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Hi,

So after my last round of subcision there was a line-line depression remaining afterwards (7 weeks ago was done). Basically the line is still persisting but the doc would like to wait another 2-3 months to see how the full healing is completed. He has, however, mentioned what can be done if we decide to do something after the full session of healing, has been almost 2 months, so I will know in a nother month and a half or so if I want to do somethign else:

My options are...for the area:

-Dermal Grafting

-Superficial fractional laser

-Superficial Subcision.

So, I was wondering if anyone here has gotten any Dermal grafting beforehand? If so on what type of scar, how many have you gotten, how did it work out for you? Was it even afterwards? Were you happy? How large of an area, etc.

I would appreciate it.

Sounds like I will probably either do that or subcision with possible fraxel afterwards to smooth it out.

This is such a hassle...but I guess that's life..

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I had it done in the past year. I am fairly satisfied with the results. It leveled off most of my scars. My scars were shallow but extensive so I had to go back several times to get a perfect fill (about 3 rounds). Scars need to be a minimum width and depth, by the way, in order to do grafts. I think it's 1 mm or so, but I'm not positive. They can only do dermal grafts on rolling scars. For larger icepicks, they do a punch graft, which is similar, except they use the scar itself as a graft rather than using dermis from the back of your ear. Does your doctor offer this procedure?

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I had it done in the past year. I am fairly satisfied with the results.

Datura, do you know if temporary fillers like Restylane or Juvederm can be used to accomplish the same result (leveling of the scar) than dermal grafting?

How did you treat the the surface of the scar to improve their structure?

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I had it done in the past year. I am fairly satisfied with the results.

Datura, do you know if temporary fillers like Restylane or Juvederm can be used to accomplish the same result (leveling of the scar) than dermal grafting?

How did you treat the the surface of the scar to improve their structure?

I have never tried fillers before, so I can't say for sure. I mean theoretically, fillers with subcision should give you the same result, albeit temporary. I still have to find time off from work to do resurfacing treatments. I am thinking of going old school and doing dermabrasion rather than lasers, but that probably won't be for awhile since I can't afford the downtime right now.

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My scars were shallow but extensive so I had to go back several times to get a perfect fill (about 3 rounds). Scars need to be a minimum width and depth, by the way, in order to do grafts. I think it's 1 mm or so, but I'm not positive.

Do you have any idea on the maximum depth a rolling scar can be in order to be almost leveled after grafting or filling? Or is there only a certain percentage by which a deeper scar can be raised?

Unfortunately I have a couple of deeper scars...

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I think if a doctor is skilled, you can get the level of fill you want. In fact, I you would probably have better results grafting a deeper scar because there is less room for error as they don't have to be as precise.

My scars were shallow but extensive so I had to go back several times to get a perfect fill (about 3 rounds). Scars need to be a minimum width and depth, by the way, in order to do grafts. I think it's 1 mm or so, but I'm not positive.

Do you have any idea on the maximum depth a rolling scar can be in order to be almost leveled after grafting or filling? Or is there only a certain percentage by which a deeper scar can be raised?

Unfortunately I have a couple of deeper scars...

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Datura do you think they can dermal graft an area of about 1 cm square or so?

From what I understand, as long as the scar has soft edges and it is large enough (i.e. >1mm) it is probably suitable for grafting. My doctor doesn't graft boxscars (scars with clearly defined edges). Rather, he does an excision. This is a less reliable technique than grafting, but apparently boxscars are not suitable for grafting. My recall is a little fuzzy, since it has been awhile since he discussed the technique with me, but this is what I gathered from his description. Hope this helped.

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I had it done in the past year. I am fairly satisfied with the results. It leveled off most of my scars. My scars were shallow but extensive so I had to go back several times to get a perfect fill (about 3 rounds). Scars need to be a minimum width and depth, by the way, in order to do grafts. I think it's 1 mm or so, but I'm not positive. They can only do dermal grafts on rolling scars. For larger icepicks, they do a punch graft, which is similar, except they use the scar itself as a graft rather than using dermis from the back of your ear. Does your doctor offer this procedure?

Hi Datura,You had 3 rounds???? So the doc took skin tissues from behind your ear 3 times to fill the scars?I thought this was a one time treatment...

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Yes, I thought it was a one time treatment as well.... It sounds like doctors will take skin from your ear or back and use it on your skin and will maybe laser or sand it down to blend in....??

If Anyone is very knowledgeable please post.... this is a great topic as a skin graft seems to be the real way to get rid of scars...and I do not know why there are all these BS treatments out there when a skin gfaft is probably the best way to get rid of a deeper scar.... It just makes sense.

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Yes, they take collagen from behind both ears alternatively. You generally have to wait six weeks between rounds for everything to heal properly and the grafts to settle.

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I had it done in the past year.

Datura, did you consider other filler alternatives (temporary fillers) or Sculptra and why did you choose dermal grafting over other treatment options?

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Basically, the doctor collects dermis from the back of your ear and cuts it to fit your scar and then places it in with a tweezer like apparatus. Then they place mini bandages, like steri-strips on the grafts. These come off on their own in 3-5 days or so. The doctor generally doesn't do more than 15 grafts in one round. The whole procedure is fairly quick. I am in probably in the office for about 30 minutes total. But again, the more skilled a doctor is, the faster and more precise they are able to be. There is technically no downtime, if you are comfortable going out with the bandages on, but otherwise 5 days or so and you are back to normal, with maybe slight redness from the grafts. I chose grafts because it is low cost, low risk and permanent. With temporary fillers, you have to keep returning to get top ups, and it ends up costing more in the long run. I paid a flat fee for surgery, like $150 and $35 a scar. All things considered, I think the cost is reasonable.

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how does the ear look like after the procedure?

Oh, I didn't mention anything about the ear. Naturally, because the cut is so deep, they stitch up your ear and bandage it. I guess my blood doesn't clot easily (as the nurse put it: "You're a bleeder"), so she had to bandage it very heavily. It was pretty embarassing, walking around with layers of bandaging on the back of my ear, like I had a gunshot wound, but what can you do. Anyway, everyone heals at different rates, but for me it took about 2 weeks until my ear fully healed. In the meantime, you change the dressing twice a day and apply polysporin and a bandage to the cut until it heals.

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5 days of downtime that is excellent. Just redness, that is really great Datura!!

Did your doc have to laser it down or sand it in to blend in?

Does it blend in well after the treatment/ look natural?

Did you have any longer rolling/ box scars or whatever grafted?

Why did you need it 3 times?

It seems to be if you have a scar and they graft new skin there that it would be a permanent thing and itw ould replace the old scarred skin and you would be left with new fresh skin...so why did it take 3 times? I am very curious about this.

Did you ever have any other treatments? Are you satisfied overall?

Thank You.

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Knicksrock, it sounds like you're thinking of skin grafts, which I think is for burn scars. Dermal grafts work to level the scar. Think of a subcision and a filler, except you are using your own collagen to fill the scar rather than Juvederm, restalyne or whatever. Dermal grafts don't do anything for the surface, though. For that you need a resurfacing treatment. But since the grafts bring the scarring up to the surface, there is less onus on the resurfacing treatment, so it should be more effective. Think of grafts as doing the heavy lifting and the resurfacing treatment as a finish. My doctor recommended profractional and microlaserpeel. But I think that's because that's what he uses, not necessarily because it's more effective than others. I think, ultimately the person using the laser or dermabrasion is more important than the tool. I still haven't decided yet on what I'm using and besides, I have to find time off of work. And that's not going to be for at least for several months or so. Even without resurfacing, though, I am satisfied with the improvement I've gotten with the grafts.

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I had a few dermal grafts. My view, without having tried Silicone Mricro Droplete, is that the latter is a more precise procedure, likely to lead to better results.

I had dermal grafts for 3 excisions that turned out poorly. The Dr. said the rest of my scars were too small for a graft. Remember, the graft is a small peice of dermis from behind the ear that is planted under the scar by creating a small pocket, with the hope that collagen will grow around it and help even the depression caused by lost dermis. In one case, I got a small improvement, approximately equal to the small scar created from the pocket slit. In another case, after a couple rounds, there was definite improvement (80%). However, in the third case, either because the peice of dermis was too large, inserted too close to the skin surface, or my body simply created way too much collagen, it has left an unsightly lump.

Having seen how this works, it seems that it is hard to predict results. I would think the SMD method can insert more droplets in multiple spots with no slit to create a pocket. It is inherently more precise from that perspective of usng multiple small droplets ather than a single larger piece of dermis. I will not try further dermal grafts, but may try to SMD. That said, silicone is a foreign material, which is a disadvantage.

Hope this helps

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However, in the third case, either because the peice of dermis was too large, inserted too close to the skin surface, or my body simply created way too much collagen, it has left an unsightly lump.

Can't your doctor drain the lump to level it? I've had a few lumps occur from overfilled grafts as well, and he just drained it to level it off.

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I can't conceive how it is drainable. It is a firm small round lump. Being a little unhappy and busy, I have decided not to go this route any further. If I do anything, it will be travel to a Silicone Mciro Doc. Perhaps he can inject around it to make it more level. There is definitely lost tissue in this excision area, so it may be best to try to raise the area around with several small injections. Otherwise, I think it will need to be shaved off. It does not bother me that much. Just trying to point out that, having had the procedure, I can see why fewer Docs are doing it.

Yes, in my case, it was simply transplanting small pieces of drmis under the depressed scar so that it raises up.

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