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Hello all -
I am writing for some advice on my scarring and to determine if you all think I would be a good candidate for subcision.
I am 37 and at age 25 I did punch floats and full-face dermabrasion by one of the best doctors in the world for these procedures. My results were mixed. I had something like 28 punch floats or punch excisions. A couple weeks later I underwent a full face dermabrasion (FYI people, it hurt like hell but I'd probably do it again). The right side of my face improved dramatically from those procedures. The left side not so much and I was actually left with slightly worse scarring on my upper cheek near my left eye where the punch float actually made that particular scar worse than it was before. I can actually feel the indention very clearly when running my finger over my upper cheek. It is pretty deep.
I'm reluctant to do anything for fear of making it even worse. However, I am curious about subcision and a filler like Bellafill.
Keep in mind these photos are with the worse possible tangential lighting. Would you call these boxcar or rolling scars?
Any thoughts would be greatly appreciated!
Yes you would be a good candidate for subcision and filler. Can you pull the skin between your fingers and notice a improvement, this simulates subcision.
I agree dermabration is much better than laser, without the risk of fat loss. It of course has long down time, is bloody, they should have given you more lidocaine if it hurt maybe a pain pill as well. You can also do deep peels like Phenol or TCA, but they are not individualized to the scar like a skilled dermabration.
You could subcise and do filler, so it does not re tether, and then do your dermabration when they pop back up. Typically 3 or 4 are needed of each.You could do that over the next year or two.
I cannot tell as the photo is on a angel they are a combo of rolling ad boxcars, definitely atrophic.
I would not even consider bellafill until you have HA filler after your subcision and see how you like it. There is no going back with Bellafill, and if it's done wrong, then your stuck. Bellafill also has side effects/ Better to start out and see how you like the filler or what you would like to change when and if you do Bella.
I have a mooncrater like scaring so I can understand, and think the bet ting would be subcision, filler, dermabration, and finally Bellafill if you wanted to touch it up.
Keep us updated with what works for you.
Learn more about subcision in the faq below under it's section (it's in my signature).
Thanks for your reply.
With regard to pulling the skin, the bad scar at the top of my cheek does not really disappear. The best way I can describe it is that it is like a tufted piece of leather or fabric (skin) on a piece of furniture. It is really bound. That's why I wonder it it might be too deep for subcision. Am I accurate in thinking that one that is really deep/tethered deeply is not a great candidate for subcision. I have a chicken pock scar on my right cheek (which remained after dermabrasion, btw). This deep scar high on my left cheek is deeper than that chicken pock scar. I know I am probably not describing this correctly but it feels like it is all the way tethered down.
Also, am I correct to assume that subcision without doing a filler (of some kind) at the same time would only (or likely) allow the scar to just re-tether itself down during healing and thus render the subcision kind of pointless.
I'm also worried about the insertion point for the needle causing new scars.
Here is another photo, not sure if it helps any more than the others. Slightly different angle.
I think subcision with filler would help. The filler especially. If they do not cut a pocket with subcision then it will donut around the scar. They need to release the bonds.You only other options are lasers (possible fat loss / dermabration is better), which I do not recommend, and dermabration which will make the scar more spread out but not filled. A combo of subcision, filler, and dermabration would work well for you. Superficial scars (texture) don't do well with subsicsion, dermabration helps more or acid peels. Deeper scars need filler and to release the strong tethers.
I want you to get a dermastamp or the derminator on [removed] and stamp those spots to do some collagen induction at home.
By the way I am around your age so I get the age related aspect of the treatment as well (what this does to scars). I use sculptra personally for fat loss, subcision, and HA filler. I've done all the types of treatment.
Derminator / Dermastamp = collagen production. Collagen production softens scars. This of course will not release tethers, or fill up the volume loss (filler). But it is a good option with the other things to treat the issues. It's the closest thing we have to lasers and can do at home. He also will need a peel or dermabration to soften texture after he is done with sub and filler. When I give suggestions, choose what works for you and what doesn't ... that's just a option;-)
