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PokerFace

My Fraxel Re:pair experience

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Greetings,

So two days ago, I had finally gone through with my Fraxel Re:pair treatment at the Cosmetic Vein & Laser Center in Williamsville, NY. I currently live in Toronto, but this particular clinic was my best option in terms of cost and experience. Like everyone else, I had arrived an hour early in order to get myself prepped for the treatment.

Let me start by saying that I'm a 20 year old male, with no prior history of adverse health conditions. Accutane, teamed with my initial breakout has left me with a few scars...blah blah blah (same shit, different poster).

They started off by putting numbing cream on face, followed by a shot of toradol in my rear (strong anti-inflammatory), which at the time felt like a huge punch to my ass. Half an hour later, I was given two vicodin along with two valium. An additional 30 minutes passed and it was time for my procedure. I decided to only get my cheeks, temples and forehead treated since those are my "problem areas", where many VERY shallow icepick, and extremely mild rolling scars were present. My nose, area below my nose and chin remained untouched. I also have two relatively deep chicken pock boxcar scars; one on my forehead and one on my left check, which I specifically asked to have treated multiple times. Let me start off by saying that my scars are EXTREMELY shallow, but somewhat excessive and scattered. I have done three Fraxel Re:store (SR1500) procedures in the past with very minimal to no results so I felt like it was time to move up the scar treatment hierarchy. The entire procedure cost 2175 USD.

I made it very clear to the doctor that I wanted the highest treatment settings that the FDA allows and he agreed to do just that. The doctor performing the treatment has done over 100 Re:pair treatments so far, so I felt quite comfortable in his hands.

THE TREATMENT:

First impression: ouch?!

Now I've previously had Fraxel Re:store performed at the highest FDA approved settings (which I had absolutely no trouble tolerating) and this is comparable to that in some regards. Like the Re:store, it feels very similar to a ballpoint pen being pressed and rolled along your skin. This time around, however, it felt as if this pen was spewing flames of pain everywhere it passed. The doctor began by injecting various parts of my face with local anesthetic (about 12 needle pricks in total) to offer additional numbing. I'm not going to lie, I have a very high tolerance for pain, but this can be quite painful in sensitive areas. At no point, however, did I ask him to stop for a "breather" or lower the settings. I was given two squeeze balls during the procedure, which I actually found myself clenching quite tightly at times. My best advice to give anybody about to undergo the procedure is to take DEEP, meditative breaths, while intermittently clenching your teeth when the laser passes over sensitive areas. I found that the aforementioned exercises helped me quite a bit. Now as of right now, I'm not positive about the settings used (I know they were very aggressive), but I will be sure to inquire about them during my Monday checkup and post back here for my next update. I know for a fact that he did four passes on all areas treated (one pass being back AND forth). He also wielded the laser vertically and horizontally, if that matters at all.

The entire procedure took about 40 minutes and I experienced no pain whatsoever after the treatment was over. Immediately after the procedure, my face had an unnatural resemblance to that of a zombie from a George Romero film. The pinpoint bleeding was excessive and I was literally beat-red with blood covering my entire treated areas. The blood from my forehead actually trickled down my nose, so it appeared to be the whole package; a brutally skinned victim of Hannibal Lecter. Of course on my way home, I was getting curious stares from all sorts of onlookers. I simply stared right back and bulged my eyes, which the children apparently found quite frightening (I'm awesome, I know). Even at the border, while returning to Canada, the patrolman was wtf'ing me HARD. He must've thought I had some type of skin-eating disease, since he was quick to let me through (even without a passport). He clearly didn't want to catch this strange plague (most likely caused by youthful premarital sex and the devil!)

In hindsight, I really should've gotten my entire face treated. The lines of demarcation are VERY evident, which is kind of disappointing, since I was going to try and pass this off as a sunburn in a few weeks.

"UGGHH, yeah, I must've forgot to put sunscreen on my nose and my chin...silly me". FAIL.

I returned home that day, did my vinegar soaks, drenched my face with Aquafor, took my prescribed meds, and called it a day.

My scars aren't currently visible due to the swelling and redness. I very much understand that microswelling lasts upwards of over a month, so I'll hold off on my subjective bullshit improvement percentage until the third month post-treatment.

DAY 1 POST:

-four vinegar soaks

-crusting gone

-smooth skin

-red as fuck

So, I'm currently on day 2. Going to continue with my vinegar soaks and Aquafor application religiously. I have a bunch of pictures from day 1, but I'm too lazy to upload them now (I'll do it later so don't fret). The doctor also took some snapshots right before the procedure, so I'll grab those from him too as soon as I can.

This erythema (intense redness) is driving me crazy though. I got treated VERY aggressively, so I'm assuming the redness will reside in a little over a month. I really should've done my whole face, but live and learn, I guess. The doxycylcine is really helping my breakouts too (I haven't gotten one whitehead so far), so that's good news.

Anyways, I'll keep everyone updated. If anybody has any questions or comments, by all means, feel free to speak your mind and ask away.

I apologize for the length of this post, but I wanted to be as informative as possible.

CHEERS!

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I hope this works out for you too. I will be following your progress.

Shoot, I guess now it's my turn to get on it. Haha

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PokerFace, GOOD for you, and good post. Don't forget ice for the swelling. Are you the guy from Toronto, and where did you go in the US?

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PokerFace, GOOD for you, and good post. Don't forget ice for the swelling. Are you the guy from Toronto, and where did you go in the US?

Hi Dudley, thanks for the comment.

To be honest, I don't look too swollen (albeit, there is some). I'm not certain if it's going to get worse on subsequent days, but I currently don't feel any need to reduce the "swelling" with ice. The physician told me that I can decide whether or not to use ice based on how it looks/feels. I will, however take some ibuprofen just to be sure and possibly decide to ice it on future dates.

To answer your question, yes, I'm from Toronto. I went to The Cosmetic Vein and Laser Center in Williamsville, NY (Buffalo area), which turned out to be no more than a two hour trip. I learned of this place from a previous thread and I believe you subsequently reminded me of it again.

The Cosmetic Vein and Laser Center

The staff there are very friendly, knowledgeable, and helpful.

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Good luck and keep us updated! I have some shallow (but extensive) scarring as well and I'm wondering how effective repair is on the shallower stuff.

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Awesome post.

Please continue keeping us updated!

I do have a few questions though. What color skin do you have? I'm guessing very fair skinned. How long were you off accutane before you started scar treatment? Do you know if there is anything you can do about erythema? My biggest worry about fraxel repair is intense erythema as you said. Knowing my skin, I think it'd linger for months and months after.

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I will read this later when I get the chance. Goodluck to you. PLEASE keep us updated bro and good luck again!

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PokerFace, I thought that was you from Toronto. If you haven't experienced swelling by now you probably won't. After my first Re:pair, by the 2nd day, I was so swollen that I couldn't even recognize myself. It sounds like you are doing great.

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Is vinegar really ok? I can imagine the sting when you apply it on the raw skin. Anyway the pics from repair looks good, then again, the pics from restore looked good as well although it didnt mean a rat's ass lol.

Hope you get the improvement u seek.

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Thanks for the encouraging words. I will most certainly keep everyone updated, as I would hope to expect the same from anybody in my position.

Raiderdood - I have fairly pale skin (I'm of Slavic decent) and I wear sunscreen on a regular basis. I finished my six month course of Accutane in May of 2008 and subsequently started my Fraxel Re:store treatments in February of 2009 (approximately nine months later). I did one treatment per month (total of three), where I then took a three month "hiatus" before my Re:pair procedure. As for the erythema, the prolonged redness was also one of my main concerns. I realized the "clinical" downtime was 3-6 days, but the "social" downtime was much longer (depending on the aggressiveness of the treatment). Right now, I resemble a burn victim, which actually brings me great comfort, ironically enough. This is primarily due to fact that generally speaking, longer down times usually yield better results. My "wounds" healed within one day (I'm a very fast healer), so now I'm simply dealing with heavy redness. As far as redness treatments are concerned, there are two lasers that I'm aware of that target redness, and can fade the treated skin back to normal skin tone (with 2-3 treatments); These are IPL (intense pulse light) and pulse dye lasers, the latter one being a bit more powerful and ultimately more effective. Regardless, you will need to wait 3-4 weeks post-Re:pair before you can use these lasers, seeing as your skin would still be recovering from the fractional co2 treatment.

Dudley - Yeah, hopefully youth is on my side in terms of my healing capabilities; so far so good.

:)

Vanyel - Vinegar is a perfectly suitable substance for post-op cleansing, as long as one is using it in the proper concentration. I was told to poor out 30mL of water from a 500mL bottle, and replace that water with 30mL of white vinegar (roughly a 16:1 ratio). This solution works great to keep the skin clean (vinegar is an antiseptic), and also to gently exfoliate dead skin; it does not sting whatsoever. Vinegar soaks are actually fairly universal in most post-Re:pair instructions so there is really nothing to worry about.

This picture illustrates my normal skin tone:

2009

Once again, I'd like to emphasize that my scars are VERY shallow and extremely difficult (if not impossible) to see in many lighting. Additionally, they are mostly all located on the sides of my face and are not evident from the front. Most people find it difficult to see them unless I clearly point them out in a mirror (close up) or the lighting is "perfect" lol. To be honest, it's more of an uneven skin texture I got from a mild chemical burn via ACV a few years ago (in my more naive days). It's as if my skin grew thicker in some areas, and remained thin in others, if that makes sense. Anyways, regardless of the severity of my scars, they don't bother me that much or debilitate my social life whatsoever. I just figure I'd get a treatment done now, since I can afford the downtime and the financial hit. I plan to be working in a professional setting later in life so it'd be nice to have great skin. I will try to upload the "day one post treatment" photos tomorrow.

Thanks for reading.

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Wow, this is a very indepth and well informative post about fraxel. My last visit to the derm prescribed Fraxel but it was rather expensive for my tastes. It was something like $400-600 a session and forr the amount of scarring I have, she thought that 8-10 sessions would benefit me the best. Ahahaa, yea right lolz

It will definetly be interesting to see some before&after pics to really get an idea what results you can expect. Granted, it probably depends alot on skin type&Severity of scarring but it will bet interesting none the less.

But I hope it really works for you.

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PokerFace, your posts are excellent! From your picture one cannot tell that you have scarring. You may well achieve good results with only one Re:pair.

BeautifulPerserve, your doctor is quoting you prices for Fraxel Re:store not Fraxel Re:pair. I paid $5, 000 for my first Re:pair, $2,000 for the 2nd and I just scheduled my 3rd for Oct 30 for $1,000. Re:store is non-ablative and uses the Erbium Laser, and Re:pair is ablative and uses the CO2 Laser. There is very much confusion because of the similar names. Their first laser was called Fraxel Re:fine

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Hi PokerFace: Was Fraxel Re:pair the only option for you at this point? As you said yourself, your skin condition isn't that bad. Did the doctor suggest anything else? IPL, perhaps? I'm from Buffalo, by the way. And I just had my first laser treatment (Starlux 1540) which I briefly posted about in the laser section. I regret not considering the place you went to. Please keep us up-to-date.

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Hi PokerFace: Was Fraxel Re:pair the only option for you at this point? As you said yourself, your skin condition isn't that bad. Did the doctor suggest anything else? IPL, perhaps? I'm from Buffalo, by the way. And I just had my first laser treatment (Starlux 1540) which I briefly posted about in the laser section. I regret not considering the place you went to. Please keep us up-to-date.

Well, as far as laser treatments are concerned, fractional technology seems to have the most hype surrounding its ability to effectively treat acne scarring. The doctor at the CVLC actually told me during my Re:pair consultation that I’d be a perfect candidate for their Fraxel Re:store, seeing as my scarring was very mild. I explained to him that I’ve already had three, high-setting treatments [of Re:store] with a very experienced laser technician (one of the first to employ that technology in Toronto) with disappointing results. He explained to me that using the Re:pair would be analogous of killing a mouse with a bazooka. Of course you’ll kill the mouse, but it’s a little overkill. I agreed to do it regardless seeing as I was sick of these other bullshit treatments that caused minimal downtime. I wanted that fucking mouse DEAD! Haha

In terms of other treatments, I was also considering full face erbium but other than that, there’s not much else that anybody’s offering (I’ve done quite a bit of research on the topic). Of course, there are strong, full-face chemical peels (TCA), but I wasn’t too keen on that since I feel that some of my scarring came from a mild chemical burn in the first place. What drew me to fractional co2 lasers was the fact that it’s not completely ablative; the surrounding tissue of the areas treated significantly expedite the healing process, allowing for a lesser chance of further complications. The Starlux 1540 fractional laser is essentially the same technology and laser as the Fraxel Re:store, except for the fact that they’re created by different manufacturers. I know some people have had good results with fractional erbium lasers, but I’ve heard many more negative reviews than positive concerning acne scarring. I feel that three treatments on the highest settings should’ve yielded at least SOME kind of improvement; a glimmer of hope that would entice me to continue. Unfortunately, this did not happen. I actually initially bought a series of six, but then got my refund for the remaining amount after I expressed my dissatisfaction. From what I understand, IPL is not used to treat acne scarring, but rather sun damage, rosacea, and pigmented lesions. I strongly doubt it will do anything for pitted scars.

I would STRONGLY suggest doing your research and going to MANY consultations before committing to any type of scar treatment procedures. You should feel comfortable with the physician and make sure you ask plenty of questions. After all, a smart consumer is an educated one.

UPDATE:

Post op – Day 3

-Vinegar soaks/ Aquafor four times a day

-still very red

-same shit, different day

Well, I couldn’t seem to upload my Day 1 pictures from my sister’s Blackberry (she left the software disk at home or some shit) so I’ll upload those some other time. In the meantime, here are some pictures from day 3. As you can see, I’m still VERY red. Don’t mind the greasy hair, it’s got Vaseline in it, FML.

Front-Left

Right side

Front

Bottom

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So Pokerface, what are you doing during your downtime? lol

hah, lots of reading, hold'em, and HBO. I'm actually getting lots done around the house though, so it's not all bad. Just a pain that I can't go golfing :(

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Alright, so I’ve just returned from my latest checkup and have some new information to share. Apparently, the settings used on my face were not the highest they could’ve been which initially concerned me. My settings were as follows:

Energy – 40 millijoules

Depth – 1060 micrometers

50 % skin coverage

Now from what I understand, the highest setting for energy is 50 mj; depth is 1300 micrometers, and I’m not certain concerning skin coverage.

I inquired as to why he did not nuke my face at full throttle and he managed to give me a fairly convincing explanation. According to him, if he were to increase the depth, and keep the skin coverage constant, there would be a much higher chance of scarring and hyperpigmentation with my particular skin type. He also stated that with my particular type of scarring (very shallow yet excessive), the coverage is a more significant factor than the actual energy and depth used. Now whether or not he was just trying to cover his ass, I don’t know, but quite honestly, that’s a good enough rationale for me. I’d hate to have gotten further scarring or to have been redder than I already am anyways.

I stopped the vinegar soaks yesterday (day 4 post op) and started using the topical steroid at night. I also began using topical clindamycin (with spf 15) during the day since I got quite a few whiteheads from the Aquafor. I'm now washing with Dan's cleanser (best cleanser ever btw), so it's now a lot less maintenance. I remain quite red, but it’ll gradually fade so I’m not overly concerned. My skin is still a little dry but not nearly as bad as it was during the first few days. I don’t think I’ll post any more pictures as of yet, seeing as there are no dramatic changes from the previous images I recently uploaded. If I were to change anything about the procedure, I would've gotten my entire face treated, rather than certain areas. That untreated "T" area just looks wrong haha.

ughh

If worst comes to worst and I don’t manage to achieve my desired results in this single treatment, but there is still a relatively significant amount of improvement nonetheless (anything over 20%), I will most definitely go for another treatment six months down the road. Apparently, results are cumulative so time will tell. I’ll keep everyone updated.

Again, I'm open to any questions or comments,

Stay frosty :cool:

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PokerFace, glad to hear you are doing well. You supplied some good data. If your scars are shallow it does seem like overkill to go to a higher setting. Any picture prior to 3 months are always inconclusive, and clouded by microswelling. I firmly believe results are cumulative and that is why I have my 3rd Re:pair set to go.

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So Pokerface, what are you doing during your downtime? lol

hah, lots of reading, hold'em, and HBO. I'm actually getting lots done around the house though, so it's not all bad. Just a pain that I can't go golfing :(

I see. When do you plan to start going out to socialize, work, or go to school again?

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So Pokerface, what are you doing during your downtime? lol

hah, lots of reading, hold'em, and HBO. I'm actually getting lots done around the house though, so it's not all bad. Just a pain that I can't go golfing :(

I see. When do you plan to start going out to socialize, work, or go to school again?

The redness was quite intense the first few days, but it's actually beginning to fade quite rapidly now. I'll probably give it another week and a half, give or take a few days. It'd most likely be sooner if I didn't have these evident demarcation lines since I'd be able to pass it off as a sunburn; I clearly can't do this with demarcation lines. If anybody decides to go through with the Re:pair, please ensure that you're doing a full face treatment.

Also, the highest energy settings are 70 mJ, I believe, not 50 mJ...typo.

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DAY 1 POST:

-four vinegar soaks

-crusting gone

-smooth skin

-red as fuck

LOL first time I read I thought this was the derm's note...I was like..that's a really nice descriptive technical term! :ninja::lol:

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Do u know if the downtime for Repair is more than the amount of downtime needed for Restore?

At $2175 US, that seems like a great deal considering most people are paying over $3000 for the entire face. Was this the set price or did you get a special deal from the doctor?

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Do u know if the downtime for Repair is more than the amount of downtime needed for Restore?

At $2175 US, that seems like a great deal considering most people are paying over $3000 for the entire face. Was this the set price or did you get a special deal from the doctor?

Yes, there is a longer downtime for the Re:pair. From my experience, the "social" downtime from the Re:store was on average five days. On the other hand, the Re:pair has a "clinical" downtime of about 2-4 days, followed by additional "social" downtime of 1-6 weeks, depending on the laser intensity. I'm one week post treatment so far and I can't see myself being comfortable enough to go out for at least another two weeks. The topical steroid is helping fade the redness gradually but I still have ways to go. I'm supposed to be getting this TNS recovery complex to expedite the healing process.

$2175 US was the set price. If I were to go for a second procedure, they'd knock off an additional 10% for me, which I would probably put towards doing my entire face anyways.

Update:

The one trackmark I initially thought was simply a red line (caused by the overlapping of the laser paths), now seems to be a shallow depressed scar. As for the rest of my face, it seems as if the Re:pair "undid" all the collagen building that has taken place over the past year. The scars that faded over time (the past few years) have come back in full force. I understand that full results and collagen production take anywhere up to 6 months to show, but I can't help but feel dissapointed as of right now; not because the swelling has gone away and my old scars have reappeared (I expected this), but my older scars appear worse in addition to the appearance of a new scar. sigh lol.

I'm not judging anything right now though, I'll wait and see if things get better. I'm also planning on speaking to the doctor concerning this new scar.

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oh man. that doesnt sound too cool. but as they say, collagen growth takes awhile and i'm sure your results will be positive.

as for your new scar, well at least its a line and not a hole haha. i'd rather have a line and play it off as a cut or something.

hang in there.

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Update:

The one trackmark I initially thought was simply a red line (caused by the overlapping of the laser paths), now seems to be a shallow depressed scar. As for the rest of my face, it seems as if the Re:pair "undid" all the collagen building that has taken place over the past year. The scars that faded over time (the past few years) have come back in full force. I understand that full results and collagen production take anywhere up to 6 months to show, but I can't help but feel dissapointed as of right now; not because the swelling has gone away and my old scars have reappeared (I expected this), but my older scars appear worse in addition to the appearance of a new scar. sigh lol.

I'm not judging anything right now though, I'll wait and see if things get better. I'm also planning on speaking to the doctor concerning this new scar.

don't get discouraged! it really is too early to judge at this point. i think you'll see major improvement over time. i think it makes sense that the re:pair might 'undo' some of the previous collagen production. but surely it will only induce stronger collagen production since the laser is stronger.

i'm in a similar boat - just a week and a few days after my second starlux 1540 (i think we've spoken before over a similar accutane induced scarring experience. my scarring is like yours- shallow but abundant). the swelling has gone down and my scars seem more pronounced and on top of that i've got red patches on the areas he went deeper. i'm pretty disappointed at the moment but trying to remind myself that the collagen takes a while to kick in. MAYBE!!?

i'm really anxious to hear about your results from re:pair. if i don't see more results i might look into re:pair between my next school semesters.

and thanks for posting your pictures - it is really helpful for those of us considering getting the same treatment!

are you taking any supplements that help with healing: zinc, vit-c, vit-e, etc??

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