4 hours ago, Leon1994 said:

Can't understand the people here who are no doctors and say that CO2 is the badest thing ever

Well, for those who are not in-the-know, here's a brief rundown on how much laser, especially CO2, can potentially damage the skin, along with the video from our all-time favorite guru showing how deep erbium laser could penetrate at max depth. Now I'm not saying laser is all evil and one should avoid laser at all cost. There are times when the use of laser is warranted but these days with doctors peddling laser for everything under the sun...well, you get my point.
 

Comparison of tissue effects of carbon dioxide and Er:YAG lasers

Each Er:YAG pulse removes only 25-30 µm of tissue compared to the pulsed carbon dioxide, which removes 50-100 µm.

The laser output of Er:YAG is directly absorbed by collagen and dermal proteins, whereas the carbon dioxide laser vaporizes extracellular water in the dermis. Each Er:YAG pass generates the same amount of ablation, whereas the pulsed carbon dioxide generates a decreased vaporization depth with each pass. Also, a very small additive effect of increasing thermal damage occurs with the number of passes; proportionately, pulsed carbon dioxide has more energy contributing to thermal damage per pass.

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If Er:YAG can shoot through 365 pages of paper, how much more do you think CO2 can vaporize? 
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Guess how many pages of paper your praised Infini can permeate ?

@tasinhooooYour doctor is doing the procedure, please ask him these questions. You are also PMing and I try to advise so thank you for your patience.

8 hours ago, tasinhoooo said:

Guys is it safe to fly a few hours (4-5) after subcision,prp,tca cross?Will that swelling or blood filling be a problem on my flight?I dont know if i will have a complication/side effect during flight which causes high blood pressure.A doctor told me that is unsafe.I'm worried about blood clots/thromvosis.Can you please inform me about that?Thanks in advance.

Dr Chu told you that? I think people, including guys from this forum, fly over to see him and hop on a flight right after... I am gonna do exactly that  because last time in Denmark I stayed 2 more days and I felt it was super unnecessary. The only thing I will be worried about is sunshine  - I hope the weather will be super ugly and rainy But I agree with BA, you re  clearly pannicking, and while I empathize with you, it is getting overwhelming. Maybe you can start your own topic about your trip and questions, or...?
Can you try to get a few tranquilizers from your local doc before the trip. I really think you re gonna need them.
I am not a medical expert but you re not gonna get blood clots from just a being on a flight - if you however are prone to blood clots or blood clotting disorders, you have to inform your dr about that. 

Hi guys,

so it s been four weeks since the subcision and I must say, the scars have been filling in quite nicely- there is some progress in all of them, on some scars it is only little (10-20% maybe), on others up to 50%, especially in the mornings... I will take and add pictures in the next post.

Now I would like to bring up something different.

The more I learn about the types of scarring and proper treatments, and how they (dont) work etc-  I am starting to see real hope for my cheeks - with the help of sub+ fillers and a round of treatments for texture, I can see it going really well in the future.

However, I want to address something that is reaaally bringing me down lately --- and that is my forehead

here are some pics (I feel the first one wasn't a true reflection of these horrible, and I think for forehead quite deep, scars. notice the deep one that is right in the place where my future frown line is forming. even though the line itself is not there yet when I relax, thanks to this bitch it sort of looks I am frowning constantly)

the fact that most insiders (here, pros on realself, etc) confirm that this is often the most difficult area to treat and barely shows noticeable results doesn't add much to my frustration. as I age and frown and new lines and wrinkles form I know this will only be getting worse and worse.  

I would love to try the botox+subcision+saline approach but I am skeptical that I find someone (soon) who is able and willing to perform it.

all doctors I have seen so far, including emil, said just one word - go for laser.

(when Lim specifically says that this area poorly responds to lasers or needling and manual handling of individual scars yields best results)

I am so scared to get the usual fillers in the forehead. I see the warnings everywhere, @Obi wan also spoke about the main arteries and the risks  of emoblism etc etc. 

Guys, @Obi wan@beautifulambition or anyone else knowledgeable - will botox alone (without sub) going to help improve the appearance of scars? probably not, right?

assuming subcision is needed- the botox should be placed in the pocket - similarly as filler is?

the reason I ask in such detail is I am going to see an experienced dermatologist/filler injector in my hometown day after tomorrow and I wanna be prepared to tell her about this method. cause I don't think she will be familiar.

How does one perform vertical subcision? Isnt it kinda the same as single needling? I own a derminator - can I single-needle/subcise vertically the scars myself...?

Does any of you know if Chu might perform it? 

Also, Obiwan said that the botox in the scar alone will bring permanent 20-30% result. Can you clarify, please? I dont understand how can it bring permanent result when even botox is temporary. Isnt there a risk as with any other "spacer" that once it runs out, the scars will re-tether?

Thanks in advance for answering my questions and maybe putting my unhappy soul at ease.

I just wish there weren't so many risks associated with the treatments. I find myself being scared all the time; of fat loss, fatal filler accident... It is reasonable to be cautious but... Seems unfair to me that after I have come so far, saved up a lot of money and started this journey, I am not able to just go fearlessly forward ...

9 hours ago, EagleEva said:

willbotox alone (without sub) going to help improve the appearance of scars? probably not, right?

Unfortunately, wrinkles and scars are not created equal. Their composition is very different. You can get rid of wrinkles by relaxing the muscle while tightening the skin. Sadly, botox cannot work in the same manner for scars. However the common consensus is that it's good to have botox injection at least 1 week prior to undergoing subcision. This will supposedly give a better outcome.

@Sirius LeeAnd why is that?

I have seen good results for forehead issues with the following: rf microneedling, or fully ablative erbium resurfacing, or a deep phenol/tca peel under sedation to get under the scars.

I would not worry about these treatments because they mainly work on the upper portion of the skin and not it's vasculature. If your getting winkles you treat with botox.

Did you inquire with Dr. Emil/Chu about the botox subcision approach? Laser can be beneficial on the forehead if one uses fully ablative erbium not fractional. Limsaying handling them individually simply means to have them subcised individually weather by botox or filler and then resurfaced. It's not a one and done thing is what he's saying.

Fillers by a experienced practitioner are fine and only if they are HA placed superficially or with a cannula is very safe. The doctor just needs to know anatomy. If you don't do filler they can just subcise and use saline/botox. Botox does not need to be placed exactly in the pocket but can be spread around the muscle providing two forms of treatment (botox, and dispersed filling - spacer).

Chu would use PRP to do this and that might work for you, it's just your own blood, you would also do Chinese cupping at home. Because the simple act of subcising or cutting can make tissues under the skin, hence 20-30% "can" occur, it really depends how you heal. Worth a try with Chu right and PRP. As with anything, I am extremely honest and yes you may need more filler or it may reattach. But it's worth it, as you always get some improvement, especially if your Chinese cupping (amazon) as well.

10 hours ago, EagleEva said:

@Sirius LeeAnd why is that?

Scars, especially tethered ones, can pull against the muscle and cause wrinkles, dimples, etc.

On 14. 2. 2018 at 9:28 AM, beautifulambition said:

Did you inquire with Dr. Emil/Chu about the botox subcision approach?

Fillers by a experienced practitioner are fine and only if they are HA placed superficially or with a cannula is very safe. The doctor just needs to know anatomy. If you don't do filler they can just subcise and use saline/botox. Botox does not need to be placed exactly in the pocket but can be spread around the muscle providing two forms of treatment (botox, and dispersed filling - spacer).

Thanks so much once again.

I inquired with Chu - he doesn't do neither fillers, nor botox. They didn't answer my question about saline so I will have to see for myself in 2 weeks.
Emil... well, I sent that e-mail week after my treatment with some questions and also asking for a next treatment date and no one ever got back to me.... It s been 3 weeks, don't know what to make out of it? Professor Chu's assistant on the other hand always replies swiftly.

I am seeing the local dermatologist today. From what I understood from information online, she performs subcision with a cannula? I will see today.

14 hours ago, Sirius Lee said:

Scars, especially tethered ones, can pull against the muscle and cause wrinkles, dimples, etc.

Sirius, sorry, I wasn't clear. I meant- why a botox before sub is supposed to improve the result? Does all the frowning and moving increase the chances that the scars retethers more easily? Is this the idea behind it?

Hm, OKAY, so it was another dermatologist that was pushing laser on me (fractionated Er:YAG)... as every doctor I have seen locally so far, she has not shown me any pictures of her own work, just a presentation from the company with assumingly "before and afters" w the laser... different lightning, deep icepicks all over > smooth skin no icepicks ... yeah, sure, I am totally buying that  
I am going to see a couple more dermatologists here in my hometown but I don't expect to encounter much different reactions...everyone seems to love the laser here.

However, she performs this sort of a subcision - the style where she works with a cannula and injects Restylane with it, she calls it a "skinbooster" method. I might get this after I come back from London and wait a bit until the swell goes down.
However, I don't know what Chu will decide to do, maybe he will do mostly tca cross and in that case I guess I will have to wait til the scabs fall of beofre I get filler.

We will see.

Chu can do prp and subcision, and microneedling for a cheap price. Yes do that when you get home with the cannula. You can get filler with a cannula if the provider will do it while you heal from cross, inquire and ask them.

Dr Chu does subcision on forehead.I ve done myself.I still have bruised eyes(like a panda) and Im on day 8.I still have some lumps when i touch my skin,so when can I go for filler?

16 minutes ago, EagleEva said:

Hm, OKAY, so it was another dermatologist that was pushing laser on me (fractionated Er:YAG)... as every doctor I have seen locally so far, she has not shown me any pictures of her own work, just a presentation from the company with assumingly "before and afters" w the laser... different lightning, deep icepicks all over > smooth skin no icepicks ... yeah, sure, I am totally buying that  
I am going to see a couple more dermatologists here in my hometown but I don't expect to encounter much different reactions...everyone seems to love the laser here.

However, she performs this sort of a subcision - the style where she works with a cannula and injects Restylane with it, she calls it a "skinbooster" method. I might get this after I come back from London and wait a bit until the swell goes down.
However, I don't know what Chu will decide to do, maybe he will do mostly tca cross and in that case I guess I will have to wait til the scabs fall of beofre I get filler.

We will see.

where are you located?

@tasinhooooWhen your bruises and lumps go down. Massage them if you wish. Those lumps might provide some natural filler under the skin, especially if they are not visible 😉

21 minutes ago, beautifulambition said:

@tasinhooooWhen your bruises and lumps go down. Massage them if you wish. Those lumps might provide some natural filler under the skin, especially if they are not visible 😉

I applied castor oil and massaged a little,but I was afraid that I could be bad for my healing.Lumps are not visible,I can feel them only with touch or when I move my muscles(little pain).So,do i have to wait too,for the scars he did tca cross,to change colour(scars are still red) before doing filler?I'm on 8th day,shouldn't I start worrying about scar re-tethering?

You dont normally fill TCA cross as your raising the scar bed. If you have lumps you don't fill. I don't know how you heal, ... if nothing is re-tethering and your staying swollen then just wait till it goes down a bit. Red will stay for a long time with TCA cross. Up to you... You can skip filler the first time till you know the pattern of your healing. you will get some improvement without anything if you have lumps.

1 hour ago, EagleEva said:

Hm, OKAY, so it was another dermatologist that was pushing laser on me (fractionated Er:YAG)... as every doctor I have seen locally so far, she has not shown me any pictures of her own work, just a presentation from the company with assumingly "before and afters" w the laser... different lightning, deep icepicks all over > smooth skin no icepicks ... yeah, sure, I am totally buying that  
I am going to see a couple more dermatologists here in my hometown but I don't expect to encounter much different reactions...everyone seems to love the laser here.

However, she performs this sort of a subcision - the style where she works with a cannula and injects Restylane with it, she calls it a "skinbooster" method. I might get this after I come back from London and wait a bit until the swell goes down.
However, I don't know what Chu will decide to do, maybe he will do mostly tca cross and in that case I guess I will have to wait til the scabs fall of beofre I get filler.

We will see.

If someone cannot show you pictures of her before and afters - RUN.   It's a huge red flag.   If she is saying that lasers are the best, then it should be easy for her to provide you with pictures.  If she is only able to show you a MARKETING video, then she is most likely not an expert.   I would ask to try fillers and subcision first before doing more aggressive procedures.  Do NOT ever let someone coerce you into doing something you don't want to do.   A lot of doctors will try to strong-arm you into doing what they want with ZERO input from the patient.    Remember, you're paying them.

My recommendation from tons of personal experience with all kinds of treatments and doctors is to ALWAYS start with less invasive procedures.  And when you move up to more aggressive procedures, always do a test spot first.    This is to avoid situations like the one we just saw from a thread that was deleted.

thanks @dazzed, I'm having the same gut feeling. Luckily I have never let anyone to talk me into sth against my intuition and always walked away when getting uncomfortable/realizing its not the right professional. I personally never had problems with assertivity and saying no but I know many people do. On the other hand, now that leaves me w the feeling I described earlier. That I am all too often giving in to my fears and am not really progressing anywhere.:/
However, I have NEVER met a dermatologist presenting with their own pictures here where I live.

1 hour ago, dazzed said:

If someone cannot show you pictures of her before and afters - RUN.   It's a huge red flag.   If she is saying that lasers are the best, then it should be easy for her to provide you with pictures.  If she is only able to show you a MARKETING video, then she is most likely not an expert.   I would ask to try fillers and subcision first before doing more aggressive procedures.  Do NOT ever let someone coerce you into doing something you don't want to do.   A lot of doctors will try to strong-arm you into doing what they want with ZERO input from the patient.    Remember, you're paying them.

My recommendation from tons of personal experience with all kinds of treatments and doctors is to ALWAYS start with less invasive procedures.  And when you move up to more aggressive procedures, always do a test spot first.    This is to avoid situations like the one we just saw from a thread that was deleted.

True words. My plan when visiting the doctor in Denmark was just to get dermapen as a starter, but he insisted i do subcision for my rolling scars. Which makes perfect sense, Eva did the exact same with him so i trusted my gut feeling and agreed to the procedure on the spot. However I have in a way regretted doing something so invasive on my first visit because my cheeks are still extremely swollen (although it has been 4 days) and there are purple/red spots across my cheeks.
One thing i can't thank enough though is dermablend. Fortunately, technology and science has improved makeup to a level dermatologists can't keep up with. I can hide these purple and red spots even acne scarring! 

Golden words coming from you. And i'm not sure anymore that the doctor i paid a visit deserved my visit. Going so invasive without having any prior knowledge about me isn't the most professional thing to do. But we learn as we go and i dont  truly regret my choice, I've just learned from it

@incepticon sorry to hear you didn't find Emil a good match for you. especially since you re so close to him! I liked him, however dont understand why no one from his office responds to my e-mail now... Im really hoping it s a misunderstanding.

" Going so invasive without having any prior knowledge about me isn't the most professional thing to do "
however, I dont understand this at all... how intimate you wanna get with a doctor before he performs subcision...?  What do you want him to know about you? How many times you wanna meet him? Was it you who just finished accutane recently? In that case, you need to tell him everything you feel is important for him to know, this is really on you.

Dermapen would do nothing for your rolling scars, trust me. I love Dermapenning but I consider it rather a maintenance for the overall skin texture and tone, does very little for real scars. 

Just to underline my point from my last post: when I visited him and he isnpected my scarring, he offered TCA cross+ ERBIUM! It was me who said I'd actually like to try subcision and he agreed to do it. I def wasnt pushed into anything, actually it was quite the other way round  

I would love to switch positions with you actually. Having a local doctor who does nokor sub, filler and other kinds of subcision (yes, as a starter). Now I have only this (seemingly) incompetent dermatologists around me who dont even have a clue about the typology of scars, none of them ever touched my face, looked at me under direct lightning...

I mean, trust your intuition, absolutely  - but I think that once you set off on this Odyssey, searching for the right Dr, you might realize it s really hard and he might have been one of the better ones out there.

@EagleEva Naturally I informed him about my accutane and he said there is absolutely nothing to worry about since according to him the accutane+scar revision thought is completely debunked and holds no ground. Before visiting him I did a lot of research on this subject and most newer scientific papers agree with his points so I wasn't really worried about the accutane thing. I agreed for him to perform subcision on me because I didn't think he would go so damn agressive with the needle. Upon finishing the procedure both of my cheeks were covered in purple and red spots and they were extremely swollen.

I'm not saying he should have known about my exact skin type, but at least he could've informed me about the possible complications since i informed him that i need to be in front of people in my job on Monday. He said there is absolutely nothing to worry about. The heamatomas/seromas are still present in my cheeks and it's truly not a pretty sight with the red/purple spots alongside (again thank god for dermablend).

I honestly hope you are right and he will live up to that reputation, right now im just thinking about my cheeks and whether they will improve or get worse once the swellings and heamatomas/seromas wear off. That is the current situation and for better or worse i must live with the consquences of my own free choice. If my cheeks turn out better i will probably continue visiting him, if not i will venture on new adventures possibly across the sea.

Sidenote: he actually tried to sell me erbium laser after the subcision, which i declined on several occasions.

2 hours ago, EagleEva said:

thanks @dazzed, I'm having the same gut feeling. Luckily I have never let anyone to talk me into sth against my intuition and always walked away when getting uncomfortable/realizing its not the right professional. I personally never had problems with assertivity and saying no but I know many people do. On the other hand, now that leaves me w the feeling I described earlier. That I am all too often giving in to my fears and am not really progressing anywhere.:/
However, I have NEVER met a dermatologist presenting with their own pictures here where I live.

You made an important point.  ALWAYS ALWAYS trust your intuition.   If something doesn't feel right, take a step back and take some time to think about it.  DO NOT feel like you have to make a decision right at that moment.  The worst decisions are always made in haste and out of desperation.  As much as you want to fix your scars, you have to discount all emotions and think 100% logically and rationally.   A lot of the money-hungry doctors know how to exploit and manipulate the emotions of acne scar patients who have suffered a lot.    They see you as easy money

@incepticon I think you are way too early in your healing to make a judgement.  Subcision is one of the safer methods for scars. 

12 hours ago, EagleEva said:

Sirius, sorry, I wasn't clear. I meant- why a botox before sub is supposed to improve the result? Does all the frowning and moving increase the chances that the scars retethers more easily? Is this the idea behind it?

There is very few collagenstored in the forehead compared to, say, the cheeks. So the chance for the scar to become tethered to the muscle is quite high. As alluded to earlier, when the scar is anchored to the muscle, it will likely pull on it and created undesired effect. Over a stretch of long period (eg. years), this will create a muscle-memory. Hence the use of Botox to both relax the muscles and loosen up the tethering.

@Sirius Leeawesome, thanks for the clarification. I am seriously considering doing it before leaving for London - just in case Chu will want to subcise my forehead scars. And even if he won't and he will just tca cross them, it shouldn)t be harmful in any way, at least I m gonna have smooth forehead;) where is good to place the botox? I have them all over (see the pic) so I guess pretty much all over the forehead?