Yeah I think because fat is permanent, hopefully, that is why it is always going to be expensive. The only alternative I can think of is Sculptra, which is not permanent, and runs about 2 grand. But it can last two or more years so it might be something to think about.

Did you have any lumps from subcision? I now have lumps which look like a line of raised scarring. Not a good look.

It's so discouraging and disappointing....my scars are less shallow, but they seem more noticeable now that my cheeks are thinner. I think I was prettier before, too. I wonder what's going to happen if I lose any more weight. I'm scared of ever trying lasers now, if my body responds this way to subcision I guess doing lasers would be worse.

No, I didn't have a problem with lumps. I'm sorry that happened. Can't dermatologists go back and correct it? I would call your dermatologist.

Yes I did call - he said to keep massaging it and if not they can inject it.

I'm sure you are still pretty! Did you tell your doc about this/ask how this can happen? Subcision doesn't, or shouldn't, be going into the subcutaneous fat so I'm not sure how it could cause fat loss. That is my thinking anyway. Nor should the peel - but do you think the peel could have had something to do with it? Sometimes I wonder if all the swelling thins out the tissue.

Well, it started with my first subcision....my face swelled up pretty bad and was red, when the swelling went down my face looked thinner and people kept asking me if I had lost weight. My scarring improved, so I still went in for a second subcision. As I lose weight my face looks even thinner than when I was 20 lbs lighter.

I also had three IPL treatments last year. They were right before the subcision. Still, I noticed an immediate difference after the subcision.

I think maybe the inflammatory response caused the fat loss. I have pictures from a year ago and really see the difference.

BTW I tried dermarolling last night. It wasn't nearly as painful or intimidating as I expected, and I will probably continue to do dermarolling for the microswelling, at the very least. My skin looks super smooth today.

Yes I would probably agree with your theory, because what else could it be? I've been thinking of dermarolling. What brand/size did you use? I'm just so terrified of making it worse - it took me forever to work up the nerve to do subcision.

I bought a random dermaroller on ebay called MT dermaroller. It's 1.5 mm. Not nearly as scary as I expected. I think some peels I've had have seemed more invasive. Of course, I am being anal about sterilization. I didn't like needling, but so far I do like dermarolling.

I wanted to share this. A man shares his experiences on RealSelf with Fraxel laser. His scarring improved, and he also had fat loss, which he seems happy about:

http://www.realself.com/review/jakarta-fraxel-laser-skin

"I look much prettier not only because my skin is fresh-looking but also because the unwanted fat on my face and neck was dissolved as well."

Fat transfer is definitely a safer option since your body won't reject the tissue. It's often used as filler for anti-ageing purposes. Plus, you get to lose a bit of weight in areas like your hips/waist if they chose that area to transfer from!

Not saying you have a fat waist...but that would be an added bonus for me.

Does anyone know if fat loss from treatments like laser (or subcision and peels in starlite's case) is supposed to be permanent? I could imagine it being transitory and lasting while the tissue is still recovering from the injury (which could be a few years), but I really don't know.

I haven't really had a problem with fat loss in the face per se, but I've lost a lot of weight recently and I think my rolling scars are a bit more evident. Or it could just be that I'm just now paying more attention to them, and my bathroom lighting has changed, don't know. I plan/hope to gain weight and hopefully my skin will look more taut and rolling scars less noticeable as a result.

So the doctor who offered fat grafting with supposedly permanent results has a negative review. The reviewer said that her face went back to the way it was before after only six months, and she had scarring in the location he extracted the fat...and he extracted it from a location she specifically told him not to! Pretty unethical.

For several thousand dollars, it almost seems worth it to me to fly to a location that offers ReCell. I trust the results people have shared on this forum about ReCell. And the results last longer than fat grafting for nearly the same price. I just wish there was another option! :/

@ Lewis yes I've seen some great results on places like RealSelf, just nervous about spending that much money. I want to be sure the results will last long and be at least a little permanent.

@ austra I've heard that it takes a couple of years sometimes for the dermis to heal. It probably would be best for me to wait and see if anything changes. I've never heard of fat loss in the face caused by laser damage going back to the way it was before, though.

A quick update. I went to see the doctor earlier today who performed the subcision. He claimed that he did not note a loss of fat and that the subcision shouldn't have caused any fat loss. I tried to show him pictures but he told me since the pictures were taken at a distance and he was observing my skin up close, it was impossible to compare.

It could have been my imagination, but it looked like the nurse who was in the room was trying not to smirk. I had spoken to her over the phone and argued that I thought the loss of fat in my face was caused by the subcision, until she finally suggested that I come in and speak directly with the dermatologist.

I wasn't sure how to defend my case....whenever I showed people "before" pictures they tell me they notice a difference in the volume of my cheeks. I guess I should have expected that the doctor would try to convince me that the change was not caused by the subcision...I've never heard of a doctor or PS actually acknowledging unexpected complications were caused by the procedure, probably because it opens them up to lawsuits.

He did make a good point, that I should take care of my active acne before proceeding with more scar revision. He said that accutane can sometimes help improve scarring. I didn't want to wait a year and a half to do more for my scarring, but I guess that might be the most practical strategy.

So you are going on Accutane now? Why does he think it might improve scarring - most people say the opposite. Yeah, docs want to convince you that all went great and nothing bad happened. Good luck - keep us posted.

Yes, I mentioned the same thing and he said that it's because the skin gets really dry, that older patients who he puts on Accutane sometime get more wrinkles. I'm guessing it has to do with the high dose of vitamin A....I know that Retin A is also derived from vitamin A and people have seen improvement in their superficial scars by using Retin A long term.

I feel frustrated...I wish scar revision wasn't so expensive. I'm still noticing a loss of elasticity from where I used Fraxel Repair on stretch marks. If I had a lot of money I could try several procedures, or I could travel to the best doctor and pay as much as needed.

He did give me some samples of Tazorac and my skin looks really good after only a couple of days. The acne is clearing up and the skin looks smoother. I'm going to continue dermarolling and look into fat transfer. It still makes sense to do the scar revision before I try accutane because of the effect that drug has on skin integrity and healing.

So I've talked with a couple of PS about fat grafting. I was told that fat is injected to a deeper layer than the dermis, and they wouldn't recommend it.

I've been thinking about it, and it's true that fat is at a deeper layer than the dermis. They're both connective tissue, but not even remotely the same. I wonder now if the loss of volume I see is actually damage to the dermis and not fat loss. I think people who have negative reviews about Fraxel Repair and IPL complain about both damage to the dermis and fat loss.