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Theoretically if a surgeon performs a subcision and then inject a filler to prevent the re-tethering then the scar should be ok at least for as long as the filler lasts.
But I seepeople doing (and dermatologists recommending) multiple subcisions on the SAME scar.....why would we need to have multiple subcisions? maybe without a filler it makes sense because the scar will reattach and has to be separated again....but with a filler it doesn't make sense at all to me, unless the dermatologist doesn't break all the bonds in the first session on purpose (or put too little filler)because he wants you to come back for othersbut in that case he's a cheater and shouldn't be trusted.
Even if he can't break all the bonds in the first session (but why a competent and honest dermatologist wouldn't?), at most we could need another one but that's it (like a touch up after a filler injection). I truly don't understand the need for multiple (more than 2) subcision. One subcision per year is what i think is needed (provided the doctor insert a filler that last a year).
If a scar doesn't raise that much after two subcisions performed by an honest surgeon that try to break ALL the bonds and then inject filler then probably it will never raise much more and need also different treatments for further improvements. Or at least that's what I think
Please somebody explain it to me
The filler is used toe be a buffer. The scar isn't completely filled after subcision plus filler. For as long as the filler last, collagen can grow under the scar. After the filler is gone, the scar reattach itself again, but is not as idented as it was. And that's when you need to have subcision again. As much as you like or as much till your scar is (completely) filled.
Yes, I understand this! But the filler they put should last 9-12 months so there is no need to have another subcision after 1 o 2 months as I read here or I see some dermatologist recommend. The next subcision should be done after 9-12 month (ie when the filler get reabsorbed).
Multiple subcisions (on the same scar) spaced every month or two would only make sense if no filler is placed on the subcised scar (and we know that's not how a subcision should be performed)
I also think that if the scar doesn't perfectly raise to the level of the neighboring skin after subcision+filler then it probably never will with subcision alone and need other treatment....like a fully ablative CO2 laser to stimulate further collagen and elevation
@SimpleMuttonThere are some logical fallacies here. We do not do sub just to do sub. Secondly we are not doing sub just to release your scars, we are stimulating your body to generate it's own collagen, releasing tethers, and softening tissue attachment on the underlying anatomical facia. If you want to do one session be my guest, ... you will sadly be here complaining that subcision does not work. This is now how we treat. You will need up to 4 sessions.The skin is extremely slow to heal(collagen formation - neocollagensis). By doing one session you are doing nothing to work on a underlying problem that developed over years. It will re-attach and you will get minimum improvement. Some can not afford multiple subcisions yearly, .. .they thus do one a year and treatment time is extended. This relies 100% on how you heal and respond, some are ok with a few treatments. The most severe cases need more. You post on many threads about costs, ... that would be a waste of money to do subcision once a month as many Drs suggest, ... the patient would still not be healed. Under swelling and the newly forming collagen would be damaged(basically yo would be causing your scars to get worse), ... just because the upper layer of skin heals from subcision, ... lower layers take 3-6 months to form. We do NOT subcise monthly - Dr's will do that for extra $$$$!The biggest complaint of why subcision does not work by patients is re-attachment, this happens when they do a few subcisions monthly and say nothing worked. To truly heal the swelling has to go away, filler or cupping has to be used, and repeated for additional % of improvement. Some scars are so tethered ... you cannot see this from the upper layers of skin, they need multiple treatments, it's literally like going through concrete. You tell me how you jackhammer through that in one session (without massive down time and tissue damage), a plastic suergon hides his "newly caused "facelift"" scars, - you can't do that. Your case most of all with poor past treatment(subcision) would logically need more treatments. This isn't a waste of money, it's being frugal to observe your own healing and decide next steps.
No surgeon in 2 sessions will fix your scars. You can of course stop there, or maybe you will be lucky. IF they truly do subcision in two sessions it will be so aggressive it will be considered surgical. Your case is easier to treat than many cases I deal with daily, they have severe scars all over their face.
Yes filler can last 6- more than a year in(some), ... they will never 100% be able to fill you and make it perfect in the first subcision session, correction and reinjection will be needed. I always suggest getting another subcision in 3 months, you don't even have to get filler again, you can do Chinese cupping if you wish after this session for a month after. Top up as needed. Some cannot afford filler.
Note everything is optional, your participation, observation, healing, and desire for more % of improvement is all on you. The best healing cases here and I have helped thousands. Treat many times with subcision. It is very skill dependent of the Dr, it's also very very tiring and requires lots of strength(though hard tissues and searching for paths to break them up). They will miss something guaranteed, hence re-treatment and observation. Filler is also another factor to consider, no one after one session will have 100% improvement, ... it takes time to build collagen, increments are needed. Some heal incredibly poorly. In this case they may need ongoing filler. Then you will say to me what about permanent filler like bellafill or fat. I have to help fix so many side effects and issues from this, it's asking for trouble. Permanent fillers equal permanent problems. Filler does not lay exactly under the scar and stay there in some perfect correction, it tunnels, moves, or absorbs at different rates.Healing over time + multiple treatments areneeded. Stop at any time, the choice is yours. Some want the treatment to be over night or once and they complain incessantly when they do not get improvement that way. Why do Dr's change your prescription for glasses, ... your eyes get better or worse. Even laser surgery on them must be re-done with time. Scars will never raise and level exactly with neighboring tissues. There is a textural component and un-uniform healing. If I paint a wall and miss a spot, I go back and fix the areas that need it.
Subcision is incredibly cheap. Acne scar treatment is a slow process, ... just like the time it took for your scars to develop. Scars are very complex to treat and not universal, ...it's customized for the patient. In your case it's a need for subcision, filler, and laser or a deep peel for texture, ... there are complex cases where this won't work.
And again ifthe scar does not have tethering? If it is superficial boxcarand 3 Subcisions already did not elevate the floor of the scar? The whole scared area was elevated then after healingit went down to the original stage. This lack of tissue in the superficial layer stays the same!(chicken pox scars)Does it make sense to continue Subs?
Oneof the Drs I went to said this : if1(poss 2) Sub wont elevate the scar then it is no sense to continue.
8 hours ago, Sibel said:
And again ifthe scar does not have tethering? If it is superficial boxcarand 3 Subcisions already did not elevate the floor of the scar? The whole scared area was elevated then after healingit went down to the original stage. This lack of tissue in the superficial layer stays the same!(chicken pox scars)Does it make sense to continue Subs?
Oneof the Drs I went to said this : if1(poss 2) Sub wont elevate the scar then it is no sense to continue.
hmm I never thought of this, I'm on subcision number 1 / w suction and hopefully that solves my deepest scar. I woulddefinitely trydoing 3 subcision if you have money.
@SibelIf your referringto Chu, he has given you lots of bad advise to far and you complained about that and his subcision.
1) I covered this all above ^ .I describedthis above. Why subcision isNOT for releasing tether's alone.
2) Chicken Pox Scars are not"Acne Scars," the sub we are posting on... why would you subcise them. You treat chicken pox scars with filler, and some laser. They are more difficult to treat, as the damage under the skin is differentthan a "Acne scar". Some get them excised.
3) This is a Big One: Everything is optional with treatment, I repeat everythingis optional. You want to do (1)-one subcision, great. Please don't complain to me that nothing works. You must do what is best for your own care and scar treatment journey. Some may not heal well from a certain procedure - that is ok. Some have very little money and must do a subcision a year. All the cases with the biggest improvement(successstories) here have one thing in common, they did more than one subcision if the procedure matched their scar type.
4) Subcision is a skill dependent procedure. If the Dr is terrible, ... then yes you could have 0% results. Changing the Dr often improves results.
5) You all heal differentlyand have different issues going on(health, scars, providers, treatments, etc). Thus it is a individual thing how many subcisions you do. I have seen some patients who get no improvements in 3 subcisions, they do other treatments between and then they notice improvement from their subcisions start to work.
6) Finally see a Acne Scar specialist, not a generalist, they know what is best when treating scars. A generalist might just make things worse.
Acne scars specialists could make the scars worse too! The experience with Chu confirmed it.
11 hours ago, Sibel said:Acne scars specialists could make the scars worse too! The experience with Chu confirmed it.
Yes Chu isn't a good dermatologist to treat acne scars at all. I honestly have no idea how he could even be mentioned here. I only wasted money with him
He provides just three treatments and one is microneedling with a dermapen we can do ourselves at home, the other is TCA in which he uses an incorrect technique that does absolutely nothing and the last one is subcision in which he uses only a nokor (doesn't use a cannula) and he isn't very meticulous in doing that. And don't get me started on how he doesn't put anything in between to prevent the re-tethering.
Shouldn't be on that list anymore
So, to understand if the scar has bonds you need to touch it, to feel it, to stretch and to insert a needle. And most of the #cars do have bonds even the chicken pox. At least one Sub is needed to feel it...Dr.Emil did all that and it turned to be that there were a lot of bonds... so 3 previous Sub were not done correctly.(we wont start discussing Chu again)
In the case of "field subcision" using Mark Taylor's liberator method, which is a more aggresive technique than standard subcision, would you consider re-tethering to still be an issue? I imagine the analogy is that instead of cutting down individual trees, you are razing the forest. However, I do not have a good understanding of the re-tethering process.
@Ben_StokesYes, ... you can have re-tethering, he does not allow you to use filler after that 😉 IT's QUITE invasive. I never recommend it to anyone unless your the most severe scars and have tons of down time(weeks if not more). 2 of his treatments are worth a whole treatment course with some Drs(many treatments). I have seen damage a few times ... the patients wished they went slower.