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billyboy

My failures and successes

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I've been absent for some time, but am excited enough to report back, with the hope it helps others. I had lots of acne scarring, none on forehead and none deep.

Biggest mistake was going to New Orleans to Dr Y to have punch floats - twice, as both rounds were disasters, turning small scars into larger depressions. Avoid floats! Next big mistake was Dr. ? formerly at UCSF and now at UC Irvine who is an engaging Brit and a paid researcher for Fraxel, but a horrid surgeon, with a big name. He performed 3 excisions that turned out horribly. Avoid excisions, especially by a derm or a poor surgeon!

Fraxel restore was a significant improvement in skin by turning rough skin into smooth skin, with evening of tone anc color. But, it had limited effect on true scars. I'd rate the 8 or 9 sessions as expensive, yet worthwhile, despite the small impact on scars.

A couple years ago I found Dr. Dhawan in Fremont CA who initially tried dermal grafts and a couple subcissions. The dermal grafts helped quite a bit with 3 deep surgical scars left by the UC Doc. But, they requried several rounds to fill in. However, evetnaully I ended up with a cyst forming around each of these grafts, causing inflamation, infections and overall nastiness. Apparently, I'm promne to cyst formation and this is a risk if a single epidermal cell is in the piece of dermis inserted under the scar. That said, despite the repeated effort and problems, I'd rate this procedure fairly high if you have a large depression to fill.

I was underwhelmed by Dhawan's early attempts at subcision as well as 3 or 4 TCA cross attempts. So, I told him that I did not want to try subcision alone (ie, without a graft) or further TCA cross on ice pciks or scarrred pores. In fact, one TCA cross went way outside the scar by mistake creating a larger pit on my nose, which annoyed me. He convinced me to try heavy subcision on that scar on my visit last November. It worked incredily well leaving it 95% flat, so my view of subcision changed dramatically. So, in my most recent vist we tried a couple more subcisions. I'm prety happy at what I see with 3 of them so far, a fourth looks like it won't do anything, and a fifth was done in the wrong place. He also overcame my objection to Cross on my scarred pores because it said it so easy, no mess (like Profractional), and he has had good results with others. It's too early to tell, but I'm hopeful.

I've tried Profractional a couple times in a couple small patches of scarring with mild improvement. He used much higher settings this time on one patch with a bunch of shallow, superficial scarring. He said Sciton increased the Protocols and that Dr. Dhawan had been too timid in past. It is a very bloody, ugly procedure that will keep you indoors for a few days

I'm basically done, having had early setbacks, but enough improvement over the last few years that I'm happy with where I am. I think Dhawan's early attemts at subcision were not aggressive enough because the recent results have been so much better. I think he is the best of the scar Docs I have seen. He is quick, reasonably priced, and has expereicne with all techniques. My only criticisms are that he goes too fast sometimes and perhaps he starts out too unaggressive until he sees how you respond. Some of the scars that bother me are on side of face and sometimes he can't find them and he works on a different area, where to me there is no discernible scar. And, he was sloppy on one TCA. That said, I am finally seeing great results! I'd recommend him and also advise you to stick out underwhelming results like I had in my early visits.

Hope this helps

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if i lived closer to cali i would go see this doctor but i live on the east coast..im thinking about seeing Dr.rapapport i heard hes very experienced at subcision and tca crosses but since i got deep scars i will need repair also..thnx for coming back and updating! and im glad u got the results!!

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No more Profractional or fraxel. Blood and scabbing, even on a small patch creates downtime that I would not go through again.

It is possible I might do a couple more subcisions or TCA. The subcision is simple, no real down time and I seem to get good results now. He missed 2 scars last time. Less sure on TCA because it is not clear to me that I will get a good result from last round. If so, yet I perceive room for more improvement, I will probably do TCA also, but only if I decide to try subcision 1 more time.

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