Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
samui

Any Alternative To Subscision For Tethered Scars?

Recommended Posts

Hi All

I have just joined this forum after reading lots of useful information on this site.

I am in my 40s and have suffered with acne on and off since my twenties. Due to the aging process some previous scarring has started to surface and in particular I have a matching pair of quite deep rolling scars, one each side of my chin. I believe these are tetherered scars as when I smile then turn into unattractive wrinkles either side of my chin which don't look nice on a lady. I would like to have these improved if possible but I don't know if this is going to be possible.

From the reading I've done here and especially Mr Matt's story it seemed like subscision would be the best treatment however as these scars are below the corners of my mouth quite near the jaw line they would be appear to be in the area where there are arteries and nerves so I think this may not be possible.

Has anyone had scars like this successfully treated and how? I am not keen on the idea of using lasers, esp Fraxel as I have read alot of horror stories online and believe that it may cause other problems which would be just as bad.

Any advice from anyone?

Thanks!

Samui

Share this post


Link to post
Share on other sites

Hi. I just want to say I have the same exact thing, mainly on one side of my chin. Looks like a big wrinkle when I smile. I have not done any treatments yet, but did consult with a plastic surgeon about subcision and he did not say anything about this area being a problem. It's only problematic in that the skin is thinner so it can be harder to treat. What other type of scarring are you seeing? I also have under the skin bumpy scarring that I dont see on here very often. Also, have you had any cortisone shots? I have spent some time wondering if the cortisone shots I received in this area contributed to the atrophy.

Edited by michi31

Share this post


Link to post
Share on other sites

Hi Michi31

Apart from these two scars I have one other deepish boxcar type scar a couple of quite light rolling scars and some pin prick icepick scars which are not that noticeable. Overall the scarring is quite mild and just around my chin but I expect it will worsen as I age so would like to get something done soonish if I can. When I look down I notice that the tethered scars also create dips in my face which look horrible and very aging.

I haven't ever had any cortisone injections but used to get frequent large cysts in that area which I think are to blame. I did try hyrocortisone cream on occasions so I am not sure whether that had any bearing. I suspect not, probably they are just the result of the deep inflammation.

Share this post


Link to post
Share on other sites

That's helpful to know. Please update if and when you have any consultations or treatments. I'm currently interested in subcision and possibly lavive. Good luck!

Share this post


Link to post
Share on other sites

Hiya samui,

Have you consulted with someone skilled in subscision as yet? I've been doing a bit of research on it too as I'm considering it for one rolling scar on my cheek if my Dermarolling sessions don't improve it to my expectations. I'm hoping I don't need it, fingers crossed.

From what I've read, subscision is the gold standard when it comes to deep rolling scars. Couple that with a good, safe, Hyaluronic acid based filler and you could see awesome results. Having a filler on its own might be an option too however it may make things worse if the filler settles around the scar instead of in it, giving you a donut look. Personally I would scour the earth for the best doctor in your area and I'd make an appointment with them. They'll be able to tell you if that area is safe for subscision. Keep in mind that you'll probably need more than one session though.

Good luck!

Share this post


Link to post
Share on other sites

From what I've read, it's ok to do subcision on the chin. There are arteries and nerves all over your face. They've listed the temporal as problematic, but people have had subcision there. A food dr. Will know where the nerves are and how deep. Also, the arteries and nerves are deep, under the dermis from what I've read. Subcision isn't supposed to go to the dermis. The reason they worry about the temple and jaw is that most ppl have thinner skin there that isn't fleshy. This is just from what I've read, but it makes sense.

Share this post


Link to post
Share on other sites

From what I've read, it's ok to do subcision on the chin. There are arteries and nerves all over your face. They've listed the temporal as problematic, but people have had subcision there. A food dr. Will know where the nerves are and how deep. Also, the arteries and nerves are deep, under the dermis from what I've read. Subcision isn't supposed to go to the dermis. The reason they worry about the temple and jaw is that most ppl have thinner skin there that isn't fleshy. This is just from what I've read, but it makes sense.

Thanks for your reply. I understood that the problem with tethered scars was that the dermis scars deeply and attaches it to the underlying tissue causing the depressions. Therefore subscision needs to happen underneath the dermis. Am I wrong about this?

Share this post


Link to post
Share on other sites

From what I've read, it's ok to do subcision on the chin. There are arteries and nerves all over your face. They've listed the temporal as problematic, but people have had subcision there. A food dr. Will know where the nerves are and how deep. Also, the arteries and nerves are deep, under the dermis from what I've read. Subcision isn't supposed to go to the dermis. The reason they worry about the temple and jaw is that most ppl have thinner skin there that isn't fleshy. This is just from what I've read, but it makes sense.

Thanks for your reply. I understood that the problem with tethered scars was that the dermis scars deeply and attaches it to the underlying tissue causing the depressions. Therefore subscision needs to happen underneath the dermis. Am I wrong about this?

Subcision should happen deep into the dermis.

Explanation:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956956/

Share this post


Link to post
Share on other sites

Oh, I didn't know it went into the dermis. Oh well. I think it can be done on the chin, people have done it here & there were even studies where they listed the chin as one of the areas they performed it.

There are nerves and arteries running all over your face. They do chin Implants which I think carries more nerve risk, but they do it, and the risk is rare. I've seen peoplon real self with nerve damage from lip implants and other areas of filler on the face, so it's a risk for all face procedures ( except laser probably) because the face is full of nerves. Even dental procedures cause nerve damage but it rarely happens. You really only have the option of subcision or laser for these scars, but I don't think laser alone would help such bound down scarring. You can try dermarolling too. If you're not comfortable with subcision in this area then you shouldn't do it. I don't see a lot of info on the web about this so youll need to talk to a derm or PS to know for sure. I do know people have had the chin done with no nerve damage. Also, they recommend subcision in the chin for labiomental surgery, so they do subcision on the chin. In one of these recent topics I posted a response from dr. Lam regarding this question and he said the risk is very remote and he's not a proponent of subcision. He doesn't think it works.

A major problem with the chin is that there's so many muscles there so the scars can come back easier.

Edited by LoveGreenSmoothies

Share this post


Link to post
Share on other sites

Thanks all for your replies.

It looks like I might have to live with these scars unless I can find a surgeon who is comfortable to do the subscision. Just to clarify though I think treating scars actually ont he chin itself is probably ok with subscision, the problem I believe is with scars that are on either side of the chin ( below the corners of the mouth) where the major facial arteries fun. Other areas of the face such as the middle of the cheeks which often need to be treated do not have such major blood vessels running across them.

Share this post


Link to post
Share on other sites

I don't understand this...how do muscles relate to scars coming back?

A major problem with the chin is that there's so many muscles there so the scars can come back easier.

Share this post


Link to post
Share on other sites

Thanks all for your replies.

It looks like I might have to live with these scars unless I can find a surgeon who is comfortable to do the subscision. Just to clarify though I think treating scars actually ont he chin itself is probably ok with subscision, the problem I believe is with scars that are on either side of the chin ( below the corners of the mouth) where the major facial arteries fun. Other areas of the face such as the middle of the cheeks which often need to be treated do not have such major blood vessels running across them.

Did your dr say they wouldn't do it for tou? Who told you that?

Do tou think excision would help?

Are they right below the Jim or right under the mouth? You say they're near the jaw, but I'm confuses, bc right under the corner of the mouth isn't near the jaw...?

I don't understand this...how do muscles relate to scars coming back?

A major problem with the chin is that there's so many muscles there so the scars can come back easier.

The chin has very active muscles all over it. It makes scar revision more difficult there.mit also makes the scars get deeper over time. It also causes texture changes that look like pitting even in people w/o scarring sometimes.

Edited by LoveGreenSmoothies

Share this post


Link to post
Share on other sites

Greensmoothies - What have you done on your chin for scar revision so far? I'm travelling to see Rapaport on Monday. I'll let you know what he says...

Share this post


Link to post
Share on other sites

Greensmoothies - What have you done on your chin for scar revision so far? I'm travelling to see Rapaport on Monday. I'll let you know what he says...

Nothing yet. I was going to get subcision until all of this chin controversy happened. I'd love to hear what he tells you. We all would.

From what I'm hearing, it's okay to do it on the chin, but dr. R should totally know.

Can someone kindly explain what tethered scars are?

Scars that are bound down.

Edited by LoveGreenSmoothies

Share this post


Link to post
Share on other sites

Yeah I definitely have a lot of my hopes pinned on this appointment. I'm praying he delivers good news about possible improvements. I also have bumpy, under the skin scarring that bothers me as much as the rolling scar. I'm thinking he'll say laser for that.

Share this post


Link to post
Share on other sites

Oh wow. We have the same issues. I think I'll also need laser for there as well.

My hopes were pinned on subcision too, so I'm pretty upset about all of this too. But from what I'm reading, it seems it can be on the chin. A few drs even said so. and I know people have had it done there w/o nerve damage. Nerve damage is a risk in any face procedure. The food news is that it's usually temporary if it occurs.

Share this post


Link to post
Share on other sites

Yeah I'd probably be willing to risk it sadly. The bumpy part is bothering me more and more - it looks wrinkly when I smile. Do you have that? And now we have officially hijacked this thread haha.

Share this post


Link to post
Share on other sites

I had my consultation yesterday and Dr. R did recommend subcision the the right side of my chin for the rolling scars. He is the second doctor to do so. Actually, he recommended subcision/suction. He is now giving people a home suction device because he said "people were using vacuum cleaners and that's not acceptable." Haha. He is just starting this so hasn't personally seen the results of it yet, but I think it is a step in the right direction. As for the bumps under the skin, he called them "papules", which I think is just a generic term for bumps because they aren't acne. He said that as we age we are losing fat, esp. because of the acne, so they are becoming more visible. He recommended Fraxel Restore. I have my doubts about that - I think there was someone on another bumpy chin thread who reported someone else had gotten restore for these bumps and it did nothing? To me it seem they are definitely scar tissue that needs to be removed through ablation. I haven't decided what to do yet.

Edited by michi31

Share this post


Link to post
Share on other sites

Hey, thanks for letting me (us) know what he said. So he said subcision on chin is ok? Did he say anything about nerves etc.?

Hahahahaha!! That's sooo funny about the suction machine.

Yeah, I don't know that restore will do the trick. Scar tissue and removal is tricky. I've heard one of the pulse dye lasers helps. There was a study I read on that. It's extra tissue so abating it may not help but it may. I guess it depends on how deep they go etc. they're just tough t treat.

Yes, the chin changes a lot as we age. Those muscles really do some bad things.

Share this post


Link to post
Share on other sites

He said it was ok, and didn't say anything about nerve damage. I didn't specifically ask because somewhere in my brain I'm afraid it will trigger him to be like, oh wait a minute you're right there are nerves there and I can't do it! Which is ridiculous. I'm sure he would have said so though and he has done it in this area before.

That's interesting about the study you read - do you happen to know where I can find it? It's just such weird scarring that I never see on here. It's not atrophic and it's not hypertrophic. It's like individual bumps that when I push the skin together you can seem them like little pieces of rice under the skin (weird analogy). I started seeing them when I was on differin and duac (bp) and was wondering if the retinoids or the bp could have contributed...do you have any thoughts about this? The thing is that I see them where I had the bad acne but also lower down on my jaw and part of my neck where I never did.

Share this post


Link to post
Share on other sites

Lol, you should've asked him, but I know what you mean. You were afraid he'd reconsider.

I don't remember where it was. I saw it a few years ago. It was the pulse dye laser do hypertrophic so google that and see what you find. I'd look, but even I'd I found it now, I couldn't link it because I'm unable to do that on here and I don't have a pc right now.

I got mine when I went on retinoids. I didn't even have acne yet anywhere. I decided to switch from Bp to that bc I wanted to see if it made my skin even better. I got a ton of bumps under my skin all over my chin. It was the only acne I had anywhere. But it wasn't acne it was weird. I literally looks in the mirror and said, oh my I'd. I look like I have some kind of disease -- acne didn't even enter my mind. I think the retinoid did something weid to my skin and pores and brought stuff up but it got stuck under the skin. Like weird cysts that were small, but underneath the skin. Anyway, they all were there so long that they scarred. Once they came to the surface the skin under was destroyed., leaving striations and scarring. My skin a,so became extremely oily everywhere and then I got acne. I think the scarring that's raises is sh mostly but there's probably some raises scarring too. My deem said the same. Anyway, yes,I think retinoids ruined my skin, iow, my skin has a weird reaction. Maybe it made too much collagen or created too much turnover? Idk.

Keep me posted on how your subcision goes. It would help me a lot.

Edited by LoveGreenSmoothies

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×