dermabrasion, you are a good candidate

Rolling and boxcars. I would suspect dermabrasion, subcision are probably your top candidates. But in my opinion you will need aggressive not some light dusting like some dermabrasion is. But like myself I want to say if you get a great outcome with dermabrasion those volume gaps will likely still exist but will only be evident or shown if your skin moves. Ie dermabrasion done the right way is masterful at blending sharp edges but does not really heal significant volume (that much).

But I'm a believer in aggressive dermabrasion by the right doctor that can describe to you how aggressive they will be. I'm also a believer of subcision if you get a good outcome.

Lastly, do a test spot of either if a doctor will allow it just to see how it reacts. Don't do the whole face until you see, if allowed.

1 hour ago, Guest said:

Thank you, do you know what can help with these volume gaps? Will Fraxel and RF be useless?

Technically subcision is the only thing I know that gives a good chance at volume issues, with or without filler. Fraxel is a type of laser and I don't think it will do much. RF has varying opinions and to be honest I'm not entirely sure one way or another.

Me and another guy on this forum got old school dermabrasion where they basically sand off the entire first layer and possibly go up against the fat or something but either way I noticed over many years that it was a miracle as far as icepicks (shaving them and blending them) but when your skin bends or irritates you can definitely see creases, lines or other things where volume is imperfect. So that remains. You have more boxcars and rolling, so my hope is that dermabrasion would work similarly because the depth isn't super bad.

I only tell you this because if you get some sort of super aggressive dermabrasion and get a good outcome, you'll have to be prepared that on face value it might look much better but it's not perfect.

Now whether subcision beforehand can help alleviate some of that, or help even more than dermabrasion I have no clue. I never went down that road. I would definitely consider both. It honestly depends on your risk tolerance, depth of scars, chances of hyperpigmentation etc. Dermabrasion could cause some pigment issues or some other stuff but overall I felt the benefits far, far outweighed the side effects.

If I'm you, I'd find a doctor that does old school super aggressive dermabrasion but knows how to do it, and shave the top layer until it blends, either before or after subcision. Always TEST first if you can. Never know how you react to either.