Imperial925

Subscion on my Temples (boxcar/rolling scars?)

30 posts in this topic

Hello I'm a long time reader and first time poster. I have a chance to book a subscion with a very experienced dermatologist who has done many procedures. Do you guys think I would benefit from subscion based on my pics? And do I have a combination of rolling and boxcar scars? I ask because I read that boxcar scars don't get much improvement from this procedure. Thanks! 

BEFORE:

LEFT SIDE

IMG_2394.JPG

RIGHT SIDE
IMG_2393.JPG

AFTER SUBSISCION:
DAY 2
So far the needle points are healing well. I noticed my derm barely touched the scars closest to my sideburns on both sides. Doing my best avoiding mirrors, seeing my scars plumped up to skin level is very easy to get used to. will start suctioning tomorrow.

LEFT SIDE
image.jpg

RIGHT SIDE
image.jpg

The needle holes on this side looks huge but it's just red surrounding the hole to make it look worse than it is.

Edited by Imperial925

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I see mainly shallow textural box cars. This is a classic area to have it in. Secondly it's skin or surface level. Subcision does nothing for surface level scars. Your best bet for this condition:

Laser, which is bad because of possible fat loss and side effects, maybe it does nothing if not done hard enough, tca peels (you can do this at home) and alternate with microneedle monthly when you heal for a year, or a deep one by a dermatologist Could even be a Phenol peel, that's a serious peel. Finally dermabration by a skilled "facial" plastic surgeon is actually the best treatment. IT has fallen out of favor because it is bloody (diamond file is used to smooth out skin, and skill dependent, they must have done hundreds of them), also you need 3 of them and it has quite a long down time. 

I see a vein / artery behind the spots, which is classic for this area. This means they cannot thin down this area too much as it's already showing. Peels and microneedling would have to be done very sensitively in this area. 


 

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__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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Hey beautifulambition, thanks for the response. I already had the subsiscion scheduled and I took everything you said into consideration. I just became kind of traumatized by lasers and chemical peels that made my skin worse. But I'm sure it's only because I used to go to a dermatologist who did not have my best interest at heart. (Said a cool touch laser would take care of my scars, ended up giving me burns and more scars) and you were right about my veins behind some of my scars, I thought it was just super dark hyperpigmentation this whole time lol.

BUT I did get subsiscion yesterday, I figured it was worth a shot being it was one of the least invasive treatments with a great chance of success, it was a lot cheaper than I anticipated (less than 500) and it was done by a dermatologist with lots of experience doing subs. I also wanted to just log this whole experience whether it works or fails so people can find this helpful for boxcar scarring because I know subs is best ideally for rolling scars. AND you can never have too much experience logs/before&afters right? I honestly would be happy if it only soften the looks of my scars 

This is the day after the sub, I had very little bruising. Obviously still swollen and all scars are leveled out. Definetly waiting what the results will be in a week

RIGHT SIDE

IMG_2397.JPG

LEFT SIDE
IMG_2398.JPG

 

My dermatologist also gave me tazorac to start applying for my hyperpigmentation. Said I could start applying it today. Edited by Imperial925

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I was not trying to dissuade you from subcision ;-P, it's one of the best things we have & filler. I just have seen to many cases of superficial textural box cars. But here's hoping this journey turns out fantastic! You are going to vacuum them right with a cupping vacuum (cupping like the Chinese do) you find on like amazon? Otherwise they will re tether. You do this for 2 weeks to a month, and start a few days after your subcision. 

Keep us informed. Sounds good on the Tazorac. It' just makes the skin cycle turn over quicker. 


** Please "Like" my response above; 2016-12-08_052923.jpg  As a volunteer encouragement helps! |::wiggle:
__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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4 minutes ago, beautifulambition said:

I was not trying to dissuade you from subcision ;-P, it's one of the best things we have & filler. I just have seen to many cases of superficial textural box cars. But here's hoping this journey turns out fantastic! You are going to vacuum them right with a cupping vacuum (cupping like the Chinese do) you find on like amazon? Otherwise they will re tether. You do this for 2 weeks to a month, and start a few days after your subcision. 

Keep us informed. Sounds good on the Tazorac. It' just makes the skin cycle turn over quicker. 

I know you weren't, but you did give me great options. My dermatologist actually suggested microdeedling as well. I am not doing the suction yet actually (I wish I could). I think I'm going to do it on my 2nd sub when I have more days off work. I just wanted to see how my skin would react because I need to go back to work in 2 days. Yes I will definetly keep updating you guys with the progress. 

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2 hours ago, beautifulambition said:

I was not trying to dissuade you from subcision ;-P, it's one of the best things we have & filler. I just have seen to many cases of superficial textural box cars. But here's hoping this journey turns out fantastic! You are going to vacuum them right with a cupping vacuum (cupping like the Chinese do) you find on like amazon? Otherwise they will re tether. You do this for 2 weeks to a month, and start a few days after your subcision. 

Keep us informed. Sounds good on the Tazorac. It' just makes the skin cycle turn over quicker. 

I think Im just going out buy those Chinese suction cups. My question is how long do I leave the cup on my scars per suction?

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As much as you can stand, 4 seconds and move it to the next area repeat this 8 times over whole area. You are trying to induce bruising to keep from retethering - hematoma. 

 

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__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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Definitely start the suctioning right away!!

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If you have pitted scarring look into Subcision-Suction as well as microneeding. Check out my success


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@Imperial925, good luck, you will definitely see good improvement from subcision. I highly recommend suctioning as well.  You can use home microdermabrasion devices for suctioning. They are much faster and you can even do it at work in the bathroom.
For microneedling, derminator is a really good option.
btw can you share the name of the doctor who performed subcision? Last time I had to fly 5 hrs to visit my subcision doctor, looking for someone closer.
 
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@keving100 Thanks! I really hope for some type of improvement. I'd honestly be very happy with only 20% improvement. I did buy those Chinese suction cups so I hope it works out well. I will look into derminator, Is that what you use? If so how's your results? 
I went to Dr. William Ting in San Ramon, CA

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The derminator is great. Less than the cost of microneedle treatment. There is a whole huge thread on it if you want to see, goto the faq in my signature and microneedle. It is in that that section. 

Will be interested your review on Dr. Ting, he is very expensive as I recall. How much was your subcision per treatment? I can add him to the list of doctors in the faq. I remember he was twice the cost for laser as other bay area doctors. I know his consultation fee is high. He has laser genesis that would be great for you as well,.... Didn't he buy a home in Hawaii or something recently, it was on his Yelp reviews. I know the Drs in the area ;-)

https://www.yelp.com/biz/california-dermatology-care-william-ting-md-san-ramon

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__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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@Imperial925 i can go 2.25 mm deep with derminator without even using the numbing cream. This is because derminator has a much shorter duty cycle then Dermapen ie. the needles spend very little time inside the skin.
I would be also interested in knowing how much Dr Ting charged for subcision. i heard he has infini as well. Did he recommended any other treatment as well?
@beautifulambition, in general for what kind of scars is Laser genesis suitable for? one doc recommended me that laser as well, but i just assumed its cuz thats the only laser he owns

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Calling Mr. @Robertitoo weren't you going to get the Laser Genesis for Large Pores?

Laser Genesis is similar to V-beam with it's main objective being for reds, but it also treats large pores, and does a "photofacial," it takes many treatments, I have seen them on Groupon. For redness (it also treats some browns) I like V-beam the most (gold standard) as it works. IPL is great for browns.

@keving100

I have had infini, some people really freak out read realself.com reviews. But they told me I would have no down time. Bull! You get 2 weeks to 3 months down time. Some girls do not like the track marks even with covering them with makeup. I really think it's the doctors giving wacky healing times and promises. Also you need 3 to 6 of them and doctors will tell you one and then nothing happens. You get worse before you get better collagen wise. It's good for shallow box scars, some rolling, and works on ethnic skin. You can get it instead of CO2. Ting I think when I called was the most expensive in the bay area for lasers and Infini. Dr. Bock in Stockton is cheap for this, Dr. Dr Evan Ransom in sf has the machine, and Dr. Seven Swengel in Los Gatos. I really like the laser treatments at trivalleylivewell.com (Livermore) The owner is a nurse with more experience than these doctors have, she worked in a derms office and heart surgery, and head nurse of Washington Hospital for years, I do most of my laser treatments (cheap) here and filler tell her Beautiful Ambition sent you from acne.org, have been in some of her training seminars ;-P. I have seen tons of doctors in the Bay area and LA. They all specialize in different things.

 


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__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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@keving100 @beautifulambition So my first consultation with him was free because his staff was not getting back to me aftert trying to make an appointment twice. Thank god too, I think it's a little over 100 for a consult. As soon as he entered the room I kind of felt rushed, and he did not take a very close look at my scars. I assumed he did not need to because he can probably see any skin problem a mile away. but overall he was great at answering all my questions and concerns. He did recommend the infini laser for 2100 per treatment (kinda stopped listening after I heard the price lol) and another laser I forgot the name, that cost 1300 (I can find out). So you have two price options for subscions. You can get it done by him for 475 for every scar on your face or get it done by one of his aesthetician's for 350. They don't perform subscion on the forehead tho because of the nerves I guess. I asked him how many Subs has he done and he said "I've done so many I lost count". I only went to him because I seen all his posts about subscion on realself and he seemed very knowledable. So far so good.  The procedure itself lasted for 25 minutes. The most painful part was the first injections to numb me. After that, it was tolerable. My gf was in the room so I was trying to be macho lol

 

Edited by Imperial925

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Too funny. Yes he is too expensive for my tastes. If an  aesthetician  is doing a subcision (that's nuts) only a nurse or dr is supposed to do it. Then I would think it's not traditional subcision at least by the aesthetician (See needle below). This is because a nokor needle has a scalpel on it to cut the tethers. Many aesthetic derms only use normal needles which don't do as good of a job. See how a normal needle they stort of stab to find the spot and a nokor they cut back and forth like a knife. 

Yes  have always been sorta hesitant about his reviews. If you look on yelp lots of good ones and lots of bad ones. I suppose he pays off good reviews. He has a huge marketing budget. The not looking at you is not a good sign that means he really doesn't care and will do his standard treatments $$$$.

Regarding infini the going rate is $1000 with discounts if you buy multiple treatments. His price is sooooo expensive.

Anyone who can handle injecting can do subcision (nurse or doctor). The problem is no one does it in the bay area or elsewhere (very few) as its cheaper than their expensive procedures. They would rather laser everything. It's considered old school and not flashy like a Mohs surgery for cancer. So the older derms who are surgeons can do it or if they are say at a teaching university hospital for derm. Several can do the stabbing normal needle subcision, (but few can do the nokor as they just aren't trained in it). They stab (subcise all the time for filler injections). I think I only paid $300 a subcision full face, California Skin Institute Group have price fixed the bay are with their drs all in the group (lots of bad PS and Derms). 


Image result for nokor needle
Image result for 22g needle

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__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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Imperial925, 
475 for each scar? So how much you paid for one cheek???

Edited by Unap

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Beautifulambition,

Can you tell me which derm you  consulted with from the California Skin Institute? I want to do subcision too. I read the reviews of Dr Morganroth and am too scared to consult.

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Dr. Ting is part of CA Skin Institute (There are quite a few doctors part of their network). They are extremely expensive. $475 for each scar. Just not worth it. The filler is more important than the subcision in my mind and thus costs more by market value. They price fix with many derms in the bay area who would never get business otherwise. They take a cut for their central website and answering service. Subcision really isnt that tricky, but few doctors do it (not glamorous, does not yield high dollars like other procedures (laser), some do not take this course in med school as it's considered old school compared to the $$$$ laser). But it works!

The most reasonable (not as expensive as CA Skin Institute) / best subcision I have found in the whole SF Bay Area, CA is from Tri Valley Health and Aesthetics in Livermore (east bay) by Donna (more details are found in my faq on the bottom). They specialize in filler with their subcisions and sculptra if your fat deficient. Dr. Dhawan in Fremont is still expensive but cheaper than CA Skin Institute, his wait is like 6 months because he takes insurance and has too many people come to provide timely care.  

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** Please "Like" my response above; 2016-12-08_052923.jpg  As a volunteer encouragement helps! |::wiggle:
__________________________________________________________________________________________________________________________________________

2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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Okay, only read quickly through these posts, but $475 for one scar?  That is outrageous.   So unfortunate that he Bay Area is such a poor market for good scar doctors.   OP, I would pass on infini.  The purported pay off is not worth the risk frankly.   I've been following some outright disasters on Realself.  The more I read, it becomes clearer that lasers and energy devices are a money making scheme for the doctors with very little photographic evidence of success.  When there is photographic evidence, it's always showing the damage.  

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Maybe it is the heat produced by these machines that can damage the skin...

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@Unap @dazzed

I have done all the procedures I speak about and often advocate for no energy device treatments. The above OP has surface box cars. Anything surface is the hardest thing to treat. There is no magical surface procedure yet. With box cars they can be all over the face. You can do a hard TCA or Phenol peel on them or Dermabration, or Something like Infini and Laser. Filler often does not work because it's too close to the surface. Subcision is a amazing treatment, one of my favorite. Whenever I do filler I get it done also. The area he had it done in one has to be careful about as there is a major artery behind there. I hope it works out for him.

The bay area is so incredibly expensive with doctors even more than Hollywood PS often because everything is expensive here including housing etc. They price what their clientele will pay $$$$ Because of price fixing by CA Skin group they set the prices high, that's most of the derms who do this. It's considered cosmetic so out of pocket. They are trying to get a few thousand per session and subcision should be cheaper than say laser so they price it the same and push laser, which is quicker and easier for them. 


Infini has down time up to 3 months, just like laser. The Manufacturer and Drs often say there is no down time and promise it will do everything. Drs give false promises to often aesthetically perfect women (They are often the ones who give the bad review for this) that it will improve their flawless features. As Unap said any heat causes tissue destruction the body must heal and replace. Thus it gets worse before it gets better. Many freak out before 90 days. Sometimes it works and sometimes it does not (it can also cause fat loss in some if they go too deeply or too high with the power). So these perfect women get it done and their makeup is messed up for multiple months (yes you can have track marks for a few months). Just like a CO2 laser treatment. Secondly some doctors turn up the energy high to see improvements. When the new data shows turning down the energy is better and giving more treatments, and not going too deep into the fat. Too much and the energy creeps up to the skins surface issues. 

Real Self is great but keep in mind most are people who have had bad results and not the good ones. 

Also some patients are not good candidates for the procedure. If you are sensitive you will even have issues with laser. It's being sold also for weird reasons. IF you need a face lift it will not do the same thing. 

But yes my favourites are subcision, HA filler / Scupltra or fat loss, tca peels (they are on the surface), dermabration by a skilled Facial PS, TCA Cross for Icepicks and the derminator by owndoc.com aka micorneedling. These work and do no distrub the fat or lower dermis. IF everything else fails go try the energy devices which is a gamble. 
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2016-12-08_052802.jpg :smileys_n_people_116: CLICKABLE LINK: OFFICIAL ACNE SCAR SOLUTIONS; Q&A / FAQ :smileys_n_people_108:
TABLE OF CONTENTS:
1. SUCCESSFUL TREATMENT THREADS                                                                 7. HYPERTROPHIC / KELOID (RAISED SCARS)
2. WHAT IS ACNE & PREVENTING SCARS                                                              8. SUBCISION
3. DIFFERENT TYPES OF SCARRING                                                                      
9. FILLER FOR SCARS
4. TREATING SCARS AT HOME                                                                              10. LASER
5. SKIN: RED (PIE) BROWN (PIH), WHITE MARKS,                                               11. MICRONEEDLING
     TEXTURE, LARGE PORES,  DRYNESS, & COVERING UP SCARS                    12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS                       
6. PUNCH GRAFTING & EXCISION                                                                        13.
LIST OF ACNE SCAR TREATMENT DOCTORS

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Agree.   Lasers and resurfacing should be the last resort after doing everything else.  It's too much of a gamble.  Subcision may or may not work, but it does not have a high potential to damage you like with lasers.  At most there may be lumps that can be injected with steroids.  I think the safest, and often best route is subcision and fillers, TCA cross, and lasers in that order.  

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