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rosegirl

Double Denied--Dermabrasion and Fraxel *updated with pics*

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So, here are the treatments I've done so far: 11 punch floats and full dermabrasion with Dr. Y in March 2005. 5 Smoothbeams, from April to August 2006. And I've been using Retin-A Micro for about two years.

My scarring was mild to begin with. Dr. Y took care of the worst scarring, including the icepicks. I got three new mild scars on the pads of my cheeks from post-dermabrasion breakouts. The Smoothbeam really evened everything out, especially orange peel texture (large/scarred pores) on my cheeks. My skin has continued improving from the Smoothbeam even up to now. I know a lot of people knock Smoothbeam around here, but it worked for me.

My skin looks leaps and bounds better, it really does. I used to be terribly self-conscious about it all the time. Everytime I looked in the mirror it made me sad. I am not self-conscious about my skin anymore, except in bright, direct, flourescent light, which I think accentuates my pores and the few scars I have left. I've had four people randomly tell me that my skin was beautiful/perfect in the last two months. Obviously makeup hides a lot, and no one sees all the imperfections that you see yourself, but the point is that I've clearly come a long way. I want to emphasize that I know this, and that I don't have like body dysmorphic disorder or anything like that.

Now to my point. See, I am a perfectionist. I understand that I may never completely get rid of my scars, but I figure if I've made so much progress, why stop now? There are still visible imperfections. I visited Dr. Y to ask if he would do another dermabrasion, and he tried very hard to talk me out of it. In his typically sweet way, he put his hands on the sides of my face and looked at my cheeks closely. And he said my skin was gorgeous. He said there's always risk involved with the procedure, and though the risk is small, he would not advise doing it because my skin was already so close to 100% improved. What's the difference between 98 and 99 percent, he asked. He told me to think long and hard before making a decision. He also wrote an unsettling number of lines of notes on my chart, making me wonder if he was considering whether to refuse me treatment.

I took his advice and thought long and hard. I decided that I wouldn't go through another dermabrasion after all. I started reading about Fraxel and decided I wanted to try it instead. Today I went to see the dermatologist who did my Smoothbeam treatments for a Fraxel consultation. She said she wouldn't do it. Unlike Dr. Y, who emphasized the risk, she flat out said she just didn't think it would do anything for me. She said she loves the laser, but that she thinks I've gotten all the improvement possible. I asked if more Smoothbeams would help, and after closely and thoroughly examining my face, she said no.

I was so sad. I've heard people say that you can't get 100% improvement, but I still see room for improvement in my skin. I don't understand how if five Smoothbeams got me this far, why a few more, or the more agressive Fraxel treatment wouldn't make it even better. Is anyone with me on this?

My doctor recommended, of all things, microdermabrasion. She said it would smooth everything out nicely and improve the pores that I'm concerned about. She thinks I would be satisfied with the result. I've read the stories of many people on this board for whom micro = flushing money down toilet. And many people have stated that derms only suggest micro to get your money. However, my doc could have gotten a lot more cash outta me by going ahead with the Fraxel, so I'm tempted to take her advice on this one. I am, however, confused as to how Fraxel could not help me but microdermabrasion could?? Huh?

Anyway, I'm going to another doctor tomorrow to get a second opinion about Fraxel. It's really really sad when you're not happy with your skin and someone tells you there's nothing else you can do to improve it. I cried a little bit.

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Hi Rosegirl,

I too am a perfectionist. I understand where you are coming from. I have to say however, that you are very lucky to have had ethical professionals turn you and your money away.

May I ask how old you are and how long you've had your scars? I get the feeling that you are young and if so, there is a good chance that your skin will continue to repair itself without doing anything else, simply because young skin cells turn over and repair faster. Why put yourself at more risk? Even Fraxel has risks. Micro dermabrasion is great for very subtle skin concerns. I know it is not the greatest treatment out there but it does do some good. I am sure your doc recommended it because it would give you some texture improvement and it is a way for you to feel like you are actively doing something positive.

Have you read through some of the posts with horror stories of treatments gone bad. Please, please, try to focus on something else right now. Let your skin continue to improve naturally. And consider yourself one of the very lucky ones.

Take care,

Annde

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Hi Annde,

I'm 26. I've had some scars since I was about 21, and they got progressively worse up to age 24 when I had the derrmabrasion. I really do appreciate the doctors' honesty. It's just hard for me to believe, or hard for me to accept, that there's nothing more I can do. Especially today, I wondered if she was afraid I was one of those patients who would never been satisfied and decided not to treat me anymore. She has been nothing but wonderful and helpful every time I've seen her, and she did seem to be giving it to me straight today. However, I know doctors are taught to screen patients for cosmetic procedures by whether the patient will be satisfied with the outcome. That's why I'm going for a second opinion.

I have read the horror stories. It is one reason I decided not to go for the second dermabrasion. I believe the Fraxel risks are small, and to me they are worth it. I hope you're right about skin improving on its own in time.

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Hi Annde,

I'm 26. I've had some scars since I was about 21, and they got progressively worse up to age 24 when I had the derrmabrasion. I really do appreciate the doctors' honesty. It's just hard for me to believe, or hard for me to accept, that there's nothing more I can do. Especially today, I wondered if she was afraid I was one of those patients who would never been satisfied and decided not to treat me anymore. She has been nothing but wonderful and helpful every time I've seen her, and she did seem to be giving it to me straight today. However, I know doctors are taught to screen patients for cosmetic procedures by whether the patient will be satisfied with the outcome. That's why I'm going for a second opinion.

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Annde,

Wow, it is scary that a doctor would do that. It reminds me to be careful about what doctors recommend in the future.

Props to you for having the foresight to have a test area done. I'm sorry you had to go through all that. Have you done any other treatments since?

At this point, I really don't see myself pursuing any more invasive treatments. Dr. Y did a good job of making me think about it and talking me out of it. I'd like to do two more punch floats and try Fraxel if I get some positive feedback about the potential outcome from other doctors. I'm actually going to consult at least two more doctors to minimize the risk of being misled by one greedy or overzealous one.

I'm in a hurry to get to the point where I'm satisfied, which is why I wanted to to a dermabrasion-- to get it over with. I'm going back to school full time in the fall, and there won't be time to mess with this once school starts or anytime after really. At least not any treatments that require down time. I'm going into a profession where I won't be able to take absurd amounts of time off like I can now. It'll be school, full-time summer job, school, full-time summer job, school, permanent job.

Thanks for your thoughtful replies.

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This is hard to conceptualize without seeing your scars but maybe you could consult with a few docs who have never seen you before and without mentioning your scars, or what treatments you've already done, see what they think could be improved about your skin and how it could be done. That way they don't think you have unrealistic expectations because they are the ones doing all the evaluation of your skin and possible improvements.

I am a big proponent of Fraxel as I had great results with it but yes, as Annde said, there are risks with that too. And I tend to agree that micro derm is junk although I've never had it. BUT, the only person I know who has had total revision of acne scars was a guy I've known for years and when I told him his skin looked great and asked what he was doing he said microdermabrasion. So, maybe if since your scars are so light, it might help. His were not. They were moderate to severe rolling scars all over his cheeks and visible in all light. And now they are gone. I think it took several years of treatment once a week.

I also think that if you are truely not self conscioius about your skin anymore it is worth being very gentle with it to go the last little distance. Maybe micro derm is the answer. Or Fraxel on a low setting. I mean hey, they do Fraxel on discolored skin with no scars so why not on your nearly scar free face? I'd stay slow and steady on what ever you do so you don't over do it. If you do that I bet by fall you'd be flawless.

Good luck.

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Rose, you'd be insane to take any risks now. from the sound of it, your situation now is what I'm trying to achieve. It's not worth the risks at all.

Furthermore, you are very young. Your skin is young and comtinues to heal itself naturally.

You'd be smart to just continue with Ratin A. I actually think it might improve the little scarring you still have, esp because you're so young. Just use things that encourage collagen.

Congrats :D

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Glad you had a nice result. I won't advise either way, but it sounds like you are in a good place. Is Dy Y still in practice? I had some floats in 2006. A few turned out, but the vast majority did not and it seemed that others seeing him at that time were having simlar problems/failures with their floats. So, I decided it was too far to travel again with a low sucess rate; maybe he was past his prime. Great guy, by the way.

But, it is such a simple procedure and the 5 that worked, worked nicely. I have 5 other scars that might be amenable to floats and wish there was someone local that knows how to do them. Does Dr Y still do them?

Best wishes

PS: Also, maybe it would be wiser to channel your perfectionism in other areas: body building, school, helping others, etc. Nice trait to have, but don't take it too far and hurt your face. Your face sounds very nice already and is only one aspect of a person.

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rosegirl, if your aiming for perfection you'll never achieve it, no one has and no one ever will. If people are complimenting you on your skin than its clearly in a great condition even though it isnt perfectbut hey who's is??

anyways i would recomment microderm from experience.

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Rubern,

I know I will not achieve perfection. I just want to get as close as possible. :whistle: Seriously though, my scars are still visible. I'm not ready to accept that there's nothing else that can be done.

Billyboy,

Dr. Y is still in practice; I saw him right after Christmas. He still does punch floats. Judging from now, the areas that were punched pre-dermabrasion look better than those that were not. I can't remember before I got the dermabrasion how many floats I was happy with as-is. He did a stellar job on a cluster of three icepicks on my cheek though. They were my worst scars, and he nearly eliminated them. Did you do the punch floats without a dermabrasion? When I just saw Dr. Y, he said there was only one scar he could punch. I would like to get that one done, but I'm not doing dermabrasion again. I know some of your scars that didn't improve, but were any made worse? Did you have the little linear scars that I've read about? Any other problems? I know Animegirl had punches without following them with dermabrasion, and last time she checked in she seemed to be doing well, but she hasn't updated in a long time.

As for my perfectionism, I channel it into pretty much everything. It's an unfortunate characteristic to have, as it makes for a lot of stress.

Arctic Monkey,

I don't have any before pictures. I will try to take some close up pictures of my cheeks so you can see what they look like now. I don't know how helpful that will be, since you'll have nothing to compare it to, but I'll still do it.

Hopesprings and Violet,

Thank you for the hopeful words. I will definitely continue Retin A and avoid any invasive treatments. I'm pretty sure I'm going to try Fraxel next, then microdermabrasion if I'm still unsatisfied. At that point, I think I'll be ready to accept what I'm left with, because I'll know I tried everything. And because I'll be out of money too. :lol:

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I would take their advice and avoid the dermabrasion or fraxel. I had some sessions of fraxel and I think that it actually made my pores and skin worse. I am glad I realized it and stopped. I think alot of people fool themselves into thinking their skin getting better when the treatments are actually causing things to get worse and by the time they realize it, its way too late.

You definitely don't want to risk it. The professionals you talk to deal with skin everyday and if they say you are better off not doing it then LISTEN!

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Rose, you are in a situation where you just won 500k in a casino and you are offered a 50% chance to double it or lose it all, lol (no such good chances in any casino and in your situation they are the same as to what you can win or lose as in great chances to lose a lot and very small to gain anymore). If you're smart, you realize you're already rich instead of risking it all for more theoretical gain.

Like I said, at your age your skin has very good chances of continuing to improve itself. There are all kinds of topicals that might help - Retin A , cp's, some people swear by TNS complex, Revive, Silkia Kamillia oil and so on.

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Hi Rose

No derm, just floats and now fraxel. Initially, the floats that failed looked worse. However, these holes eventually filled in from collagen/healing response to look the same as pre surgery. I think the grafts came off in many cases with the steristrip. Two others were not lifted quite high enough, leaving a scar, so a small improvement, but not a great success. Another is slightly off center, so minimal improvement. The 5 five that worked are virtually undetectable - I have a hard time finding them even though I know where they are. I had one that definitely looks worse now. It was the only large punch, made on a bad surgical scar. It looked bad after the float. Dr Y was kind enough to repeat at no cost and it came out even worse. This tissue was not meant to be floated.

Anyway, I was really impressed by how well this could work, but I just had a low success rate. I now have a better sense of which scars are amenable to floats and I think I have 3 or 4, whcih does not justify a trip form CA to NO. Wish there was someone local that was great at this technique.

PS: I am not sure fraxel makes sense for you. As so meone, said, if it ain't broke don't try to fix it. In my area, I could get much lower prices for SR 750 than for SR 1500. The main advantages of the latter is that you can go deeper with muhc greater safety and it is less painful. I perosnally don't think SR 750 is painful and you should not go deep given your skin.

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Here are my picutres. Jeez is it hard to take close up pictures of yourself and capture the scars. I'm posting severalbecause I can't decide which ones give the most true-to-life depiction.

post-6556-1168575100_thumb.jpg

post-6556-1168575100_thumb.jpg

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I couldn't post more than one picture in the thread, so I created a photo album in the gallery. I didn't do a very good job of taking these pictures. Also, a lot of detail is lost in uploading the pictures from my computer to the website. Things look worse in real life. I will try to take better pictures later.

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Your scars look like they would benefit from TCA Cross at 50%. What's left is scarred pores, and I've had pretty good success with those using 50% TCA acid. Athough your skin looks great and I wouldn't worry about it.

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Rosegirl:

If you do follow the TCA cross advice, which I don't recommend, as you may be tempted to self treat, keep it with a qualified P.S. or a great Derm and if they say dont go farther, at the risk of thinning your skin, don't do it!

There have been many disasters here regarding at home TCA cross, needling and other self treatments methodes. Please dont do it. You have spent thousands on your face so far and have nearly the result you want. Don't risk it by doing any "acid on the face at home" type of things.

okay?

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Rose, I agree with zimareth. Your skin looks GREAT! Simply not worth the risk of spoiling your achievements.

By the way, did the Retin A do that much for you? Is it responsible for your skin looking so good?

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hey ur skin looks perfect in my opinion... if u really want to spend the extra money i would go with fraxel. hardly any risks and it might get u the results u want... but i really dont think u need any more improvement...

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EricB,

Thanks. Fraxel is what I plan to do next. I consulted a second doctor, and he thought Fraxel would give me more improvement. My scarring is more visible in person than it appears to be in the pictures. Everyone's skin looks better in pictures.

Hopesprings,

It's impossible for me to say how much Retin-A helped me, since I've been doing other treatments at the same time. I believe that it has at the very least helped eliminate my acne and improved the texture and tone of my skin.

Zimareth,

Thank you for the warning. I will not do TCA or anything else on myself. I did TCA CROSS on myself with 100% TCA way back before my dermabrasion. (I forgot to mention this above.) At best it did nothing and at worst it made my scars wider. Granted I only did it twice. Some people say you have to do it many times, but I stopped because it appeared to be making things worse. I have considered needling on one icepick scar that I got after my dermabrasion, but I'm too afraid of making it worse. No more self-treating for me.

Rustymetal,

I just don't trust myself to do TCA right. I tried it before and had bad results (see above). Maybe if I could find a doctor in the D.C. area who does it. Any suggestions?

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rosegirl, I can't really tell from the pics but I do think your skin looks pretty darn good. You don't have any discoloration at all and by doing laser, you are taking a chance with messing that up. If you are pretty fair then your chances are great, but if you have any ethnic blood in you at all, please, please, please think twice about laser. Hyperpigmentation is the very devil to get rid of.

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Rosegirl, I have had fraxel. It works great to rejuvenate aging skin, but you look young. If you have lots of shallow scars, it might be worth it. However, if you have only a few scars i don't think it is worth the money, downtime, or the slight risk of making things worse. From my experience, and apparently most other poster's, it is really not very effective at lifting depressed scars. You have been turned down by 2 docs and you are a perfectionist. I am guessing you will be dissatsified with your results.

Hope this helps

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ok

i dont want to sound insensitive, but i cant believe you are worried about your skin. That pic looks like the way someones skin is suppose to look like. your skin is like perfect. yes i see like the 2 or 3 scars you are talking about, but who on this planet doesnt have 2 or 3 scars....ummm lets see britney spears has scars, liz hurly has those scars, camerom diaz has does scars, supermodels have those scars.

you dont even have discoloration. your skin tone and color are even through-out.

again i dont want to be insensitive, but i dont think you should touch your skin further. I'm even shocked you are considering further treatments. That looks like 100 percent success to me.

I would do anything for skin like that, infact even supermodels would kill for skin like that. If you think your skin is bad maybe you need other help, i am not saying this to be rude or insensitive, but with skin like that, and you still see a problem, you might have body dismorphic disorder. You might be seeing something and amplyfing something thats not really there.

Am I the only one thinking this when I see her pic?

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And to make everybody feel good, even Angelina Jolie has a scar on her cheek (at least one that I noticed). I never noticed it before I saw a closeup of her in a movie and she had this indent on her cheek.

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