Update on surgical excision: 

My doctor looked at me today and instead of surgically excising a larger portion of my cheek as we had discussed in January, he decided to only excise my failed excision scar that shows when I smile.

I was disappointed that he reneged on his decision from the previous consult but he wanted to be conservative about it.

Anyways, I™m sitting here now with a stitch in and limiting movement. I have tape on it and have to keep it on. Stitch removal is next week. I™ll update with more pictures soon but for now there is nothing to really showcase. It™s all under tape. 

It has been a full 24 hours since the scar surgery by Dr. Mascaro (facial plastic surgeon). Here™s what it looks like. I washed and put aquaphor after this pic.

I can™t exercise or take fish oil / vitamin e until stitch removal. Must restrict movement as best as possible. It looks like dissolving sutures were used but he says he always takes it out. Another thing worth noting is that during the surgery he used a burning tool or electric circuit tool during wound closure or perhaps during removing tissue, not sure which. But that was definitely different than what my mohrs dermatologist did. 

Is that not huge compared to the scar that was there

44 minutes ago, Scarsmakemewanttodie said:

Is that not huge compared to the scar that was there

From what I have learned, the excisionis always bigger than the original scar because its taking out more skin that surrounds the scar and it requires suturing with the right amount of tension. Otherwise, it you suture a wound closed without making it longer, you are risking improper healing due to the amount of tension in suturing the scar. The less tension, the better the healing. Unfortunately, need to cut larger than original scar. However, there is consensus that linear scars provide a better cosmetic result than circular punch scars, not sure if this is officially true though.

In any case,this is a pencil thin suture, this is only 24 hours after surgery. The linear scar looks like it will heal very well (in my opinion)especially when combined with a resurfacing laser. My doctor recommends using Pico two months after. I will ask him about fraxel or another laser when I get my stitch removed and see what he says. If he clears me to get laser, I will get it within the first two weeks after stitch removal. Otherwise, I will wait the two months he recommends and get pico underhim.

On 3/29/2022 at 3:12 PM, Dontgiveupitsonlyscars said:

It has been a full 24 hours since the scar surgery by Dr. Mascaro (facial plastic surgeon). Here™s what it looks like. I washed and put aquaphor after this pic.

I can™t exercise or take fish oil / vitamin e until stitch removal. Must restrict movement as best as possible. It looks like dissolving sutures were used but he says he always takes it out. Another thing worth noting is that during the surgery he used a burning tool or electric circuit tool during wound closure or perhaps during removing tissue, not sure which. But that was definitely different than what my mohrs dermatologist did. 

 

Interesting he raised the area before closing this will help it not indent and heal flatter but again all depends on how you heal

why dont you do more subcisions with fillers? you did only 2 and one filler? I am not telling you what is best for you (and i didnt read the whole thread) just curious.

hope you will heal well. you have done so much you deserve to quit on heavy treatments. Rooting for you.

I am about to do my first excision in April. nervous af.

22 hours ago, Candy Says said:

why dont you do more subcisions with fillers? you did only 2 and one filler? I am not telling you what is best for you (and i didnt read the whole thread) just curious. 

hope you will heal well. you have done so much you deserve to quit on heavy treatments. Rooting for you.

I am about to do my first excision in April. nervous af.

Yes, may get filler for a bit after this and just rest, probably two months from now. I'll wait to see what my next move is which either dermabrasion or micro-coring 6 months from now. I may be done with excisions for the meantime because I don't want to push my luck. I have tiny little ice-pick like scars on my left cheek that I'm going to ask my plastic surgeon what he would recommend for them because he keeps saying "it would be different if you had ice-pick scar" which I do, its just more settle since my laser treatments over the years. 

21 hours ago, JesusChrist said:

Please show us excision results with harsh lighting

sure. I have pictures from March 5 under very harsh gym lighting. Let me post them now. 

Here are the excisions fully healed. More than 3 months after procedure but not more than 5 months yet. Not the biggest difference but there is a difference

A word of advice for anybody going for excision make sure the scars that you select are first of all deep and remember that other people will not see most difference. They will only see a difference when it your cheeks improve as a whole. I understand the zoom in mindset in mirror but what people see is overall and not selective. Once you decided excision then here is what you do, take a picture of the cheek thentake a marker blue then goto a mirror and mark the scars that bother you the most. Then take the picture of the cheek again. And assume if these marked scars were to be removed/tradedfor a flat line scar. Would you be happy with the improvement. If the answer is yes then excision is for you. Ofcourse you still need to consider the risk such as excision opening up. Etc

29 minutes ago, JesusChrist said:

Whats the chance of opening a scar after excised?

Very low if done correctly

And in a sensible low tension location

3 hours ago, JesusChrist said:

Whats the chance of opening a scar after excised?

I believe the small the area of excision the chances are better of not opening up. Dr Taylor give accutane for 2 weeks prior to excision for people with oily skin. He thinks oily skin doesnt heal well. Since accutane stops oil so it will have a superior outcome as per his words. I personally some of them opened up but healed flatly overtime. I dont know the logic for this. I had excision for a deep icepick on nose. When the stick came out it looked as if it dented or deep so I applied 30 percent tca to it, dont know if this played any role butAfter two months it healed like a flat line scar and direction in which excision was closed . While the other deep small linear line got closed so well that wasnt able to see it at all.

6 hours ago, JesusChrist said:

So it is flat like healthy skin? Same flatness as healthy skin? Doesnt create shadow?

I am talking about deep scar with sharp borders like icepick or boxcar, some dented but healed flatly later. Yes very hard to know where the scar was. I had fractional 5 passes with excision the same day and the results was good 2 months later

Is there a thread here that documents dermabrasion on acne scars? Im thinking of doing dermabrasion and then filler a few months from now. Need to do more research.

I have some ice puck scaring on my right cheek, going to ask my doctor what he thinks can be done with them.

I think after these procedures Imgoing to rest for like a year.Idk, I kind of need a break from thinking about my skin so often. And my skin probably needs a break from constant procedures. I would like to see if I can get micro-coring but based on their website, surgical incisions on the face need a year to be cleared to use micro-coring and also 6 months of no filler. So I would need to wait a year anyways. This is good because more research and patientswill get micro-coring done which helps to see if its effective against scarring at some point. I have confidence.

Anyways, this is my currentplan. Subject to change.

Im thinking of doing TCA cross next instead of dermabrasion. Im really scared of the pigment issues that dermabrasion may bring since Im olive toned. There are two doctors that perform TCA cross in my area so I will schedule an appointment with one of them soon, sometime next month.

Have them test out a couple of scars with tca first

Can we see an update on the excision of possible

14 hours ago, Scarsmakemewanttodie said:

Can we see an update on the excision of possible

Yes. I will postphotos some time this week.

On 4/10/2022 at 8:03 AM, Scarsmakemewanttodie said:

Can we see an update on the excision of possible

Here™s the update. My morale is low today based on my scarring. Sometimes I feel like it will never improve and I™m chasing my tail. I™m just at a really low place today emotionally and mentally. Anyways, hope you™re doing well. 

hope you will feel better tomorrow. And I know you will feelgreat when you will getsubcision and fillers. Don't give up as there isno point in it. Your skin is not fucked up at all to have that low morale. I think you are just tired.

By the way, put silicone sheets on your skin anytime you can.

1 hour ago, Candy Says said:

hope you will feel better tomorrow. And I know you will feelgreat when you will getsubcision and fillers. Don't give up as there isno point in it. Your skin is not fucked up at all to have that low morale. I think you are just tired.

By the way, put silicone sheets on your skin anytime you can.

I love you. Thank you. I think you're right, I am tired.

I'm not thinking of getting subcision per say. My plan is either TCA cross the little dots/ice picks, dermabrasion/sanding and/or filler in the acne scars.And laser for my incision, which would more than likely be the whole cheeks again. Perhaps even punch excision on the really tiny ice picks on my right cheek. It's hard to decide what is the next plan.

But man am I tired. I find it personally difficult to go to the gym in that very harsh gym lighting and share at my reflection. I haven't gone to the gym in three weeks. Mostly because of the incision but even then, I've been cleared to go since last friday. To be incredibly frank, I've been at a really low place lately. I can't describe it. I was once more motivated and looked at my scars as a small addition to me... now its all I ever think about. I can't seem to break passed my internal agony over my cheeks. I've tried and keep failing. I think part of it is me having these really unrealistic expectations and also the constant exposure to people on social media who edit their skin. Have you noticed? Even people without scarred skin use these very heavy filters, which is totally fine, but it spells out to my unconscious brain that "man, society hates skin texture". Idk if that makes sense but it's been messing with my head.

Also, to add more to the injury, my SO made a passing comment to me about my scars that made my heart collapse to the bottom of the deepest part of the ocean. I literally wanted to die in that moment. But whatever, here I am. Existing. Sleeping seems to be my only serenity lately. Yes, I am aware I probably need therapy or a diary instead of venting to someone on a forum. But hey, you caught me at a good time... where my feelings are bubbling at the surface;spilling over like a glass cup under a running faucet. This is who I am lately... consumed by vanity, or the loss of it. I'm being honest. even if this honesty is hard to bear, and probably not helpful to everyone on this forum seeking an uplifting comment. But, also if there is no rain, there is no rainbow. So. It's raining a ton over here. But its fine, this will pass.

Anyway,

I've been researching sanding for those superficial scarring which I have some here and there... obviouslydermabrasion is much more intensive but for those really superficial scarring, I wonder if some mild sanding by a doctor would be a smart idea for me. I would argue my scarring is mostly surface, meaning it doesn't descend to the deeper layers of the skin (unless I amtotally naive and wrong). So with that in mind, a mild sanding by a plastic surgeon or a mild dermabrasion and then filler might make me feel more content about my scarring... I say mild because I am afraid of pigment issues. Which leads me to my next thought, I want to spot treat dermabrasion by a doctor but still researching. I'm still waiting for this incision to heal so I can't be too hasty.

I thought this video below was interesting in how the doctor described sanding and the layers of the skin.

Additionally, I wanted to post this. Where I have my current excision, on the same cheek towards the top I havea large boxscar similar to this patient here. Notice how he explains the reasoning behind not excising a big line and the "series" of excisions (it ended up being only two) to make the line less large.

Also wanted to point out that this is almost a year later (at least from video post date), two excisions performed. Then he does resurfacing or dermabrasion to further reduce the appearance of the scar.

Assuming this linear scar healed well, it is definitely better than the former scar especially since women wear makeup that may pronounce texture. She more then likely is extremely pleased with the results of this procedure, assuming the linear scar looks even better than the healing stage due to the fact thatit would follow a resurfacing procedure. Now, imagine a doctor who has an even better stitch technique (such as Dr. Mascaro), the results could be even better.

Of course, Dr. Mascaro doesn't want to touch my upper cheek because "there are nerves there" or another reason he stated was "because it may create a dimpling when i smile" but I really just think he's more apprehensive because he may think the linear scar may be long. Not sure. Every time I try to tell him this, he gets sort of defensiveand shuts me down. He wants to wait until this incision heals "to see" which is fine but I want the entire cheek addressed at some point in terms of removing a large portion of the cheek scar that I have there. I would much rather have a linear line than a series of boxscars! But, ahh... I'll be patient. I just like Dr. Mascaro because he's truly great at stitiching up skin in a very neat way.

Also, sidenote, if you look at his lip lift patient "scars" they are little to no scarring which is rare because that surgery normally carries significant scarring from normal to highly skilled plastic surgeons. That's why I believe Dr. Mascaro is ahead in his craft in terms of making a pencil thin scar incision. Of course, the other side of the argument is that the incision is in a nasal crevice which makes it easy to hide a very fine incision line.But anyway, if Dr. Mascaro is so resistent to doing what this doctor did below, I will either do the rational thing and not excise or I will find another scar expert and try to excise the boxscar the way I envisioned.

You're probably thinking, why not go to new jersey and go to this exact doctor in the video? Because I don't like to travel very far for procedures. It's a personal choice. My rationale is I can find great doctors near me, I live in one of the largest cities in America. So, thats why.

Another video on scar excision for knowledge

2 hours ago, Dontgiveupitsonlyscars said:

I can't describe it. I was once more motivated and looked at my scars as a small addition to me... now its all I ever think about.

no matter how low we are setting our expectations, deep down inside we all hopethat miracle will occur and scars will be gone after the very next treatment. +wefeelsorry for ourselves because we have to deal with that bullshit. But all of that shouldn't matter.There is a goal and there are plenty of ways to reach it. No reason to give up.

I still don't understand why you dont want to do subcision tbh. Is it your decision or your doctor told you so?

People onsocial media removetexture because it iseasy to remove. Not so many people are good at photoshop so they do what they can. If it would be easy to usethen everyone would make themselves look like Hedy Lamar or something.

I understand you because you are a girl, but I am being absolutely honest with you - you don't look bad at all. Well, yeah, cheeks are not perfectlysmooth (today) but that's it. Will be better.You don't have that morbid level of scarring anyway (look up that Iranian doctor on Instagram).

2 hours ago, Dontgiveupitsonlyscars said:

consumed by vanity, or the loss of it

Looks like you have a very sensitive soul and mind, which is very good for a girl. You are interesting. Terrible that you have to deal with such adown to earth shit right now.One day you will write something about all of that in past tense.

Try 'Emotions Anonymous' instead of therapy. It WILL help you to overcome your negative emotions. I can guarantee you that.

PS. Silicone sheets 24/7

11 hours ago, Candy Says said:

no matter how low we are setting our expectations, deep down inside we all hope that miracle will occur and scars will be gone after the very next treatment. + we feel sorry for ourselves because we have to deal with that bullshit. But all of that shouldn't matter. There is a goal and there are plenty of ways to reach it.  No reason to give up. 

I still don't understand why you dont want to do subcision tbh.  Is it your decision or your doctor told you so?

People on social media remove texture because it is easy to remove. Not so many people are good at photoshop so they do what they can. If it would be easy to use then everyone would make themselves look like Hedy Lamar or something.

 I understand you because you are a girl, but I am being absolutely honest with you - you don't look bad at all. Well, yeah, cheeks are not perfectly smooth (today) but that's it. Will be better. You don't have that morbid level of scarring anyway (look up that Iranian doctor on Instagram).

Looks like you have a very sensitive soul and mind, which is very good for a girl. You are interesting. Terrible that you have to deal with such a down to earth shit right now. One day you will write something about all of that in past tense.  

Try 'Emotions Anonymous' instead of therapy. It WILL help you to overcome your negative emotions. I can guarantee you that.

PS. Silicone sheets 24/7

 

Yes, I'm using silicone sheets daily. I think Dr. Mascaro wanted to use silicone gel/sheets starting on the 20th but I ended up using it right away. I think it's because he doesn't want the site to get red. But I find it heals so much faster with silicone sheets from my experience so I'm using my own judgment on this. 

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subcision tbh.  Is it your decision or your doctor told you so?

I've had subcision prior but I don't think I need it unless a scar is severely indented. Most of my scars are completely surface, meaning that there is little to no tethering in my opinion. No doctor that I have seen has suggested subcision lately but then again most doctors I see say my scars are so minor that they think just a couple lasers will solve it (which it doesn't). I'm usually the aggressive patient throwing suggestions at doctors and seeing their opinions. I don't want the "laser and get out" approach anymore. I've had countless lasers and although some have helped in my journey, I performing some other procedure such as excision and then laser would be a better outcome in my opinion. The issue for me and for most is finding the right doctor to excise perfectly. I had a failed excision that I believe opened up. Although the failed excision was less noticeable, I think that was due to my constant laser/subcision and silicone sheet use. So yeah, I think my other excisions are great, I just need to resurface/refine and then approach fillers. And I'm very filler-adverse but I'm approaching a fatigue regarding scar revision that I need some taste of peace. 

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You are interesting.

Thank you! I'm definitely more on the eccentric side. I am not everyones cup of tea. I have a lot of intensity, can be overwhelming or unpleasant for most. Also, I've tried online venting forums and nothing quite hits the spot like this one sometimes. I think it's because we all share a common niche "problem" that to be honest most people fail to understand concretely and adequately. But yes, ultimately this is not the place to be in my feelings all the time, and I'm usually not, but if you catch me on a specific day, I won't shy away from expressing it.  

Here is an example excision line merged with sounding skin using dermabrasion 

Found this about dermabrasion, posting it here.

http://m.makemeheal.com/pictures/dermabrasion/co2-dermabrasion-rhinoplasty-fat-transfer-a7515

Another very good example of dermabrasion wherein the scar edges are eliminated. I don™t thing even deep phenol peel and do this. As phenol is more regenerative is damaging it hoping it would heal in a certain way as time progresses. Again dermabrasion cannot solve atrophy, it can only solve hard scar edge work. Here is a prime example¦.if the dermabrasion is done correctly you can how the scar edges are elimated but atrophy remains . After this fat filler,ha can come in.