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QuoteUPDATED MAY 2019 THREAD: for clarity First few pages are the story leading up to the treatment as described here.
Hi so after a very long time I found a dermatologist who was able to diagnose the problem that I had.
Scar tissue bands under the skin causing me to lose flexibility and changing the symmetry of my face.
She performed a subscision on the 23rd of April and then once more on the 7th of May of this year.
The below videos which I'll post are of the first subcision.
Both procedures she took over 40 minutes I'd say, kept hearing cutting noises, she was surprised how badly it was fibrosed. The cutting device that was used was a 23 gauge needle.
Is there a chance of the bands re forming/attaching? The derm did give me some tablets to take twice a day (Danzen DS) which should prevent it, I however wanted a second opinion on this.
She also had to work under the eyes as there was adhesions there too and after the subcision my face was huge and swollen and accompanied with black eyes.
After a few weeks rubbing pineapple from a tin managed to clear them but after the second procedure it's been over 3 weeks now I still have black eyes is that normal?
Also I have knots under the skin since the second procedure, massaging it I can feel them those that were not visible and it seems like that has helped release the tension that I was feeling but there are two noticeable ones which look like a nodule and another which looks like a bump on my right eye area.
Both areas of that part of the face feel numb, Is that normal? Unfortunately the derm is away in a different country to the one I am residing in hence I can't go for a follow up review.
START OF OLDER PATIENT HISTORY... Came to Acne.org with severe cheek fibrosis and did not know what to do. Update above is the final outcome.
You need to goto a derm (seems like you have gotten some bad Drs advice). We don't know if you have a fungal infection, infection, viral issues, skin rash, etc. All that stuff you listed for treatment is to much and may have perpetuated the problem. This is really stupid, all these people are telling you to do laser and things without knowing anything which is wrong with you. Where are the full blood tests? Where is the skin biopsy and have they looked under a slide? Has any swabbing been done to determine bacteria / fungi? Fungus can turn the skin dark as well. Regardless of how it looks you need to find out why this happened. Otherwise were going to be guessing with a ton of treatments which could make things worse. Throwing laser on the skin is stupid. Dr's love to do this. You were not a candidate when you were suffering with your issues. It's well known if one has any issue they are not supposed to do these treatments as it can make things worse, if not draw the bacteria / issue deeper into the skin. Again have they done a full blood panel and swabbed your skin for culture? Now for what I see in these pics it is avery complicated situation.
It is my personal opinion I look at your skin as someone who is a chemical burn victim, of course I am not physically able to make any claims just observations.
I see you have been over treated and caused tissue damage. Might have even drawn whatever was happening deeper in the skin and ruined the skins texture / quality. I see you seem to have Hyperpigmentation problems with the darker areas. You have had some fat loss. Other than that I don't see that your skin is in bad condition, no mass pitting, not major fat loss, no huge pores.
Have you considered prp treatments with something like Infini rf microneedling and laser for the hyperpigmentation v-beam, ipl, 1064nm, or excel v are all options for the reds / brown discoloration. Are you moisturizing the skin looks very dry. On some of the pics it looks like you have superficial chemical burns that have healed poorly (over treatment). This could lead to the texture of the skin. PRP would help with this - it uses your own blood's growth factors. Have you tried honey and aloe vera, ... are there symptoms of a chemical burn? You have strident marks in the cheek from over treatment and fat loss. HA filler may be necessary to smooth this out. Do not use any scrubs, exfoliants, or harsh chemicals, even peels at this point may make it worse. Have you looked into the stem cell, growth factor creams for topical regeneration.Please goto a experienced scar specialist, no idea where you are located. Several Dr's are listed in the FAQ - top post of the acne scar sub.
Once the biopsy is clear and a full blood workup. These pics look different than above. The second one from the bottom your skin is completely perfect, lowest pic you only have some bumps and tiny texture issues (your skin is again almost perfect). The top two pics you are red from some treatment, many have sensitive skin and it takes several weeks to go down.... I can see how they are confused. Dr's need to see something visual.
In the picture above the one with you need subcisions and HA filler for fat loss various places on the cheek.
Yes even though you do not have a cyst or "bump" so to speak your cheek could be filled with infection. They most likely will put you on more antibiotics or accutane. I would be using hot compresses with salt water nightly on this area, soak the area and hopefully it comes to a head. Have you tried white vinegar and iodine at night, until you can get to the derm. Take lots of vitamin c. They can use laser to kill bacteria as well in the tissues (non ablative goes deep down or the lasers for hyperpigmentation). Possibly they might have to excise the bacterial material but I doubt it unless its a big amount and easy to get to. Again get a scrapping / culture / biopsy done if they can do so, probably they will just prescribe something. Having the tca with bacteria could have drove the infection in, this also happens with microneedling. IF you are in discomfort take a pain pill and antihistamine.I don't see your face as "mush" you have a bacterial abscess. The spots are most likely hyperplashia or trapped oils /sebum in the dermis (clogged pore). I see some fat loss but this again can be fixed with subcison and filler after you fix your bacterial issues.
Read This
http://www.nhs.uk/Conditions/Abscess/Pages/Treatment.aspx
@Obi wan Thoughts...
If you was treating your skin and carried out incorrect proceedure or interfered with the healing process then it wasnt a good idea.
needling and using products straight away can drive the product deeper into your skin.
you more like threw too much stuff at your face too fast in a short space of time.theres scabbing from some type of chemical reaction in your first post.
then your pulling faces while you got chemical burns (normal with types of peels) and the skin is susceptable to wrinkling up as its part of drying,peel process but pulling the faces you have been pulling is literaly telling your skin at a vunerable time to shift itself and scrumple up.
You done home treatment and its not gone right due to either not carrying out proceedure correctly and unhygenicaly or you didnt look after skin correctly during healing process,ontop you might have done too much in too short a time.
its common for people to panic and start doing whats wrong cos they think what a peel for instance is doing might be wrong so panic stations.they start doing all the wrong things because tca peel hurts and usualy first time makes the skin wrinkle,if you watch your skin you can literaly see is crinkle up in fromt of your eyes,so person panics.
would say stop using anything bar moisturiser thats good for your face and skin type.get anti biotics and let your face heal and also let the anti biotics do their work.
Leave your face alone. Don't peel it, stamp it or anything else.
Do what the doctors tell you to do. Skin needs time to heal. My God, I had microneedling done in late August. It still has not fully healed and if I so much as use too strong of a soap (I used alternately a peel and face wash with salacylic acid -- all after a month), myskin starts to develop lumps. So I learned to just use mild soap and it's SLOWLY healing.
You are OBSESSING over your face. On top of seeing a dermatologist, I'd see a therapist to help you cope.
Truth is, and not to minimize your discomfort, but to those not in the know, you merely look sunburned. It's no reason to quit your job and drop out of college.
You mentioned a thick layer of some kind of external substance on your face, is it like a layer of skin/sebum? Does the redness itch or burn? Could it be seborrheic dermatitis, maybe? Or some other kind of fungal infection? Have you tried ketoconazole or hydrocortisone cream? Keep us posted, hope you get some improvement.
I dont understand what you mean by saying archive high tissue?
i am currently just gone 2 weeks on tetracycline/lymecycline and i am day 3 of a 25% tca peel and peeling with no probs at the moment.
one thing i noticed yesterday though is,an hypertrophic scar on my back thats been there years is sore,might be because i lean on my sofa arm sometimes with no top on so bare top and think the pressure/rubbing has made the scar go sore.feels a bit better today though.i had to take a photo last night on my phone with the timer to look at it and it was quite sore and red looking.
i am in uk.
At first glance mate that reminds me of folliculitus.its like rosacea but accompanied by pustule/papule.
flucloxacillin will/might help but penecillin made me pop out in some weird acne that lingered for weeks.i still got red mark from one thing thst popped up like a balloon on my left temple.
penecillin can have negative effects especially when used for too much.
i would say your skin looks quite severe and stressed in them pics and my advice is get into a dr asap and definately get anti biotics even if its tetracycline.just give the anti biotics time to work,i would suggest you use nothing on your skin cos it might be causing the problem,unless you know better.
RSM meeting. London. St John's hospital. OK, to get the definitive answer a biopsy may or may not be needed. Rare skin conditions may present this way - Atypical Sweets, Atypical T. facei, atypical pseudofolliculitis - folliculitis barbae,PG, atypical infections etc. The way to manage this is to get a biopsy during the time its worse, with NO topicals on it as it may obscure the biopsy and or culture results. If your dermatologist is in doubt, and none of her colleagues can give further input, your case is stepped up the ladder. At the end of the ladder lies this society called the RSM , I have heard of it before- it is called the Royal Society of Medicine. They meet up in this secret location (seriously I don't know where it is held, but somewhere in central London. This RSM thing has been going on for over 100 years when St John's Hospital was in the middle of London. There are 50- 70 Senior Dermatologist who examine you and gather and give their thoughts. You will have the collective minds of the best and most experienced dermatologist in the UK, Prof Tony Chu occasionally attends, and I know less famous guys like Lowe, Lim, and others also attended in the past. You can not just book in, but your case must be stepped up. If you see your dermatologist via the NHS, this step up process can be made. It can take months, it can be frustrating, but if you do end up at the RSM, you will get a diagnosis, as after the meeting your case will be discussed behind closed doors. I don't know much else about this meeting, I just heard it from a friend who use to take a train ride from Liverpool to London every month of his training in the UK to visit the RSM many years ago, it still exist as its engrained in the ethos of the NHS for eternity, every dermatologist in the UK knows about this, but I don't know anything more....but if you do end up there, you will get an answer. I am sorry, as I am not qualified to give any further in put on your scarring, except the above advice. Sometimes, the answer lies in a biopsy, other times a biopsy excludes other causes and you are back to square one. But take the first step, I wish you well.
Well done. This will get you an answer, as the best minds attend the RSM.
1 hour ago, Boruto said:Any idea what to do here apart from warm compress I feel like using a needle.Still awaiting results for the biopsies.
I'm sure it's hard to be patient and wait, but hopefully you'll get some answers and know what treatment to follow. Don't do anything that the doctor's haven't recommended. Is there something you can do to help take your mind off of it while you wait for the results?
Jeeesh. What country do you live in that your doctors are this incompetent?
As I suggested before, just leave it alone until you get a definitive diagnosis. Don't stick it with a needle, squeeze it, inject it with medicines from India,massage it, rub it with variousvegetablesor anything else.
I still think you need to see a therapist as well to help you cope.