yes I think a few rounds of subscision would be a great start, and make sure you do the suctioning after (at home, look on the owndoc.com site for a medical study and they sell a very inexpensive home device)....from there you could go see a professional for dermarolling on your cheeks

on this form MrMatt is the expert and he has gotten great results

for your temples perhaps a round of fraxel lasers, I've done the erbium and 3 or 4 of those would help smooth things out

and seeing the actives around your lips, I would suggest you switch to a non flouride toothpaste for a couple of weeks...if it helps make the change permanently

and start interviewing doctors around your area to see what they say and who you feel comfortable with...$4k is a good amount of money, but make sure you haggle on price, let them know you have personally saved for this, and since it doesn't appear like you have to do full face they may cut you some breaks

good luck, keep us posted!

The dermatologist or Plastic Surgeon you go to is probably going to want your acne to be under control. If you break out, it could cause more scarring.

I think the trick to treating acne scarring is by combining treatments. Your scarring looks similar in some ways to Dragz, he's on this forum and also left a review on RealSelf http://www.realself.com/review/los-angeles-ca-mixto-laser-asian-skin-for-acne-scars

If I had 4K I would travel to that doctor and get the subcision/Mixto combo. The physician seems skilled, and Dragz has (or had) a combination of boxcar and rolling scars like you do. ***EDIT I think this doctor is also located in Los Angeles!

From personal experience, subcision alone isn't a miracle cure for boxcar scars. As they become more shallow, they tend to get wider and more noticeable. I can still clearly see the edges of my boxcar scars even after three subcisions. Lasers would probably produce the same results. If I had the $ and could reverse the hand of time, I would have gotten my worst boxcar scars excised, either through punch float, punch elevation, etc.

Your scars look very similar to mine. I was interested in having subscision awhile back. However, I spoke with several Drs and they said it is only effective for ice pick scars because that is when the scars are tethered down below the surface causing the hole in the face.

I personally would recommend lasers. However, you would need a course of treatments in order to be satisfied.4k is a lot of money, make sure you shop around and try to bargain. Fortunately for you, you can probably try to tell drs to only do spot treatments on the problem areas. That is what I did in order to knock off a lot of the price. I even found a place in Orange county, CA that did my lasers for 300 a session (only for the cheeks where I had scarring). I had to bargain and tell them I would do a series of 5 treatments. So I ended up going with that.

If you want more immediate results, I would recommend excision for the larger scars. This is basically cutting out the scar and suturing it up. The scar that remains after fades over time. You are essentially trading scars. Rather than have a boxscar, you will have a thin white line. They are barely noticeable over time. The scar that remains will not depress if done correctly by the surgeon. (They suture the wound so that it is slightly raised. As the body heals the wound will flatten out and be in line with the surface of the non excised skin).

Good luck with your whatever you decide.

you could try silicon injections, it will work very well but you have to go to someone highly experienced, im talking 10yrs bare minimum. It would also be cheaper than any laser procedure. They usually charge around $1000 per session.

I thought that subcision was intended for rolling scars? I've never heard of it being used to treat icepick scarring. I imagine it can be done, but subcision provides the best results for rolling scars.

Silicon injections aren't going to help if the scars are tethered down. It can create a donut effect. Plus you're injecting synthetic, non-FDA approved material into your skin.

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yes I think a few rounds of subscision would be a great start, and make sure you do the suctioning after (at home, look on the owndoc.com site for a medical study and they sell a very inexpensive home device)....from there you could go see a professional for dermarolling on your cheeks

on this form MrMatt is the expert and he has gotten great results

for your temples perhaps a round of fraxel lasers, I've done the erbium and 3 or 4 of those would help smooth things out

and seeing the actives around your lips, I would suggest you switch to a non flouride toothpaste for a couple of weeks...if it helps make the change permanently

and start interviewing doctors around your area to see what they say and who you feel comfortable with...$4k is a good amount of money, but make sure you haggle on price, let them know you have personally saved for this, and since it doesn't appear like you have to do full face they may cut you some breaks

good luck, keep us posted!

Hello there, mrsrobinson

Thank you for you encouragement. I'll differently be doing some intense research on suctioning and it's effects. I have also seen the wonders of dermarolling and I'll differently give that a try. This picture was taking around two years. I didn't quite notice that my temple scars are no longer present. My skin has healed my scars on its own. Tomorrow I will be posting two updated pics of my scars so you guys can visualize it better.

I actually went on a non fluoride toothpaste regime for about 2 months. I didn't notice any acne relief around my lips. According to "Chinese face mapping", break outs around someones mouth has to do with hormonal in balances.

Anyways, I will be keeping you guys updated if I decide to go forward with this decision anytime soon.

The dermatologist or Plastic Surgeon you go to is probably going to want your acne to be under control. If you break out, it could cause more scarring.

I think the trick to treating acne scarring is by combining treatments. Your scarring looks similar in some ways to Dragz, he's on this forum and also left a review on RealSelf http://www.realself.com/review/los-angeles-ca-mixto-laser-asian-skin-for-acne-scars

If I had 4K I would travel to that doctor and get the subcision/Mixto combo. The physician seems skilled, and Dragz has (or had) a combination of boxcar and rolling scars like you do. ***EDIT I think this doctor is also located in Los Angeles!

From personal experience, subcision alone isn't a miracle cure for boxcar scars. As they become more shallow, they tend to get wider and more noticeable. I can still clearly see the edges of my boxcar scars even after three subcisions. Lasers would probably produce the same results. If I had the $ and could reverse the hand of time, I would have gotten my worst boxcar scars excised, either through punch float, punch elevation, etc.

Hello there Starlite sorry for the late reply as I was re reading Dragz story all over again to freshen up my memory . Yes my scars are similar to Dragz.

The doctor that performed his surgery was Dr Rahimi. I've heard that Dragz was just endorsing Dr Rahimi. Some negative remarks have made me a bit skeptical about Dr Rahimi... These remarks I found a couple of days ago on this post. http://www.acne.org/messageboard/topic/324141-had-an-appointment-with-dr-rahimi-rahimi-but-not-sure-if-i-need-mixto-please-comment/#entry3312989

My acne is not yet quiet under control, but I don't have break outs that end up giving me scars anymore. I only break out around my lips and chin due to hormonal in balances. I don't know when my hormones are going to get under control. I was just thinking of getting subcision done on the scars that subcision would work best for. Since my acne is still not under control I haven't decided to get Mixto laser that dragz did, since it practically covered his whole face. What i'm trying to do is improve my scarring as of now later in the future when I no longer break out Id love to get the Mixto laser done aswell..

punch float, punch elevation. i'll differently remember that and do some research on those techniques.

thank you so much Starlite . I learned a thing or two from you. Which is very well appreciated.

What do you think. Should I get subcision done on my rolling scars for now and wait it out until my acne is under control to do something similar to what dragz did?

acnescarsarehell

I have never heard subcision be done for ice pick scars. I have heard that Doctors often lie and say that laser treatment is the way to go. This is because they can make a good amount of money on these laser sessions. Do you have any pictures of your improvements? I would love to see how well your cheeks healed using your techniques.

Excision for the larger scars is something new to me and I will have to do some research on that, but thank you for bring more methods to tackle these scars away.

Subcision is best done for circular deep scars (rolling scars).

Unfortunately due to your skin type and scars - I don't personally think subcision would help too much as your cheek scars have jagged edges (could be worth a try though). An aggressive co2 laser might be too rough on your skin type but could help.

I would try to find a doctor who can do subcision, excision, laser and tca cross all in one session depending on the specific scar. No idea how good he is but Dr Philip Young does something along those lines -

"Combining these Acne Scar Treatments is another way of optimizing results. We have found the best approach is through stages where 1.) fat grafting is the first thing started 2. then subcisions, excisions, deep chemical ice pick peeling 3. the last stage is carrying out the co2 laser resurfacing with dermabrasion for the deeper scarred areas. We combine dermabrasion to bring the resurfacing to a deeper layer in a more controlled fashion."

http://www.drphilipyoung.com/procedures/scar-revision/

Scroll down to the videos on the bottom. Watch the 4th one.

If you have a 4k budget my suggestion will be to do stem cell enriched fat grafting first. Dr. Sydney Coleman and Dr. Bafitis are good at this as they probably harvest the fat from Intellicell. After that you can do subcision with dermal grafting. But you need to get your acne under control first maybe through diet, supplements, juicing etc.

http://www.drbafitis.com/dr-bafitis/meet-dr-bafitis/stem-cell-therapy-and-regenerative-medicine/

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

.

You know I haven't heard anything abou tt

 

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

Same, I had 3 vials of juvederm injected into boxcars in the cheeks and the ice picks in temples. I was left with a puffy area that looks like I got punched in the cheekbones, which I massaged and by 2 months was gone. There was almost 0 aesthetic improvement for the $1500 spent.

What do you think about enerjet? I don't have much hope that the juvederm that it injects is going to do much given my past experience, I am just hoping that the pressure it uses to attack the scars from the sides, deep under the skin, is what will make it effective. I don't lose much by trying, if it doesn't work well, I lose $700 and then move on to 1.5mm professional dermarolling, which I have high hopes for.

I thought the theory with enerjet is that the fillers create a space under the untethered scar for collagen to grow into. Which sounds a bit fanciful to me.

You know I haven't heard anything abou tt

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

Same, I had 3 vials of juvederm injected into boxcars in the cheeks and the ice picks in temples. I was left with a puffy area that looks like I got punched in the cheekbones, which I massaged and by 2 months was gone. There was almost 0 aesthetic improvement for the $1500 spent.

What do you think about enerjet? I don't have much hope that the juvederm that it injects is going to do much given my past experience, I am just hoping that the pressure it uses to attack the scars from the sides, deep under the skin, is what will make it effective. I don't lose much by trying, if it doesn't work well, I lose $700 and then move on to 1.5mm professional dermarolling, which I have high hopes for.

you know what I haven't heard anything about enerjet. After my bad experience with Restayln, I sort of put all fillers in the "don't waste my time and money" category. I did meet with a dr one time that said there was supposed to be a filler coming out in the near future with almost permanent results (lasting over a couple years). However, like I mentioned before I feel like these fillers are only good for large holes and wrinkles. I feel like acne scars are different due to the fact that some of them are tethered below the surface and require subscisions etc. I just do not have faith in these fillers. Plus if you think about it, even if it works you will need to have follow up treatments forever in order to maintain the results. A syringe of Restayln starts at around 700+.

I have done about 12 sessions of lasers (erbium and c02) and have gotten some good results. And these results are not fleeting either. I would say that I had scars on a scale of about 7 out of ten on my cheeks. Now I would say they are about a 3, which I consider pretty good. I just recently had a dermabrasion just to try to attack every angle of the scars and have gotten further improvement. I would say around 30% improvement.

I hope these fillers work for everyone else. Maybe I was just unlucky. However, I just hate to see people get this false hope in them. Then they waste their money and time.

Can you elaborate a bit on your laser treatments eg. scar type, what colour skin you have, How many CO2's and erbiums did you get and which laser produced the best results? Your improvement sounds quite impressive. Thanks.

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

Same, I had 3 vials of juvederm injected into boxcars in the cheeks and the ice picks in temples. I was left with a puffy area that looks like I got punched in the cheekbones, which I massaged and by 2 months was gone. There was almost 0 aesthetic improvement for the $1500 spent.

What do you think about enerjet? I don't have much hope that the juvederm that it injects is going to do much given my past experience, I am just hoping that the pressure it uses to attack the scars from the sides, deep under the skin, is what will make it effective. I don't lose much by trying, if it doesn't work well, I lose $700 and then move on to 1.5mm professional dermarolling, which I have high hopes for.

I thought the theory with enerjet is that the fillers create a space under the untethered scar for collagen to grow into. Which sounds a bit fanciful to me.

>You know I haven't heard anything abou tt

I had some fillers done in the past (restalyn). I only saw improvement when there was the initial swelling. After it went down, I had some bumps on my face that did not improve the scars. I truly believe fillers are made for wrinkles or deep holes. I do not believe acne scars respond well to fillers based on my experience.

I've been told by someone whose been injecting for 10 years they only work well on deep scars, otherwise forget it.

yeah that's what I have noticed as well. Even then the results and quickly fleeting. Many drs will try to sell this product so everyone beware! bc it is a waste of money and does not last. Some drs just want to turn a profit. I have some mild boxcar scarring and I saw no improvement at all. In fact I was left with a bump the size of a quarter that I had to massage for several months to try and break up.

Same, I had 3 vials of juvederm injected into boxcars in the cheeks and the ice picks in temples. I was left with a puffy area that looks like I got punched in the cheekbones, which I massaged and by 2 months was gone. There was almost 0 aesthetic improvement for the $1500 spent.

What do you think about enerjet? I don't have much hope that the juvederm that it injects is going to do much given my past experience, I am just hoping that the pressure it uses to attack the scars from the sides, deep under the skin, is what will make it effective. I don't lose much by trying, if it doesn't work well, I lose $700 and then move on to 1.5mm professional dermarolling, which I have high hopes for.

you know what I haven't heard anything about enerjet. After my bad experience with Restayln, I sort of put all fillers in the "don't waste my time and money" category. I did meet with a dr one time that said there was supposed to be a filler coming out in the near future with almost permanent results (lasting over a couple years). However, like I mentioned before I feel like these fillers are only good for large holes and wrinkles. I feel like acne scars are different due to the fact that some of them are tethered below the surface and require subscisions etc. I just do not have faith in these fillers. Plus if you think about it, even if it works you will need to have follow up treatments forever in order to maintain the results. A syringe of Restayln starts at around 700+.

I have done about 12 sessions of lasers (erbium and c02) and have gotten some good results. And these results are not fleeting either. I would say that I had scars on a scale of about 7 out of ten on my cheeks. Now I would say they are about a 3, which I consider pretty good. I just recently had a dermabrasion just to try to attack every angle of the scars and have gotten further improvement. I would say around 30% improvement.

I hope these fillers work for everyone else. Maybe I was just unlucky. However, I just hate to see people get this false hope in them. Then they waste their money and time.

Can you elaborate a bit on your laser treatments eg. scar type, what colour skin you have, How many CO2's and erbiums did you get and which laser produced the best results? Your improvement sounds quite impressive. Thanks.

I just have localized scarring on my cheeks. I am a Asian with fairly olive skin. I am not dark nor am I really light just sort of in the middle. The good thing about c02 and erbiums is that if they are done fractionated, then the risk of hypopigmentation is greatly reduced. I had some doctors tell me this would not even be an issue. The only time I have been told it was an issue is if the laser was programmed to totally ablate the skin (meaning to take a full layer off and is very aggressive). However, even in that scenario the hypopigmentation is not that big of an issue. From what I heard, you only risk hypopigmentation if you go too deep into the skin. You can get collagen regrowth going into the middle layers without risking any hypopigmentation. There is no need to go too deep in the skin as that can also cause more scarring. This is one pro of the laser treatments. They are computerized so the operator can know exactly how deeply they are going depending on the micron settings.

After doing erbium and c02 treatments, I have received roughly the same results from each. The erbiums created pin point bleeding while the c02 did not. The erbiums were also more unsightly during the healing due to the bleeding. I would say with each session I would have roughly 5-8 % improvement which is why I decided to do so much of them. Previously I had done peels, restayln, vbeam/smooth touch, and microdermabrasions which barely helped. In total I had 6 erbium treatments spaced out 4 weeks apart and about 6 c02s. Some of them were spaced 2 months apart because after doing a lot of treatments, the area treated gets thinner and the redness started taking longer to go away. However, if you continually use a hydroquinone gel this would greatly help. Lasers can yield some very impressive results. I went to a consult one time where a dr was saying I could get 40-50% improvement with a fraxel restore. I believe what they were selling was a more aggressive treatment, but the downtime was almost double. The one knock on lasers that I have found is that since they ablate the skin (including the depressed skin), it will uniformly take the skin off. What this means is that the contour of the laser also follows the contour of the depression. What that translates into is that even though you're ablating the skin to make it smoother, you are also following the ridges of the scar. This can take away from the results of the treatment. In addition, once a scar has formed, the skin has what is called skin memory. It will remember that there was the depression in the skin due to the trauma of the acne breakout. So even when you ablate the skin, the skin will try to regrow itself in a similar fashion with the scar. That is why a lot of treatments are usually recommended.

With that in mind, I decided to also try and go with the dermabrasion. The dermabrasion carries slightly more risks but the ablation of the skin sands down the unevenness of the scars rather than "following the contour" of the depression as I had just described above. This makes it so the edges are less noticeable in the scar and therefore makes the scar less noticeable when light hits the depression. I would estimate my recent dermabrasion yielded roughly 30-40% improvement. If you find a dr that is experienced this is also a good treatment. Let me know if this helps. After the dermabrasion I feel if I get one more treatment I would be at the point I would maybe have one or two scars left. I might finally be coming to the end of my 8 year journey! let me know if you have any other questions I definitely want to help out where I can. So many drs try to sell you stuff just to steal your money and or create unrealistic expectations.

I also forgot to mention I had rolling scars, a couple ice pick scars that just look like enlarged pores, and boxscar scars throughout. The majority of my scars are boxcars and were fairly wide and deep.

above I meant fraxel "repair" not restore. Restore is the poor mans version that does not ablate.

also I would not get too caught up in how skin the lasers take off because the real way lasers help is my stimulation of collage regrowth. Only a dermabrasion would be very effective with evening texture of the scars with sanding of the skin. Every laser treatment I had, the scars came back after it healed due to the skin memory. In addition, I would not put too much emphasis on different laser companies such as mixto, fraxel, matrix etc. I have had them all. The efficiency of each one depends on the user settings and strengths programmed. Even a very weak laser can burn and permanently scar someone if programmed to use the max settings. A lot of drs try to sell they use the most up to date lasers. I would not put too much emphasis on this in your decision making purpose. What the drs don't tell you is that they rarely own the lasers. They lease them and never own them. However, everytime they lease the laser they have to pay large portions to the leasor. So in order to turn a profit they have to sell the laser to enough patients. Just something to keep in mind when drs try to sell you certain products. Surgery is a business for gain and unfortunately, scarred individuals like us are usually very desperate.

I agree with the points brought up.

Filler will only work on rolling, non-tethered scars that have a smooth surface. They do not work on jagged, sharp edge scars like large boxcars. I actually think some of your rolling scars may benefit from subcision and filler, but not the sharp edged ones. The exception though may be if you did filler with Enerjet, which from the accounts of a few members, seems to work on boxscars / icepicks (mainly due to how it is delivered into the skin).

@EagerMiner, I cannot believe the doctor injected you with 3 syringes of Juvederm. That is excessive, and I can see why you would look puffy and distorted afterwards. Seems like that guy was out for your money.

Excisions do work, but only if you heal well. Otherwise, you could be left with a bigger problem if the incision line stretches and becomes depressed (happened to me).

Lasers could help to soften the sharp edges of some of your scars, but you need to be careful due to your darker skin type. Be prepared for hyperpigmentation for at least a couple of months.

Lastly, $4K is a pretty decent budget, but from my experience even that kind of money goes pretty quickly. Have a plan, and do test spots to see what your skin can handle. If something goes wrong, it could take a lot of time and money to correct it, and eat into your budget quickly.

Oh, be wary of the doctors who promise unrealistic improvement and try to upsell you on procedures. Don't go to med spas or buy one of those packages! If it doesn't work, or worst, if they cause more scarring you've already dropped the money.

.