Hi, subcision might work if there is some tethering. In my experience some of my boxscars became shallower with subcision, but they weren't surgical scars. Could I ask if the wounds reopened after scalpel excision?
Sorry I also noticed you made an earlier post, documenting your excisions. Your results looked quite good. Are these the same scars?
I read your old thread too because I was curious. Personally I'm wondering how you progressed to the current? My old doctor did one for a small icepick and the excision is both double the size, and the linear heal is redeven 10 years later. I think excision is a messy type of surgery personally. I think I even got a round area of hypopigmentation from it, probably loss of something in the area. In normal light you can't see the hypopigmentation but in various sunlight you can see it (2 inch radius around excision give/take).
How many re-excisions did you get, and did the last one turn out poorly, did something go wrong like open up and not heal well? Hopefully someone can lend some advice on whether subscision or something else would be helpful.
52 minutes ago, harmlessboy1441 said:I read your old thread too because I was curious. Personally I'm wondering how you progressed to the current? My old doctor did one for a small icepick and the excision is both double the size, and the linear heal is redeven 10 years later. I think excision is a messy type of surgery personally. I think I even got a round area of hypopigmentation from it, probably loss of something in the area. In normal light you can't see the hypopigmentation but in various sunlight you can see it (2 inch radius around excision give/take).
How many re-excisions did you get, and did the last one turn out poorly, did something go wrong like open up and not heal well? Hopefully someone can lend some advice on whether subscision or something else would be helpful.
I'm very curious too, because I got a scalpel excision and the resultturned out well. There's still a scar there but overall the new scar is much better than before (less sharp edges, and overall smaller scar than previous). I'm wondering if the above results were from too many excisions or perhaps the surgeon wasn't skilled. I'm considering getting an excision on a different scar but it seems like excision is a roll of the dice. There are so many factors such as scar type, healing ability,the skill of the surgeon and aftercare. I've seen a few results from excision on these forums and it seems quite hit or miss, where some swear by it and others have poor results.
I've re-excised each scar twice. It looked good the first 3 months then the scars started widening. I wore tape every single day but it made no difference. My plastic surgeon was very skilled.
That's why I don't want to do it again because it's risky. I'm interested in subcision but don't know if they work on surgical scars.
36 minutes ago, FriendlyRose said:I've re-excised each scar twice. It looked good the first 3 months then the scars started widening. I wore tape every single day but it made no difference. My plastic surgeon was very skilled.
That's why I don't want to do it again because it's risky. I'm interested in subcision but don't know if they work on surgical scars.
Why is the area so large I dont understand for an icepick scar. Some studies also confirm using laser and excision in the same session so first they do co2 fractional pass and then excise the scar. Here is a study there is no other modality from the basis the picture that can give you the most improvement. There is full ablativeerbium laser or high power co2 laser you can use on edges you canalso do subcison, subcison can be donefor all kind of scar even surgical scars, and once the edges are soft you can lift the area using filler. This route could take many session and would be time consuming.
https://www.instagram.com/p/BbBkiJbHHGN/?utm_medium=copy_link
similiar scar edges like yours: https://www.instagram.com/p/CESCfrGAZqH/?utm_medium=copy_link
Laser plus excision same session:
https://academic.oup.com/asj/article/18/5/342/191363
its your choice, see what you see fit.
48 minutes ago, getsmart121 said:Why is the area so large I dont understand for an icepick scar. Some studies also confirm using laser and excision in the same session so first they do co2 fractional pass and then excise the scar. Here is a study there is no other modality from the basis the picture that can give you the most improvement. There is full ablativeerbium laser or high power co2 laser you can use on edges you canalso do subcison, subcison can be donefor all kind of scar even surgical scars, and once the edges are soft you can lift the area using filler. This route could take many session and would be time consuming.
https://www.instagram.com/p/BbBkiJbHHGN/?utm_medium=copy_link
similiar scar edges like yours: https://www.instagram.com/p/CESCfrGAZqH/?utm_medium=copy_link
Laser plus excision same session:
https://academic.oup.com/asj/article/18/5/342/191363
its your choice, see what you see fit.
I had it re-excised two times so the area is larger. It wasn't a punch excision but an elliptical scalpel excision and each time the surgeon had to cut out a larger piece of skin.
I'm going to read more into laser. Thank you.
50 minutes ago, FriendlyRose said:I had it re-excised two times so the area is larger. It wasn't a punch excision but an elliptical scalpel excision and each time the surgeon had to cut out a larger piece of skin.
I'm going to read more into laser. Thank you.
Id say yeah definitely look into subcision and filler, it can really make a difference if there is some tethering. Imo subcision is less risky than most of the acne scar procedures too. Lasers could make a difference too but I'd look into subcision first to bring the scars up as laser works better the shallower the scar is.
Also did I read that correctly, you had it rexcised twice meaning you had 3 excisions in total?
5 hours ago, Jackson1234 said:Id say yeah definitely look into subcision and filler, it can really make a difference if there is some tethering. Imo subcision is less risky than most of the acne scar procedures too. Lasers could make a difference too but I'd look into subcision first to bring the scars up as laser works better the shallower the scar is.
Also did I read that correctly, you had it rexcised twice meaning you had 3 excisions in total?
Correct. I will definitely do subcision. I went to a consultation today for subcision with HA filler. Looking forward to try it.
10 hours ago, Jackson1234 said:Id say yeah definitely look into subcision and filler, it can really make a difference if there is some tethering. Imo subcision is less risky than most of the acne scar procedures too. Lasers could make a difference too but I'd look into subcision first to bring the scars up as laser works better the shallower the scar is.
Also did I read that correctly, you had it rexcised twice meaning you had 3 excisions in total?
At this point would it be wise/safe to raise the layer underneath with subscision? Wouldit be safe/wise to fiddle with the dermis underneath? I'm just asking because I'd prefer she get a helpful procedure and not gamble anymore.
Would fat transfer + something be an option, even if it's subscision? She needs healthy volume in my mind.
As getsmart said, you'd probably have to smooth the edges so you could liftand blend the scars first, then subscise and fill. That may be the only option worth it at this point that might be worth pursuing.
I would say don't do any excisions anymore, but also I have to say, why did your doctor do such a drastic cutout for icepicks or boxcars or anything? And to do it over again I don't know. Your results in between looked decent I just don't know how it went from icepick to decent to fat loss like that. If it was in the last 2 years maybe you should ask an attorney if this went beyond just bad outcome and was borderline negligent, I don't know. Most states have a 2 year statute of limitations.
I mimic getsmart's opinion but either way it's probably going to be time consuming, and please find a good surgeon.
25 minutes ago, harmlessboy1441 said:At this point would it be wise/safe to raise the layer underneath with subscision? Wouldit be safe/wise to fiddle with the dermis underneath? I'm just asking because I'd prefer she get a helpful procedure and not gamble anymore.
Would fat transfer + something be an option, even if it's subscision? She needs healthy volume in my mind.
Good point. I wasn't suggesting she get subcision and filler without consulting a fewspecialists and doing research. All I can give is my experience and subcision/filler was a great first step in bringing up rolling/boxscars. However, yes its very important to not rush into things and get the correct opinion before proceding further.
58 minutes ago, Jackson1234 said:Good point. I wasn't suggesting she get subcision and filler without consulting a fewspecialists and doing research. All I can give is my experience and subcision/filler was a great first step in bringing up rolling/boxscars. However, yes its very important to not rush into things and get the correct opinion before proceding further.
I mean, or maybe this is one of those cases that fat filler or something permanent and more natural might be wise, assuming she found a really talented surgeon. I just don't know. I wouldn't want to raise or interfere with the dermis or any functioning of the hypodermis without getting an expert to calculate the risks and best course of action. I'm afraid of obvious pigmentation issues with messing with the deeper layers. If you injure the dermis functioning the hypodermis stops producing pigmentation and who knows it could cause more side effects in the area.
In this situation I'm still at a loss for how the chain of events went from icepick scar(s) to rather decent interim photos of excision to the current state. I get that the OP said "he kept taking more out" to attempt to do something, but I'm at a loss as to why, or under what reasoning. I'm just trying to understand how she was advised to do an excision and/or keep doing them leading to worse outcomes.If in any of that chain there is negligence, I would seek legal before statute of limitations, that's just me though and the bar is incredibly high for any legal.
That said, there have to be some procedures that would add volume, I am just not knowledgeable enough. My best guess would be like what get smart indicated, you blend/smooth the edges (which are steep currently) then you fill. But as he also said it would require a lot of time and proceduring. Again, maybe fat tissue filler would be applicable in this case, I don't know, even if it's applied gradually.
18 minutes ago, harmlessboy1441 said:I mean, or maybe this is one of those cases that fat filler or something permanent and more natural might be wise, assuming she found a really talented surgeon. I just don't know. I wouldn't want to raise or interfere with the dermis or any functioning of the hypodermis without getting an expert to calculate the risks and best course of action. I'm afraid of obvious pigmentation issues with messing with the deeper layers. If you injure the dermis functioning the hypodermis stops producing pigmentation and who knows it could cause more side effects in the area.
In this situation I'm still at a loss for how the chain of events went from icepick scar(s) to rather decent interim photos of excision to the current state. I get that the OP said "he kept taking more out" to attempt to do something, but I'm at a loss as to why, or under what reasoning. I'm just trying to understand how she was advised to do an excision and/or keep doing them leading to worse outcomes.If in any of that chain there is negligence, I would seek legal before statute of limitations, that's just me though and the bar is incredibly high for any legal.
That said, there have to be some procedures that would add volume, I am just not knowledgeable enough. My best guess would be like what get smart indicated, you blend/smooth the edges (which are steep currently) then you fill. But as he also said it would require a lot of time and proceduring. Again, maybe fat tissue filler would be applicable in this case, I don't know, even if it's applied gradually.
I can only speak from experience but I've had 4 subcisions and some were quite aggressive and deep. I did not get any pigmentation issues. As for fat filler what I've heard is the results are inconsistent with more side effects. In some cases fat transfer isn't permanent either, as the body absorbs the fat overtime.
And yes I'm also confused at how the plastic surgeon could have kept suggesting more excisions.
34 minutes ago, Jackson1234 said:I can only speak from experience but I've had 4 subcisions and some were quite aggressive and deep. I did not get any pigmentation issues. As for fat filler what I've heard is the results are inconsistent with more side effects. In some cases fat transfer isn't permanent either, as the body absorbs the fat overtime.
And yes I'm also confused at how the plastic surgeon could have kept suggesting more excisions.
Yep. I can only say that I've only had one smaller excision but it's caused serious problems on my cheek so when a doctor does it over and over again and it seems to get worse, I have to question what he or she was trying to accomplish.
I have no real problem with subscision as it untethers and doesn't generally remove or disrupt any material as far as I know. The real problem after the subscision is what do you fill it with. You're choices seem to be temporary garbage or hit or miss unpredictable stuff like fat filler or permanent stuff that could clump.
The problem with OP is I don't know if I'd play around wish subscision if the middle of the scar is near the dermis at this point. I believe injuring the dermis will disrupt pigmentation production. An expert needs to make the call on specifics. The problem is these doctors really let us down. Do you know how many Derms I went to in the last year just to get either wrong, misleading or incomplete info. It's so frustrating.
Hi Friendly Rose,
I'm in the same boat, and I am really frustrated as to how doctors still recommend excision even through these results. I had my acne scar excised two times only to have really unsatisfactory results with the excision procedure, leaving me with a larger scar than what I previously had.
Just wondering what had worked for you to eliminate or at least lessen the appearance of your excision scar?