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Poloho, it is a small world.
I am anxiously awaiting to see my results from yesterday with Dr. Dhawan. If it turns out as well as the trials, I will be happy. I think I will have a goood sense for excisions in 10 days, but I guess it takes 2+ motnhs to really see the effect of grafts.
Did you have subcision with your grafting. Yesterday, he did 5 excisions with 1 mm and used material for grafts in 3 scars (2 were filled last time in first trial). I am curious as to your experience (or any other words of wisdom) with him on:
1. Excisions
2. Dermal grafts (sounds like it was just mild improvement, with need for added material)
3. Stand alone subcision on very shallow scars
Does this Leave any horrible marks? Like has anyone had any really bad experiences with this? Please let me know...Do you think that this would be a good treatment for my boyfriend? he has minor scars like poc marks on his temples only.. Small area.. thanks
I think so Amy, else TCS cross would also work.
I had punch floats by a name doc, Dr. Y, and they left bad holes, leading to excisions. Prior to that, none of these scarred pores were deep enough to justify an excision. It is way too early for me to assess dermal grafts.
Dr Dhawan says there is no chance of making things worse (Like with my float disaster), but that grafts sometimes don't take, fill enough or will overfill. I think he said about 75% of dermal graft patients will later have a resurfacing procedure, laser, dermabrasion, micro dermabrasion to even it out. Basically, dermal fat is inserted under scar to plump it up and there is no visible incision mark, so it seems hard to imagine how things could loook worse. I believe the body will, over time, grow collagen around the implanted graft to cause further plumping, which will improve result, but could also lead to overfill.
This procedure seems similar to silicone microdroplet (from what I have read), except you are using your own dermis, rather than silicone.
Dhawqan would not excise one flaot scar becsue he said it was deep enough. However, if my other excisions turn out as well as my trial, I will ask him to do it becasue the trail excision turned out great. My point is that if your BFs scars are tiny, excisions might work better than grafting.
Hey all, thanks for the replies.Billyboy - Not quite sure if I have a large face or small face, probably a medium size face? The fraxels were also done for my entire face.
Sheryllynn - No I did not speak to my doctor about my concerns, since I only found out about this after all the treatments were done. I figure even if I explained to him my concerns, its not like he would perform free fraxel procedures on me to compensate for the relatively small number of passes.
I was thinking maybe the lower number of passes/kj could be attributed to the fact that I have asian skin? Then again, I have read posters on here who have received 8 passes per treatment with asian skin and not having any incidences of hyperpigmentation. I really have no idea what to do right now, I suppose all I can do is wait a couple months, let my skin heal, and see where I stand. I will probably be considering doing full face dermal grafts as my next step.
On another note, Billyboy I have seen Dr. Dhawan for dermal grafts, and I have to say that I experienced a mild improvement on my boxcar/rolling scars on temples. However, one of the scars was overfilled by the dermal graft, and ended up being uneven with the skin. I had that scar excised 2-3 months later by some big name doctor in Asia, which probably yielded a worse result than if I had just let the dermal graft finish healing by itself. Overall, I do think dermal grafting done by Dr. Dhawan on scarring should be pretty effective in theory. But, in my experience, I do not think that one graft will yield the desired improvement for most scars, and that around 2-3 grafts will have to be done per scar in order to reach satisfactory improvement. Also, overfilling may be a pretty big risk, as I do not see how it would be possible to even out the raised surface unless you laser it down or something.
Poloho - I would call the doctors office regarding your treatments. You've paid a lot for your Fraxels. Ask what happens if you don't see any results . I believe you should get a free one. Especially paying $7000 for 4 fraxels. I know a well known doctor that charged a lot for services and then when results were not good from the procedure provided additional treatments. Make sure to stand up for yourself! Don't be intimidated by doctors.
poloho -- definitely ask your doctor about the number of passes. also, just making sure you know that because one stroke is back and forth, it counts as two each time they do it. so you may actually be getting double the number you think?
regardless, that isn't very much...i think 8 passes (4 times full face with a back and forth stroke) is the general minimum people have been getting.
especially with fraxel 1 which is not going to go as deep, that number of passes seems like it's not doing anything for you.
also, it looks to me like the 20% you mention is just the standard 'each treatment covers about 20% of the face,' right? not an actual measurement...i think that's something reliant says because a fraxel rep mentioned that to me -- it has to do with the density level and how many wounds are created on your face as the laser passes over it...
what was the total output (in mJ, i think) for each of your treatments?
Hi all,
Billyboy - I've only had dermal grafts with Dr. Dhawan. He did perform subscision on those scars before he planted the dermal grafts in though. When I asked him about stand alone subscision, he told me that this was not the optimal way to treat the scars, as he believed that if there was nothing underneath the scar, it would just form a depression again. I'm happy to hear that you've experienced the complete filling of two of your scars though. Could you please disclose the depth of these two scars? I considered mine pretty moderate, as my temples were probably my most heavily scarred area in my opinion, but I only received mild improvement on them.
After further thought, I think I probably should have gotten the rest of my scars dermal grafted until they were at least even with my skin before I went about with the fraxel procedures. This probably would have yielded the best improvement. I do have pictures that were taken before my first fraxel and 3 weeks following my third fraxel if anyone is interested in seeing for reference.
Sheryllynn - Thanks, your advice is much appreciated. I think I will contact my doctors office if I do not see any improvements, and hope for some additional procedures. However, I think I will wait 3-4 months before I contact them since supposedly the full results of fraxel are not apparent until a couple of months after your last one.
Bluemorpho - I think the 20% was my specific coverage over my face, not the standard, since it appears as some people have gotten anywhere from 20-30% coverage from one treatment. I am not quite sure about my doctors technique with passes, though I would assume that he should be very skilled at it with his reputation. I think he went 70 MJ deep for the last two of the four treatments.
With 2 exceptions (prior excisions that separated), my scars are shallow. I had several scarred pores that were made deeper by failed floats, but even those are pretty shallow. I may have given you the wrong impression. My success with dermal grafts is very mild at this point. He added dermis yesterday, so we shall see how it looks in 8 weeks.
His trial excision, with just a single surface stitch and dermabond, turned out great. I am hoping the 4 grafts and 5 more excisions turn out as well.
I thought the same way about subcision - that it needed to be followed by a filler. However, he said several of the scars I wanted to try it on were too shallow so he just did subcision.
Hi all,
Billyboy - I'm sure your dermal grafts will turn out fine - at most, all that will happen is you may need to go in for another graft to plump up the scar further. Either way, subscision + grafting something underneath the scar would appear to be the most logical way at plumping up a scar. Furthermore, at a price tag of roughly 30 dollars a spot, I'd say thats a pretty small price to pay, compared to other options such as Fraxel. Please keep us up to date on how your dermal grafts turn out, as well as your excisions.
I may have roughly 20-30 scars on my face dermal grafted this coming December, but still am unsure of it at this point. Billyboy, do you remember if Dr. Dhawan explicity said that the grafts were permanent? I do not remember what he told me, as I had the grafts done a year ago. All I remember is that I was not fully satisfied with the results of the graft at 2 months post procedure, so I had the excisions done on them. I also do not recall seeing much further improvement after the initial 1-2 weeks following the procedure.
Amy - The decision to undergo Fraxel or not is up to your boyfriend, as only he can decide if he is willing to risk his time, money, and skin to improve his scarring. In my experience, and from what I've heard from many derms, studies, and posters, Fraxel is the safest laser for scarring on the market right now, and the risk of unsatisfactory improvement are far greater than the risk of harming his skin. However, this is unprofessional advice coming from someone with no medical experience, so I would ask that you have your boyfriend do some research into the matter if he is truly interested in improving his scarring.
Another question I have, can fraxel work on scars on the nose? Recently I had this dried up blackhead that was inside a bump, after some washing the lump fell out, now im left with a little indent with round boardering, looks like a tiny holepunch. Its not very notiacble but with direct lighting going down on my face you can see it clearly since its in the centre of my face. I heard tissue on the nose is hard to treat, im wondering if fraxel can help this indent or if its even dangerous to try on t he nose.
My understanding is that dermal grafts are expected to be permanent, which is the primary advantage over fillers. Last time he used the soft dermal tissue from behind ear. This time he dissected the epidermis off the 5 punch excisions and used that as the grafting material. He feels this works better because the punch graft material is firmer.
Stitches are in for 7 days then redermabond for another 3 days or so, at which point I can start swimming again. Prior excisions failed because Surgeon cut out an area with a couple small scars and there was too much tnesion on incision, so it separated. He did not use dermabond or intradermal stitches. I now know it is best to use the smallest possible punch and excise each scar individually. Prior surgwon was incompetent.
There is no downside to fraxel other than cost and time. But, the upside is not huge based on my experience. (i.e., low risk, low return)
Can fraxel help the look of white lumpy uneven rough scar tissue? as i have this type of scarring after a botched dermabrasion on my cheek and jawline, and i just don't know what to do, all i know is i can't live any longer with this disgusting scarring on my face, i wont leave the house AT ALL because of it, it has ruined my life, I just want to know if fraxel really is an otion and if i will more than likely help, anyone think it will? has it helped anyone else with raised tough white scarring?
Please, please answer, i am so utterly desperate.
Hi all,I just completed a series of 4 fraxel treatments for acne scarring four days ago. My scars could probably be labeled as mostly shallow to moderate rolling scars, with more boxcar scars on my temples. I've actually been around the forums for quite a while now, but haven't really posted anything before.
Anyways up until now, I have not seen any improvement on any of my scarring. I was very confused as to why this was the case, as the cosmetic dermatologist I go to is very famous and has been regarded as one of the best laser surgeons in the nation. He also charges quite a large price tag accordingly (I paid almost 7000 for 4 Fraxels). However, upon examining the majority of the forum posters' treatment data, I was pretty shocked. It appears that most people have been receiving about 6 more passes per treatment than I have. My treatment data is listed below as follows..
Fraxel SR1500 treatments
Fraxel #1 3/15/07
40 MJ 2 passes with 312 density
4.03 kj
20% coverage
Fraxel #2 5/3/07
70 MJ 1st pass with 224 density
40 MJ 2nd pass with 392 density
5.22 kj
20% coverage
Fraxel #3 6/7/07
70 MJ 1st pass
45 MJ 2nd pass
4.74 kj
20% coverage
Fraxel #4 6/28/07
70 MJ 1st and 2nd pass with 225 density
4.22 kj
20%
From my treatment data above, would it be reasonable to assume that the reason I am not getting any results is because I'm not getting enough passes per treatment? I'm not really sure what to make of this at the moment. Like I said, my cosmetic dermatologist is one of the top in the nation, and I do trust his experience. It's just that the discrepency between my treatment levels and the treatment levels of fellow posters here is just way too big to ignore, and I feel I must question whether my treatment levels were high enough to improve my scarring. Thanks for reading.
I think the number of passes probably makes a difference, and my dermatologist indicated the same when I asked her about it. That being said, I have only been able to tolerate 4 passes on the aggressive settings on my cheeks (my scarred area). After 4 treatments, I am seeing improvements, but it has not been quite the miracle I had hoped for, by any stretch of the imagination. I have 2 treatments, left, however, so the jury is still out on if the downtime/pain/$$ are worth it.
I certainly do appreciate you posting your results. Finally, my suspicion are confirmed. You are the ONLY one on here who ventured into the 70 mjs settings multiple times and didn't see good results who posted about it. That is so so heartbreaking for me, but in a sense helps to know. I think I will probably discontinue my treatments after this. I am so so depressed 🙁
Hi all,I just completed a series of 4 fraxel treatments for acne scarring four days ago. My scars could probably be labeled as mostly shallow to moderate rolling scars, with more boxcar scars on my temples. I've actually been around the forums for quite a while now, but haven't really posted anything before.
Anyways up until now, I have not seen any improvement on any of my scarring. I was very confused as to why this was the case, as the cosmetic dermatologist I go to is very famous and has been regarded as one of the best laser surgeons in the nation. He also charges quite a large price tag accordingly (I paid almost 7000 for 4 Fraxels). However, upon examining the majority of the forum posters' treatment data, I was pretty shocked. It appears that most people have been receiving about 6 more passes per treatment than I have. My treatment data is listed below as follows..
Fraxel SR1500 treatments
Fraxel #1 3/15/07
40 MJ 2 passes with 312 density
4.03 kj
20% coverage
Fraxel #2 5/3/07
70 MJ 1st pass with 224 density
40 MJ 2nd pass with 392 density
5.22 kj
20% coverage
Fraxel #3 6/7/07
70 MJ 1st pass
45 MJ 2nd pass
4.74 kj
20% coverage
Fraxel #4 6/28/07
70 MJ 1st and 2nd pass with 225 density
4.22 kj
20%
From my treatment data above, would it be reasonable to assume that the reason I am not getting any results is because I'm not getting enough passes per treatment? I'm not really sure what to make of this at the moment. Like I said, my cosmetic dermatologist is one of the top in the nation, and I do trust his experience. It's just that the discrepency between my treatment levels and the treatment levels of fellow posters here is just way too big to ignore, and I feel I must question whether my treatment levels were high enough to improve my scarring. Thanks for reading.
I think the number of passes probably makes a difference, and my dermatologist indicated the same when I asked her about it. That being said, I have only been able to tolerate 4 passes on the aggressive settings on my cheeks (my scarred area). After 4 treatments, I am seeing improvements, but it has not been quite the miracle I had hoped for, by any stretch of the imagination. I have 2 treatments, left, however, so the jury is still out on if the downtime/pain/$$ are worth it.
I certainly do appreciate you posting your results. Finally, my suspicion are confirmed. You are the ONLY one on here who ventured into the 70 mjs settings multiple times and didn't see good results who posted about it. That is so so heartbreaking for me, but in a sense helps to know. I think I will probably discontinue my treatments after this. I am so so depressed 🙁
From what I understand about Fraxel it takes TIME. To state that because someone has ventured into the 70 mjs setting a few times RECENTLY proves or disproves nothing. It is not like traditional laser resurfacing where results are more or less immediate because the top layer of skin has been burnt off. I had my first fraxel yesterday. I will have one a month for the next 5-6 months. My derm appears to be reasonably aggressive beginning with 40 mj and 8 passes plus a couple of extra on my cheeks where scarring mostly is. HOWEVER, I am not even going to begin to look for true long-lasting improvements until 5 or 6 months into this. I am not saying fraxel does work, what I am saying is that trying to assess its efficacy on the basis of a couple of recent treatments is not the way to do it.
I also just wanted to say that I am nearly forty. I have lived with acne scars for many years. My heart goes out to all those that are younger and feel that scarring is ruling their life. I just want you all to realise that scarring is not a death sentence, it needn't stop you from doing absolutely ANYTHING you want to in life (except maybe being a poster model for acne preparations!). Despite my acne scars I am extremely happily married with two beautiful children and am living my dreams of being a writer with my first book coming out next year.
I don't say any of these things to boast about them, I simply say them to give you hope. You are not defined by your acne scarring. Getting rid of them is good, but they will not stop you achieving what you want to - believe me! Is is very, very important that you do not let them depress you to the extent that they rule your life.
Caesar2
Thanks Caesar2, but it is so much easier said than done. And its because it is my face, MY face I am talking about and having to deal with scarring on the face is very traumatizing.
I also called Roche and told them about my experience with Accutane and the depression I am going through with the scars. I am also trying to see a shrink, but I just can't seem to get over it. I'm trying to be more postive, but it is so hard when I put so much work into my face only to have it look like hell still.
Anyway, POLOHO when the doc did your 70 mjs settings, did you have a lot of residual rednes and rawness lasting for weeks. Because that is what I had. I really thought the best way to go at acne scars are HIGH DENSITIES and HIGH SETTINGS for MOST DEPTH. You might be missing out on the former if he isn't doing enough passes. This is what I am HOPING is true.
It is just so hard because I truly lose hope when I see someone like you who has had multiple treatments at 70 mjs and still complains of unsatisfactory imrpoevemnt. In fact it scares me alot, and I wanted to know about this for so long.
Ylem, you really need to compare total energy, not just the intensity. In my opinion, Poloho was undertreated based on her low total KJs. Perhaps her doc feared pigment problems because she is Asian. I have read articles where docs state that full face for acne scarring should be close to 10 KJs in each session.
Hi all,
I had quite a bit of residual redness with the 70 MJ settings that lasted about about two to three weeks on average. However, my skin was never really raw to speak of after it all peeled off around day 7 or so post fraxel. As it is right now, I still feel Fraxel can be effective, though I did not receive satisfactory results at the moment. Keep in mind like many other people say, you must wait a few months to see the full benefit of it. Also, I am not the typical 70 MJ treatment example you would want to look at, since I was likely undertreated. It appears the average fraxel patient on here receives roughly 6 passes more than me, and a whole lot more energy as well.
Also, like Caesar2 stated, just because we have acne scars does not mean that it stops us from having a good life. While acne scars are very depressing and are quite the pain to live with, it is not the end of the world. A lot of us here are still young, and I am confident that acne scarring procedures will only get more and more advanced in the future.
In my case, I have to say that I was/am deeply affected by my scarring. I'm 21 now, and I've had scarring for roughly 2 years. In these two years, I've transformed from pretty social guy into a little more than a recluse. You know, after I found out I had possibly been undertreated for Fraxel, I expected myself to feel really bad, since it felt like I had so much riding on the success of this Fraxel. However, this was not the case, and for some reason, whether it be good or bad, I feel like through this fraxel failure/unsatisfactory result I have learned to come to terms more with my scarring. My scarring is shallow to moderate, and I have quite a large amount of it. Maybe even with future treatments it'll never all go away, and I'll never have perfect skin again, maybe it will.
We only live once, so wouldn't it be a total shame to waste your whole life sitting indoors thinking of your scars, and how much better your life could be if you were scarless? I went out to a social event for the first time in a while yesterday, and I have to say that my scarring apparently did not detract anything from my social experience. I still had a really good time, and it was good talking to all those friends that I had neglected or stopped hanging out with due to my scarring. Basically what it comes down to is we can either live with scarring, and have a fulfilling life filled with friends, family, significant other, a good career and such, or we could live with scarring, and have none of those above. Which one would you rather pick? I believe I made my choice yesterday, as it still is very fun hanging out with my friends, even though I have acne scarring.
For now, I will probably just wait out a few months so I can get a good estimate of my fraxel results. I'm leaving the country soon to start a new job in Japan. As I am a recent college graduate, I'm going to try to focus on my career mostly for the next few years, and try not to let the scarring get to me too much. I still have treatments/procedures done when I can, but like I said, I'm going try not to think/concern myself with the treatments too much, and instead redirect my energy elsewhere. Whats the point in worrying about something you can't control? It's just unneeded extra stress. Good luck to everyone on the board with their treatments, and thanks Caesar2 for pointing out the painfully obvious but not always apparent fact that life does not end with acne scarring.
Oh, and Billyboy, I'm a guy.
Sheryllynn - I noticed on another post that you had seen Dr. Sire for subcision... how were the results? I've seen Dr. Sire previously as well for a consultation, but he refused to do subscision on me without a filler such as restylne underneath it.. much to my disappointment. Did you have any temp filler injected under your scarring?