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Rob_X_22

Tightening Skin

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i have alot of lose skin under my jaw i'm 37 anyway when pull my skin tighter my scars completely dissapear ...is there any good methods out there to get this done surgically?

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Well there some people who get facelifts to accomplish the skin tightening effect, which also happens to flatten certain scars. These are usually much older patients though who are candidates for facelifts. At 37, I think you are way too young for such aggressive surgery, and frankly facelifts just look strange on men. Take a look at Burt Reynolds, although that's an extreme case. There are also neck lifts to tighten the jawline.

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I actually think facelift is worth considering. Acne scars start to look way worse as the skin ages, they are also responsible for many new wrinkles, especially around the mouth. A facelift procedure will not only remove the sagging skin and wrinkles but also smooth out the scars as it tightens the skin a lot.

As for working out... a very low body fat percentage on some people make their face skin look pretty terrible as the scars/wrinkles are much more visible. Same thing happens with skin damaged by stretch marks.

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Rob, have you looked into aggressive subcision, suction, and possibly fillers? Your issues are mainly down to rolling scars and volume loss, which is the sagging you are referring to. I feel like that combo will help in your case. I do remember that you are pretty fit to begin with, so with such low body fat it usually takes a toll on the face, especially if you have volume loss from cystic acne.

Edited by blahblah82
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i tried the suction subcision at home and the suction deformed a spot on my skin i was to agressive ...fillers would work wonders ...or cut about an inch of skin out under the jaw lol

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Really? Have you tried subcision done by a doctor though? True subcision is done with an 18 gauge Nokor needle and it has to be in the right plane to really get improvement. An 18 g needle is huge and scary looking, so that will have to be done by a doctor under local anesthesia. It would be excruciating to do at home.

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no i haven't but i have been told to do so

and yeah the neck lift pics you see on real self are impressive!

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Rob, have you looked into aggressive subcision, suction, and possibly fillers? Your issues are mainly down to rolling scars and volume loss, which is the sagging you are referring to. I feel like that combo will help in your case. I do remember that you are pretty fit to begin with, so with such low body fat it usually takes a toll on the face, especially if you have volume loss from cystic acne.

blahblah82 is spot on. I think subcision (like the type Acne.org member Mr. Matt had done) and fillers or fat grafting would be ideal for you.

There's no need for you to get aggressive surgical procedures.

Edited by CherrySoda08
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What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.

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What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.

Images of fat grafting from a plastic surgery center in NYC (scroll towards the bottom of the page); http://www.lipostructure.com/procedure/scarring/

What is your opinion on these? They look wonderful, but I don't know whether or not to believe that this procedure would be permanent.

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Guest GetMeTheResults

I've seen some nice results with ultrasound laser treatment on loose necks, but I doubt it it will pull your facial skin down.. I think it only tightens the treated area.

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For Rob, I feel like these scars are perfectly suited for subcision and volume replacement with fillers. In general fat doesn't seem great for small indentations, but are good for large areas of volume loss. For example, if your acne caused so much scarring that there is volume loss in the cheeks, ie sunken cheeks, then I can see how fat grafting would help replace that volume and give a more normal contour. If you have small but numerous indentations, then most doctors I've read on Realself say fat is too globular and lumpy to be injected smoothly beneath a small indentation.

Rob I feel like in your case, all these extreme surgical procedures are more risky then actually helpful. I don't think you need any radical procedure. You have the kind of scarring and volume loss that reminds me a lot of Mr. Matt, and clearly subcision and suction helped him a lot. Of all the scar procedures, subcision is relatively affordable and actually EFFECTIVE.

Also, in the fat grafting pics on that doctor's site, notice that they all had significant volume loss in the cheeks. That is why fat grafting was appropriate. If say they had smaller, but numerous indentations, fat probably would not have worked so well. Isn't it also interesting how acne scarring can age a person through the loss of volume?

What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.

Images of fat grafting from a plastic surgery center in NYC (scroll towards the bottom of the page); http://www.lipostructure.com/procedure/scarring/

What is your opinion on these? They look wonderful, but I don't know whether or not to believe that this procedure would be permanent.

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For Rob, I feel like these scars are perfectly suited for subcision and volume replacement with fillers. In general fat doesn't seem great for small indentations, but are good for large areas of volume loss. For example, if your acne caused so much scarring that there is volume loss in the cheeks, ie sunken cheeks, then I can see how fat grafting would help replace that volume and give a more normal contour. If you have small but numerous indentations, then most doctors I've read on Realself say fat is too globular and lumpy to be injected smoothly beneath a small indentation.

Rob I feel like in your case, all these extreme surgical procedures are more risky then actually helpful. I don't think you need any radical procedure. You have the kind of scarring and volume loss that reminds me a lot of Mr. Matt, and clearly subcision and suction helped him a lot. Of all the scar procedures, subcision is relatively affordable and actually EFFECTIVE.

Also, in the fat grafting pics on that doctor's site, notice that they all had significant volume loss in the cheeks. That is why fat grafting was appropriate. If say they had smaller, but numerous indentations, fat probably would not have worked so well. Isn't it also interesting how acne scarring can age a person through the loss of volume?

Okay, I didn't understand that fat isn't great for small indentations. Thank you for clarifying that.

As someone who's had subcision performed on a rolling acne scar on the lower left side of my face, I can personally vouch for its effectiveness. I think it has the potential to benefit Rob greatly.

It is indeed interesting (and a bummer) how acne scarring can age a person through the loss of volume.

Edited by CherrySoda08
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+1 to subcision + sculptra. Finish it off with some facial hair and you'll be good to go.

Fat grafting won't do much for acne scars - since fat is too soft/palpable and sinks back down with the scar.

Your main temporary options are hyaluronic acid fillers - which are more for finishing touches and not overly deep scars and they last 6 months - a year OR something like sculptra/radiesse - which is more a deep filler and it works kinda like scaffolding attracting collegen to grow - it lasts about 2 years. Personally I think sculptra is the best filler to mix with subcision. The main goal of fillers isn't really to improve your result, it's moreso to prevent the scar bands from reattaching after subcision. Also a lot of doctors will mix different fillers together to give a better result.

For Rob, I feel like these scars are perfectly suited for subcision and volume replacement with fillers. In general fat doesn't seem great for small indentations, but are good for large areas of volume loss. For example, if your acne caused so much scarring that there is volume loss in the cheeks, ie sunken cheeks, then I can see how fat grafting would help replace that volume and give a more normal contour. If you have small but numerous indentations, then most doctors I've read on Realself say fat is too globular and lumpy to be injected smoothly beneath a small indentation.

Also, in the fat grafting pics on that doctor's site, notice that they all had significant volume loss in the cheeks. That is why fat grafting was appropriate. If say they had smaller, but numerous indentations, fat probably would not have worked so well. Isn't it also interesting how acne scarring can age a person through the loss of volume?

What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.

Edited by acnescar123
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Agree with everything except the Sculptra part. I think it's a terrible product with a checkered history of complications (lumps, granulomas) and plus it takes too damn long to show results. With hylaluronic acid fillers, what you see is what you get and you don't have to go through 5 sessions to get to your final results like with Sculptra. I think Juvederm Voluma is superior to anything out there right now available in the US market place. It lasts roughly as long as Sculptra, but with none of it's side effects and is fully reversible with an enzyme. There's no do-over with Sculptra and it's imprecise because you have to wait to see how much collagen grows. BTW, the collagen that they keep touting is really scar tissue that is the result of a foreign body reaction to wall off / encapsulate the Sculptra. I've mentioned it before, but Sculptra is just dissolvable suture material that has been powderized, and suspended in a solution before injection. The fact that it takes months for the collagen to grow makes it not a good "spacer" material to prevent scar bands form reattaching. You'd need immediate volume to fill that void. Also, like fat, Sculptra is better suited for global volumizing, not minute injections into individual scars. It can also suddenly start growing larger uncontrollably depending on how aggressive your body responds to the material. You could end up looking too overinjected.

+1 to subcision + sculptra. Finish it off with some facial hair and you'll be good to go.

Fat grafting won't do much for acne scars - since fat is too soft/palpable and sinks back down with the scar.

Your main temporary options are hyaluronic acid fillers - which are more for finishing touches and not overly deep scars and they last 6 months - a year OR something like sculptra/radiesse - which is more a deep filler and it works kinda like scaffolding attracting collegen to grow - it lasts about 2 years. Personally I think sculptra is the best filler to mix with subcision. The main goal of fillers isn't really to improve your result, it's moreso to prevent the scar bands from reattaching after subcision. Also a lot of doctors will mix different fillers together to give a better result.

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What kind of fillers are we talking here?

In my opinion they are worthless since they dissolve after few months and the scars reappear again.

Best solution here are the permanent ones but they come with some risks. Also a lot of doctors on realself claim that its difficult to get good results on acne scars with fat grafting.

Best results ive seen were done with silicone injections and they are permanent.

Images of fat grafting from a plastic surgery center in NYC (scroll towards the bottom of the page); http://www.lipostructure.com/procedure/scarring/

What is your opinion on these? They look wonderful, but I don't know whether or not to believe that this procedure would be permanent.

I agree, these results are great. The "before" pictures also show what the loss of volume due to scarring can do to our skin.. deep lines, similar to nasolabial folds.

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those results of that 37 yo guy are awesome i have the same type creases!

Please let us in the forums know when you've found doctors who perform the procedures you're interested in getting.

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I agree with everything Blahblah said about Sculptra. Do your research on horror stories and don't even risk it. I do not remember Sculptra's old brand name but you can probably figure it out via a Google search. I would look it up but I am on my phone.

You are far too young for a facelift, Rob, and the sagging isn't that noticeable. I wouldn't have noticed it if you didn't point it out. I have sagging skin too and consider it a part of aging. Going under the knife carries the risk of irreversible damage as well.

I vote for a few aggressive sessions of professional subcision and a safe HA filler, something that doesn't have the potential to create permanent raised scarring with a foreign material embedded in your skin. I question the ethics of any doctor who recommends Sculptra or silicone.

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