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RaptorPilot

I'm Ready to Fix My Acne Scars

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I'm ready to take another shot at improving my acne scars!
About 15 years ago I did laser resurfacing on my face, and it helped improve the scarring quite a bit.  I believe it basically changed the scars from box type to rolling...  Until recently, the scars were really not very noticeable and I was completely fine with them.  Now, I am 41 years old.   My skin is sagging from age, and from weight loss and the scars are much more apparent to me... at least I feel they are.
 

Here are some current photos, taken in the worst possible lighting.  


IMG_7760.JPGIMG_7761.JPG

(I was stung by a wasp under my right eye about 90 seconds after I took these photos!! >_<)

I've seen one dermatologist who suggested Restylane filler, to help return the volume to my face.  I gave it a try and it worked, but only for about 1 month before the scars came back - no where near the "up to 12 months" he quoted.  I actually went back to the same derm and decided to try filler again, and it lasted about exactly the same... 1 month.  He said that if I keep doing filler, it will improve the scars over time.. has anyone else heard of this?  I have a feeling he is just pushing the filler because it is so easy.

I've been doing quite a bit of research, and it seems that Subcision is an excellent option for me.  I'm very concerned about the recovery, even a week is hard for me to clear...  Perhaps if my bruising is minimal, I can just go on with my life.

I'm thinking of starting small to see how see how the recovery goes.  Maybe just hitting the big ones on each cheek during my first appointment.

When I got the filler injections, I did not have any marks or bruising at all.  The first time, I heard a few pops like I've read others describe... but not on the second time.  Maybe this is a good sign for what I can anticipate as for bruising.

Anyone have some feedback or suggestions?
 
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I feel like your derm's trying to fool you into doing the same thing over and over again. If you haven't seen noticeable results after the fillers have gone away, there's no way they're somehow magically going to fill your scars up the more you do them. I have never seen worthwhile improvement from anyone who's done lasers. But maybe someone else has. I've seen some really amazing results from subcision and TCA, but the results from these seem to depend heavily on your diet and healing response. The price of a procedure never suggests its effectiveness although it's easier to believe that expensive treatments are better.

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2 hours ago, RaptorPilot said:

I'm ready to take another shot at improving my acne scars!
About 15 years ago I did laser resurfacing on my face, and it helped improve the scarring quite a bit.  I believe it basically changed the scars from box type to rolling...  Until recently, the scars were really not very noticeable and I was completely fine with them.  Now, I am 41 years old.   My skin is sagging from age, and from weight loss and the scars are much more apparent to me... at least I feel they are.
 

Here are some current photos, taken in the worst possible lighting.  


IMG_7760.JPGIMG_7761.JPG

(I was stung by a wasp under my right eye about 90 seconds after I took these photos!! >_<)

I've seen one dermatologist who suggested Restylane filler, to help return the volume to my face.  I gave it a try and it worked, but only for about 1 month before the scars came back - no where near the "up to 12 months" he quoted.  I actually went back to the same derm and decided to try filler again, and it lasted about exactly the same... 1 month.  He said that if I keep doing filler, it will improve the scars over time.. has anyone else heard of this?  I have a feeling he is just pushing the filler because it is so easy.

I've been doing quite a bit of research, and it seems that Subcision is an excellent option for me.  I'm very concerned about the recovery, even a week is hard for me to clear...  Perhaps if my bruising is minimal, I can just go on with my life.

I'm thinking of starting small to see how see how the recovery goes.  Maybe just hitting the big ones on each cheek during my first appointment.

When I got the filler injections, I did not have any marks or bruising at all.  The first time, I heard a few pops like I've read others describe... but not on the second time.  Maybe this is a good sign for what I can anticipate as for bruising.

Anyone have some feedback or suggestions?
 
I think you look good regardless of scars. I mean, if you want to fix them that's your choice but I don't think it really takes away from you.
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I agree, you a great candidate for subcision. The recovery for subcision is short enough, especially if you do not bruise easily. You might be able to get away with having it performed on Friday and returning to work on Monday.

One of the biggest issues with subcision is the scar reattaching to early, preventing the scar from being allowed to raise up. To prolong attachment once the scar is cut, suction or fillers are often used. You may actually want to try subcision + filler. It is more expensive, but should still offer good results with a quick recovery.

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I had very similar scars to you and after four subcision and suctions my skin has definitely improved. That's your best bet.

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53 minutes ago, PCT14 said:

I agree, you a great candidate for subcision. The recovery for subcision is short enough, especially if you do not bruise easily. You might be able to get away with having it performed on Friday and returning to work on Monday.

One of the biggest issues with subcision is the scar reattaching to early, preventing the scar from being allowed to raise up. To prolong attachment once the scar is cut, suction or fillers are often used. You may actually want to try subcision + filler. It is more expensive, but should still offer good results with a quick recovery.


I get subcision in two days. I am thinking subcsion with TCA cross for my scars, similar to OP, but with lots on temples too.
Would subcision plus a filler work better? Can you do three treatments on the same spot?
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3 hours ago, Dan34 said:

I had very similar scars to you and after four subcision and suctions my skin has definitely improved. That's your best bet.

How was your recovery after each subcision?  How many days did you have bruising, or the needle holes?
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18 minutes ago, RaptorPilot said:
3 hours ago, Dan34 said:

I had very similar scars to you and after four subcision and suctions my skin has definitely improved. That's your best bet.

How was your recovery after each subcision?  How many days did you have bruising, or the needle holes?

Took around 10 days before I felt comfortable going out in public, but I also had prolonged bruising for up to a month. It seems like you've suffered long enough and if you're mentally strong then going out in public with some bruising is not a big deal and worth it for the end result. 
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I had subcision on the 5th of this month. I'm still a little bruised under the eyes and some yellow spots on my face and I showed up to work today. I had to wear some makeup to cover some of the bruising. >_<

Edited by ambergris
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The quickest route would be subcision and a more robust filler like Voluma as suggested above.  Permanent fillers like Bellafill are an option since you already know that your scars can accommodate filler material.

Important question though, do you find that the filler actually dissipates or does it get displaced and moves to the edges of your scars?  That might explain why the filler seems to go away so quickly.  It may actually still be there but the scar tissue is so dense in the middle of the scar that it pushes the filler to "donut" around the actual scar.   In this situation you would absolutely need to subcise and create a pocket underneath each scar and then fill it with a stronger, more robust filler.  If you put permanent fillers in like Bellafill without subcision to release those tethered bands that are pulling your scars down, it will also get displaced.   Bellafill is not easy to fix if it is over-corrected.



 

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On 7/13/2016 at 8:02 PM, guzm0268 said:

I get subcision in two days. I am thinking subcsion with TCA cross for my scars, similar to OP, but with lots on temples too.
Would subcision plus a filler work better? Can you do three treatments on the same spot?
How did your subcision go??
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1 hour ago, RaptorPilot said:
On July 13, 2016 at 10:02 PM, guzm0268 said:

I get subcision in two days. I am thinking subcsion with TCA cross for my scars, similar to OP, but with lots on temples too.
Would subcision plus a filler work better? Can you do three treatments on the same spot?
How did your subcision go??
Its went good, i have a lot of swelling and a few lumps but that is to be expected (especially since it covered larger areas) but I've been reading that all the swelling is good. i advise to have plenty of down time , i have 10 days hope its enough since i also did TCA cross. 
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On 7/14/2016 at 1:42 AM, beautifulambition said:

 Your doctor should know better. It's tethered down, so how can it lift (most likely it doughnuted or got lost in the fat loss of aging). 


Perhaps when I first went to him, I was concerned about fat loss in my face which is why he pushed the filler...  but I am much more concerned with the shadowed pits then I am with face volume.  Perhaps the filler is still there, just was pushed away from the scars making them look even deeper!
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On 7/19/2016 at 11:36 PM, beautifulambition said:
Raptor, Can you take your individual scars between your fingers and pull them tight making them disappear. IF you can as we mentioned above you need a high particle filler Voluma (1.5years) or Perlane / LYFT. A pocket under each scar must be created with subcision followed by filler. In the long term you can do Bellafill / Artefill (permanent) if this works for you. Your filler doughnuted or you did not have enough to make a diffrence. IT looks tethered, filler will not correct tethering, just freely lifting skin.  Laser does not make fat loss volume or get rid of tethering. 

I see you live in the bay area, what part do you live in. I'm a local, different doctor to recomend around here ;-P

I'm from South Bay, Campbell.  I've seen dr morganroth a few times, both he pushed and I took the silk filler.   I know he does quite a bit of subscision as well. Edited by RaptorPilot
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I have my first subcision scheduled for Thursday!  I am excited to see if this surgery will improve my scars.  I'd like to do everything I can to minimize the recovery time and bruising.  I was told not to take any blood thinners, and avoid red wine.  I also read that I should take a supplement called  Arnica Montana.  Any other suggestions to help minimize pre and post bruising?

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55 minutes ago, RaptorPilot said:

I have my first subcision scheduled for Thursday!  I am excited to see if this surgery will improve my scars.  I'd like to do everything I can to minimize the recovery time and bruising.  I was told not to take any blood thinners, and avoid red wine.  I also read that I should take a supplement called  Arnica Montana.  Any other suggestions to help minimize pre and post bruising?


Prolonged bruising is actually what you want otherwise your scars will retether and you won't get much improvement.
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Well, I made it in for my first subcision on Thursday August 25th.  The appointment was fairly easy, my doctor again suggested restylane filler instead of subscision.  I had this done twice earlier this year, on his recommendation... he said that the filler would still work to permanently improve the scars over time, but I felt that it was having only a very short term temporary improvement and no permanent improvement.  I think he likes pushing the filler, because it is very easy for him to do.

The subcision procedure was fairly straight forward.  The numbing shots hurt a little bit, but not bad.  The operation was painless and fairly quick, he did about 40 scars.  I did not really hear the "popping" sounds that others have described, but I did hear some sounds that I would describe as more of a "grating".  The doctor mentioned that some scars were "soft" under and that there are many reasons that could happen... but he didn't explain.  I'm guessing that means there was no scar tissue to break up, and I will likely see no improvement.

I've made some photos to document my journey.  
Here is my before photos, I found the worst possible lighting to show shadows.  When I am about 4 weeks post, I will try to get more photos in the same conditions.
Before.jpg
Here is what I looked like immediate post surgery.
Post1st.jpg
Here is where I am at right now, worst bruising showing on my right cheek - especially that one spot.  However, that is good because that was one of my deepest scars.  I am guessing I will have that bruise for another week...
Post1st4days.jpg



The swelling is starting to go down.  I'm guessing the bruising will be gone this week, and my face will look like before... but hopefully the final stage of healing will work to shallow some scars.

I did not do anything really post, just an ice pack the night of and the next day.  There wasn't any pain.  I haven't really cared about how it looks, I've still been going out every day.  People notice but no one has said anything, my wife says it just looks like I have a dirt smear on my cheek.
 

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He moved on with his life as most people do when they have success here and find proper treatment. We have outlined all these techniques for scar types when we help posters and they are covered in the FAQ. Filler and subcision is offered as a solution often

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On 10/13/2017 at 7:05 AM, beautifulambition said:

He moved on with his life as most people do when they have success here and find proper treatment. We have outlined all these techniques for scar types when we help posters and they are covered in the FAQ. Filler and subcision is offered as a solution often

^Yes, but at least one last sunny day picture would have been helpful to see what one subcision session did for him.  He did say a year ago he'd post in 4 weeks.  Is there anyway to recall him? ^_^
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@Urbanite Why would anyone's pictures matter other than show and tell...

1) They are not you, you will heal differently and react differently to treatments. You could have better or worse results, (results may vary). Something might work for him that won't work for you, etc.
2) The dude took this pic 4 days after you realize with all that swelling even the most severe scars do not show up in any sort of light right.
3) I can make you look the same, just like Hollywood, we pump you with lots of fillers until your cheeks pop up and then wallah no scars show. Scar treatment is never one and done, it takes a long time to heal from these procedures, things can change in that period. You need several subcisions to see results. As I recall helping him he had filler after which plumped him up quite a bit, until his further subcisions. He was going to only subcise when the filler ran out. As you know it lasts many months.
4)He did Infini treatments as well.
5) When you move on with your treatment, why would you come back here haha, you live in happy bliss sans any memory of the hard times, they are not paid like Drs to Photoshop or do photo shoots of pictures. Most doctors use these 4 day after pics as they look all nice and plump (swelling). 5)This is why I say never do filler when your too swollen, it's like poking in a pin-cushion. 
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8 hours ago, beautifulambition said:
@Urbanite Why would anyone's pictures matter other than show and tell...

1) They are not you, you will heal differently and react differently to treatments. You could have better or worse results, (results may vary). Something might work for him that won't work for you, etc.
2) The dude took this pic 4 days after you realize with all that swelling even the most severe scars do not show up in any sort of light right.
3) I can make you look the same, just like Hollywood, we pump you with lots of fillers until your cheeks pop up and then wallah no scars show. Scar treatment is never one and done, it takes a long time to heal from these procedures, things can change in that period. You need several subcisions to see results. As I recall helping him he had filler after which plumped him up quite a bit, until his further subcisions. He was going to only subcise when the filler ran out. As you know it lasts many months.
4)He did Infini treatments as well.
5) When you move on with your treatment, why would you come back here haha, you live in happy bliss sans any memory of the hard times, they are not paid like Drs to Photoshop or do photo shoots of pictures. Most doctors use these 4 day after pics as they look all nice and plump (swelling). 5)This is why I say never do filler when your too swollen, it's like poking in a pin-cushion. 

^Yes, yes.  And that's why I'd hoped after the swelling went down we could see what a session of subcision did for him.  It's very informative even though everyone is different.  His scarring is VERY similar to mine.

I wish he would have followed up.
 
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On 10/13/2017 at 8:05 AM, beautifulambition said:

He moved on with his life as most people do when they have success here and find proper treatment. We have outlined all these techniques for scar types when we help posters and they are covered in the FAQ. Filler and subcision is offered as a solution often

Would love to see the final improvement... 

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