14 hours ago, 91baby said:

Have you looked around in perth? My dr doesn't officially list subcision as a treatment she provides (as in, its not advertised on the surgery's website etc) i had to call and enquire. So it might be worth actually calling some places in perth and asking about the procedure. Its such an easy procedure so i don't see why you wouldn't be able to find someone in Perth! I wouldn't be going overseas just for subcision, its too simple a procedure for all that effort if you get me

Is it that simple though? I know it's a fairly safe procedure, but I was considering Singapore because they have some of the best. I do know of one guy here actually, but its just at like a medical spa/cosmetic kind of place, not a dermatologist.

On 06/04/2017 at 1:02 PM, Flooressence said:

On 05/04/2017 at 10:31 PM, 91baby said:

Have you looked around in perth? My dr doesn't officially list subcision as a treatment she provides (as in, its not advertised on the surgery's website etc) i had to call and enquire. So it might be worth actually calling some places in perth and asking about the procedure. Its such an easy procedure so i don't see why you wouldn't be able to find someone in Perth! I wouldn't be going overseas just for subcision, its too simple a procedure for all that effort if you get me

Is it that simple though? I know it's a fairly safe procedure, but I was considering Singapore because they have some of the best. I do know of one guy here actually, but its just at like a medical spa/cosmetic kind of place, not a dermatologist.

It is really, really simple. Some people even perform it at home on themselves (im not game enough). If you are going to Singapore already then i say go for it, but if its your ONLY purpose for going i really don't see the point in going to all that effort. All the doc is doing is inserting the needle and fanning it back and fourth under the skin. I think the main reason some have better improvement than others is because of the aggression the doc uses. My doc is aggressive but not as aggressive as some I've seen! Its quick, the downtime is manageable/not painful, the swelling/bruising is easily concealed (for me anyway) and the side effects are slim to none! In saying all that i would def go to a doc not just a spa-type place

I am getting my first subcision with filler in 3 weeks. I just watched some video on the procedure, and how does it not leave a scar? The nokor needle looks huge.

@QuanHenry - tbh ive never watched the doc do my subcision so i dont know how big it is haha but never had any problems

The hyaluronic acid i ordered is at home waiting for me yay so ive booked my 4th subcision for the 28th of may. I know my doc will push the dermapen but im so keen to try a tca peel.. the problem is, she doesn't do peels..!!! If only i knew for sure the very best option between needling and peels. I think a part of me just doesnt want to be so upfront with my doc. I hate feeling like im kind of telling HER what i need rather than HER (the professional) telling me. ARGH. Over the easter long weekend ive been feeling better about my skin.. and then today at work BAM i looked at myself in the elvator mirror under the fluerescent lights and i feel crap again... ughhh

@91babyThere is a old secret with doctors ... If they will not treat you according to the care you need, you can goto another one in between ;-P You need to do what is best for you as a patient. Find a doctor by calling around who will do a TCA peel on you, and let them know that is all you are looking for. Med spa places can also do this type of thing. Many doctors don't do peels because they have lasers to charge $$$$ and be supper quick with. I know in AUS nurses and even assistants can do peels in Drs offices. I'd just call and say I am looking for a TCA peel does your clinic provide this. When they see you they will try to get more $$$, say you want a peel.

Mirrors are kinda funny like that. Avoid them!

@beautifulambition yes, you're right! I just wish she did peels as it was hard enough going into one doctor's office bare faced let alone another one! I dont think i would trust a spa. Would you say the downtime is exactly the same regardless of in-office or at home? As long as it's the same percentage? Ive been looking at reviews on realself and the results look promising. 

i cant wait for the day i DONT have to avoid mirrors!

@91babyYes should be the same in a clinic or at home. Probably quicker at home. Remember you were concerned about down time. I want you only to do one area at a time. The stronger the acid the more down time, and the more the results (it will take more than one time of repeated treatment). The advantage of a clinic is they can do stronger peels than at home, and if any down time or questions / concerns address them. Some of have makeup specialists like Dr. Lim's Clinic in Brisbane.

@91babyThis is something that I am highly interested in doing myself. Not trying to be too forward but I think you are very pretty and your scarring to me looks fine. However, I am glad to see this method is working out for you. I will be following this thread. Thank you.

On 22/04/2017 at 11:05 AM, MSFSnake said:

@91baby This is something that I am highly interested in doing myself. Not trying to be too forward but I think you are very pretty and your scarring to me looks fine. However, I am glad to see this method is working out for you. I will be following this thread. Thank you. 

i would recommend it its helping.. little by little.. but as a procedure on its own it is limited in results. I have made a promise to myself to stay as active as possible on this thread even if it takes years! Thank you that is very kind!

Just so everyone has an idea of the issues i want to address; heres some pics.

Even though the subcision has helped somewhat, the shadowing is still there and probably will be until i can achieve a flat skin surface.

i try to take pictures in the most harsh lighting possible !

@91babyThanks for sharing the pics, I see as we talked about before TCA peels helping you and skin boosters which are superficial HA injections they have in AUS, Restylane vital is one brand there are several. This will hydrate your skin and help some, but of course the peels will resurface that top texture. Have you thought about using retin a cream aka tretinorin and vitamin c serum with your microneedling at home between treatments for upkeep. I think that would help alot.

16 hours ago, beautifulambition said:

@91baby Thanks for sharing the pics, I see as we talked about before TCA peels helping you and skin boosters which are superficial HA injections they have in AUS, Restylane vital is one brand there are several. This will hydrate your skin and help some, but of course the peels will resurface that top texture. Have you thought about using retin a cream aka tretinorin  and vitamin c serum with your microneedling at home between treatments for upkeep. I think that would help alot. 

 

is retin a cream over the counter? What is its purpose? (Sorry if i sound dumb lol) all i really know about it is that it dries out the skin (which is a no no for scarring) - and is it something i could also use with the hyaluronic acid serum i have? I have actually found the HA serum to be quite drying.. which is weird because i thought it was supposed to moisturise!?

also, ive been thinking and could you suggest a peel that isnt as strong as tca but strong enough to help with scarring? Something i can do more frequently and with less downtime (at least until i can take more time off work to do a tca peel)? I am going to do one dermapen treatment with my next subcision and then peel! Thats the plan then heal, then subcison/dermapen, heal, peel etc. Im hoping these 3 procedures combined and alternated will get me good results! 

@91baby Retin a, aka  tretinorin, isotretinorin, isotrex, retinol can also be found in various over the counter creams. Paula's choice has one with Retinol. These are not as strong as retin a but still work the same way. The advantage of these items is cell turn over and antioxidant properties. The skin brings out fresh skin quicker, and heals more rapidly. If you ever run into drying issues use a heaver cream or skip a few night(s) in between application for less results. I use this often at night. You can put a moisturizing cream over it once it dries into the skin. 

HA is not drying, what is happening is your skin is drying, and it's sucking up the moisture. Here is a trick. When your face is wet and out of the shower this is when you apply HA because it locks in the moisture. Some people need more moisture on top of this and put a thick cream moisturizer or lotion coating on top.  

Glycolic is less strong than TCA, they even sell it on acne.org here i the store. I just don't want you to be mad at me when you get minimal results as this is not a strong peel with major down time. In the study of those acid pee white papers , All things acid peel link you should read. They all use strong peels, keep this in mind if your getting minimal results. Pixel Peels are considered low down time peels but are only sold in Dr's offices and Spas. Jessner peels are also a good alternative peel. You can read all about them in the All things acid peels link the faq towards the bottom. 

The doctor who does microneedling should be able to do skin boosters: Restalyne Vital on you, she does filler right? I see this helping you as well. 
 

Hyaluronic acid (HA) is a glycosaminoglycan composed of alternating D-glucuronic acid and N-acetyl- D-glucosamine monosaccharide residue. These are cross-linked to form long unbranched chains, which form an anionic biopolymer. The 3-dimensional structure forms a space-occupying molecule, and the chemical makeup draws a large volume of water to the compound. Due to its combination of properties, endogenous HA contributes turgor and elasticity to the dermis.

Hyaluronic acid has become the leading dermal filler due its combination of low allergenicity, high biocompatibility as demonstrated in ocular and intra-articular uses, and longevity. It is suitable for injection into facial skin, where, in addition to providing immediate and short-term augmentation, it appears to induce longer-term effects by stimulating collagenesis by native fibroblasts.^1,2 Improvements in its in vivo longevity by cross-linking have further boosted its popularity. To maximize its utility and range of applications, HA has been prepared in a variety of forms, which vary in viscosity and formulation. Hyaluronic acid's viscoelastic properties are a function of the length of the molecular chains of the polymer, cross-linking, concentration, and particle size.³ Medium viscosity HA is best for moderate lines and wrinkles, such as glabellar lines and nasolabial folds. It is injected into the mid-to-deep dermis. Finer HA formulations are available for correction of fine facial lines, such as perioral and periorbital rhytids, and are injected in the superficial dermis. Specialized formulations are designed to be injected into the lip, while others indicated for restoring volume lost due to natural aging or HIV-related lipoatrophy are injected into the subcutaneous or supraosteal regions.

Restylane^® Vital is a low-viscosity HA gel, available in 12 mg/mL or 20 mg/mL. It is injected with a metered dose injector that deposits 10 ¼L per injection site (Figure 1).

Given the properties, superficial injection, and microdosing delivery technique, Restylane Vital is an excellent candidate product for the treatment of ice pick acne scars. Twelve patients, whose moderate to severe ice pick acne scars had responded well overall to fractional laser resurfacing but who exhibited residual deep focal ice pick scars, were treated with Restylane Vital. The improvement was immediate, as expected, and the treatment was well tolerated by all patients. Restylane Vital therefore appears to offer an improved treatment modality for the treatment of acne scarring.

Skin Boosters for Face

 

Skinboosters injection into cheeks

 

Skin boosters are related to dermal fillers in terms of what they are made of, the difference with skin boosters compared with dermal fillers is that they are not structural, ie they only improve the skin, rather than improve the supporting structures of the face.

Aging of the skin

Over time, levels of the naturally occurring substance responsible for maintaining skin hydration, HA, reduce.

Hyularantic acid is a moisture binding substance in the skin, giving the skin firmness, plumpness and elasticity. It helps prevent lines wrinkles and fold forming. Moisturizing the surface of the skin with creams cannot replace the Hyaluronic acid loss which is occurring over time.

The solution is to restore the skins natural hydration where the loss is occurring.

What are skin boosters?

Skin boosters replace the body™s Hyaluronic acid and rejuvenate the skin from the inside, it restores the skins hydrobalance, improves the elasticity and skin structure. Creating a youthful luster and glow

What is the procedure for skin booster injection?

The patient has consultation and photos and signs a consent form.

For skinbooster injection into the face, a cannula is most often used. A small injection of local anaesthetic is given in 4 areas on the face (2 at each hairline and 2 at the jawline) a fine needle then creates a hole through which the cannula can enter. The skin booster is injected through the cannula

Pain relief during treatment

A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.

If a cannula is used, local anaesthetic is used prior to the cannula being introduced into the skin

There is local anaesthetic in the dermal filler

Ice is always used to decrease pain and to reduce the risk of bruising.

Very rarely patients will use Penthrox for skin boosters

Nitrous oxide (happy gas) is available for patients to use

How will I look immediately after the skin booster injections?

There will be redness and swelling

The skin around the 4 entry points for the cannula may be white due to local anaesthetic.

Who is suitable for skin booster treatment?

Everyone is suitable (not pregnant or breastfeeding patients)

in particular;

* Those with tired and dry thin skin, lack of skin tension

* Those patients with signs of skin aging

* Those who want the most natural looking results

* Those who are frightened of dermal fillers because or are already happy with their structure, but still want to improve their skin. These patient will be very suitable for skin boosters

* Those with thin skin

* Those with acne scarring

Results for skin boosters:

Improved skin elasticity tone and thickness.

Smoother and firmer skin

Prevention of wrinkles, lines and folds

Protocol for skin boosters

one treatment, once per year suggested, but many patients have it 6 monthly because they love the results

Side effects risks of skin boosters

Bruising occurs in a significant number of cases.

Swelling in the injection area will occur. This may last for 5 days

Infection is a very rare complication, but always a possibility when the needle goes into the skin.

Necrosis (blood vessel being blocked, interfering with blood supply to the skin) is very rare. This could lead to scarring

Need for further treatment: 

How long until the patient will see results

The results will be seen immediately.

Results will improve over the next 3-6 months as collagen stimulation effects start to show

Cost of skin boosters

From $420 per ml. Full face requires 3-4mls. So typical cost for treatment is $1260

Before and after skinboosters, dermal filler, lightening cream and tretinoin

Before and after 1 treatment of 3mls of skinboosters in cheeks.

@beautifulambition thank you for that, all very helpful as always! i would prefer to use the actual retin a if im gunna give it a go. Where can i purchase retin a from? Any side effects or anything i should know? Besides wearing sunscreen (always do) and would i use it before or after that HA? 

ive never heard of skin boosters! That sounds great.. although i dont think i can inject anything until im completely done with the subcision, is that correct?

As for the peels, i just wanted to start doing something while im waiting to be able to get a decent amount of time off work. Ive been reading more tca reviews and some people dont even begin peeling until day 6. I just cant afford that kind of time off  do you think doing a less deep peel than tca would be a waste of time?

Oh and i have read the peel thread (well browsed it) sooo many pages !!!

thanks again

@91babyRetin A you can purchase from ebay, the usa site, and have it shipped there, you have a harder time importing thing in with customs so hopefully its not impounded. Your doctor could possibly prescribe as well. It's a standard beauty cream, so she should be ok with this.

As you dry out, you could do it a few times a week .5% percent . In that case I would wash your face, apply the cream (retin a) then HA, and any cream over it at night.

Skin boosters are great for dehydrated skin, they can be used superfically, Dr Naomi in Sydney loves them. Yes you probably should finish your subcision first.

Do some glycolic or Jessner peels maybe that's all you need. I just wanted you to be prepared it will take off minimal amounts of epidermis. Something is better than nothing. I think the majority on Holiday, or take a few sick days off and do it with a weekend. This is why you do a tiny spot test to see how you heal, and what you can do during that period.

Only the first page has the majority of my posts, safety, and studies on the acid peels sub

@beautifulambition i had a look for retin a but we need a prescription to order online and importing im assuming will take ages. Could you suggest products that contain retin a? Might be easier for now. Also, have you heard of the dmk enzyme therapy mask? I have seen a couple things about it, nothing bad, only good.. would be great to hear your thoughts

i was doing glycolic peels but only a low % and it mostly just 'exfoliated' rather than any actual peeling. Maybe i need a higher % 

im going to speak with my work about the possibility of getting access to work from home 1 or 2 days per week when having treatments and hopefully if they're flexible with me i can really get stuck into treatments!!! I just have a huge amount of trouble speaking directly to anyone at work about my skin so i might need to think of another excuse hmm!!

Differin is now a generic in the US. It's another derivative of vitamin a like Retin-A. It was a prescription only acne medication for like 15 years but just recently became over the counter. You can literally buy it at Target now.

2 hours ago, dazzed said:

Differin is now a generic in the US.  It's another derivative of vitamin a like Retin-A.  It was a prescription only acne medication for like 15 years but just recently became over the counter.  You can literally buy it at Target now.  

that's great! Unfortunately im in australia and that isnt the case here wahhh !!!

@91babyDon't AUS take a trip to Thailand ;-P sold over the counter there. Here is a video by Davin with some products, but I think they are all prescription he does talk about Retinol type creams being over the counter and just as good. I know Paulas Choice Sells some. Other than that can you go into a chemist and ask or something? There aren't reviews for AUS products like Amazon in the states.

dmk enzyme therapy mask - that is a light peel, you need more than a light peel and exfoliation for the cheeks. Just like you said with Glycolic was not that strong before.

Yes talk to your work, say you need to goto a dermatologist for some surgery procedures and need 2 days off at the beginning or end of the week when they have some time. Tell them you'd even be willing to work 3 longer 14 hr days or two weekends when your not getting your treatment. Because you need time to heal. If they push you get a note from the microneedling Dr or something.

@beautifulambition thank you! I found an Australian paulas choice website and have found a 1% retinol cream with good reviews. I will be using it in conjunction with 'moogoo msm soothing cream' as a moisturiser  (because i have used it previously and love it) and the HA is just making my skin kind of tacky and i dont like it! Im continuing it around the eye area though so it doesnt go to waste 

Will report back after ive started using the retinol cream and after my next subcision (and dermapen if i dont chicken out!)

thought id just post some quick pics of what my skin looks like in the morning.. just to show the difference from morning to afternoon. Oh how i love morning skin!!!

Having a quiet saturday night so i thought id show the products im currently using (because i love them!)

the first product is my cleanser, but once a week I'll leave it on as a mask.

the second is the retinol product ive just ordered and will get back to ya'll on how i go with it!

the third product is my sunscree which is AMAZING for acne prone/oily skin - it feels great on my face.. i hardly know ive applied it! 

and lastly my moogoo msm cream which i use as a moisturiser.. so lightweight and doesnt leave the skin sticky or tacky. And all natural!

did ur doctor use any kind of filler after subcision? Or did he recommended to u?

@MikyMor no filler has been used my doc only ever mentioned combining subcision and dermapen. I would have done fillers by now if i was done with my subcision but because i still want a few more subcisions i cant have fillers done as the subcision needle needs to be able to break up tethering beneath the skin and if the filler is sitting underneath the skin too i don't think that would work very well! 

1 hour ago, 91baby said:

@MikyMor no filler has been used my doc only ever mentioned combining subcision and dermapen. I would have done fillers by now if i was done with my subcision but because i still want a few more subcisions i cant have fillers done as the subcision needle needs to be able to break up tethering beneath the skin and if the filler is sitting underneath the skin too i don't think that would work very well! 

Why can't you do sub with filler? 

My plan is to do sub with filler, after that prob use retin a aswell as tca peels and when i see that the filler begins to wear off, i will start microneedling. Once the filler is totally gone i may repeat the whole thing. 

If you have the filler as a spacer, there is no need to subcise the scar because it is still untethered because of the filler.