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billyboy

Successes and failures

In the hope that some of you won't repeat my many mistakes, here is what worked and did not work.

FAILURES

Punch floats by Dr Y in New Orleans. Several years ago, he was the "positive rage" on these boards. I traveled to NO and had him do many punch floats given my desire for no further travel (i.e, get it all done at once, even if scar was tiny). Floats produced larger, deeper scars or no change, so I went back, thinking that the steri srips did not hold the floats in place. I had the same bad experience the second time as did many others who visited him during this period after Katrina. Either he lost his touch, or the previous posters had completely different results than the post Katrina posters.

3 Excisions by Dr Zachary at UCSF now at UC Irvine, who is a consultant to most of the laser makers. He was a charming Brit, but a terrible surgeon, whom I would not trust after my horrible experience with him. I'm not surprised that he is consultant and spokesperson for the laser companies because he is well spoken and will do anything for money. Furthermore, I am guessing he has learned that he is a poor surgeon and should leave that for others.

These experiences have made me cynical of "name" Docs.

MILD SUCCESSES

Subcision did not work for me. Not sure why not. Perhaps the doc was not aggressive enough. Also, my scarring is mostly from lost tissue and shallow. I have no sense that the scar Is "tethered" or bound down, so perhaps these scars don't respond to subcision. Also, I am now 58, which could make a difference. At least it caused no regression like the first 2 failures.

Fraxel refine and restore (8 total as per below) helped with even tone, shallow scarring, but no effect on deeper scars. Overall improvement of say 20%, which isn't very good after 8 sessions and many $s, but most were the first generation machine. I notice that I flush much more easily in respone to heat (sauna and steam), but it does not bother me much. Also, I think my skin color is very slgihtly lighter where the fraxel went. Hardly noticable though.

Dermal grafts of dermis from behind the ear under scars have been quite successful in correcting the 3 failed excisions, where the scar separated and there was significant tissue loss. This procdure seems analogous to SMD, except it is probably safer, as it is your own skin. On the other hand, I suspect it is much harder to be precise in the scar correction with grafts than with SMD. The good is that, with multiple visits, it has rasised the scars to essentially even with the surrouding skin. But, it is a a little lumpy and far from perfect. I considered going to Dr. Lam, but after my horrible experience with Dr. Y, decided to stay in the Bay Area and away from name Docs. Not trying SMD may have have been a mistake, but dermal grafts have worked pretty well. My Doc has also tried grafts under a few larger ptis, besides the 3 failed excision corrections, but with limited success. Importantly, every scar was improved, with none worse than before.

TOO EARLY TO TELL

I have many very small ice pick scars, left over from Dr. Y using hsi smllest puch tool. We tried 2 spots tests with pro fractional. I was underwhelmed. That said, I may try spot treatments, as my final step after TCA cross.

Cross seems counterintuitive but my DOC started doing it with some success on other patients and suggested I try it. Anyway, I had 5 scars crossed 7 days ago, so I won't know results for some time. If this seems to work, then I will do another round and may finish off with spot profractionals, not whole face.

MY BIGGEST MISTAKE, IN HINDSIGHT, was trying to correct small scars surgically. Leave these alone as you may make them worse, except for possibly a fractional laser at the end. Also, if I had it to do over again, I would have dermal grafts or SMD on a very few bad scars, TCA on small ice picks, and then finish with several fractional laser treatments. In other words, fill the valleys and then minimally tighten/sand down to a more even finish with a couple laser treatments. but again, the verdict is still out on TCA cross for me, but it seems safe, albeit counterintuitive.

Hope this helps.

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hi a billy,

long time no see here on this message board. like you, i have had a lot of doctor treatments, with all the grief that goes with that. I have now struck on the solution though. daphne dermal filler. You apply it topically and it works. I can safely say I won't be having anymore medical procedures for my scars, now I have my daphne. I'll send you a link (not allowed to post links on the board). :rolleyes:

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Thanks Rupert

Congrats on you success. I'll look into Dapphne. Yes, I have not been on boards for awhile and had no treatments for awhile, but I am revisiting.

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Good luck on your CROSS treatment! I just had my first TCA CROSS on monday with Dr. Lam. So I am hoping for great results :)

Just curious, what is your post treatment care like? I just wanted to compare the instructions I got from Lam with yours.

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Good luck on your CROSS treatment! I just had my first TCA CROSS on monday with Dr. Lam. So I am hoping for great results :)

Just curious, what is your post treatment care like? I just wanted to compare the instructions I got from Lam with yours.

I did not get good instructions (mine were done on March 1), but I avoided washing area for several days. Let me know what your instructions are. I'm a little concerned; 4 were on my nose and one on cheek. They all look worse now, which I understand happens and then they fill in. But I'm worried, given my past failures, that my nose won't turn out well since I seem to have some bad luck when it comes to scar correction. My biggest fear is that my Doc and I had a miscommincation. He did a very small nose scar that did not bother me. Worse, the acid must have fell off the applicator because he treated an area 2 to 3 times larger than scar. The other 4 had the TCA confimed to inside scar. It formed a big scab, which came off, but there is another scab underneath. Right now, it looks like a much bigger pit will form. I know it will get better with time, but I know he made a mistake on that one.

How do yours look so far? Good luck

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