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sanjoseskin

Los Angeles Doctor Referrals Please... & Going Rate$ For Deepfx, Totalfx, Fraxel

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What is the current going rate for ablative fractional CO2 treatments like DeepFX or Fraxel re:pair in California?

I know some doctors still charge crazy prices like 5-8 grand per treatment, but that's just insane, especially since the technology is no longer really new.

Can anyone recommend any good doctors in the Los Angeles area, and how much the above treatments roughly cost now?

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Dr. Rahimi does Mixto for $3000 for the first session, second session free, $500 for every session afterward. He's improved my scars quite a bit: http://www.acne.org/messageboard/index.php/topic/315693-asian-doing-mixto-for-acne-scars-on-cheeks/

I, however, wouldn't think it's specifically worth traveling across the ocean just for Rahimi, though. He's a good doctor, but there's bound to be just as equally good doctors in Europe. In fact, there's probably more in Europe than here in America, since you guys get all the latest treatments first.

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Dr. Rahimi uses MixTo, but he combines it with subcision. Based on some comments I've read by other MixTo doctors on Realself, I believe combining subcision with laser treatment at the same time is a MixTo technique because they also combined subcision with laser treatment. The laser doesn't penetrate as deep as Repair or Deep FX but by combining a session with subcision, I believe it is as effective.

I also consulted with Dr. Rahimi back in June. He is passionate about helping acne scar sufferers. He did treat one of my scars during consultation for free, and I've definitely noticed an improvement to the one scar. I was quoted the same price as DRaGZ, $3000.

I've also sent you a PM about my consultations with other Total FX doctors in LA, who are worthy of consultation and comparable in price.

Choosing a doctor is so difficult!!

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Dr. Rahimi uses MixTo, but he combines it with subcision. Based on some comments I've read by other MixTo doctors on Realself, I believe combining subcision with laser treatment at the same time is a MixTo technique because they also combined subcision with laser treatment. The laser doesn't penetrate as deep as Repair or Deep FX but by combining a session with subcision, I believe it is as effective.

I also consulted with Dr. Rahimi back in June. He is passionate about helping acne scar sufferers. He did treat one of my scars during consultation for free, and I've definitely noticed an improvement to the one scar. I was quoted the same price as DRaGZ, $3000.

I've also sent you a PM about my consultations with other Total FX doctors in LA, who are worthy of consultation and comparable in price.

Choosing a doctor is so difficult!!

Thanks, and choosing a doctor is hard!

Anyone else been to good derms in L.A.

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Is Mixto the only fractional CO2 laser that has a different handpiece, head, what have you capable of shaving down scar edges? This seems so essential for boxcar scars.

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Is Mixto the only fractional CO2 laser that has a different handpiece, head, what have you capable of shaving down scar edges? This seems so essential for boxcar scars.

I believe this can be done with other lasers, but not Re:pair, because it has a rolling head that is somewhat imprecise.

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Is Mixto the only fractional CO2 laser that has a different handpiece, head, what have you capable of shaving down scar edges? This seems so essential for boxcar scars.

I believe this can be done with other lasers, but not Re:pair, because it has a rolling head that is somewhat imprecise.

Dragz, your doctor is Dr. Rahimi? Does he have the lumenis machine or only mixto?

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Is Mixto the only fractional CO2 laser that has a different handpiece, head, what have you capable of shaving down scar edges? This seems so essential for boxcar scars.

I believe this can be done with other lasers, but not Re:pair, because it has a rolling head that is somewhat imprecise.

Dragz, your doctor is Dr. Rahimi? Does he have the lumenis machine or only mixto?

Dr. Rahimi uses MixTo. He doesn't use Lumenis Ultrapulse or Fraxel Repair. However, he takes a different approach and does subcision immediately after a MixTo session.

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Hey TokyoGirl, for your spot treatment on one scar, did Dr. Rahimi use the different head to sand down the edges or anything, like he did with Dragz?

Or was it just a simple one shot with the laser?

I'm just contemplating how much a difference shaving the edges down makes. I've never heard of another doctor doing this to treat scars.

It makes sense though because the fractional lasers don't really "resurface." Stimulating the scar to plump up and sanding down the top of the scars

seems like the perfect way to treat an atrophic scar.

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I can't speak for TokyoGirl, but when he did the test spot for me, it was literally just a little zap. Nothing fancy.

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Hey TokyoGirl, for your spot treatment on one scar, did Dr. Rahimi use the different head to sand down the edges or anything, like he did with Dragz?

Or was it just a simple one shot with the laser?

I'm just contemplating how much a difference shaving the edges down makes. I've never heard of another doctor doing this to treat scars.

It makes sense though because the fractional lasers don't really "resurface." Stimulating the scar to plump up and sanding down the top of the scars

seems like the perfect way to treat an atrophic scar.

I don't know if he used a different head. I couldn't see him because I was wearing goggles (I think). I had something over my eyes, but don't remember the specifics. He did more than one pass, and the scar crusted, scabbed & peeled. I didn't experience that with Deep FX. With Deep FX, I had pinpoint bleeding & oozing, followed by redness. With MixTo, the edges of the scar are definitely smoother. I didn't experience any smoothing of edges with Deep FX. That's why I believe people should really go for Total FX when treating certain types of scars with Ultrapulse. With Deep FX,, my scars definitely plumped from the bottom up, which I expected. I just didn't realize it wouldn't have an effect on the surface & texture of my skin. Deep FX sends energy & heat deep into the dermis for collagen remodeling. Active FX resurfaces the epidermis, which is probably comparable to the "sanding down" technique mentioned by MixTo doctors. With that said, I have heard the phrase "sanding down" mentioned by MixTo doctors. I just think it's a term & technique used by doctors who specialize in MixTo. Doctors who specialize in acne scar treatment with Total FX call it "multi-layer technique", which means they do a few passes over the scar switching between Deep FX & Active FX to produce a better overall result.

I can't speak for TokyoGirl, but when he did the test spot for me, it was literally just a little zap. Nothing fancy.

Interesting. He did a few zaps (I felt, maybe 4) on my scar, and the area scabbed about a quarter of an inch surrounding it. In fact, a pretty big mole next to my scar almost completely vanished for weeks. It has since returned though. sad.png

Edited by TokyoGirl

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Oh, it scabbed for me, too, and I guess it was technically two zaps. But it was done in like...five seconds.

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Oh, it scabbed for me, too, and I guess it was technically two zaps. But it was done in like...five seconds.

Yeah, it was done pretty quickly. I think he did 4 zaps. It was a boxcar scar, but the shape is weird. He may have zapped it from multiple angles.

Edited by TokyoGirl

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Given the improvement on your deepest scar from the test spot, do you think it's possible to get 90% improvement or more on shallower scars?

I don't expect to irradicate all my scars but besides my bigger "deepies" I'm covered in small, almost superficial scars that would be awesome to get rid of.

And thanks to all for their detailed replies! These firsthand accounts help others make judgement calls a lot easier than the ill-taken before and after photos on doctor and laser websites!

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Given the improvement on your deepest scar from the test spot, do you think it's possible to get 90% improvement or more on shallower scars?

I don't expect to irradicate all my scars but besides my bigger "deepies" I'm covered in small, almost superficial scars that would be awesome to get rid of.

And thanks to all for their detailed replies! These firsthand accounts help others make judgement calls a lot easier than the ill-taken before and after photos on doctor and laser websites!

I don't know. I haven't seen 90% improvement on any of my scars. I believe DRaGZ has though.

With your comment in mind, I have to mention one thing that I have also questioned -- can a laser, especially a fractional laser, actually release tethered down skin? I asked a few doctors about this and was never given a straight answer on how this is possible without subcision. That's one reason I liked Dr. Rahimi's approach because he recommended subcision and showed me how my scars are tethered down. My scars are pretty much all shallow now but many have a base to them. When you pull the skin tight, the scar doesn't smooth out.

Are your scars tethered down? If not, then I would think laser could smooth them out without subcision.

Edited by TokyoGirl

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Thinking about the way fractional lasers work, I don't think they could untether skin. In fact, I would argue those that don't get results with laser alone is because their scars are tethered down. I read somewhere that performing subcision not only releases your scars but also allows the laser to penetrate more easily and deeper. The lasers work vertically to ablate whereas subcision works horizontally to detach.

I'm pretty sure my scars are tethered. They are all boxcars and tiny scarred pores/icepicks but when I stretch my skin they raise a little, moving with the skin but they are all still visibl, especially the walls of the scars. The only thing I wonder is if subcision even helps shallow, jagged boxcars?

DRaGZ, did Dr.Rahimi perform subcision on your boxcar scars or just rolling scars? Also, you mentioned your icepicks scars are pretty much gone. Do you mean the little holes are closed up and where they used to be is smooth? Mine are pretty shallow but their circular border makes my face look speckled.

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I wish Dr. Rahimi had the Lumenis UltraPulse machine. He only has mixto?

I'm kind of surprised there aren't many more doctors in Los Angeles who are experienced with acne scar revision.

Anyway, does anyone know if Lumenis has a physician finder tool? I can't find the feature on their website.

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Given the improvement on your deepest scar from the test spot, do you think it's possible to get 90% improvement or more on shallower scars?

I don't expect to irradicate all my scars but besides my bigger "deepies" I'm covered in small, almost superficial scars that would be awesome to get rid of.

And thanks to all for their detailed replies! These firsthand accounts help others make judgement calls a lot easier than the ill-taken before and after photos on doctor and laser websites!

I don't know. I haven't seen 90% improvement on any of my scars. I believe DRaGZ has though.

With your comment in mind, I have to mention one thing that I have also questioned -- can a laser, especially a fractional laser, actually release tethered down skin? I asked a few doctors about this and was never given a straight answer on how this is possible without subcision. That's one reason I liked Dr. Rahimi's approach because he recommended subcision and showed me how my scars are tethered down. My scars are pretty much all shallow now but many have a base to them. When you pull the skin tight, the scar doesn't smooth out.

Are your scars tethered down? If not, then I would think laser could smooth them out without subcision.

Rahimi claimed that the laser can untether rolling scars, but it's a much more indirect process than subcision, and hence not as effective. This is taking into account that subcision, even when used optimally with suction, requires several procedures for tethered-down scars, so imagine how long it would take a laser to do anything.

Thinking about the way fractional lasers work, I don't think they could untether skin. In fact, I would argue those that don't get results with laser alone is because their scars are tethered down. I read somewhere that performing subcision not only releases your scars but also allows the laser to penetrate more easily and deeper. The lasers work vertically to ablate whereas subcision works horizontally to detach.

I'm pretty sure my scars are tethered. They are all boxcars and tiny scarred pores/icepicks but when I stretch my skin they raise a little, moving with the skin but they are all still visibl, especially the walls of the scars. The only thing I wonder is if subcision even helps shallow, jagged boxcars?

DRaGZ, did Dr.Rahimi perform subcision on your boxcar scars or just rolling scars? Also, you mentioned your icepicks scars are pretty much gone. Do you mean the little holes are closed up and where they used to be is smooth? Mine are pretty shallow but their circular border makes my face look speckled.

He did subcision for both boxcar and rolling. Rolling + boxcar on my first procedure, where the left side of my face got much better, and then just the boxcars on my right the second time.

By "pretty much gone," I mean that they no longer cast a shadow, even under harsh light. There is a bit of speckling, and the shape of the scar for about 50% of my icepicks are not gone, but it looks more like freckles than an indented scar. I believe I am still hyperpigmentated in those icepicks, which I didn't even notice until they got flatter, so I've been doing kojic acid.

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DRaGZ, that's great news and congrats again on your improvement. I wouldn't mind having freckles haha. Did he perform subcision on each boxcar, including smaller ones? I have probably 20-30 per cheek. I don't know if a doctor would treat all of them or just the bigger ones?

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In those sorts of cases, especially when lots of scars are grouped together, each "subcision" treats an entire area of skin at once. The biggest subcision I have seen was on a youtube video, and they were treating about an inch-wide portion of scarred skin. So you don't always do subcision for specific scars, especially when they are clustered in specific groups.

Keep in mind, my scarring isn't gone, and probably never will be. But it's much, much more bearable. It's reached the point where I generally don't care about them, and if I do, I just tilt my head to the left, like I'm deep in thought, and they disappear on the right side of my face, haha.

I'm gonna go in for another treatment in December, since a break is coming up.

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Anyway, does anyone know if Lumenis has a physician finder tool? I can't find the feature on their website.

Their search tool is here:

http://www.skinandhe...hysician_search

I didn't find it very helpful.

Thank you for the link :)

I'm having the hardest time finding a qualified acne scar revision doctor in the Los Angeles area. Frustrating.

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