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For Washingtonians: my consults w/Drs Ragaz & Rasmussen


I've recently gone on my first consultations with doctors that treat scars and just wanted to share my experiences for anyone who's seeking doctors in western WA.

First, I had a pretty brief consult w/ Dr Anna Ragaz in Seattle for subcision tx. She does a light TCA/retinoic acid peel (10% I think, optional, but included in price) right before the subcision and recommends N Lite treatments as a follow up. She usually does 3-6 rounds of sub, which seemed like a lot to me. The cost is $450/sub and $99 for consult (can be applied to tx).

I also met w/Dr Rasmussen in Silverdale for a Smoothbeam consult. The consult (med/cosmetic combo) was about an hour (!) long altogether (I was the last patient of the day). He seemed like a knowledgable and caring derm. I had many questions and concerns and he took the time to address all of them. He suggested multiple tx options for a derm condition I had that my usual derm had never suggested, even though I was having little success after 1+ yr of the standard tx.

Having said that, I don't know how much experience they have with smoothbeam. He didn't give all the answers I was hoping to hear, based on SkinRN's advice. They don't do test spots. They start at 11, then move up to 12. They'd be willing to use a higher setting if requested, but obviously they'd have less exp w/the higher settings. The cooling setting is 40 for both. He said a couple people had blistered at 12, none at 11. The cost is $250/tx, consult w/dr $75 or ARNP $50, applicable to tx. The ARNP does most of the tx, but dr will do them if requested.

In contrast to Dr Ragaz, he thought that my rolling scars were too shallow for sub. When I asked about icepicks, he mentioned the TCA Cross. He doesn't do this now, but at least has heard about it from another dr recently and was willing to look into it. He thoght 100% TCA was too risky though. Hopefully he'll reconsider using 100% after doing some research. They also have the IPL and Aurora. He seemed very pleased w/the results from the IPL ($550).

He may be opening a satellite office in Gig Harbor soon if he can hire another ARNP. This would be much more convenient for me, so I think I'll wait and see if that gets off the ground before I make another appt.

I see I've nearly written a novel now, but if there's anything I didn't cover I'd be happy to answer any questions (after Sunday, anyways).

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He thought the 100% could be damaging and make the scars look worse. That's not an uncommon reaction for docs to have since they'd normally never use that high concentration. I'm hoping that once he reads the paper and discusses the treatment with the dr that's performing it now, he'll feel more comfortable with it. He seems to be fairly cautious in general.


I've gotten such great info from this site, especially from yourself, that it's nice to finally have something helpful to contribute.

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