Pictures would help. Lasering after excision helps soften up the resulting scar. It did for me but your mileage may vary.

Don't do any more Infini. It won't do anything for that.

Ask doctors how they plan on closing the scar - what method and type of stitching.

On 10/17/2022 at 3:45 PM, SubState said:

Hi all,

I have large pores due to oily skin in my T-zone. The last couple of months I have been using tretinoin and it seems to be making the texture a bit better. However, I do have 2 large scarred pores that bother me a lot. They are relatively close to each other (0.5cm) in a straight line right along the bridge of my nose just above the tip. The sebacious glands are hyperactive for these two pores it seems and they fill up with gunk quickly, they actually look better with gunk in them because when they are clear it looks like I have huge holes in my face. They are about 1mm in diameter. I've tried infini and microdermabrasion already which did absolutely nothing for me. I've been battling with my confidence due to these pores for a long time already but I am finally done with it so I am determined to try something more drastic.

I've thought about TCA/phenol cross on them but there are some reasons why I'm hesitant to do this. 1) I am really afraid of widening them as I have seen several people mention this happening and 2) The sebacious glands are still very active and this would greatly inhibit healing as the scab would just be pushed out by new oil. 3) If helpful at all, it would likely require many treatments so that would be a long healing process, and perhaps not practical if I have to travel a long way each time I get treated.

Therefore I am considering doing elliptical excision of the two pores together or punch excision on each of them separately. This will also remove the sebacious glands. I know this will likely form a new scar but I'd much rather have a thin line scar that is off-color than these 2 holes in my face that have been destroying my self confidence for over 15 years already. I am half white/asian so I have a slightly tanned skin, my scars usually mean there is a slight pigment loss but no keloid luckily.

I am luckily in a position where I don't mind taking some time off work and traveling all over the world to find the best treatment possible and I don't mind spending a lot of money on it if that means I can get the best plastic surgeon/dermatologist for this. My question is: How do I find these people? Does any of you know of some of the top facial scar surgeons or a place where I can find them? I live in the Netherlands and there doesn't seem to be any acne scar specialists here so I'm hoping someone here can point me in the right direction. If I find a treatment option I will document it here with pictures.

Thanks for reading

Substate

All the questions you have are natural but there's no easy answers. Even today "top docs" are mostly reputational and a great local doctor can at times exceed the so-called experts. It depends on lots of things. I always advocate going to an experienced doctor though.

I am hesitant about TCA cross I've seen it widen/deepen with my own eyes, and saw various stories on here. The one's that get great results do something different or have good luck or something but it does happen. Also, if you do a acid cross, you MUST do 1 to test and not do like several as the doctor will sacrifice your face to "save time" is despicable imo.

If you post pictures it's possible to see if anything might work best but in general pore scares are very hard to improve because by nature they are shallow and risks could exceed the potential gains.

On 10/20/2022 at 2:20 AM, harmlessboy1441 said:

All the questions you have are natural but there's no easy answers. Even today "top docs" are mostly reputational and a great local doctor can at times exceed the so-called experts. It depends on lots of things. I always advocate going to an experienced doctor though.

I am hesitant about TCA cross I've seen it widen/deepen with my own eyes, and saw various stories on here. The one's that get great results do something different or have good luck or something but it does happen. Also, if you do a acid cross, you MUST do 1 to test and not do like several as the doctor will sacrifice your face to "save time" is despicable imo.

 

Thanks for the reply. Yeah I was really hoping someone here knew a name or a platform on where to find one. Realself is horrible IMO, the closest thing I can look for in terms of excision is Mohs surgery, and there are some pretty spectacular results there. Maybe I can look for top plastic surgeons that have had great results with Mohs surgery and ask if they would be willing to do an excision.

Quote

If you post pictures it's possible to see if anything might work best but in general pore scares are very hard to improve because by nature they are shallow and risks could exceed the potential gains.

Aren't pores very deep but not wide? I thought that made them harder to deal with since the floor has to come up such a along way and the risk of widening them is always there.

1 hour ago, SubState said:

Aren't pores very deep but not wide? I thought that made them harder to deal with since the floor has to come up such a along way and the risk of widening them is always there.

Well the pore itself is deep but I would suspect it depends what the damage looks like and where it is.

If its just pores you are worried about I wouldnt excise them not worth the benefit . If they are very big box scar or ice pick thats a diff story

12 hours ago, No_hope_is_back said:

If its just pores you are worried about I wouldnt excise them not worth the benefit . If they are very big box scar or ice pick thats a diff story

Well they are pretty huge, so I would think an excision done by a skilled surgeon would leave a very small scar that looks much better than the sagged pores. I don't mind my generally large pores/texture just the two that have enlarged so much it looks awful

10 hours ago, SubState said:

Well they are pretty huge, so I would think an excision done by a skilled surgeon would leave a very small scar that looks much better than the sagged pores. I don't mind my generally large pores/texture just the two that have enlarged so much it looks awful

So do you think the large pores have turned into ice picks or box scars ? Excision seems pretty extreme for just enlarged pores . If were talking actual large pores and not actual ice pick/box scars

Sounds like you have what I have (see pic) technically scarred/stretched/joined pores which I hope is just surface level. I have wondered if an excision would be the answer (I'm very self conscious about them). I'm currently undergoing some microneedling treatment (had my first session). I'm hoping that will at least smooth my overall skins texture and hopefully improve their appearance. 

Only thing I can think of since there's no fat in the area is some sort of treatments to shave the edges. I have no clue if this would work but maybe some non aggressive dermabrasion or maybe even some chemical peel of sorts could be something to investigate. It's definitely more risky since the area is razor thin though but I totally understand the feelings. I would try to research those two and see if there are any options. Both would have to be carefully done if any apply.

On 10/30/2022 at 1:36 AM, Riffles said:

Sounds like you have what I have (see pic) technically scarred/stretched/joined pores which I hope is just surface level. I have wondered if an excision would be the answer (I'm very self conscious about them). I'm currently undergoing some microneedling treatment (had my first session). I'm hoping that will at least smooth my overall skins texture and hopefully improve their appearance. 

Yeah pretty much exactly what I have only mine are a bit more spaced inbetween. Lmk if microneedling does anything for you, for me it didn't do much but maybe for you it will. I'm still looking at surgeons I will update once I know more.

On 10/30/2022 at 1:40 AM, harmlessboy1441 said:

Only thing I can think of since there's no fat in the area is some sort of treatments to shave the edges. I have no clue if this would work but maybe some non aggressive dermabrasion or maybe even some chemical peel of sorts could be something to investigate. It's definitely more risky since the area is razor thin though but I totally understand the feelings. I would try to research those two and see if there are any options. Both would have to be carefully done if any apply.

To be fair, I've never seen any before/afters from peels/dermabrasions that solved pore issues. Scar surgery is just is so limited it seems even in this day and age. Really hoping for a massive scientific breakthrough in the next couple of years in scarless healing but I'm doubtful