TCA CROSS for the deepest boxcars, subcision/suction for the rest, multiple rounds. Some needling in between wouldn't hurt either, the more treatments you combine the better the end result.

Your scarring is pretty much identical to mine. I've tried lots of treatments.

I had a treatment done 2 weeks ago called 'Restylane Skin Boosters.' By far the best treatment I've had so far, made a REAL difference. I need a further 3 treatments over the course of 6 months, so expecting even better results. - http://www.restylane.co.uk/Products/Skinboosters/

Dermal-filler also helped.

Laser treatment did not work at all for me.

Enerjet worked a little.

I think the scars are a little too wide and big for TCA Cross. It's really designed for narrow but deep ice pick scarring. This seems more like the deep rolling and boxcar variety. I would say multiple subcision + suctions would help you the most. Fillers is also a possibility. If you're in the US there is a permanent filler called Bellafill, previously called Artefill. This is permanent so there are definitely risks (but supposedly small as stated by the company). Permanent fillers can cause granulomas years, even decades, down the road, but I think the majority of people do okay with them.

Radiesse could work, but it is very thick and might look lumpy if not injected with flawless technique. For me personally, the only things that gave true visible results have been fillers and dermabrasion. Although dermabrasion is a very rough recovery with many risks.

subcision + fillers ( look for deep fillers like( radiesse / volbella / voluma or maybe your own fat ) and inifin (radiofrequency needling )

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I think the scars are a little too wide and big for TCA Cross. It's really designed for narrow but deep ice pick scarring.

Sufficiently deep boxcars can be CROSS'd, the only real danger of CROSSing is spillage onto adjacent, undamaged skin. If you have enough atrophy to work with then this isn't a concern.

If I were you I'd just stick to Subcision + Suction (3+ sessions) for at least a year or two, then go from there.

Factoid I agree with your recommendations, except I strongly would caution against using high concentration TCA in scars that wide. I have had mulitple TCA crosses and it is not a pleasant procedure when you have large areas of scarring to cover. In fact, I think it would turn out disastrously. Why risk it when subcision is much safer and would work better and quicker to elevate these scars? Remember subcision's effect is all under the skin, so you are not left with open wounds that need to heal by secondary intention (open would healing).

These below are the kinds of scars that TCA Cross is meant for, which are deep but very narrow. You could do TCA Cross and possibly get the OP's wide scars to raise up, but the skin will not look normal. It will be white and look like thickened scar tissue. Remember, TCA Cross basically scars up the inside of the ice picks so that the hole closes on itself. It is basically creating a better looking scar.

http://acnespecialists.com.au/before-after/tca-cross-lasers-red-scars-and-other-scar-treatments/case-12-ice-pick-and-mixed-acne

Thanks for all the responses. I think subcision and a dermal filler are the way to go. The Restylane Skin Boosters are very interesting too. Do you know how long they last and would they affect any other procedures being done after? I've had CO2 laser treatment twice before on my cheeks and temples and I wouldn't do laser again. The Dr was keen to keep repeating the procedure as soon as my skin had healed but, apart from the downtime, I felt my skin was taking too much abuse. Several years later and the treated areas are still slightly redder than the untreated areas. So I'm considering other treatments now.

If I were you go with Subcision and suction. Having looked at those pics above, I need to do the same! I've not found anyone in the UK that will do the temples yet though as they say the skin it too thin.

I've been advised to get 4 treatments of Restylane skin boosters, and then it would need topped up every 6 months. It's about 200 per treatment.

We will definitely need to keep in touch though, as our scarring is very similar.

Cheers.

Yes those subcision pics look great. Disappointing that you can't find anyone willing to do subcision on the temple area in the UK. On the other hand it's reassuring to know that Dr's will consider the outcome and not just take the money. I think I'll try the restylane skin boosters to start with. Have you got before and after restylane pics by any chance?

Do UK Dr's in general not like performing subcision around the temples or just subcision in general?

you could try taking these pictures to them and see what they say. Don't bother with lasers yet..

as for what you said about being reassured, yeah that's not the case in the states, unfortunately.

Subcision is the way to go. I'm a completely different person now, thanks to it

Yes those subcision pics look great. Disappointing that you can't find anyone willing to do subcision on the temple area in the UK. On the other hand it's reassuring to know that Dr's will consider the outcome and not just take the money. I think I'll try the restylane skin boosters to start with. Have you got before and after restylane pics by any chance

On 9/7/2015 at 2:52 AM, Robertitoo said:

If I were you I'd just stick to Subcision + Suction (3+ sessions) for at least a year or two, then go from there.

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Are these your photos?

They do perform subcision in the UK, it is purely the temple area as they say it's too risky with the skin being so thin. I've now asked 4 surgeons in total, and they're all top-end trusted professionals based in London.

Based on your results I'd love to have it done. - I don't know if I could at the moment though as I've had derma fillers etc. I'd have to wait until they die down in 18 months.

This is where I'm at now. This is after treatments with Enerjet, infini, Voluma filler and Skin boosters.

I took the after pic just now in the worst possible lighting and angle showing them in their full glory.

Bear in mind I'm supposed to get 4 treatments of the skin booster and only had 1 so far.

ps. You might not think that's a huge difference considering the number of treatments I've had, I don't want to blow your hopes.

I'd like to point out, the before photo was taken with an old iphone, it doesn't reflect how bad my scarring actually was. The after pic on the other hand was taken with a really good digital camera so it's much more clear.

ps. You might not think that's a huge difference considering the number of treatments I've had, I don't want to blow your hopes.

 

I'd like to point out, the before photo was taken with an old iphone, it doesn't reflect how bad my scarring actually was. The after pic on the other hand was taken with a really good digital camera so it's much more clear.

So of all the treatments you've had the skin boosters were by far the most effective?

I'd say overall so far...

Enerjet made a real difference to the actual texture of my skin, and made some of the scarring a little less harsh.

Infini done absolutely nothing and was a complete waste of 500.

The filler I got is Voluma, so it wasn't actually used to treat the scars, it was to plump out the temples as they were seriously hollow because of fat loss. Voluma goes deep down to the bone. I've not had dermal-fillers which work 2mm deep to treat the scarring as yet. If you look at the before and after, not focusing on the scars but instead the difference is depth, you can see what Voluma has done, especially that huge dip I had at the bottom on the before pic. That's now flat.

Skin boosters definitely made the biggest difference as opposed to Enerjet of Inifini.

With the severity of your scarring you will definitely need a combination of difference treatments.

My aim now is to get another 3 Skin booster treatments, and then get a derma-filler that works close to the skin that should plump out the scars.

I have a similar kind of scarring only on the temple area. Thinking of subcision (with suction) or Skin Boosters as a treatment, or maybe both? Which one to start with? @templeofdoom, let us know about any updates regarding your next treatments. If I am correct Skin Boosters is a temporary filler right?

My scars:

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If you can get Subcision and suction available to you, then go for it. It seems the results are great.

Skin Boosters & fillers always last part of the process. They are temporary, they advise getting 3 or 4 treatments, every 4 weeks. Then 1 top up every 6 months.

Will do, not sure when my second appointment is going to be yet.

Skinboosters is essentially hyaluronic acid fillers, but they are made thinner so that they can be used superficially. Other dermal fillers are thicker and meant for deeper injections.

Hey,

I managed to find a photo of my scarring not long before I had the filler and booster treatments, taken on the same camera, at a similar angle in the same lighting.

I think this gives a better indication of the before & after.

Are skin boosters temporary? The results are really great btw

They are....I've been advised to get 4 treatments, 1 every 4 weeks, and then I'd need a top up every 6 months.

They cost around 200 a treatment.

One question though.

Would TCA Cross method work for this ^^ type of acne scars on the temple ? I know these are not ice pick scars, but they are somewhat similar.

Also, the effects of TCA Cross treatment is permanent as far as I know, whereas fillers are not.