clinic where I had to talk to a sales rep, instead of the doctor! I think your instincts are right on, there are some clinics that mainly want your money! Even if they wanted me to talk to a sales rep first, "and then the doctor will see you after that" -- no way. Legitimate doctors don't have salespeople working for them!






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