Tracking progress of my subcision treatments and a few other at home treatments. Lots of additional progress pictures and a video of me stretching and animating my left cheek in my albums.
Subcision was performed with 18 gage and 20 gage needles, saline was injected after the subcision.
Before/After 2 subcision treatments:
(8/9/2016) and (1/10/2017)
(8/9/2016) and (1/10/2017)
(8/9/2016) and (1/10/2017)
(8/9/2016) and (1/10/2017)
Approximately 3 hours after 1st subcision:
Skin Details:
- Age: 31
- Age of scars: 10-15 years
- Skin Type: Caucasian, Fitzpatrick 2.(My evaluation)
- Scar Types: Moderate(3) and Mild(2) per Goodman and Baron qualitative global scarring grading system, consisting of rounded boxcar scars and rolling scars. Tethered vs Non-Tethered? Most scars disappear completely or nearly completely if I stretch them far enough, or stretch from opposing sides of the scar at the same time. Some scars pucker when I animate.(My evaluation)
Treatment history:
- Smoothbeam (many) - 10+ years
- CO2 Laser - 10+ years
(I have no idea what improvement these laser treatments yielded, I took no pictures and have a very poor memory of my skin. I also had extremely unrealistic expectations, I don't think I would have been happy with anything less than 100% improvement at the time)
- Dermastamp 1.5mm (very mild treatment only on worst scars) - 06/29/2016
- TCA 12.5% peel, 2 layers - 07/17/2016
- Subcision 1 - 08/10/16
- Dermastamp 1.5mm - 10/28/2016
- TCA 12.5% peel, 1 layers - 11/17/2016 (Poorly done, gauze was too absorbent, not enough of the acid was applied to my skin)
- Subcision 2 - 12/13/16
Suction Device: Kangzhu 12-Cup Biomagnetic Chinese Cupping Therapy Set
Current Regimen:
AM
- Avalon Organics Intense Defense Cleansing Milk
- CeRave Moisturizing Lotion
- Neutrogena Ultra Sheer Dry-Touch Sunblock SPF 55
PM
- Reviva Labs Alpha Lipoic Acid Vitamin C Ester and DMAE Cream, every third or fourth day Retin A 0.05% instead.
(As needed Organic Jojoba Oil and additional CeRave Moisturizing Lotion. Also some Eucerin Eczema Relief given to me after subcision)
Vitamins & Minerals:
- 25 - 50mg Zinc
- 5000IU Vitamin D3
NeoCell Super Collagen Type I & III + Vitamin C (Only during subcision recovery)- Youtheory Collagen type 1, 2, & 3 (Only during subcision recovery) - trying this brand for 2nd subcision
Dr. Peter Rullan of Chula Vista, CA is the doctor who performed the subcision. He and all of his staff that I interacted with were great.
I know it's just a few hours since your subcision but your before and after picture looks simply amazing. Now that I think of it, I think the Dr injected me with saline which caused me to swell up substantially...much more than you did. I must have mistaken the saline he injected for HA filler and ended up not suctioning. Oh well...Next time i would skip the aspirin pre-subcison and definitely suction post-subcision.Today I believe is day 15 post-subcision for me. The swelling have all gone down, however, I'm still bruised and some of my scars have reappeared. I still have a couple of subcutaneous nodules that have subsided somewhat and I would say I have about 20-30% improvement in my scars at the moment. Anyhow...good luck in your journey and keep us updated. I will be following your post closely and look forward to hearing about your progress.
Congratulations on your treatment!! My scars are also a lot like yours so this is my treatment of choice as well. Enjoy this first week of swelling! It really makes the skin look normalish again, I love it. From the pictures it really looks like the doctor got to every scar so that's one good thing already. Keep us posted and good luck!
Yeah, I remember the swelling after CO2 so very well, was difficult having the scars reappear. For this treatment I am much more prepared and knowledgeable, so there wont be any surprises once the swelling goes down. There is a spot or two that look somewhat like depressions in the pictures but it is just blood/ink, everything is completely smooth at this point so I think all or nearly all of the scars on my cheeks and temples were treated.
24 hour update:
I took 500mg of Tylenol immediately after the subcision and didnt feel anything but some minor pain yesterday. Today there is no pain at all, just some tightness from the swelling which has already subsided a lot. I can see some minor unevenness in a few locations and some of the actual scar tissue that I have is more obvious now that it is not at the bottom of a rolling scar. I dont like sleeping on my back so that is one of the more annoying parts of this treatment for me. I intend to try and sleep on my back for at least the first two weeks to avoid applying pressure to the area.
4 hours ago, thepwhisp said:If you don't mind me asking. Where did you get your subcision done? Currently looking for a decent doctor. Thanks
Added the doctor's name to the original post.
I chose to not actively try to reduce my bruising, hematoma, swelling, or inflammation. There just was not enough info for me on the advantages and especially the disadvantages of taking Arnica, Vitamin K, Bromelain, or Aspirin during subcision so I took the conservative approach.I am still too swollen from the saline to know how my skin is responding and how suctioning will affect my skin, butI intended to maintain the hematoma at the location of the scars for as long as possible. I planned on suctioning as often as I needed to maintain a slight elevation in the scar, at this point I am a bit unsure though.
FIrst off, I am not sure how the saline affects the process. I dont see many of the dark purple pools of blood under the scars so I am not sure how much of the fluid under the subcised area is blood or saline at this time.
Second, I am beginning to wonder how effective suctioning will be when a large area is subcised. If a single scar is subcised and then suctioned, all of that blood pools under the scar as there is nowhere else for it to go. In my case, a lot of scars were targeted from a single entry point. So if I suction, all of that blood will likely just distribute itself wherever within that large "pocket".
72 hour update:
The right side of my face has mostly returned to a normal size, the left is still enlarged. I started suction on sections of my cheeks late yesterday, today I added my right temple. Still figuring out how much pressure to apply and all that, I have induced some bruising and I think raised one or two scars that were depressedbut have not elevated any of the scars above the skin level. Some don't seem to be affected by suction, could just be me learning how best to perform it and not applying enough negative pressure.
I've noticed two really small ice pick scars near my temples, from needle insertion I am assuming, not really concerned with them though. They are hardly noticeable and I think it is likely they improve over time. I have found two harder lumps forming, one on each cheek. One of them is visible, the other just noticeable by touch. I decided to apply a slight bit of pressure to them with my finger a few times and will probably continue to do so. I have not read about anybody doing this so early in subcision so I am not advocating anyone else to do it as well, just thought I might as well document what I am doing.
Day 5 update:
My entire face has basically returned to its normal size. I have been getting more aggressive with suction, usually a 4-5 times a day. I have yet to suction my left temple yet as it remained swollen the longest and is still perfectly smooth as best I can tell. I keep a rough count of passes to try and stay somewhat close to 8 - 12 as the study suggests, but will do less or more as I feel is needed. The diameter of the smallest cup is quite large compared to the nozzle used in the study, 16mm vs 5mm, but seems to work well enough. Not much else has changed, maybe a little bit more unevenness in my left cheek, but I have not seen a great deal of re-depression. The two lumps that have developed are still there, no change to them. I stopped bothering with trying to apply small amounts of pressure/massage to them as it didn't seem to do much beyond reduce their size for a few minutes. These next few days are the most critical, I'm cautiously optimistic though.
Your results are very impressive, thanks for taking the time to post and keeping us updated. Try not to stress over the bumps/needle insertion marks, I'm sure your surgeon can address them if they bother you after you are healed up. Looking forward to hearing how everything heals in the coming weeks. 
Still early in the healing process but I think it is a good sign that I only have a bit of re-depression so far. The first day or two of noticing the lumps did have me worrying a bit even though they are common after subcision. Not really stressing oven them now though, they usually reside on their own or like you said there are treatment options. Glad to post my progress, the people on here who shared their results are a large reason why I opted to have the procedure done.
Great recovery!
Does feel ridiculous, the suctioning, doesn't it? 
I find that sometimes it works better to use the suction device without a cup inserted, just using the smaller adapter for those smaller spots.
I hate to be that guy as I was also ecstatic after my first subcision but be realistic that most of it is swelling, not all, you'll definitely see great improvement, but some is. About the lumps, I wouldn't worry about them in the first 1,5-2 months and even after they may take a while longer to go away.
You are one good looking mf!
Keep it up, one of the best posts I've seen here in a while!
The recovery has been great, much easier than I was expecting. The suction is a bit awkward, especially at first. I had been thinking I would try it without the cup, maybe I'll give it a shot. You are right about not getting overly optimistic, I know what sort of improvement is likely. It is tough though, every day that passes and my face remains relatively smooth, it is odd how quickly that can start to feel normal.
Every day I've been feeling more and more like the results are going to be good, glad you guys think so as well. I went into this subcision expecting that I would follow it with a 2nd and 3rd, based on how everything has gone so far I won't hesitate to set up that next appointment once I've healed.
8 minutes ago, PCT14 said:Every day I've been feeling more and more like the results are going to be good, glad you guys think so as well. I went into this subcision expecting that I would follow it with a 2nd and 3rd, based on how everything has gone so far I won't hesitate to set up that next appointment once I've healed.
Give it 3-6months+ though. Let it do it's thing
Day 7 update:
Still going well, not much to add. More scars are now visible but not to a great degree. One scars on my right temple seems to have returned close to its originalsize, but this scar was more of a larger surface issue and is very different from all the rest. Might suction a bit less frequently going into the second week, still not sure.
Good luck with your healing ! 
I had subcision done in 2013 and it went really well ! I don't take pictures of myself/skin , so I honestly don't have anything to show you , but It did help. I am going to start doing mini subcisions at home. The lumps you have will go away by time if they haven't by now. I had a few lumps and I think they took about 6 weeks to go away. They weren't really noticeable , I could just feel them. Good luck and keep us updated my friend !
2 week update:
Almost all of my scars are still improved significantly and I don't recall reading about people experiencing worsening results after the two week point. Many of the scars re-appeared to some degree over the last week but it was expected. There is also one scar that appears worse to me at this time, but there is a lump next to it that might be affecting how it looks. I think the pictures make me look a bit more bruised and yellow than I do normally, in some light I cant really see any bruising. I can still see and feel some harder lumps but nothing that I am concerned about at this time.
I've been suctioning twice a day and still avoiding applying pressure to my face, the rest of my routine has been largely unchanged.
17 hours ago, PCT14 said:2 week update:
Almost all of my scars are still improved significantly and I don't recall reading about people experiencing worsening results after the two week point. Many of the scars re-appeared to some degree over the last week but it was expected. There is also one scar that appears worse to me at this time, but there is a lump next to it that might be affecting how it looks. I think the pictures make me look a bit more bruised and yellow than I do normally, in some light I cant really see any bruising. I can still see and feel some harder lumps but nothing that I am concerned about at this time.I've been suctioning twice a day and still avoiding applying pressure to my face, the rest of my routine has been largely unchanged.
glad to hear you are making progress. I'm about two weeks into my recovery as well. I'm glad your scars are improving. I also have noticed an improvement in my scars but i will wait a little bit longer before i settle with my results and am avoiding taking pictures. I also still have two lumps as you do but they seem to be fading with the passing days.
Looking forward to seeing our progress in months 1 and 2!
Looking ahead, do you plan on having another subcision treatment?
I do think I will have another subcision treatment. The procedure is cheap enough and I have not experienced the side effects like scarring at needle insertion sites or nodules that some people do. My rough plan for now is to wait a couple of weeks then needle a few times at 5 week intervals, maybe toss in a tca peel or two, and then have subcision performed in December.
I have not been watching the nodules I have close enough to say they are fading, but they are definitely not getting larger. Glad your experience with subcision has also been mostly positive, hope your scars continue to improve from here on out.
5 hours ago, PCT14 said:I do think I will have another subcision treatment. The procedure is cheap enough and I have not experienced the side effects like scarring at needle insertion sites or nodules that some people do. My rough plan for now is to wait a couple of weeks then needle a few times at 5 week intervals, maybe toss in a tca peel or two, and then have subcision performed in December.
I have not been watching the nodules I have close enough to say they are fading, but they are definitely not getting larger. Glad your experience with subcision has also been mostly positive, hope your scars continue to improve from here on out.
Thats good. Same here, i plan on having another treatment in October. I've needled in the past for quite some time (every month for about two years) and I haven't had the results i'd like so i thought i'd have subcision. Even with subcision, i'm not expecting too much as i know it will take several treatments before any significant improvements. i know that another user had a post about subcision and saw amazing results at two weeks but later at approximately a month after his scars returned. A lot of it has to do with the swelling after the subcision so it appears as though the collagen has repaired itself but when the swelling goes down some of the scars are more noticeable.
I'll attach the link to his post http://www.acne.org/messageboard/topic/256333-combo-treatment-subsicion-fraxel-re-cell/?page=1
It would be great if we had updates on his post as it was done in 2009.
4 hours ago, mr.wantsgreatskin said:Thats good. Same here, i plan on having another treatment in October. I've needled in the past for quite some time (every month for about two years) and I haven't had the results i'd like so i thought i'd have subcision. Even with subcision, i'm not expecting too much as i know it will take several treatments before any significant improvements. i know that another user had a post about subcision and saw amazing results at two weeks but later at approximately a month after his scars returned. A lot of it has to do with the swelling after the subcision so it appears as though the collagen has repaired itself but when the swelling goes down some of the scars are more noticeable.
I'll attach the link to his post http://www.acne.org/messageboard/topic/256333-combo-treatment-subsicion-fraxel-re-cell/?page=1
It would be great if we had updates on his post as it was done in 2009.
Ernesto had 90 % improvement (subjective), after a few weeks 55% and then after8 months 75%. He was very happy with his results.
Sure there can be some swelling, I believe most results are permanent.