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acnescar123

Member Since 18 Aug 2012
Offline Last Active Today, 02:19 AM

#3440021 Tightening Skin

Posted by acnescar123 on 08 July 2014 - 12:34 AM

+1 to subcision + sculptra. Finish it off with some facial hair and you'll be good to go.

 

Fat grafting won't do much for acne scars - since fat is too soft/palpable and sinks back down with the scar.

 

Your main temporary options are hyaluronic acid fillers - which are more for finishing touches and not overly deep scars and they last 6 months - a year OR something like sculptra/radiesse - which is more a deep filler and it works kinda like scaffolding attracting collegen to grow - it lasts about 2 years. Personally I think sculptra is the best filler to mix with subcision. The main goal of fillers isn't really to improve your result, it's moreso to prevent the scar bands from reattaching after subcision. Also a lot of doctors will mix different fillers together to give a better result.

 

For Rob, I feel like these scars are perfectly suited for subcision and volume replacement with fillers.  In general fat doesn't seem great for small indentations, but are good for large areas of volume loss.  For example, if your acne caused so much scarring that there is volume loss in the cheeks, ie sunken cheeks, then I can see how fat grafting would help replace that volume and give a more normal contour.  If you have small but numerous indentations, then most doctors I've read on Realself say fat is too globular and lumpy to be injected smoothly beneath a small indentation.   

 

Also, in the fat grafting pics on that doctor's site, notice that they all had significant volume loss in the cheeks.  That is why fat grafting was appropriate.  If say they had smaller, but numerous indentations, fat probably would not have worked so well.  Isn't it also interesting how acne scarring can age a person through the loss of volume?  

 

 

 

 

What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.




#3439303 Recommendations For Reliable Sources For Diy Scar Treatment

Posted by acnescar123 on 03 July 2014 - 10:23 PM

For the "official" stuff:

 

The official dermapen is ~$400 for the personal (fixed needles - sold with 0.5mm but you can swap out to 1.5mm ($75 for 5)) and although prices aren't listed, I'm gussing ~$700 for the professional and ~$1000+ for the medical version.

 

The my-m http://bellaireindustry.com/my_m.html you can get the official version for around $450-$500.

The mesopen http://www.bellairei...om/mesopen.html - not sure on price.

The eclipse http://www.eclipsemicropen.com/ is around $3000 for a full medical starter kit with materials + needles and such.

 

Keep in mind disposable costs for the needles as well.

 

The you have the better quality knockoffs like:

 

http://www.ibeautyma...ma-roller-en-2/

 

Which IMO - I would rather pay extra for the "official" versions.

 

The cheap knockoffs, no idea - but I would be somewhat scared of blunt needles.

 

This thread might help as well :

http://www.essential...=asc&&start=850

 

Another option that can be looked into is a tattoo gun and doing "dry tattooing."

 

http://www.acne.org/...-dry-tattooing/

 

TCA you should be able to get here:

 

https://www1.fishers...searchType=PROD

 

Scroll down for the higher concentrations. Ie I think :

 

https://www1.fishers...PROD&hasPromo=0

 

https://www1.fishers...PROD&hasPromo=1

 

https://www1.fishers...PartNum=A322500




#3439298 Deep Scar / Ice Pick Scar Cure By Water Fast

Posted by acnescar123 on 03 July 2014 - 09:40 PM

Glad to see Panos back on the forum. crazy2.gif




#3438260 Had Fractional Co2 Done

Posted by acnescar123 on 27 June 2014 - 10:48 AM

why no updates?  im guessing you didnt get the improvement you was hoping for.

 

I actually got fairly good improvement and had 2 more treatments done (combination with laser (3 pulse depth), subcision, filler), was just waiting to post until everything was done + could see final result & since this thread turned into a debate about lasers.

 

CYN-011_Workshop_Online_Resource_093011.pdf_-_2014-06-16_03.46.16.jpg

 

 

I float in and out of the forums. What is the talk about ScarFX?

 

GBKderm in SD started using it - but according to their medical reports it has no real benefit + more risks compared to the deepfx, since according to them 2mm is more than enough to get the max benefits of lasers. It's useful for body scarring and hypertrophic scarring according to them though.  http://clderm.com/scaar-fx-lumenis/ . If someone is in the area - they have every laser available, so maybe they can include scaarfx into the treatment.




#3404754 Silicone Microdroplet Fillers

Posted by acnescar123 on 31 December 2013 - 12:49 PM

Also, I wouldn't rush out and say Dr. Lam is the foremost expert either.  He definitely has the gift of gab and can sell ice to an eskimo, but the actual results are not that great.  Take a look at his pictures.  They are modest at best, and some are just crappy.  

 

Dr Lam is probably the biggest expert on silicone for acne scars. I agree though - the pictures on his site aren't that impressive, but IMO that's what the results are actually like vs the pics Dr Channing has on her site and why I said the OP should go look at them.




#3404451 Silicone Microdroplet Fillers

Posted by acnescar123 on 30 December 2013 - 02:07 PM

Dr Lam is the best "known" doctor in the US that performs silicone microdroplet injections. He has a bunch of actual pics on his site.




#3397143 Does Moisturization Helps Scars To Fade?

Posted by acnescar123 on 25 November 2013 - 11:25 PM

My scars look better after appling moisturizer as well - but next day they're back to normal. Think it just looks better while its applied.




#3366308 Had Fractional Co2 Done

Posted by acnescar123 on 14 July 2013 - 11:26 AM

Since this forum has turned more into putting urine and other crap onto your face rather than actual medical devices, thought I would detail my experience.

 

Some other good threads on lasers:

 

http://www.acne.org/...cars-on-cheeks/

http://www.acne.org/...-cheekstemples/

http://www.acne.org/...o2-with-photos/

http://www.acne.org/...ates-to-follow/

 

History:

 

Had pretty bad acne in teens that left scarring as I didn't really do anything to treat the active acne. Mainly boxcar and icepick scarring. Scarring was localized on only the cheeks and that was a major factor in finding a doctor - one who would agree to only treat the cheeks. Also wanted a doctor that would go as aggressive as possible.

 

<space reserved for before pics>

 

Pre-procedure:

 

Was given pain pills, valium type injection, valtrex and an anti biotic. Was also given a blood thinner as the plastic surgeon believes more blood = better results and it prevents blood clots. Was pretty loopy for the procedure.

 

Procedure:

 

Was given ~10 local injections on the cheeks. No numbing cream was used. He did light settings on the outside of the cheeks and a strong setting with multiple passes on the inside where the scarring was.

     

      Pain - 3/10

      Swelling - 9/10 (eyes were almost swollen closed). I assume this is mainly because of the injections rather than the laser. I was frozen up pretty good

       General Discomfort - 3/10

 

Immediately post procedure had a tiny bit of pain, intense swelling and cold compresses were applied. Was sent home around an hour later with some polysporin applied to the face.

 

Post procedure/day 1:

 

c6q.png

 

 

Have just been applying aquaphor. There is just some mild residual pain and bad swelling but otherwise nothing else to note.

 

Day 2:

 

es7i.png

v2y.png




#3361875 Truth Revealed On Laser For Acne Scars**must Read***

Posted by acnescar123 on 27 June 2013 - 01:12 AM

Most of us who've researched lasers have seen that post. Thing is - he doesn't suggest anything else.....so there isn't really any reasonable options other than lasers. I'd also be happy with 50% improvement from lasers. He also hasn't the fractional co2 lasers, everything he says is about the old school co2 lasers.

 

Lasers don't work for everyone - but you can either believe one doctor who most people don't seem to like (http://www.ratemds.c...r-OMAHA-NE.html) or other doctors & medical studies (http://www.acne.org/...-study-results/). Also technically speaking needling and lasers work on the same principle - except that laser adds heat. It kinda doesn't make sense to me when people say needling works and lasers dont (they both cause the same pinpoint damage to the skin and approx. the same depth).




#3355455 Fractora Rf Needling Device

Posted by acnescar123 on 06 June 2013 - 08:51 AM

 

fractora-histology.jpg




#3354411 Mixto Sx Co2 Fractional Laser Surgery Diary: Asian With Ice Pick Acne Scars O...

Posted by acnescar123 on 02 June 2013 - 11:09 PM

Collegeboy - that's most likely because traditional co2 doesn't go deep at all

 

AblativeFractional-diagram.png

 

I think what most likely happens is that the top of the columns gets healed quickly (within the 1-2 weeks) and then the columns underneath the top layer take a few weeks to properly build up collagen and thus why you notice a plumping effect a few weeks later. I don't think they need to go deeper than the scar itself, but they need to go deep enough to hit the bottom of the scars. Technically speaking - I don't think blood matters a lot with lasers as in principle lasers are supposed to coagulate the blood vessels at the same time as they burn it off.

 

Also from what I understand, almost all fractional co2 lasers can reach similiar power settings - it's just based on the doctor to properly set them up (except the ultrapulse which can reach 100% ablation).

 

According to slee's post - his doctor used, "7/20/9 or 7/20/10" which is an index setting of 7, density of 20% and a power setting of 10 watts which on the mixto website are the base settings for acne scars:

"21. What is the best setting for acne scars?  Use the 300µm spot - start with a setting of 12 Watts and Index of 7 with a density of 20%. For sever acne scars a double pass or an increased density of 40% could be chosen if clinically indicated."

 

However, if the doctor wants -

 

"The MiXto does have the ability to go as deep as our competition when using the 180µm handpiece with the proper Wattage and Pulse Duration, however clinical evidence is showing that while using the 300µm handpiece, at 10-12 watts, 20- 40% density, and an index of 6-5 (3.5-4ms) in enough to produce significant skin tone, color, and skin tightening results while maintaining patient comfort and satisfying their expectations."

 

Now in terms of depth - the mixto can go up to 500 microns, whereas the deepfx can go up to 1600 microns BUT the epidermis of the skin is only 100 microns (1600 microns is something you use for scars on the back for example). Since he's using a power setting of 10 and the mixto can go up to 20 (for 500 microns) - he's probably at around 250 microns of depth.

 

Personally speaking with a lot of the stuff you read online about lasers, you have to take into account skin tone, treatment parameters, type of laser etc. I haven't read too many reviews of people who actually knew they were treated at the maximum settings with a fractional co2 laser and with 2-3 treatments (and there are a lot of people who can't use the maximum settings ie asians).

 

I think the key to treating acne scars with fractional co2 is power + depth. If you do too much power - you won't reach deep enough to treat the scars and if you do too much depth but not enough power - you get activefx/fraxel restore. Ideally you should be at 500+ microns with a 40%+ coverage

 

The energy setting doesn't matter too much as that is just the power it needs to reach a certain depth i.e.

 

NsxozOx.png

 

Most doctors only go until they hit the reticular dermis - which is ~300-700 microns in depth (as there is no more tissue to ablate). The issue with icepicks though is that they're usually around 2000 microns in depth (boxcars are ~500) - this is why the top of the scar will improve and look softer, but the scar itself is too deep to actually improve. Dermabrasion is usually around 300 microns and Phenol peels are 500-1000 microns. The new scarfx is 4000 microns.

 

The reticular dermis beings around where the pink ends in the pictures:

 

acne-scars-types.jpg




#3333176 Fractional Co2 Laser Results

Posted by acnescar123 on 13 March 2013 - 06:01 PM

I think most of them do 2-3 treatments in a span of 2-3 months and then wait 3 months to see what happens. That seems to be the ideal thing to do - if you can combine it with subcisision, even better.

 

For ice picks I would look into tca cross first, laser after.




#3333113 Fractional Co2 Laser Results

Posted by acnescar123 on 13 March 2013 - 12:05 PM

Too see reasonable improvement - you would need at least 2-3 sessions over at least a 3 month period (ideally longer though) + a few more months to see the actual final results (3-6 months).

 

 

i havent had it done but might do it in the future. i saw a plastic surgeon who said i would need 5-6 treatments spaced one month apart. i think he mentioned something about how it takes months for collagen production and that i would start to see results after a few sessions so i am guessing at least 3-6 months or so. 

 

That sounds more like fraxel restore, not a co2 laser.




#3332521 Photos Of My Scars - What Would You Do To Fix These?

Posted by acnescar123 on 11 March 2013 - 09:01 AM

Just wanted to say that your scarring looks much better compared to the original photos (even with the redness).




#3332047 Silicone Microdroplets Doctor In Southeast

Posted by acnescar123 on 09 March 2013 - 12:52 PM

Maybe it might be worth contacting Dr Lam and asking if there's a doctor in your area he knows/recommends?

 

Here's some I found on google:

http://www.topdocs.c..._id=443&pid=103

http://www.onlyfaces...ble-fillers.cfm (scroll down to the silicone part)