2 hours ago, salmonavocado said:

Would really appreciate any advice on what treatments I should pursue.

The best treatment for smoothing out the jagged edges is using the good ol' Erbium Ablative laser. Basically you're completely removing the top epidermal layer.

However, this step should always be the last option in the overall treatment plan. You first want to fill the hole as much as possible FROM THE BOTTOM and then resurface the top. As such, using RF like Intracel is a good bet. Be that as it may, I always believe pairing Sculptra with RF will give a better result. Hence, I suggest you get a single injection of Sculptra 4 weeks PRIOR to RF.

Your case reminds me of this (Insta video below): You already did subcision (so that is done - I would do cannula filler or cannula subcision on that cheek area),

As Dr Lim did TCA paint technique which is a lower % of tca multi coat to box cars. Then he resurfaced with fully ablative erbium. Icepicks were treated with higher % cross.

Your main concern is textural you say above, that means laser resurfacing or peels.

Because of your ethnic skin you will PIH (hyperpigment). Makeup can be used. Please get some skin bleaching cream albutin and konjac and use nightly with tretinorin / retin a for 3 weeks prior to treatment and a week break before treatment. Further discoloration can be treated with Picosure which is perfect for ethnic skin and helps collagen rejuv in this skin type.

I would not do rf needling for your scar type, you have surface scars and ethnic skin. They go 1.5mm and deeperin these skin types to avoid this which will not help with your surface scars. They mightcause grids and PIH issues and you will be back here with issues.

Paint TCA and resurfacing is a better way to go.I would not do sculptra filler for your scar type - your not fat deficient (HA is fine or you can get away with PRP / saline).

@Obi wanCan you take a second look. Thanks

Thanks for your replies!

@Sirius Lee I've heard ofErbium, but was under the impression that given my skin type, there was a decent chance of complicationslike additional scarring? If not, I'll definitely keep it in mind.

@beautifulambitionI was actually considering going for another round of subcision on just the bigger scars. Is there a big difference between Nokor vscannulasubcision?

Sounds like it would be smart for me to start incorporating TCA.Is the paint technique very specialized? The biggest challenge is finding a good practitioner haha.

Not an easy job - these are one of the harder scar types to treat. Subcision for this type of scarring is not ideal. If you know a specialist who can safely TCA paint (Not CROSS, nor peel), and perform CO2 high power but low density this can be very effective and predictable. 3-5 sessions depending on your immune system. Once they are raised, as @Sirius Leementioned Erbium but like BA said, you will have PIH. Trade is that you get a better result. Another method is surgical elevation. Very tricky to do. Surgical excision of the broader box car, but leave the pedicle intact. Surgeon will use a surgical tape to elevate the scar. From there, wait 6 weeks, then flatten with erbium laser. Remember your skin type- this plays a limiting factor. Be very careful of subcsion and filler - can easily make things worse. Its one of the harder scars to treat. If you are in Asia, possibly see Prof Goh, if you are in the US, the usual guys can handle this case. All the best, and above all, STAY SAFE.

@Obi wan

Darn, it's pretty discouraging to hear that these are difficult to treat.Hopefully, still not impossible. Either way I won't give up!
TCA painting sounds interesting, but I've never encountered anyone who offers this technique. Who are the usual guys that you are referring to? I'm based in the Bay Area, CA.

@salmonavocadoGo see Rullan he see's ethnic patients. Just a cheap flight away in SD. Rulla specializes in acid peels and teaches other drs how to use them, he also knows extensive dermatological surgeries.

Dr Ting is nearby to you (Also Asian ) but he is all about $$$$$$ and is part of a bay area price fixing group CA dermatology who controls the bay area derms.

You can treat PIH locally (Bay Area) with lasers like Picosure/Vascular Laser once you get treatment. Remember to do your nightly bleaching cream Konjac and albutin and tretinorin or differin to avoid PIH, stop one week before treatment.

BA