I do not know the best approach to treating scar texture and shallow scars. I am currently stamping. It is too early to see any results. I would have thought laser is the best approach to treating texture and shallow scars. I think it is great for softening scars, tightening, lifting to some degree and sanding down sharp edges. However it doesn't appear to have the ability to transform the texture of scars back to normal and can make enlarged pores more noticeable.
I don't know much about CO2RE but if your doctor used the highest settings for the depth stated, then it is equivalent to Active FX or MixTo. In other words, it is not a deep laser. You will likely experience softening to the surface area of your scars and overall skin tightening. I would be surprised if you notice much shallowing to your deeper ice picks because the laser simply couldn't have hit the base of those scars.
With one pass at that depth, you may not experience much hyperpigmentation. Your skin just might look slightly sun burned where the laser passed. Hard to say. I did not hyperpigment from Active FX. I did experience it where Deep FX was used. Active FX was also the most painful experience of my life while Deep FX was tolerable.
Good luck with healing. I hope you experience a good level of improvement.
Finding the right doctor and treatment can be a journey in itself. I highly recommend that you take your time and do your research using professional opinions, patient reviews and credible studies. I think you are off to a great start. Multiple professional opinions will help you make the right decision for you. Don't rush the process or make a decision in haste. Always remember that "cosmetic" doctors are also in a business to make money. I find the number of detailed reviews for Rahimi on Realself and Yelp highly suspect as they all began to suddenly appear in the same detailed fashion on a pretty predictable schedule over the last 2+ years and they all followed DRAGZ post on this forum. I think it is highly unfortunate too because I do think Rahimi has the skills and experience to help scar sufferers with proven techniques. Unless he is simply chasing the mighty dollar at this point, I don't understand why he would recommend a temporary "lifting" treatment to someone who suffers from facial scars. I am actually upset by it because I know what it is like to spend $1000s on a procedure that can't provide any permanent improvement to atrophic scars. I also know what it is like to end up with further damage. Collagen remodeling will happen with any facial procedure. Procedures can produce positive, negative and no results during the remodeling phase.
If Ultherapy turns out to be another Thermage, there is a chance you could experience additional fat loss down the road. A doctor's skills and experience are irrelevant when a device so new, no one truly knows the longterm effects.
Unfortuately it is impossible to know if the hole will remain. No one can predict how your skin will heal. Personally I would only use neosporin to prevent infection while the skin is broken. Otherwise I would keep it moisturized and use Vitamin C serum, plus a good sunblock with Titanium Dioxide and Zinc Oxide. Taking supplements like Zinc. and Vitamin C are helpful. The redness will definitely fade in time. The hole or divot should also improve as the area heals. Be gentle with your skin by not picking or rubbing the area and the chance of permanent scarring will be lessened. Vitamin E and Aloe have never prevented scars for me, and I used to apply both. I used to apply aloe directly from the plant and unfortunately it didn't prevent scars. If you don't normally scar and the divot was caused by a normal pimple that wasn't cystic, didn't become infected and was not picked, then it should heal fine over time.
Based on the lighting and angle, it's hard to judge the severity of your scars. With the lighting, any shadows could be exaggerated. Looking at the photos sideways is not natural either. I don't see very many scars in the top photo but do see active acne, as well as hyperpigrmentation. I would say you have minor scarring on that cheek. Clearing the acne & hyperpigmention would provide you good improvement. In the bottom photo, you appear to have some boxcar & ice pick scarring as well as hyperpigmentation, but it's really hard to tell. I'm not sure if I see rolling scars or texture shadows in some areas. Better pictures would help. Either way, I would not call your scarring "severe".
I'm curious to know if the OP has taken a break of 4-6 months from needling, and whether the scars resurfaced & returned to normal. I'd also like to see photos.
It's not possible for skin to fully heal or for the dermal collagen remodeling phase to even begin at one week. What you see on the surface does not reflect what's happening under your skin or at the molecular level. As a result, you can cause more damage than good by needling with 1.0-2.0 mm roller/stamp every 1-3 weeks. I understand the desire to improve your skin quickly and also what it is like to be amazed with results when your skin is still swollen and in the stage of repair. However, you have to be realistic too. If you want to obtain permanent,long-term improvement without risking damage, then it's best to take it slow and allow new collagen to form before attacking your skin again. I just get concerned when I see threads like this because people reading it are going to try it at home and some are going to end up causing long-term damage, following the advice of anonymous people on the Internet.
I have never heard of co2 laser diminishing blackheads. Do you mean the laser vaporizes blackheads or helps them surface? I have heard of people getting blackheads and millia after co2 laser when they used aquaphor or Vaseline, as their pores ended up clogged. If you do decide to do laser, I highly recommend using a post-op kit, like Avene's SOS Complete kit and their Cicalfate cream, instead of Aquaphor/Vaseline. I used Aquaphor after TCA Cross and my first laser treatment. Both times, I broke out and ended up with blackheads. Using Avene's kit, I didn't experience any issues and found the spring water very calming for my skin. I do still get blackheads when I wear makeup, so I have completely stopped using powder since my second laser treatment.
I wish there was an "ignore" option on this forum.
If someone has had a bad experience then by all means post it. It is important that everyone know the risks involved, and as far as I have seen there are no "real" treatments that are risk free. Even in my Laser thread I don't shy away from complications, and I reference the famous Christine case on RealSelf. Just recently I saw photos of a staph infection that looked remarkedly like Christine's case. If so, the doctor failed to diagnos her condition.
I agree with you 100%. I am just tired of her false claims, belittling comments, and negative attitude. At one point, I was terrified of laser treatment. In fact, I was shaking when I entered the room for my treatment. I am so glad I took the risk. It's the best decision I ever made in treating my scars. I've had bad experiences in my treatment journey as well. However, I believe those were my experiences. I would never slam the method or anyone who has had success from it because it didn't work for me.
With that said, I hope her comments don't discourage anyone from seeking help. Laser doesn't work for everyone. A small percentage have suffered from side-effects and complications. For me, I was willing to take a risk to improve my quality of life. It was absolutely worth it. There are many here who have done laser and have seen improvement as well.