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truckg

My experience with Fraxel RE:pair and also with temporary fillers

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Just wanted to share my experience with you all, since this site has been very useful to me in the past. :dance:

About 5 months ago I had the Fraxel RE:pair (at pretty high settings) to treat my acne scars. I followed the pre and post-operative instructions, and, in the weeks following the surgery, I experienced one of the most horrible cystic acne outbreaks I have seen. I did have some active acne at the time of the surgery, and it seems that the laser somehow triggered a massive outbreak leading to large (golfball size and larger) puss-filled cysts and smaller whiteheads all over my face but especially on my cheeks (an area where I had gotten cysts in the past). I saw the dermatologist many times during the weeks following the procedure, and he was able to lance and drain (and inject with kenalog) many of the cysts to bring things under control (little by little the cysts were able to be brought down -- sometimes it took multiple days of draining to get all the puss out -- usually had to wait until the cyst came to a head to do this). It took a lot of draining and injecting (the steriod was dilluted, of course, to try to prevent atrophy) of cysts to finally calm things down. Luckily things did get under control within a couple weeks, but I wonder if I might have gotten a few additional scars because of this massive outbreak. If I had not treated this cystic outbreak immediately (luckily many of the cysts had come to heads, which made them easier to drain), I cannot imagine that they would have gone away on their own for quite some time.

5 months later:Was it worth it? Well, the redness lasted a little more than 3 months, gradually fading over that time. The improvement on my scars? I'm not sure.I haven't taken new pictures to compare with my pre-op photos. My scars are definitely still there, and at this point I can say that the results have not been particularly dramatic, but I'm going to wait to see the pics side by side before I make a final judgement on that. I will tentatively say that I don't see any noticeable improvement at this point. The worst part, though, was that the cystic breakout in the weeks following the procedure totally pulled my attention from scar-correction to acne management/trying to prevent NEW cysts from creating more scars. :wall:

:hand: Anyone with active acne should know that a MASSIVE breakout is a real possibilityimmediately after the procedure. We aren't just talking about small whiteheads (that many people attribute to the Aquaphor and other post-op care topicals); no, we're talking gigantic, potentially new scar-causing, puss-filled, red, sore and hardened cysts... and A LOT of them. It's like a reunion of every large cyst you've ever had, in the location where you've ever had one all at once. I really believe there is something about the heat of the laser that affects the sebaceous glands in some way causing them to go wild. When doctors attribute all post-op breakouts to the vaseline and things like Aquaphor alone, I am VERY skeptical.

As far as the temporary fillers go, I have found that Juvederm has been able to both improve and, with some more shallow scars, totally elminate the appearance of the atrophic acne scars that I have. :surprised: I have ALSO found that the filler actually made some other scars look A LOT worse. :wacko: What happened was the filler eventually seemed to settle AROUND some scars, creating a very harsh looking crater/canyon/donut effect. I'm not sure if this was due to the manner of injection or just bad luck or maybe the "tethering" of the scar tissue. When the doctor injected me he first performed subcision, which left my face swollen like a balloon. He then injected me when I was swollen, and I can't imagine how he could have known exactly where (even with the black sharpie marks on my face) and how much to inject. Thank goodness these are temporary fillers that can be remolded, flattened or easily dissolved, if need be. After that experience I tried Restylane in a few other areas, and found it to be softer than Juvederm and seemed to look better... but this time it was with another doctor. Soon I plan to get more Restylane injected only in the depressed scar areas that saw improvement in the past (mostly in the areas around my mouth and jawline -- unfortunately, the injections in my cheek areas seemed the most likely to experience the crater/donut effect... and those are the areas I need the most treatment).

Anyone have similar experiences? Find something that works better? Special tips?

Bottom line:

Fraxel Re:Pair --> at this point, not a huge help. oh, and it made me breakout immediately afterwards BIG TIME.

Juvederm/Restylane-->> only moderately helpful, but not a big help for extensive scarring.

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does anyone have before/after photos of their Juvederm of Restylane fillers to treat acne scars?

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TruckG, I am sorry to hear of your bad experience. It is good that you are sounding the warning bell for people with active acne. I doubt that most people will be satisfied by their initial Fraxel Repair procedure. I saw enough improvement from my first laser to realize I would try it again, and it is with the 2nd treatment that results are more noticeable. I am planning my 3rd Repair for either June or in the fall. I hope that 3 will be enough, but I will consider 4 if need be. Acne scars are tough buggers, and it takes patience to deal with them.

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May you please state what type of scarring you have? As far as I know, fillers are good for rolling scars but not meant for ice pick scars. What type of scars did you get injected?

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It's so hard for me to classify the type. Most were broad-based saucer-like and rolling scars. The scars are all different. I don't really have any very deep ice pick scars. My derm had said that many would respond well to many of the scars... but, unfortunately many of the scars he said would respond well to the filler ended up donuting. You're right that we are told over and over that fillers are good for rolling scars, but I was not particularly impressed with the improvement. It basically just pushed up the scar rather than fill it in... leaving a lumpy look to some parts of the face. In fact, under adverse lighting my face looked not one bit more smooth after I had had the fillers. These kinds of fillers just didn't seem particularly precise. Of course, I so wish I could report otherwise. I have heard that silicone micro-droplet technique works much better for acne scars, but there are risks associated with that permanent filler... perhaps the benefits of silicone outweigh the potential risks? That's where I'm at now... looking into silicone and maybe dermal grafts. Lasers just don't seem to do enough (or anything at all that I've noticed) to fill in depressed areas. Where volume is lost and there is atrophy, it seems to me the only way to replace the volume is with an injected filler of some sort.

May you please state what type of scarring you have? As far as I know, fillers are good for rolling scars but not meant for ice pick scars. What type of scars did you get injected?

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They nearly all vanish when the skin is stretched. In fact, immediately after the injections my face was so swollen... leaving everything looking so smooth. Of course, that did not last. I wonder if it's because the scars are too tethered down or what... and I have had several subcisions, including one the day of the filler injections. Maybe it's still possible to get good results with these hyaluronic acid-based fillers... but I'm beginning to get more skeptical... have you ever seen one (let alone several) examples of someone who had lasting significant improvement (even if it lasted just a few months) on moderate acne scarring with these (other than silicone) fillers? I'd love to see the pictures, if you are aware of such examples.

Before your treatment, how much did your scars flatten out when you stretch your skin out?

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Thanks for the message. I agree that multpile fraxel re:pair sessions are worth looking into. I would have already scheduled a second (even though I haven't seen dramatic results -- I am THAT desperate I guess... hehe), but the whole massive cystic breakout thing is making me want to put off lasers for the time being. have you ever looked into fillers, by the way?

TruckG, I am sorry to hear of your bad experience. It is good that you are sounding the warning bell for people with active acne. I doubt that most people will be satisfied by their initial Fraxel Repair procedure. I saw enough improvement from my first laser to realize I would try it again, and it is with the 2nd treatment that results are more noticeable. I am planning my 3rd Repair for either June or in the fall. I hope that 3 will be enough, but I will consider 4 if need be. Acne scars are tough buggers, and it takes patience to deal with them.

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They nearly all vanish when the skin is stretched. In fact, immediately after the injections my face was so swollen... leaving everything looking so smooth. Of course, that did not last. I wonder if it's because the scars are too tethered down or what... and I have had several subcisions, including one the day of the filler injections. Maybe it's still possible to get good results with these hyaluronic acid-based fillers... but I'm beginning to get more skeptical... have you ever seen one (let alone several) examples of someone who had lasting significant improvement (even if it lasted just a few months) on moderate acne scarring with these (other than silicone) fillers? I'd love to see the pictures, if you are aware of such examples.

Before your treatment, how much did your scars flatten out when you stretch your skin out?

There are quite a few people here who claim Restylane has worked great for their scars for a couple months. It is not suppose to last very long and one will need to injected at least every 3 months or so.

How long did your results hold up by the way?

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Have you seen the pictures? I don't doubt that they were pleased. But, for me, the change was barely noticeable... it didn't flatten out or fill in the scars as I had wished it might come close to doing. The stuff stayed in for several months.

They nearly all vanish when the skin is stretched. In fact, immediately after the injections my face was so swollen... leaving everything looking so smooth. Of course, that did not last. I wonder if it's because the scars are too tethered down or what... and I have had several subcisions, including one the day of the filler injections. Maybe it's still possible to get good results with these hyaluronic acid-based fillers... but I'm beginning to get more skeptical... have you ever seen one (let alone several) examples of someone who had lasting significant improvement (even if it lasted just a few months) on moderate acne scarring with these (other than silicone) fillers? I'd love to see the pictures, if you are aware of such examples.

Before your treatment, how much did your scars flatten out when you stretch your skin out?

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Hi Truckg,

Thanks for sharing your experience with Fraxel Re:pair. I too am about to go for a Re:pair treatment as soon as I find the doctor or surgeon I am most comfortable with.

I'm sorry to hear about your post-procedure acne breakout. Perhaps before your next procedure you could ask the doctor performing the treatment to prescribe you some oral antibiotics (doxycycline or minocycline) the week prior and post treatment. This may very well eliminate or at least reduce the severity of your post-Re:pair breakouts (I know this helped after my re:store treatments).

Also, if you're looking for something to reduce the post-procedure redness, I believe IPLs or pulse dye lasers can be performed about one month after your Re:pair.

I have a question: approximately how long was your social downtime? (the amount of time it took for you to be able to comfortably go out with your friends)

Again, thank you for sharing your experience and good luck on your future scar improvement endeavors.

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Hi! Actually, I was on antibiotics at the time of the procedure. I read about others having similar flare-ups after the procedure. I wish you the best with your procedure, but caution you against feeling too optimistic. I have yet to see any pictures of any members on here who experienced real acne scar improvement with the re:pair. As far as the downtime goes, I'd say I was red for about 3 months. Women can probably wear makeup after a week or so. Re:pair is nothing like the re:store.

Hi Truckg,

Thanks for sharing your experience with Fraxel Re:pair. I too am about to go for a Re:pair treatment as soon as I find the doctor or surgeon I am most comfortable with.

I'm sorry to hear about your post-procedure acne breakout. Perhaps before your next procedure you could ask the doctor performing the treatment to prescribe you some oral antibiotics (doxycycline or minocycline) the week prior and post treatment. This may very well eliminate or at least reduce the severity of your post-Re:pair breakouts (I know this helped after my re:store treatments).

Also, if you're looking for something to reduce the post-procedure redness, I believe IPLs or pulse dye lasers can be performed about one month after your Re:pair.

I have a question: approximately how long was your social downtime? (the amount of time it took for you to be able to comfortably go out with your friends)

Again, thank you for sharing your experience and good luck on your future scar improvement endeavors.

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I also had a pretty major breakout following my Re:pair procedure (performed in Nov). I did not have awful cystic outbreaks but I had hundreds of clogged pores. I did not have much active acne before the Re:pair. Even today, my skin is much more breakout prone than before Re:pair. I feel like a teenager again (I'm 24). I was told by a dermatologist that the laser brings things the surface, which can cause breakouts. The skin is so fragile following the Re:pair, that it seems further scarring could easily occur with a major breakout.

I have not seen significant scar improvement, though I may look into a second spot treatment if I build up the nerve. The procedure was very painful for me, so it is hard to work up the courage to go under the laser again. For me, the Re:pair was not worth the money ($3500). I'm glad that you posted this as a heads up to all considering the Re:pair.

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