9 hours ago, Dontgiveupitsonlyscars said:

Update:

I've seen a few more doctors who are willing to punch/excise my scars. Mostly dermatologists. I have one more derm to see this Thursday and then Dr. Mascaro sometime next week. I'm going to try to schedule one more appointment with a reconstructive plastic surgeon because my gut tells me there is something to explore there. I'm just having trouble with my schedule lately. I'm going to post photos I took last night of how my skin looks. I am at my ideal weight, and I'm very fit. This indicates that swelling or facial fat is at the very minimum. This is what my scars look like under my hallway light, presently. 

Currently I have two open options:

1. My derm who did the CO2 laser ultrapulse said she would "punch" four scars at a time that she thinks is "severe" and laser one month after. I don't like her so she is my last resort. 

2. A derm who is very near to me who is willing to do one scar each month with laser 5 days after and one month after. She was at first very hard to convince to punch or even excise my scars. She tried to convince me otherwise because she thinks if we took out all my scars, I would have lines everywhere which is probably true but I don't want every scar theoretically excised, just the larger ones that stand out. She said there was not a doctor in the world who would agree to do excise my scars based on her first impression of my skin. I showed her the photos below and I pleaded insistently with different hypotheticals to convince her that I am more than willing to at least explore the possibilities. She finally agreed and said one scar at a time, and she was willing to do the procedure this week. I wanted to wait until I saw Mascaro so I pushed it to Wednesday of next week. I don't want her to punch my large boxscar because I don't think punch is good for that scar, so that means I have to pick the next best scar. I think I have an idea of which one but any suggestions based on the pictures below would also help me. Does anyone think that punch of a linear boxscar has optimal results? My logical brain is saying that scalpel would be better. In addition, she wants to have the stitches in for 7 days instead of 5 days, why is that? Also she wants to do laser on my cheeks instead of spot treating the scar, wouldn't this be counterproductive for the next scar excision if all goes well? I feel like my cheeks swell for a three months after laser which gives the false illusion that my scars are less which is not great if I want my scars to appear for the purpose of excision. 

3. I had another derm who was willing to punch out a few scars but she didn't have laser in her office. I decided against going with her because of the convenience factor. 

I'm hoping Mascaro gives me at least some insight on scar revision for my scars and what is the best method to approach it with the goals I have in mind. I highly doubt he will agree to excise my scars based on my experience lately with seeing all sorts of doctors. I still have a few more left to see that I am having trouble either reaching or my schedule is in conflict with their operating hours. I'm also highly busy with my graduate program and other factors in my life that make this journey very complicated. But I am resilient. I will prove that. 

 

Let me know any comments you have or answers to my questions. 

 

Notes:

Photos may appear as if its copied & pasted repeatedly but its not the same photos, its actually me trying to show different angles in the way the light may show certain scars more than others and vice versa and it may appear as if they are all the same photos. I was wearing moisturizer, you will notice a white cream on my face. The first few photos are my left side, which is my worst side. The last four is my right side, with the famous large boxscar. I'm thinking of punch excising a scar on my left cheek marked in red with derm #2 next wednesday, good choice?

Right side

Have u had ultrapulse CO2 ?

14 hours ago, Miro said:

Have u had ultrapulse CO2 ?

Yes

On 10/28/2021 at 5:21 AM, Dontgiveupitsonlyscars said:

Yes

Were u happy with results ? Im considering this type of treatment , its best CO2 laser on market , but i dont know if its worth it

Update: I went for a consult by a new derm yesterday and spontaneously got punch excision and scalpel excision on six scars. Probably not the best decision to just get it right then and there, especially since I had to see Dr. Mascaro on Monday and had a punch excision scheduled with another derm on Wednesday of next week. But I did it. I rescheduled Dr. Mascaro to late December consult and re-scheduled my other derm for another time.

Here is the facts of my punch/scar excision procedure:

• it was $870 + $50 for co pay for appointmentand the other part my insurance covered.
• The laser they have is fraxel, which they wanted $1,150 for but I got it down to $525. I'm going to get laser immediately after the stitches are removed, which is on Thrusday (a total of 7 days with stitches in).
• The stitches are regular sutures, the black kind. The derm wanted to do dissolving but luckily I knew dissolving actually causes more inflammation and can potentially make a scar deeper.
• Currently I have bandages on my cheeks and I have not seen the stitches yet. I am authorized to remove the bandages 48 hours after, which would be tomorrow at 6pm.

I have questions.

1. Is fraxel a good laser to get after stitch removal?
2. Should I go somewhere else, if so, would another doctor do it the same day?
3. Three weeks later, I'm going to get laser again. I have a fewoptions. Fraxel, CO2 ultrapulse, Excel, or Fractional CO2 Laser. Which one is best? I could also get erbium but that doctor is very far from me at the moment.
4. I ordered scar strips from Amazon suggested by LivingWithFaith.
5. My derm says to get growth factors, what is that and where can I find it?
6. When I get laser, should it be full cheeks or just spot (i.e. where the excisions were done)?

I am taking Vitamin c supplement and vitamin a. I'm trying not to chew a lot. I slept all night with my face forward, which was hard because I kept waking up at night. I have some pictures where the derm marked my cheeks before the procedure and I have bandage pictures. I'm really swollen. I'm trying not to smile too much. I'm drinking water. I can't wet my face for 48 hours. I can't workout for 7 days.

What other information do I need to know? Please comment.

There is two additional scars I didn™t circle that was removed but I forgot which ones they were. Once I get the bandages off, I will know and so will you. 

11 hours ago, Miro said:

Were u happy with results ? Im considering this type of treatment , its best CO2 laser on market , but i dont know if its worth it

No, I wouldn™t say I was. But I only got it once. I plan to do it again at some point for my excisions though. We all have different skin types and we heal differently, what may work for me may not work for you and vise versa. Let me know what you happens if you get it. 

On 10/29/2021 at 4:45 PM, Dontgiveupitsonlyscars said:

There is two additional scars I didn™t circle that was removed but I forgot which ones they were. Once I get the bandages off, I will know and so will you. 

No, I wouldn™t say I was. But I only got it once. I plan to do it again at some point for my excisions though. We all have different skin types and we heal differently, what may work for me may not work for you and vise versa. Let me know what you happens if you get it. 

Honestly can™t wait too see the results I™m planning on doing the exact same and your basically my guinea pig. How big was your biggest excision and any co2 laser will be perfect my recommendation would be a higher density lower power fractional as your aim is to blend the new scars in as best as possible so if you can damage the surrounding skin and let it all heal back as one it will work perfectly.

On the right cheek the larger ones are these what you are planning on getting done if theese smaller ones are a success

Day 3 of punch/scar excision. 

I washed it with cetaphil lightly by pressing with a wet gauze pad, then rinsed with a clean wet gauze pad. Then applied Aquaphor and put regular bandages on my face. They didn™t give me much aftercare instructions, just simply to not wet it for the first 48 hours. I am swollen. 

13 hours ago, Scarsmakemewanttodie said:

Honestly can™t wait too see the results I™m planning on doing the exact same and your basically my guinea pig. How big was your biggest excision and any co2 laser will be perfect my recommendation would be a higher density lower power fractional as your aim is to blend the new scars in as best as possible so if you can damage the surrounding skin and let it all heal back as one it will work perfectly.

On the right cheek the larger ones are these what you are planning on getting done if theese smaller ones are a success

My box scar on my left cheek is the biggest. The doctor used scalpel excision for that one. It's the first two images of this post. Doc who did excisons only has fraxel in the office, I believe. Should I schedule laser with someone else the following day after stitch removal for another laser such as co2? Or get fraxel and then get eCO2 3 weeks later? Also, should I do laser on the whole cheek or just spot treatment? @LivingWithFaith @getsmart121 @Amanda Hall

Did the derm put Botox ?For laser,As per studies its 4 weeks post excision. But catharis user did it at 2 weeks post excision.

Also did he follow lagner lines before closing sutures in a specific direction?

1 hour ago, getsmart121 said:

Did the derm put Botox ?For laser, As per studies it™s 4 weeks post excision. But catharis user did it at 2 weeks post excision.

Also did he follow lagner lines before closing sutures in a specific direction?

No botox. Ever since the first derm told me it makes the face droop around the mouth area, I decided against it. I am getting laser the day the stitches come out which is on thursday and then laser 3-4 weeks after with perhaps a stronger laser such as the eCO2. Then, 4 weeks later, laser again. Then another 4 weeks, and laser again. The dilemma is if I should spot treat or do entire cheeks. By the way, nothing is set in stone. I am still debating everything and which course I should take. I want to be advised properly. 

I thought @Catharsis2018 did Erbium 1 week after excision? Which would be what I am doing (minus Erbium)

Hard to tell if he followed lagner lines. Didn't even think of it in that moment. 

I would argue he did for my larger scar on the left cheek, based on this diagram. 

Holy moly that's some amazing results/progress.

Do you have an approximate diameter for the largest scar

My bad, she did one week after excision

4 hours ago, harmlessboy1441 said:

Holy moly that's some amazing results/progress. 

My face is swollen

4 hours ago, Scarsmakemewanttodie said:

Do you have an approximate diameter for the largest scar

I think it was 2 

4 hours ago, getsmart121 said:

My bad, she did one week after excision 

No worries  

I think catharsis did two weeks from the time of excision not immediately after stitchescame out.Its too early, So technically 1 week after stitches were out so two weeks in total check her post and the timeline.

Thanks for all the documentation and commentary. You are the best.

On 11/1/2021 at 10:50 AM, getsmart121 said:

I think catharsis did two weeks from the time of excision not immediately after stitchescame out.Its too early, So technically 1 week after stitches were out so two weeks in total check her post and the timeline.

Oh! Heres a study I just read.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144433/#!po=1.38889

Go down to where it says timing of treatment.

Treatment within the first few weeks resulted in faster resolution of scar stiffness and erythema, and less frequent development of hypertrophic scarring. Moreover, excellent color blending of the treated scars was obtained after treatment. Other studies have since confirmed the benefits of treatment as early as the time of suture removal.Initial consensus recommendations for nonablative fractional laser Fraxel (Reliant Technologies Incorporated, Mountain View, CA, USA) included treatment at 2 to 4 weeks after injury/postoperatively.

It appears with nonablative lasers, the earliest would be two weeks according to this study and then doing it again 6-8 weeks later. Perhaps doing it right after stitch removal is too aggressive? I need to research this further. The study has photos of those who did nonablative 2-4 weeks after, and the results are great.

I need more people who got excision to confirm the timeline ofgetting laser. It would help. @LivingWithFaith@Catharsis2018
@Amanda Hall

*sorry for the different text sizes, Im on mobile.

EDIT:

This news article lead me to another article about using laser after stitch removal and I'll copy and paste the relevant details.

https://www.wistv.com/story/6819438/health-alert-fraxel-for-scars/

"After a series of treatments, scars begin to fade. Dr. Rokhsar says, "And so what we noticed in this study, in this pilot study, is that the scars that were resurfaced right at suture removal or within two weeks of suture removal, dramatically improved after a series of five resurfacing sessions with the Fraxel laser."

https://www.mdedge.com/dermatology/article/7070/aesthetic-dermatology/fresh-scars-respond-well-fractional-laser-treatment

^{"Half of each scar was treated every other week for 10 weeks (five sessions) using an energy level of 20 mJ and a density of 1,000-2,000 microthermal zones per square centimeter."}

^{There may be a conflict of interest here though because the doctor advocatingFraxel after suture removal took part in developing Fraxel. So please note that if it is relevant to you.}

^{He treated the scar every other week with Fraxel. Would that be far too aggressive? How would I be able to use the silicone sheets and massage the scar before the 6 week mark if I were to do Fraxel laser every other week? What do you think?Apparently at the 6 week mark the scars are at their half-maturity stage and if the scar is stiff, the results won't be optimal. I have more questions than answers now. I wish there was a more consistent infoto find out the best method to tackle surgical scars (excision) and treating those scars to they are more pleasing, especiallyon the face. I am driven to do the very best I can to make these scars as invisible as possible, so I would do what it takes. I just need a path thatis outlined that in theory promises the best results,not including my skin, age, or healing process. I'll figure it out.}

^{So, I'll try to seek more answers before Thursday, but it's hard. I don't know whether to:}

^{1. do fraxel laser immediately after stitch removal}

^{2. do fraxel one week after stitch removal}

^{3. do fraxel every other week on excisions (5 sessions)}

• ^{option 3 is expensive and places me in a lot ofrecovery but if its well worth it, it'd do it}

^{4. [insert option 1,2 or 3], eCo2/or alternative4-5weeks after the first laser is done, 6-7 weeks if option 3.}

^{What do you think? I need more insight!}

Omg excision I cant wait to try this out myself hope healing and everything goes well will be keeping and eye on this thread.

12 hours ago, shei514 said:

Omg excision I cant wait to try this out myself hope healing and everything goes well will be keeping and eye on this thread.

Thank you! I get stitches removed tomorrow at 4:30pm. Then fraxel. Im going to give him the settings that the study did above. Ill post pictures tomorrow 🙂

This is Before stitch removal; I have numbing cream on. 

After fraxel dual laser. 40 mj and 8 passes on each excision. 

Here is three hours after fraxel. Doc wants to see me in 4 weeks. I might do resurfacing in two weeks with another doc because I™m concerned about the excision scars becoming large. And then possibly get fraxel again 2 weeks after that resurfacing laser. We will see. This is all up in the air right now. 
 

instructions:

-stay out of sun

-aquaphor on wounds until they close up a bit. 
-sunscreen that is tinted (apparently more SPF in it) 

-Ice face.

im able to workout, but I haven™t yet. 

It might looks worse in the beginning but as you heal it will become finer and tighter,you can also do spot tca cross 30 percent on the area.

10 hours ago, getsmart121 said:

It might looks worse in the beginning but as you heal it will become finer and tighter, you can also do spot tca cross 30 percent on the area. 

I'm worried about using TCA as I find it somewhat unpredictable, especially if I do it myself. I'm not sure. I might just stick to lasers. but thank you

4 hours ago, Dontgiveupitsonlyscars said:

I'm worried about using TCA as I find it somewhat unpredictable, especially if I do it myself. I'm not sure. I might just stick to lasers. but thank you

Or phenol cross on the excision. Lol can you believe I even did excision on the nose as well. Scars on the nose side healed well. But there was one deep scar after excision was looking really messed up. I dabbed a 30 percent acid 10 days post excision and it healed like fine line. But it took like a month and half to really fill in and tighten. 

Day 3 after stitch removal. I used silicone sheets yesterday and wore it all night. Will wear it all day today. I™m going to the gym now. Here™s some photos of my skin thus far. My face is still very swollen, I can tell because it looks like I don™t have a single scar, when I certainly do. The gym should reduce my swelling by some, I™ll try to take pictures after. 

By the way, I™m using this brand. Got it from Amazon, as suggested by @LivingWithFaith

6 hours ago, Dontgiveupitsonlyscars said:

Day 3 after stitch removal. I used silicone sheets yesterday and wore it all night. Will wear it all day today. I™m going to the gym now. Here™s some photos of my skin thus far. My face is still very swollen, I can tell because it looks like I don™t have a single scar, when I certainly do. The gym should reduce my swelling by some, I™ll try to take pictures after. 

By the way, I™m using this brand. Got it from Amazon, as suggested by @LivingWithFaith

Was it single sutures or multi sutures?

On 11/6/2021 at 3:33 PM, getsmart121 said:

Was it single sutures or multi sutures?

I have no idea.