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manduh

My Experience w/ Fractional Co2 & Ebrium

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Hi Everyone

I wanted to share my recent experience with Co2 Fractional and Ebrium laser resurfacing with all of you. I had it done a week ago to treat my primarily rolling acne scars on my cheeks and temples but there are a few icepicks and boxcars strewn in there as well. The procedure was done by Dr. Stephen Mulholland of SpaMedica in Toronto, Ontario.

In addition to those lasers, I also had ‘facetite’ which is essentially radio-frequency subdermal rejuvenation. If anyone is interested in hearing more about this portion of the procedure, please feel free to ask.

I will also be doing some fraxel (I assume restore) and IPL treatments beginning in approximately 6 weeks to build upon my improvement and those post-op procedures are considered ‘complimentary’ by SpaMedica, but I’m sure they’re factored into the price somewhere! I have done a lot of research and while I don’t expect ‘wow’ results from the IPL or fraxel, I believe they may still be beneficial and I am open to trying to achieve more improvement in the depth of my scars as well as overall complexion.

Pictures are forthcoming. Dr. Mulholland's office took quite a few pictures from different angles prior to my procedure being performed and I have requested that those be sent to me. I had the procedure done 8 days ago and once I can be sure that the swelling has subsided I will take updated pictures to show my results.

So far I am still fairly swollen in my cheeks and temples so I can’t be sure about my percentage of improvement quite yet.

If anyone wants to ask any questions about the procedure itself or my recovery, I would love to help because I know how valuable acne.org was for me when I was deciding whether to go ahead with this.

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Rather than writing one big post about my experience so far, I am going to break it up into smaller chunks.

Pre-Procedure:

Dr. Mulholland is a very well known plastic surgeon world wide who has pioneered many popular treatments available today. He is most well known for his work using lasers and he came very highly recommended by my dermatologist. When I had my consultation with him several months ago, he suggested a mix of fractional co2 and ebrium laser resurfacing as well as facetite. He said that the best I could hope for was between 50-70% improvement in the depth of my scars. I opted for general anesthetic because I'm a big baby and I didn't want the anxiety of worrying about how painful the procedure would be. I had a pre-op appointment about 1.5 months before the procedure to take pictures and to go over what I was to do and not to do before the procedure.

Before the procedure I did a lot of research about what products I could use to heal after the procedure. I didn't want to use aquaphor or any other 'occlusive' vaseline ointment that seems to usually be suggested for laser resurfacing patients because my skin is still acne prone and very sensitive. My doctor's office actually suggested La Roche posay's Cicaplast for the first 5-10 days after the procedure. I went out and bought a tube (around $20) and tested it out on some dry areas I had at the time and it broke me out horribly. I started doing some more research and I came across Avene's Restorative Cream Cicalfate. I bought it (around $20 also) and began testing it out and really liked the way my skin reacted to it. It is for ultra sensitive skin, non-comedogenic, and fragrance free. Anyway, I also picked up a can of Avene Thermal Spring Water. I decided I would use these 2 products to help me heal.

I don't know if it helped at all, but I began taking a multivitamin and vitamin C about 1 month before the procedure.

I was really concerned about having a breakout either from the procedure itself (it aggravates acne in some people) or from the heavy cream's that would be on my skin for several days. I asked my dermatologist to put me on antibiotics in preparation for that so I began tetracycline (100 mg a day) about 4 weeks before the procedure also. I had to stop the tetracycline 5 days before the procedure because it can cause skin to be more photosensitive.

The Good Wife is on so I'm going to run now but next time I will write about the procedure itself!

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thanks for posting. i am in the process of figuring out what to do about my skin and do consider laser resurfacing. i will be anxious to hear about your experience and good luck to you! You have to be pretty strong to go through this type of thing - i give you a lot of credit!

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The procedure took just over an hour. I was under general anaesthetic so I really can’t say anything about the actual procedure or what was involved. I do remember waking up in the recovery room being very uncomfortable because there was an intense burning feeling on my face but the nurse would apply cool compresses and that made it feel a lot better.

I remember catching a glimpse of myself in a mirror while I was still there and the nurse told me not to focus on how I looked but it was impossible not to! I looked absolutely frigging terrible. My face was bloody, which I expected, but it was also swollen beyond belief. They applied an antibacterial cream to my face before I left. I was prescribed Clindamyacin to take 3x daily, some Tylenol 3 and Percocet.

I got to go home about an 1.5 hours after the procedure. My brother and sister in law took me home and he joked that he was surprised no one called the police after seeing some girl with a swollen, busted up face sleeping in the backseat.

After I got home it took a while to get over the shock of what I looked like. Again, that swelling was super intense and although I expected some swelling, I didn’t expect it to completely transform the appearance of my face. I think seeing me like that was hard on my family, but I took it in stride and didn’t get too hung up on what I looked like in those early days.

The one thing I noticed was that the Avene Cicalfate wasn’t occlusive enough. During those very early days (days 1-3 especially) you need constant moisture and the Cicalfate would absorb, especially while I was sleeping, and I would wake up with some dry spots which were uncomfortable. So, unfortunately, I had to use aquaphor during the night time hours. It wasn’t until all of the dead skin had fallen off that I stopped using aquaphor and switched over to Avene Cicalfate full time (roughly on day 5).

I was told to do saline soaks every 2 hours during those early days as well as to apply cold compresses to reduce swelling. I soaked large pieces of gauze in saline and then just laid them on my face until they began to dry up, then I would soak another piece and apply it in the same way. This is to remove any dirt and bacteria that’s built up on the surface of your skin.

I would also like to tell anyone that’s interested that by no means was I in any pain after the procedure. My consent booklet described ‘intense burning and discomfort’ after the procedure but I experienced none of that. The most painful thing about this entire thing was how I looked for the first 5 days!

Gradually, the dead skin began to shed. On day 3, some parts that were treated with the ebrium laser began to slough off. The parts that were treated with the co2 laser were the last to come off, which occurred around day 4-5. The ‘shedding’ process was probably the most irritating part of this process because you just feel so disgusting applying this thick aquaphor goop to skin that’s barely hanging on to your face. You absolutely do not want to be in public for the first 5 days at least.

After the dead skin had sloughed off, the pinkness tone to my face wasn’t as severe as I was expecting. It was definitely pink, but I was expecting much worse. Overall I had about 4 whiteheads/pimples pop up, which is much better than I was expecting.

On day 6 I went back to my doctor’s for a check up and I was told I was healing at an advanced rate, which is good. I started washing my face with a gentle cleanser on day 6 but I’ve been told not to resume my acne regiment for another week.

It is now day 9 and I am still swollen but it is going down everyday. These aren’t my true results but geez do I wish they were! This swelling is very deceiving and I have a feeling it’s going to be a heart breaker once it all goes away.

Next time I will write more about the facetite component of my procedure.

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I had smartxide laser Oct last year, the scars get deeper, I seem get more scars from the procedure. I am nto sure if I want to go back for the second treatment. would you please share your result after a few month, because in the first month, the new skin will make you feel improvement, however when it come back to normal, I can see the scars all there.

Thanks

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Sorry for the lack of updates.

I wish I had more to report about my actual results but I’m still so swollen. I’m not sure what I can attribute all of this lingering swelling to – the facetite or the actual laser resurfacing. My cheek bones and the area where I have my scarring on my cheeks is still very sore, it feels almost like a really deep bruise.

The redness is noticeable and I had one girl tell me it looks like I had a chemical peel done. Where my scars are I can see the red marks have popped up (I have red undertones to all of my scars) but no actual indentations have come back – yet! But it’s only a matter of time, unfortunately. That being said though, the redness would be easily covered by makeup and has been since day 6 or 7 post-procedure. I’m just choosing not to wear any because I can’t be bothered.

I had my last ‘check up’ appointment with my surgeon’s office on Tuesday. They said I’m healing well and everything is going as expected. I’m concerned though because I still have a lot of numbness in my face in certain areas where I literally have no feeling. They attribute this to the facetite and they say it’s normal but I would have thought I’d see some improvement by now.

There isn’t a lot on the Internet about the use of facetite for improving the appearance of acne scarring and I’ll be honest, I trusted that my doctor knew best and I put my faith in him that this would improve my overall results.

On my consent booklet, it says facetite is a technique to remove unwanted deposits of fat from specific areas of the body, including the face and neck. The procedure is performed by inserting a hollow metal instrument known as a cannula through small skin incisions and passing it gently and slowly back and forth through the area of fatty deposit. The cannula is attached to a vacuum source which provides very low pressure suction needed to remove fatty tissue. My doctor performs 5 types of FaceTite/Subdermal laser tightening which includes radiofrequency assisted facetite/subdermal tightening.

Radiofrequency assisted facetite/subdermal laser tightening is a method whereby radiofrequency electrical current is applied to the fat to liquefy prior to gentle extraction. It provides ‘some skin tightening’ and is a more gentle form of lipo than other types offered by my doctor for the face/neck.

While I do feel that my skin is ‘tighter’ because of how it looks and feels, I’m not sure at this point what impact this procedure has had on the appearance of my acne scarring or whether the tightening is not just b/c of the laser itself. We’ll see, I guess.

I have 3-4 more procedures that will be done throughout the summer of either IPL or fraxel:restore. Depending on my final results my doctor will recommend a combo or just IPL. My vote is for 3 IPL treatments because I’ve always had strong red undertones to all of my scars as well as very stubborn hyperpigmentation from previous acne so I think that would do a lot to improve my overall complexion. Plus I don't have a lot of confidence in fraxel:restore based on reviews.

They said I can expect to be fully ‘healed’ in 3-4 weeks so we’ll see what the next 1.5 weeks bring.

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Quick Update:

24 days post-surgery today.

I don't know if I'm still swollen or not, so hesitant to report on final results still. I've seen others report way too soon and it is very misleading to people considering this procedure. I still have a lot of pain on my cheekbones and in the area where I was lasered. When I smile I still feel like I have small tennis balls in the apples of my cheeks so I'm not going to report on improvement until these side effects are gone just to be sure. Right now there is huge improvement in the depth of my scars, but again: we'll see.

The downsides I'm experiencing are:

I'm still numb in many areas due to the facetite. I'm really worried this isn't going to resolve. In fact, when I smile one side of my face goes up noticeably higher than the other side. They tell me the nerves in my face were 'stretched' (read: not broken) and that they will eventually tighten back up again and everything will return to normal. But... I haven't seen barely ANY improvement in the numbness since Day 1 and would have thought by now I would have.

I'm also still slightly pink/red. It's annoying but it's getting better all the time.

I have several areas on my face where the lines from the laser are still clearly visible (right side under mouth, right cheek by temple and left cheek area). I don't know how, when or if this is going to resolve or what I can do to lessen the appearance... any suggestions? Right now I'm back to my regimen which is alternating Environ AVST Level 1 (Vit A, C, and E), M2 and BP.

I also got botox in my forehead and I gotta say, I am really impressed. I have a tendency to raise my eyebrows a lot so I had the beginnings of some pretty deep wrinkles on my forehead but w/ the laser + botox it has really improved.

Product I'm trying out: Lycogel... it's a camaflouge make-up. Set me back $85 but the coverage is impressive. I would say it is a very good foundation for post-op patients who have ot return to work but for me, at least, the coverage is too heavy for my normal everyday use.

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29 days (or just over 4 weeks) post procedure.

Those small tennis balls in my cheeks now feel like marbles, so that’s good I guess.

Redness is still quite intense. Hyper pigmentation from pre-procedure is still there and seems to stand out even more now because it is a more intense shade of pink/red.

Laser/grid marks have faded on my cheeks, but is still very noticeable by my mouth. I’m concerned about that spot.

Numbness is improving, but still very much present in some areas. I can’t believe it but my cheekbones are still sore – 4 weeks later! That facetite really did a number on me.

Scars – indentations by my temples have filled in dramatically. Cheeks are still swollen so it gives the appearance of a smooth texture but similarly to my temples, I’m expecting it to suck back in a bit in the next few weeks.

One thing I did notice is that my ice pick scars have been filled in w/ a white dot in the middle..is that collagen? Does anyone know?

I hope this is helping some of you!

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can u tell why did u did both lasers? or u just did one?

cause my doctor from cancun told me that i can get laser pixel (co2) in all my face

and erbium laser just in the parts with more problems or scars...thats what did u do?

and how much % improvment have you gotten from this first session?

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Actually I think my doctor wanted to do the opposite (ebrium on less severe areas, co2 on areas where I had acne scarring). I think the point is to minimize the risk - from what I understand there is more risks involved w/ using the Co2 so should not be used unnecessarily (i.e. on skin that isn't damaged/scarred).

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Guest Timehealsall
Actually I think my doctor wanted to do the opposite (ebrium on less severe areas, co2 on areas where I had acne scarring). I think the point is to minimize the risk - from what I understand there is more risks involved w/ using the Co2 so should not be used unnecessarily (i.e. on skin that isn't damaged/scarred).

pics... please?

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Like I said above a couple of times - I'm still swollen. I had an invasive procedure called facetite also done and it has left me with a lot of lingering swelling and bruising.

The pictures are coming, I promise.

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Guest Timehealsall

how bad was your scarring to begin with?

how bad was your scarring to begin with?

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Like I said above a couple of times - I'm still swollen. I had an invasive procedure called facetite also done and it has left me with a lot of lingering swelling and bruising.

The pictures are coming, I promise.

Manduh my darling i wish u the best of luck! i also live in toronto so its nice to see that if this works i can go there no problem =) i just hope u did your research on lasers and understand the concequences from them. keep us updated where all cheering for you !

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how bad was your scarring to begin with?

how bad was your scarring to begin with?

I have mainly rolling scars on my cheeks/temples. I don't know how to classify it... it isn't severe, but it isn't mild so I guess it's somewhere in between.

no_hope - I thought I knew what I was getting into, but now I'm not so sure. I guess I'll give it a few more weeks and we'll see...

No changes otherwise since my last post. I'll report back in a week or so!

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its weird... a lot of people on this board say rolling scars are the easiest to treat... but why do so many people still have them?!

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its weird... a lot of people on this board say rolling scars are the easiest to treat... but why do so many people still have them?!

money and time issues.

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Guest Timehealsall
its weird... a lot of people on this board say rolling scars are the easiest to treat... but why do so many people still have them?!

money and time issues.

really? I would spend all my money and time to fix my shit

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some of us aren't made of money. some of us don't rely on parents, or whomever. some of us work low paying jobs. it took me 5 years to save up 2 grand to get some kind of treatment done.

i have a car payment, school loans, water bill, etc. some of those things are more important to pay.

Edited by maggie07
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The thing with these treatments is that they require a great deal of patience and time. They're not miraculous procedures and it takes plenty of time till u notice improvements. It could be really frustrating but it's worth it..anyway hope ur healing well and keep us updated x

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I agree that these procedures are VERY expensive and do require a lot of downtime... both things that most people can't afford.

I guess when I know my results I will be in a better position to say whether or not it has all been worth it.

I wanted to let you know that today (which is day 32) I finally noticed that the rolling indentations on my one cheek have appeared slightly... not to the extent they were pre-procedure or even close to that (yet) but they're there. I'm not being unrealistic b/c I knew this would happen, it's just to say that obviously micro swelling lingers for a long time. My other cheek must still be swollen b/c no indentations are apparent even in the worst lighting/angles.

Otherwise, everything is pretty much the same. General shade of pink/red is subsiding but very slowly.

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Yesterday marks 7 weeks since my procedure and everyday I am noticing that the swelling continues to go down (revealing more/deeper indentations) but so far, at least, there is an improvement. I don't know if I would call it a 'significant' improvement, but it's an improvement.

I'm really disappointed and having kind of a tough day today. Everyday you hope those are the real results but gradually the swelling continues to go down and the texture gets worse and worse. I kind of feel hopeless today that I'll ever get the improvement I'm looking for (which isn't perfection, by any means... just skin I can live with). Anyway, I still have potentially 3-4 fraxel re:store's that are going to be starting as early as June 27 so we'll see if I can get any more improvement with those.

My complexion is a total mess but the redness from the laser is a lot better. I might have a fotofacial done on June 27 or a fraxel:restore... it's up to my doctor once he sees my improvement up until now. I still have a lot of numbness in my face which is still very concerning but they keep telling me it will resolve. My cheekbones still feel bruised to the touch.. all of these symptoms make me think my skin isn't fully 'healed' yet... which might mean even more swelling it yet to go down :(

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