You have box cars on your temples and some fat atrophy under the eye area of the cheek. There was a gentleman who did well with your type of scars recently with Subcision to the temples, microneedling them monthly and alternating with tca peels to the scarred areas.

Doctors will push having laser which has side effects (like possible fat loss), the machine they use most for this type of scarring is Infini RF microneedling but I would not start with this till you did 3 subcisions and the microneedling and tca peels (At derm, or a med spa) for about a year.

While Bellafill is permanent, it is not instantly noticeable. They must do it over a few filling sessions and it's more expensive than other fillers because of it's permanence. It is done over a period of time. you can do this in conjunction with your subcision if you wish.

http://www.acne.org/messageboard/topic/366500-subscion-on-my-temples-boxcarrolling-scars/

Hey beautifulambition, thanks for the response. I think I've changed my mind about BellaFill. It's permanent and not good for the skin; side effects may show up down the line. I'm definitely not interested in lasers as well.

Do you have any doctor recommendations? Who are the best in the USA for this type of scarring?

Also, I couldn't find any after photos on the link you sent to see the improvement he had.

The picture shows up for me for this one, he shows his after pic from subcision, his temples had box cars as well and he did subcision.

Please checkout my FAQ below (signature). Doctor recommendations are on the bottom. Checkout sections: subcision, microneedling, and tca. I think these 3 things will help you. For the fat loss under your eye, you could do sculptra or HA filler. Same for the subcisions on your temple ha can be used to keep from rethering or... I believe the person in the thread I linked just used a acupuncture vacuum found on like Amazon.

I'm considering going to Dr Davin Lim. I watched his video on scars, and was very impressed. Do you know how long it takes to get an appointment with him? I sent them an email as well.

There is no need to fly to Australia if you live in the USA. Dr. Lim says this himself to those who post they want to see him all the time. Many on my list were his training mentors. I would imagine the wait is quite long, he is booked. You will have to be there for a few months to do treatment. He will use lasers on you. Anyone can do subcision locally in the list on my below FAQ. If that is what you have your heart set on go for it and report back here what was done and the outcome.

If you had to choose between the below 3 options which would you choose:

1. Tri Valley Health (their website only shows results using Sublative, which I've never heard about).

2. Dr. Emer (uses Bellafill as a filler.....)

3. Dr. Philip Young (uses same multi-step treatment plan for all acne scars, and it starts with a laser).

Dr. Emer is like Davin but he very Boutique being in Hollywood. His prices are exceptionally high. He's trying to be a celebrity and you pay for that. He will use tons of stuff on you $$,$$$. He also does Bellafill but is all into the lasers. His specialty is liposuction. But he's also a General Derm.

Does she use any other filler besides Bellafill? I'd prefer the natural HA ones.

Yes, a nokor needle is one my requirements as well for subcison.

Do you think I'd see any extra improvement with microneedling + PRP along with the subcison/filler? I feel like these two are the safest. I'm going to stay away from energy devices unless the person can promise the device is as safe as subcison.

She has ALL fillers. My favorite is Vobella for the temples and Voluma for the cheeks or Resty lyft.

I think you can buy a microneedle at home owndoc.com derminator and even do it after your treatments for upkeep. I think you need filler and subcision. She does prp and miconeedle if you wish, but I don't think this will give you the most results.

What area worries you the worst, the temples?

Subcision, filler, tca peels are great, microneedle for upkeep. There is laser down the line if needed. Also Bellafill if you get tired of fillers or like the look.

Yep, definitely the temples. The left side is worse imo. Regarding the area that needs a sculptra, just so we're on the same page, is that big scar from the screenshot below the area you were referring to? 

Also, how soon do you think I can get an appointment with her? 

The sculptra is for the cheeks, they look fat deficient, see what she says as she is seeing you face to face, she may just use HA here. She specializes in fillers.

Make a appointment for subcision, the receptionist won't know much about it.

Cool, I really appreciate it.

Regarding the cheeks, I wouldn't want them touched at all. I like the way they are; maybe the picture is just making it seem they are fat deficient.

I just the need the scars on my temples improved. One thing that concerns me is the before/after photos. There's only 2 on their website and the patients had very minor scaring.

What do you think about Dr. Rullan? He has a couple of good before/after photos for subcision. Not sure if it's with a nokor needle, however.

Before and afters mean nothing to me. As doctors can hire marketing and photoshop experts to handle all their photos. Others don't even worry about photos so much.

Sure goto Rullan if you want, it's just Subcision not very complicated, I have the full list on the faq of doctors that are closest to you.

Since you are okay with maintenance I would just do something like Voluma or Restylane Lyft since it lasts quite a while and is still reversible if there is an issue. Personally I think maintanence one or twice a year is the way to go since you avoid the issues with permanent fillers. Also, over time fillers last longer and longer if you keep doing them. There is a level of permanence that happens with repeated use of fillers.

Hi Guardian10 ! Just wanted to let you know my personal experience with Bellafill. I went in to get Bellafill in September 2015. Other than a bit of needling with a dermapen/stamp, I had never tried anything for my scars. I have a mix of icepicks and boxcars on my cheeks. The doctor did subcision at the same time for my boxcars before using the Bellafill. They took before pics and I haven't gone back for comparison, even though they called and asked me to. Bellafill does NOT give immediate results and can cause problems down the road. I am not concerned as I only went once for this. It takes time for the collagen to build, so do not believe the ads that say you get immediate results. That is just bullshit. Sadly I was not aware of the pump/vacuum thing to keep the scars from re-tethering after subcision, but with the Bellafill, I don't think they have re-tethered anyway. I have seen a little improvement, but nothing like they advertise. Please stay away from Bellafill. It is NOT worth the money. I have done one TCA Cross with some good results, and did my second TCA Cross yesterday, which seems far better for my type of scarring. I think with a year of alternating between TCA cross and TCA peels I will be very happy . As BA says, getting results for acne scars is not "one and done". BA really knows his stuff and I would trust his advice more than a Doctor who is wanting your money. I am not a professional by any means, but I think I would go with BA's suggestion of subcision and needling with TCA peels (not CROSS like I am doing). Best wishes to you. And btw, you are very good looking as you are.

So has the Bellafill caused problems for you?

We will let kat22 respond with her experience on Bellafill but wanted to add...

@dazzedI have wrote several articles of the side effects of Bellafill that are well known. Have you read my FAQ? There is also discussion under the link in the FAQ on all things filler. Bellafill is not as safe as a HA filler and banned in most of the world, it was created in Germany and Banned there. and most of Europe / Canada due to it's side effects. Dr. Lim will not use permanent fillers besides fat as well. Permanent fillers have permanent problems. There are no truly micro sized injections from a severe atrophic scarred person, when you get mass (fat loss) through multiple injections side effects occur.

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Kat22 -- I appreciate the compliment. Yea, I won't be doing BellaFill. Not worth the risk.

I've consulted with a doctor, and he recommends subcision with a temporary filler. However, the filler won't be applied on the same day. I would get the subcision done on a Monday, and then come back on Thursday for the filler. Any thoughts on that? I thought that was something that is done at the same time.

Guardian - I will leave this to BA. That being said, from what I have read, it seems filler is done at the same time, but there must be a reason the Doctor is waiting. I will see if I can find anything online!

The reason he's telling you to wait is so that the swelling immediately after subcision can distort and disguise your scarring. That makes it harder to inject the filler precisely. Although I wonder if a few days would really be enough to allow the swelling to go down. I've seen doctors do both, subcising and filling on the same day, or subcising and filling on a subsequent visit.

15 hours ago, beautifulambition said:

We will let kat22 respond with her experience on Bellafill but wanted to add...

@dazzedI have wrote several articles of the side effects of Bellafill that are well known. Have you read my FAQ? There is also discussion under the link in the FAQ on all things filler. Bellafill is not as safe as a HA filler and banned in most of the world, it was created in Germany and Banned there. and most of Europe / Canada due to it's side effects. Dr. Lim will not use permanent fillers besides fat as well. Permanent fillers have permanent problems. There are no truly micro sized injections from a severe atrophic scarred person, when you get mass (fat loss) through multiple injections side effects occur.

Thanks. I'm already aware of this, I was just curious what issues it may have caused for Kat22 specifically.

The Dr also stated that subcision would only result in a minor improvement, while fillers would help the most based on the pics. So would subcision even be required? Could I just do the fillers?

If the scars are tethered, you need subcision first to free them, otherwise you will end up with "donuts", meaning that the skin around the scar is lifted, but the scar is still "stuck down". Not sure I explained that well enough!