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michi31

Several Subcision Questions

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I am wondering about subcision on particular areas of the face. Specifically, I am hoping to hear peoples' experiences of subcision done on the chin. I have rolling scars on the right side of my chin that I think may be the result of cortisone injections. I'm curious because I've read from people that subcision in the chin area is not as effective as other parts of the face. This is pretty discouraging, because I believe this is the only treatment that will work for me - possibly along with fillers.

Which brings me to another question - what are peoples' experiences with subcision with and without fillers?

And finally, any good doctor recommendations? I am in upstate NY. I can travel to NYC and surrounding areas although obviously this is not as convenient.

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Cortisone injections wouldn't have caused the scars. In fact, they probably prevented the scars from being worse than what you see them as now.

The chin actually isn't a particularly hard are to treat, and I think subcisions are allowed there.

What makes you think only subcision would work there?

Edited by DRaGZ

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Thanks for your response. I suspect cortisone caused the depressions because I believe previous shots did the same thing. They were minor but permanent. I don't know why I got more. I was in a state of panic over the outbreak and thought it wouldn't happen again. Actually it didn't happen until four months later. A plastic surgeon I spoke with actually asked if I had cortisone in those spots, and said that depressions can occur later as in my case. I suppose I'll never know for sure if this is what happened.

From the information I've gathered here and other places, I believe subcision is necessary to lift the scar. I don't think lasers can lift scars, and this matches the opinions of some doctors including the one I had the consultation with. At this point I want to go ahead with it, but I'm getting cold feet over the thought that it might make things worse. One plastic surgeon I met with who just pushed laser said he thinks it would make things worse, and that's why so few doctors offer it. As if lasers don't make things worse. He was awful.

I'm just getting nervous when I read about nodules and other side effects. I'm wondering if should do it along with filler - the PA said in this case it is more the filler and less the subcision - I suppose ony the cutting necessary to ensure the filler doesn't donut. I don't know what to do.

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Thanks for your response. I suspect cortisone caused the depressions because I believe previous shots did the same thing. They were minor but permanent. I don't know why I got more. I was in a state of panic over the outbreak and thought it wouldn't happen again. Actually it didn't happen until four months later. A plastic surgeon I spoke with actually asked if I had cortisone in those spots, and said that depressions can occur later as in my case. I suppose I'll never know for sure if this is what happened.

From the information I've gathered here and other places, I believe subcision is necessary to lift the scar. I don't think lasers can lift scars, and this matches the opinions of some doctors including the one I had the consultation with. At this point I want to go ahead with it, but I'm getting cold feet over the thought that it might make things worse. One plastic surgeon I met with who just pushed laser said he thinks it would make things worse, and that's why so few doctors offer it. As if lasers don't make things worse. He was awful.

I'm just getting nervous when I read about nodules and other side effects. I'm wondering if should do it along with filler - the PA said in this case it is more the filler and less the subcision - I suppose ony the cutting necessary to ensure the filler doesn't donut. I don't know what to do.

Depressions can occur if you ever had cystic or nodular acne, period. What would've been worse was leaving them untreated and letting them stay there for weeks, that would've cause much bigger problems.

Lasers can lift scars. They've lifted mine and several other people's on these forums alone. From what I've found, most doctors who claim that lasers don't work is because they haven't figured out how to properly use it themselves. In particular, there is this one doctor in Las Vegas who runs a famous Q&A and radio show thing, and he is adamantly against lasers. But then it turned out that it was because he had performed laser treatments before by simply following instructions on a card and nothing happened, and he was particularly peeved because he had paid for the system he couldn't even use properly. In reality, you have to tailor the treatment for each specific patient and each specific type of scarring. The chin, in particular, is a pretty easy spot for a laser to treat.

That being said if a doctor claims they don't want to use laser on you, that is probably the safer bet. It means that, at the very least, they aren't comfortable handling the laser themselves, which means you wouldn't get the proper result you're looking for.

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Thanks for your response. I suspect cortisone caused the depressions because I believe previous shots did the same thing. They were minor but permanent. I don't know why I got more. I was in a state of panic over the outbreak and thought it wouldn't happen again. Actually it didn't happen until four months later. A plastic surgeon I spoke with actually asked if I had cortisone in those spots, and said that depressions can occur later as in my case. I suppose I'll never know for sure if this is what happened.

From the information I've gathered here and other places, I believe subcision is necessary to lift the scar. I don't think lasers can lift scars, and this matches the opinions of some doctors including the one I had the consultation with. At this point I want to go ahead with it, but I'm getting cold feet over the thought that it might make things worse. One plastic surgeon I met with who just pushed laser said he thinks it would make things worse, and that's why so few doctors offer it. As if lasers don't make things worse. He was awful.

I'm just getting nervous when I read about nodules and other side effects. I'm wondering if should do it along with filler - the PA said in this case it is more the filler and less the subcision - I suppose ony the cutting necessary to ensure the filler doesn't donut. I don't know what to do.

My dermatologist would not perform subcision on my chin due to arteries that run on both sides of the chin area. He did, however, use TCA CROSS on the ice pick scars that I had there and also used a Pearl Fractional laser treatment. I also have done numerous dermarolling sessions on my chin, so I don't know if the improvement I've seen on my chin area is due to the laser or due to the dermarolling.

Having been through four laser treatments myself over the past five years or so, I feel that subcision is the best treatment for dealing with tethered scar tissue (i.e. rolling scars). I found that coupling subcision with dermarolling combined with chemical peels and topicals was a very effective combination.

Everyone is different, so I hope that you find a series of treatments that works for you and your scarring.

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Hi Mr. Matt! I've read your thread and am glad you responded. You give so many people hope! Unfortunately the scars on my chin are the rolling type, maybe one or two small pits - not sure how to classify that (perhaps TCA cross would work on those?). The doc didn't say anything about arteries but now I am wondering. I sort of feel that if I can't do subcision there then nothing will work, for the reason that I think they are tethered. I would be pretty upset if it wasn't an option, but I should bring it up. This is such a difficult process. I wish I had one local doctor I could count on, but I haven't been able to find one. You are so lucky that you do.

Just wanted to add that I think the hardest thing about choosing subcision is the incredible variabliity. I have to jump through major hoops; talk it out with family, find day care, travel, and of course the down-time. And if it's not a positive result, or worse if I have nodules or lumps or god forbid it makes things worse, I don't know what I'll do. Anything you think helped minimize negative side effects for you?

Edited by michi31

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Anything you think helped minimize negative side effects for you?

Yes, first and foremost, I had a skilled surgeon who performed the procedure on me. So, I didn't have any scarring or infection from the procedure(s) that I had done.

Second, I did use ice on my face as the doctor recommended to help reduce the swelling and I didn't take any aspirin or Vitamin E the week before my procedures (both can increase the amount of hemoragging that occurs.

Keep in mind that I did the subcision/suction method for my fourth and final round of subcision. Because of the suction, there was prolonged bruising and swelling and I had subcutaneous lumps which lasted for at least six weeks. However, the positive side was that the scars did not reappear on my left cheek at all. This was an amazing result for me.

I saw my dermatologist last month to show him the results and I asked him if he had injected any fillers whatsoever into the scars and he said 'no'. I was glad that was his answer because I had a tremendous amount of collagen remodeling that occured and the fibrous bands never reattached themselves.

I sincerely hope for your sake that you can find a treatment that is both safe and effective for the location of your scarring. By the way, my dermatologist would not perform subcision on one scar on my left temple due to the fact that a large vein is present there. It simply wasn't worth the risk of causing major trauma and hemorraging for him to do this.

Keep us posted on your journey.

Matt

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Anything you think helped minimize negative side effects for you?

Yes, first and foremost, I had a skilled surgeon who performed the procedure on me. So, I didn't have any scarring or infection from the procedure(s) that I had done.

Second, I did use ice on my face as the doctor recommended to help reduce the swelling and I didn't take any aspirin or Vitamin E the week before my procedures (both can increase the amount of hemoragging that occurs.

Keep in mind that I did the subcision/suction method for my fourth and final round of subcision. Because of the suction, there was prolonged bruising and swelling and I had subcutaneous lumps which lasted for at least six weeks. However, the positive side was that the scars did not reappear on my left cheek at all. This was an amazing result for me.

I saw my dermatologist last month to show him the results and I asked him if he had injected any fillers whatsoever into the scars and he said 'no'. I was glad that was his answer because I had a tremendous amount of collagen remodeling that occured and the fibrous bands never reattached themselves.

I sincerely hope for your sake that you can find a treatment that is both safe and effective for the location of your scarring. By the way, my dermatologist would not perform subcision on one scar on my left temple due to the fact that a large vein is present there. It simply wasn't worth the risk of causing major trauma and hemorraging for him to do this.

Keep us posted on your journey.

Matt

Hey Matt. Glad things are doing so great for you manrolleyes.gif . I was going to chime in to ask a question and make a statement. In the thread titled "Man in The Mirror" there is a poster titled 10 years with this. If i remember correctly he said he was currenty seeing Dr. Despain. The same doctor you saw. He has scars on both sides of his chin and it appears that Dr. Despain did subcision in those areas and improved things quite a bit. So that may give hope to the creator of "this" thread. Also, I am slightly confused becuase if you check the pictures, it appears those scars were on his chin. Is that the wrong area? Honestly, I was supposed to see Despain a couple months ago but have postponed it for the time being. I was thinking about waiting until i was settled into my College ALgebra course or just waiting till the course is over. The thought of me driving 2 hours to see Despain gives me butterflies in my stomach. I think I have a general anxiety about seeing doctors anyways but I fight these feelings of fear about the whole situation. I havent figured out if these fears are irrational or not. Many people say subcision is very low risk and whatnot. That makes me feel better but I guess anything with risk makes me feel uneasy. If I could even improve 1 of my scars ide be thrilled.

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Anything you think helped minimize negative side effects for you?

Yes, first and foremost, I had a skilled surgeon who performed the procedure on me. So, I didn't have any scarring or infection from the procedure(s) that I had done.

Second, I did use ice on my face as the doctor recommended to help reduce the swelling and I didn't take any aspirin or Vitamin E the week before my procedures (both can increase the amount of hemoragging that occurs.

Keep in mind that I did the subcision/suction method for my fourth and final round of subcision. Because of the suction, there was prolonged bruising and swelling and I had subcutaneous lumps which lasted for at least six weeks. However, the positive side was that the scars did not reappear on my left cheek at all. This was an amazing result for me.

I saw my dermatologist last month to show him the results and I asked him if he had injected any fillers whatsoever into the scars and he said 'no'. I was glad that was his answer because I had a tremendous amount of collagen remodeling that occured and the fibrous bands never reattached themselves.

I sincerely hope for your sake that you can find a treatment that is both safe and effective for the location of your scarring. By the way, my dermatologist would not perform subcision on one scar on my left temple due to the fact that a large vein is present there. It simply wasn't worth the risk of causing major trauma and hemorraging for him to do this.

Keep us posted on your journey.

Matt

Hey Matt. Glad things are doing so great for you manrolleyes.gif . I was going to chime in to ask a question and make a statement. In the thread titled "Man in The Mirror" there is a poster titled 10 years with this. If i remember correctly he said he was currenty seeing Dr. Despain. The same doctor you saw. He has scars on both sides of his chin and it appears that Dr. Despain did subcision in those areas and improved things quite a bit. So that may give hope to the creator of "this" thread. Also, I am slightly confused becuase if you check the pictures, it appears those scars were on his chin. Is that the wrong area? Honestly, I was supposed to see Despain a couple months ago but have postponed it for the time being. I was thinking about waiting until i was settled into my College ALgebra course or just waiting till the course is over. The thought of me driving 2 hours to see Despain gives me butterflies in my stomach. I think I have a general anxiety about seeing doctors anyways but I fight these feelings of fear about the whole situation. I havent figured out if these fears are irrational or not. Many people say subcision is very low risk and whatnot. That makes me feel better but I guess anything with risk makes me feel uneasy. If I could even improve 1 of my scars ide be thrilled.

I had some rolling scars on the left and right portions of my cheeks and Dr. DeSpain did not recommend subcision on these areas due to the high risk of hemorraging. The area on the right was close to the jaw line and the area on the left extended from the jawline up to the left portion of my lip.

I don't particularly enjoy seeing doctors myself, but I think that you'll find Dr. DeSpain to be very approachable and he is open to questions and suggestions. I recently went to an ENT to discuss a different medical issue and he was completely full of himself - arrogant and unapproachable. Some people go into medicine for all the wrong reasons.

If you are unhappy with your appearance, I think you owe it to yourself to find a doctor somewhere that you're comfortable with and who will answer your questions and treat your problem effectively.

The worst part about subcision are the needles used with the anesthesia. As far as the procedure itself, I never felt anything during any of my four procedures. If you do schedule subcision, you may want to schedule it right after finals as you'll have a week or two of bruising and swelling.

Matt

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I'm new here, sorry to barge in on your post. I have some questions, and I don't know how to get a hold of anyone. Mr. Matt, I suppose these questions should be more directed to you.... I hope you get this...

Hello, sorry to bother you. I'm really at a loss with what to do. I have this scar on my forehead, about the size of a pinky nail in width (sorry, can't think of a better description) but its very shallow, probably as thick as a piece of printer paper.... but what bothers me is the size of it, and also when I lift my eyebrows, you can see the edges of it, and I feel like it might be tethered down because when I lift my eyebrows my forehead now wrinkles differently, and compared to other wrinkles it looks dented in with the scar... if that makes sense.

I got the scar in June this year, and I've dermarolled/ needled it once at the end of August, and again last weekend. I'm not sure if you've dermarolled, but I think it has helped. I also have a smaller scar inbetween my eyebrows that's a few millimeters wide, which I've had for a few years. Which didn't bother me so much, but if I can make it go away, then that would be great because its in an awkward place.

I'm just wondering if subcision can help me?

Will subcision work on shallow scars?

Did you have any shallow scars that showed improvement?

Are the results permanent?

Have you had any changes?

Is there still scar tissue there?

Should I give the newer scar more time?

I'm sorry to bother you, I feel really guilty for joining this website, I know my scars aren't that bad, considering I only have a couple. But I've been dealing with oily/combination skin since middle school, and I fear I may only get more scars. And being young and dumb, I feel like I've brought this on my self for picking at my skin, thinking I'm invincible.

But when I got the larger scar on my forehead, I think I lost my mind a bit. I mean, I have no one to talk about this with. My mom, my sister, never had skin problems like mine, and they think I'm being vain. But I feel like its not fair. They've never had this pain... its hard to understand something unless you too have gone through it.

Oh, I'm rambling... sorry. I'm just sort of hoping if I give a little background, you won't just reply to me "fuck off" like countless other people. I'm really losing hope. And there's just an overwhelming amount of negative in my life right now, I'm trying not to think about doing something stupid... but I can't get over the fact I did this to myself, and now, I feel like I will never be happy until I can get these things fixed...

I'm trying to not let it take over my life, but its really affectd me...

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ForeverAndPatience,

You sound tormented over two shallow scars. Have you considered consulting with a doctor? Describing your scars doesn't really help any of us visualize them. Even then, it's hard to answer any of your questions. If you posted pictures, we might be able to suggest some possible options, but only a doctor can really evaluate your scars for treatment.

I don't see where any member of this board has told you to "fuck off". I am sorry if countless people have told you this.

There's no need to spam the forum with the same post copied over and over. If you're not getting a response, then I would assume no one can provide you any advice.

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Yeah, sorry. I'm just trying to get myself together again. I don't mean to 'spam', I'm new to this, so I don't really know got it works. I can probably take pictures, but how would I send them? O.o

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I'm new here, sorry to barge in on your post. I have some questions, and I don't know how to get a hold of anyone. Mr. Matt, I suppose these questions should be more directed to you.... I hope you get this...

Hello, sorry to bother you. I'm really at a loss with what to do. I have this scar on my forehead, about the size of a pinky nail in width (sorry, can't think of a better description) but its very shallow, probably as thick as a piece of printer paper.... but what bothers me is the size of it, and also when I lift my eyebrows, you can see the edges of it, and I feel like it might be tethered down because when I lift my eyebrows my forehead now wrinkles differently, and compared to other wrinkles it looks dented in with the scar... if that makes sense.

I got the scar in June this year, and I've dermarolled/ needled it once at the end of August, and again last weekend. I'm not sure if you've dermarolled, but I think it has helped. I also have a smaller scar inbetween my eyebrows that's a few millimeters wide, which I've had for a few years. Which didn't bother me so much, but if I can make it go away, then that would be great because its in an awkward place.

I'm just wondering if subcision can help me?

Will subcision work on shallow scars?

Did you have any shallow scars that showed improvement?

Are the results permanent?

Have you had any changes?

Is there still scar tissue there?

Should I give the newer scar more time?

I'm sorry to bother you, I feel really guilty for joining this website, I know my scars aren't that bad, considering I only have a couple. But I've been dealing with oily/combination skin since middle school, and I fear I may only get more scars. And being young and dumb, I feel like I've brought this on my self for picking at my skin, thinking I'm invincible.

But when I got the larger scar on my forehead, I think I lost my mind a bit. I mean, I have no one to talk about this with. My mom, my sister, never had skin problems like mine, and they think I'm being vain. But I feel like its not fair. They've never had this pain... its hard to understand something unless you too have gone through it.

Oh, I'm rambling... sorry. I'm just sort of hoping if I give a little background, you won't just reply to me "fuck off" like countless other people. I'm really losing hope. And there's just an overwhelming amount of negative in my life right now, I'm trying not to think about doing something stupid... but I can't get over the fact I did this to myself, and now, I feel like I will never be happy until I can get these things fixed...

I'm trying to not let it take over my life, but its really affectd me...

I would recommend that you go to a dermatologist and get your two scars evaluated and to see if they are in an area that can be subcised safely. There are some areas on your face where arteries run and it may not be considered wise to possibly rupture one of them with a Nokor needle.

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@Mr. Matt

Thanks for the reply.

It's probably my best bet. I guess I will mention my skin issues at my next appointment with my doctor, in a month, and see if she'll refer me to a dermatologist.

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Anything you think helped minimize negative side effects for you?

Yes, first and foremost, I had a skilled surgeon who performed the procedure on me. So, I didn't have any scarring or infection from the procedure(s) that I had done.

Second, I did use ice on my face as the doctor recommended to help reduce the swelling and I didn't take any aspirin or Vitamin E the week before my procedures (both can increase the amount of hemoragging that occurs.

Keep in mind that I did the subcision/suction method for my fourth and final round of subcision. Because of the suction, there was prolonged bruising and swelling and I had subcutaneous lumps which lasted for at least six weeks. However, the positive side was that the scars did not reappear on my left cheek at all. This was an amazing result for me.

I saw my dermatologist last month to show him the results and I asked him if he had injected any fillers whatsoever into the scars and he said 'no'. I was glad that was his answer because I had a tremendous amount of collagen remodeling that occured and the fibrous bands never reattached themselves.

I sincerely hope for your sake that you can find a treatment that is both safe and effective for the location of your scarring. By the way, my dermatologist would not perform subcision on one scar on my left temple due to the fact that a large vein is present there. It simply wasn't worth the risk of causing major trauma and hemorraging for him to do this.

Keep us posted on your journey.

Matt

Hey Matt. Glad things are doing so great for you manrolleyes.gif . I was going to chime in to ask a question and make a statement. In the thread titled "Man in The Mirror" there is a poster titled 10 years with this. If i remember correctly he said he was currenty seeing Dr. Despain. The same doctor you saw. He has scars on both sides of his chin and it appears that Dr. Despain did subcision in those areas and improved things quite a bit. So that may give hope to the creator of "this" thread. Also, I am slightly confused becuase if you check the pictures, it appears those scars were on his chin. Is that the wrong area? Honestly, I was supposed to see Despain a couple months ago but have postponed it for the time being. I was thinking about waiting until i was settled into my College ALgebra course or just waiting till the course is over. The thought of me driving 2 hours to see Despain gives me butterflies in my stomach. I think I have a general anxiety about seeing doctors anyways but I fight these feelings of fear about the whole situation. I havent figured out if these fears are irrational or not. Many people say subcision is very low risk and whatnot. That makes me feel better but I guess anything with risk makes me feel uneasy. If I could even improve 1 of my scars ide be thrilled.

I had some rolling scars on the left and right portions of my cheeks and Dr. DeSpain did not recommend subcision on these areas due to the high risk of hemorraging. The area on the right was close to the jaw line and the area on the left extended from the jawline up to the left portion of my lip.

I don't particularly enjoy seeing doctors myself, but I think that you'll find Dr. DeSpain to be very approachable and he is open to questions and suggestions. I recently went to an ENT to discuss a different medical issue and he was completely full of himself - arrogant and unapproachable. Some people go into medicine for all the wrong reasons.

If you are unhappy with your appearance, I think you owe it to yourself to find a doctor somewhere that you're comfortable with and who will answer your questions and treat your problem effectively.

The worst part about subcision are the needles used with the anesthesia. As far as the procedure itself, I never felt anything during any of my four procedures. If you do schedule subcision, you may want to schedule it right after finals as you'll have a week or two of bruising and swelling.

Matt

Matt,

We're the scars he refused to treat closer to the jaw or the chin? Sorry if this sounds obtuse, but what can hemorrhage in the chin? If it's true, I'm totally screwed and I'm freaking out right now.

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Anything you think helped minimize negative side effects for you?

Yes, first and foremost, I had a skilled surgeon who performed the procedure on me. So, I didn't have any scarring or infection from the procedure(s) that I had done.

Second, I did use ice on my face as the doctor recommended to help reduce the swelling and I didn't take any aspirin or Vitamin E the week before my procedures (both can increase the amount of hemoragging that occurs.

Keep in mind that I did the subcision/suction method for my fourth and final round of subcision. Because of the suction, there was prolonged bruising and swelling and I had subcutaneous lumps which lasted for at least six weeks. However, the positive side was that the scars did not reappear on my left cheek at all. This was an amazing result for me.

I saw my dermatologist last month to show him the results and I asked him if he had injected any fillers whatsoever into the scars and he said 'no'. I was glad that was his answer because I had a tremendous amount of collagen remodeling that occured and the fibrous bands never reattached themselves.

I sincerely hope for your sake that you can find a treatment that is both safe and effective for the location of your scarring. By the way, my dermatologist would not perform subcision on one scar on my left temple due to the fact that a large vein is present there. It simply wasn't worth the risk of causing major trauma and hemorraging for him to do this.

Keep us posted on your journey.

Matt

Hey Matt. Glad things are doing so great for you manrolleyes.gif . I was going to chime in to ask a question and make a statement. In the thread titled "Man in The Mirror" there is a poster titled 10 years with this. If i remember correctly he said he was currenty seeing Dr. Despain. The same doctor you saw. He has scars on both sides of his chin and it appears that Dr. Despain did subcision in those areas and improved things quite a bit. So that may give hope to the creator of "this" thread. Also, I am slightly confused becuase if you check the pictures, it appears those scars were on his chin. Is that the wrong area? Honestly, I was supposed to see Despain a couple months ago but have postponed it for the time being. I was thinking about waiting until i was settled into my College ALgebra course or just waiting till the course is over. The thought of me driving 2 hours to see Despain gives me butterflies in my stomach. I think I have a general anxiety about seeing doctors anyways but I fight these feelings of fear about the whole situation. I havent figured out if these fears are irrational or not. Many people say subcision is very low risk and whatnot. That makes me feel better but I guess anything with risk makes me feel uneasy. If I could even improve 1 of my scars ide be thrilled.

I had some rolling scars on the left and right portions of my cheeks and Dr. DeSpain did not recommend subcision on these areas due to the high risk of hemorraging. The area on the right was close to the jaw line and the area on the left extended from the jawline up to the left portion of my lip.

I don't particularly enjoy seeing doctors myself, but I think that you'll find Dr. DeSpain to be very approachable and he is open to questions and suggestions. I recently went to an ENT to discuss a different medical issue and he was completely full of himself - arrogant and unapproachable. Some people go into medicine for all the wrong reasons.

If you are unhappy with your appearance, I think you owe it to yourself to find a doctor somewhere that you're comfortable with and who will answer your questions and treat your problem effectively.

The worst part about subcision are the needles used with the anesthesia. As far as the procedure itself, I never felt anything during any of my four procedures. If you do schedule subcision, you may want to schedule it right after finals as you'll have a week or two of bruising and swelling.

Matt

Matt,

We're the scars he refused to treat closer to the jaw or the chin? Sorry if this sounds obtuse, but what can hemorrhage in the chin? If it's true, I'm totally screwed and I'm freaking out right now.

My doctor didn't specify the name of the artery, but, based upon the attached photo in this link, I believe he was concerned about severing the lingual artery.

I had scarring on my chin area and the deepest scarring on the left and right sides of my chin and a little along the jaw line.

I have one rolling scar on my left temple that he would not treat due to another major artery that resides there - I can actually see a major vein in the area and I appreciate the fact that he didn't want to risk a major hemorrage in either area. Could you imagine the bruising I could have had or worse?

I've used my dermaroller extensively on the areas that my doctor wouldn't treat - my chin looks much better today.

when I saw my dermatologist in August, he was amazed at the progress that I had made and asked if I had been using any serums to help 'jump start' the collagen process. A friend of mine commented last night how youthful and healthy my skin looked - my wife made a similar comment. All of these procedures (chemical peels, TCA Cross, subcision, etc.), have resulted in collagen development and have a cumulative effect. They occur incrementally over time - usually, many weeks, months, and possibly years from what I have read. I expect that my complexion will continue to improve a little bit more based upon the research that I have read.

I think that it is always best to follow the sound advice of a good doctor and avoid any major complications. Subcision is relatively risk-free compared to some of the other options out there: punch excision, dermabrasion, etc.

Hope this helps.

Matt

Sorry, I forgot to include the link

.

http://catalog.nucleusinc.com/generateexhibit.php?ID=7185

Edited by mr. matt

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Thank you , Matt, for taking the time to answer my question and including a link.

I have scars on the other artery, the facial artery, I think. I guess There is no hope for my scarring there. They are deep and bound down and really the only scars I was wanting improvement in the most. I doubt dermarolling would help them. This is a huge setback for me.

I looked last night and there are studies where drs performed subcision and it said it included the chin, so I'm a bit confused. Dr. Orentreich was one of the drs performing the experiment. Maybe one of us could call and ask about the chin. I don't want to travel so far only to be told they can't do it.

I should've known I would never be able to get rid of my scarring.

I also saw some threads here where people said they had it on their chin, so I don't know if there mds just didn't know aout this or if it's only certain areas of the chin. Maybe they can't go deep? In the one study they used a 24 gauge needle which is not as deep as a 19 or 20.

The temple makes sense because the skin is very thin there, not a lot of fat tissue to have the artery far down. I hate to think I cant do anything about these scars.

Edited by LoveGreenSmoothies

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Okay, so I've done more research and I found an article about subcision saying to avoid the temporal, auricle (around the ear) and mandiblur area. The one I wonder about is the mandiblur. Not sure if that extends into the chin because I'm getting mixed things online. I can't paste the article bc of the device I'm on. Sorry.

I only found one source that mentioned that. Many people here have had it on the chin so I don't know what to think.

There was nothing about the facial nerve or the lingual artery in the article, so idk what to think aout that.

I do know people have had it on the chin and temple-- maybe they shouldn't have? I wish someone who knew for sure would come along and post.

While looking for an answer I found this answer to this exact question from Dr. Lam:

"hi,

thanks for sharing. i rarely perform subcision as i find it does not help that much in most acne scars. in other types of tethered scars featured in the article, that makes more sense. i think nerve damage across the entire face is pretty unlikely since nerves emanate very deep below the muscle except in the temple region where they lie more superficially. in that one area and also under the mandible (jawbone) the nerve can lie more superficially. in the cheek, you should be fine. in the central forehead, the nerve is a bit variable but theoretically could be injured if coming up right over the eyelid area where it terminates. it depends on the exact location but in general it is pretty hard to damage facial nerves with subcision technique in most of the face."

Dr Lam is not a fan of subcision and he says it's fine except for the temple or jawline. I also found another article that said its fine except for the temple area because the nerves are below the skin pretty deep. I wish I could copy and paste but I'm not able to on this iPhone. They do injections on the chin area and injections actually go pretty deep, so I'm very confused.

Edited by LoveGreenSmoothies

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Okay, so I've done more research and I found an article about subcision saying to avoid the temporal, auricle (around the ear) and mandiblur area. The one I wonder about is the mandiblur. Not sure if that extends into the chin because I'm getting mixed things online. I can't paste the article bc of the device I'm on. Sorry.

I only found one source that mentioned that. Many people here have had it on the chin so I don't know what to think.

There was nothing about the facial nerve or the lingual artery in the article, so idk what to think aout that.

I do know people have had it on the chin and temple-- maybe they shouldn't have? I wish someone who knew for sure would come along and post.

While looking for an answer I found this answer to this exact question from Dr. Lam:

"hi,

thanks for sharing. i rarely perform subcision as i find it does not help that much in most acne scars. in other types of tethered scars featured in the article, that makes more sense. i think nerve damage across the entire face is pretty unlikely since nerves emanate very deep below the muscle except in the temple region where they lie more superficially. in that one area and also under the mandible (jawbone) the nerve can lie more superficially. in the cheek, you should be fine. in the central forehead, the nerve is a bit variable but theoretically could be injured if coming up right over the eyelid area where it terminates. it depends on the exact location but in general it is pretty hard to damage facial nerves with subcision technique in most of the face."

Dr Lam is not a fan of subcision and he says it's fine except for the temple or jawline. I also found another article that said its fine except for the temple area because the nerves are below the skin pretty deep. I wish I could copy and paste but I'm not able to on this iPhone. They do injections on the chin area and injections actually go pretty deep, so I'm very confused.

Like I mentioned before. There was a guy here named 10years with this. Look for him. He had subcision done by the same Dr. as Mr. Matt. It appeared that he has scars underneath his mouth that he had treated by subcision. Maybe he had used another procedure. Or maybe it really is about "Exact Location" on the face. I assume that these doctors know facial anatomy very well.

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I looked for him but can't find him. I'm on a cell.

I think the temple and jaw area are the spots that are more risky bc of the skin not being fleshy. I don't think anyone would bleed to death but there could be temporary or long term nerve damage. Generally, the nerves and arteries are deep in the skin, probably below the dermis and subcision doesn't go that deep. There are risks of nerve damage all over the face from the injections of lido, but it's very rare. They go deep with restylane too and that's also a risk for nerves.

You actually run the risk of Nerve damage with dental procedures as well but it usually doesn't happen often. The dr needs to mess up and hit the nerve.

People get chin implants where they put the implant far down under the dermis and it's usually fine, so I think it's a remote risk with subcision, and one I'm willing to take.

I wouldn't do temple or jaw because I don't have a lot of flesh there. Same with near the ear and sides of face nearthe hairline.

Many people have had the chin done. I'm doing it unless the dr gives me a reason not to.

Edited by LoveGreenSmoothies

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I had a second conversation with a plastic surgeon today about subcision in the chin area. He didn't say anything about this problem. The only problem he has experienced is that because the skin is thinner than say, the cheek area, it tends to bleed more. So if the blood all comes out then there is no result - no lump that forms underneathe. One woman he subcised near and under the mouth area formed white bumps that exuded some sort of white puss...he just said it's more unpredictable in this area. Although one other person didn't have any issues. This is why he prefers to do fillers with subcision in the chin/mouth area - to control the amount that forms under the scar. He does the filler first and then subcises to the extent necessary to prevent any doughnuting. So I'm really torn about whether to just do subcision in this area - which I view as a potentially more permant result - or do the filler with subcision and get the more reliable result with less downtime. What do you guys think?

I looked for him but can't find him. I'm on a cell.

I think the temple and jaw area are the spots that are more risky bc of the skin not being fleshy. I don't think anyone would bleed to death but there could be temporary or long term nerve damage. Generally, the nerves and arteries are deep in the skin, probably below the dermis and subcision doesn't go that deep. There are risks of nerve damage all over the face from the injections of lido, but it's very rare. They go deep with restylane too and that's also a risk for nerves.

You actually run the risk of Nerve damage with dental procedures as well but it usually doesn't happen often. The dr needs to mess up and hit the nerve.

People get chin implants where they put the implant far down under the dermis and it's usually fine, so I think it's a remote risk with subcision, and one I'm willing to take.

I wouldn't do temple or jaw because I don't have a lot of flesh there. Same with near the ear and sides of face nearthe hairline.

Many people have had the chin done. I'm doing it unless the dr gives me a reason not to.

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Thanks for the info.

Subcision with fillers sounds doable. You can compromise and do one round of subcision and see what it does for you. If you're not happy, do another with fillers too.

Where is this ps located?

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I had a second conversation with a plastic surgeon today about subcision in the chin area. He didn't say anything about this problem. The only problem he has experienced is that because the skin is thinner than say, the cheek area, it tends to bleed more. So if the blood all comes out then there is no result - no lump that forms underneathe. One woman he subcised near and under the mouth area formed white bumps that exuded some sort of white puss...he just said it's more unpredictable in this area. Although one other person didn't have any issues. This is why he prefers to do fillers with subcision in the chin/mouth area - to control the amount that forms under the scar. He does the filler first and then subcises to the extent necessary to prevent any doughnuting. So I'm really torn about whether to just do subcision in this area - which I view as a potentially more permant result - or do the filler with subcision and get the more reliable result with less downtime. What do you guys think?

I looked for him but can't find him. I'm on a cell.

I think the temple and jaw area are the spots that are more risky bc of the skin not being fleshy. I don't think anyone would bleed to death but there could be temporary or long term nerve damage. Generally, the nerves and arteries are deep in the skin, probably below the dermis and subcision doesn't go that deep. There are risks of nerve damage all over the face from the injections of lido, but it's very rare. They go deep with restylane too and that's also a risk for nerves.

You actually run the risk of Nerve damage with dental procedures as well but it usually doesn't happen often. The dr needs to mess up and hit the nerve.

People get chin implants where they put the implant far down under the dermis and it's usually fine, so I think it's a remote risk with subcision, and one I'm willing to take.

I wouldn't do temple or jaw because I don't have a lot of flesh there. Same with near the ear and sides of face nearthe hairline.

Many people have had the chin done. I'm doing it unless the dr gives me a reason not to.

Ide maybe do a round of subcision by itself and see how you fare. If you like it then proceed with fillers as needed. "If" you need fillers at that point.

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Yes I think you are both right - see how subcision goes first. There are very small pits which he says don't respond well to subcision..he says the larger areas respond better. Not sure if I should just get filler in those. This doctor is in NYC.

Thanks for the info.

Subcision with fillers sounds doable. You can compromise and do one round of subcision and see what it does for you. If you're not happy, do another with fillers too.

Where is this ps located?

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