This is a really long entry documenting my experience. Subcision part is in bold. *
I've had acne since i was about 13 years old. I'm currently 25 years old and throughout the years I've learned how to minimize my acne to the best of my ability. My father had really bad acne growing up as did I. Experts say that acne has nothing to do with diet, however I tend to disagree. I've lived with it for more than ten years now and it wasn't until recently that I've learned so much about it.
Carbohydrates, alcohol, dairy, gluten, stress and lack of sleep are all contributors to my acne. My diet is pretty clean so the breakouts are not like they used to be however I still have acne scars.
Anyways, on to the acne scars..
I believe it was in 2014 when I started looking into working on my scars. Initially i tried chemical peels such as TCA peels (in different strengths) and they helped with my appearance as they helped with shedding of the older skin and revealing newer skin so i had less breakouts. I didn't know that the chemical peels were not helping the scars very much.
Then I discovered that the scars would need to be addressed subdermal and bought a ninety dollar Micro needling pen on eBay (MyM I believe). The idea behind the micro needling is to use the needles to break up the collagen fibers underneath the scar so they can remodel and fill in.
So I continued to use the micro needling pen as i saw some (not much improvement) and figured that I would need a stronger Micro needling device because maybe the needles werent penetrating the skin the way they should be so then in 2015 I purchased the Derminator from vaughter wellness (owndoc) and noticed the difference in the design of the system. Again, I saw some minor improvements in my skin with the use of one needle 2.25mm setting. After about a years worth of use, I eventually realized that a lot of the improvements may have been some temporary swelling so I was a bit disappointed.
It wasnt until about May 2016 or so that I realized that I would need help. Help from a professional as my acne scars were a bit deeper than the average and would need to be medically treated. Ive looked into treatments such as fillers, laser,TCA Cross, micro needling and subcision and found that subcision would be my best option for the type of scars that I had. After watching so many different acne scar videos, reading different reviews on realself.com, I finally built up the courage in July 2016 to set up a consultation with Dr.(plastic surgeon) as he was one of the few doctors who performed subcision for acne scars. We set up an appointment to have subcision for my acne scars on August 8th, 2016.
Weeks prior to the subcision treatment, my skin was relatively clear (aside from the scars) that I didnt mind what I ate too much as I was a bit too comfortable in my own skin that I had a few breakouts because of the trail mix I ate (m&ms, peanuts, etc). So I had a week or so to really clean up my diet, get some good sleep to heal the skin prior to the treatment.
So on Monday, August 8th, 2016, I drove (approx. 45 min) for my treatment. Nurse prepped me by numbing the skin through the five injections. Then Dr. went to work on my skin. It felt a little strange as Ive never been this numb on my face before. Dr. would ask if I felt anything and I told him surprisingly I couldnt really feel anything. The subcision treatment looks pretty intense but fortunately the nurse did a good job with numbing my face that it was painless. I did hear the noise from what sounded like the breaking of the collagen fibers under the skin. The whole process was approximately an hour from start to finish and I paid $500.00. I was prescribed antibiotics and prednisone (steroid). My face was red and swollen and it was difficult to blink my eyes as I was pretty numb, but the blinking wasnt a big deal, it was the driving part that was difficult because of my vision (I drive a stick shift car and needed both hands).
Later approximately three to four hours after the procedure the numb was starting to wear off and I began to feel a lot of pain. The pain was in my cheeks and in my head (headache). It hurt pretty bad but after I had some food, my prescription and took an antibiotic and some ibuprofen I felt much better and really no pain since this treatment day.
Tuesday, Day 1 I looked like a chipmunk as my cheeks were completely swollen and my face resembled that of Quagmire from family guys. On Thursday, day 3, I still had some swelling and the bruising started to settle as I developed a black eye from the bruising. Perhaps if I really needed to go back to work I could have but I took the next three days as sick days to heal more comfortably. By Saturday, day 5, I was back at work and really the main side effect I had was a black eye and some minor swelling on my left and a lump on my right cheek. You can still see the scabs from where the needles were inserted (two points) on both sides of my face but its not a big deal.
Today is Wednesday, day 9 and the swelling on my left cheek is nearly gone, the black eye is not as bad and the lump on my right cheek is still there but not as large. Im thinking the lump will eventually go away with by a few more weeks. The lump on my right side is a bit hard to the touch but as of right now Im not too worried about it. I just had an intense treatment last week and my body is doing what it needs to do to repair itself. I was expecting some side effects and Im just glad that the majority of the swelling is gone so I can deal with a minor bruise under my eye, a yellow-ish tint to skin and a small lump for a bit.
Ive read other acne.org users blogs and posts and was inspired to also document my journey so that I may help others that could use the help and that could learn from my experience and mistakes. I know that acne and acne scars are very tough to deal with as its emotionally taxing and I want to help others out because I too looked for reviews and blogs and anything and everything that I could learn from to help treat myself.
I wanted to be thorough so that I may help answer peoples questions because Im sure eventually you may have the specific questions and you can always look back and hopefully see what my experience in that situation was like. Im expecting about a two month healing process before I may evaluate and consider what my next move is. I plan on having another subcision treatment done and I have a follow up on Monday, September 12th, approximately a month after. My plan is to have a few subcision treatments done to address the scarring and then get on a low dose of isotretinoin (accutane) to treat my acne and help minimize sebum production. Im not doing both because isotretinoin has many side effects including slower wound healing which would not be a great idea if I have a subcision treatment while on isotretinoin.
Anywho, I wish I had not broken my phone so that I may have taken higher quality photos of my skin during the healing days of subcision but these are from an iPad 2 so quality isnt as great.
Ill probably write again either in a week or month, depending on when I feel it will be necessary.
i'll attach some before/after as i go. (below will be about a week before (end of July 2016 ) and day after subcision (tuesday 08.09.16)
1 hour ago, PCT14 said:A lot of what you describe is similar to what I experienced in my subcision treatment. Looking forward to your followups in the next weeks. Best of luck.
Thank you. I just checked out your post as well. I know i wrote a lot but I'm sure someone who will read this will find some benefit to it so they have an idea of what to expect. Likewise i look forward to your progress as well. I'm expecting to have slight improvement and know this may not be the only treatment I have done. Good luck to you too.
August 24th, 2016.
Wednesday, day 16:
I've been trying not to update this post too much so that i can get to the point and summarize what i've been experiencing after my subcision treatment. As of today, I feel like I'm seeing improvements in my skin. I find myself taking several looks at the hand mirror because i see improvements. I'm not expecting much from it even though I'm thinking positively. I feel that if you set your expectations too high then you may find yourselfdisappointedlater on. I understand and i'm aware that its only two weeks into the treatment/healing process and that this is not the end result (another reason whyi try not to over-analyze each day with a microscope). I feel as though as my skin is making progress because since i've been trying to address the scars (past two years or so), I've been taking pictures, looking in the mirror and just trying to get familiar with my skin. I'm aware of my skins condition and find myself taking a second look in the mirror because its almost as though i'm seeing something thats not there; seeing improvement. Its almost as though i'm doubting what i'm seeing because its good news (too good to be true). Again, i understand that its only two weeks and it takes time for the swelling to go down, collagen to rebuild etc etc. I understand all of that my friends, which is why i won't upload any photos just yet as they may be misleading for some people and I've seen people posting negative comments on someone elses posts because of these "misleading posts" so I will not give anyone ammunition to do so on mine. Anywho, i feel as though my skin is improving and i'm not here to convince anyone because at the end of the day its me who wears this skin.
As far as what my skin looks like right now:
I still have two lumps and i'd be lying if I said i didn't. It was expected and I'm not afraid of them as it is typical. I believe the lumps will go away with time as it is part of the healing process so I will not let that affect my thoughts on the treatment. The lump on my left cheek is nearly gone and you can't really see it on my face but when i press down on my skin with my fingertips i can feel it (its not very large). The lump on my right side is slightly more protruded and is the size of a quarter. It doesn't hurt unless i press down on it really hard and even then it's not necessarily painful its just uncomfortable (feels like a bruise). The lump is still there but I believe its fading because it seems to get smaller when I wake up and touch it. Really the only way to know its fading is by touch as i don't really feel it on my face. It feels slightly numb on the surface of the skin (epidermis). It resembles a cyst in the way its shaped and feels with finger tips i'd assume but its definitely not a cyst from what i'm aware of. Anywho, I can still feel some swelling on my temples so i know for this my skin is not %100 fully recovered. my temples feel a little plump and again, feel soft and squishy.
I'll admit that I'd truly appreciate the progress thus far if I didn't have this blemish on my forehead. I've had a few nights of bad sleep and we all know that sleep deprivation is not good for acne and the skin. Sleep deprivation results in a lower immune system and increased stress (cortisol) which influences inflammation in the body and increases sebum production--> acne/blemish etc. SOO aside from that, I'd be pretty happy during this stage of the progression as my face is not swollen like a chipmunk anymore. I will work on my sleep and continue to eat clean.
I ordered Zinc to help assist with my battle with acne. I've taken Zinc in the past and I've noticed improvements. Zinc helps immune system (reduced inflammation) and helps your body manage the hormone levels (acne is hormonal).
Depending on how things go within the next few weeks or so (acne management), I plan on having a second subcision treatment possibly in October (two months post first treatment). I say depending on how things go because I'd imagine a lot of us can relate when i say we are in a dillemma when it comes to combating acne with acne scars and one must choose either or sometimes. At least thats the case in my situation because I'd really like to take Isotretinoin (commonly known as accutane) to address the acne (even though my acne is not nearly as bad as it once was years ago). Although my skin doesn't break out AS bad as it once did, I still have breakouts I deal with. I feel that if I have a course of Isotretinoin I may better address the acne itself so that it stays out of the way of me trying to address the acne scars (which are a result from acne), so it only makes sense. HOWEVER, the bad thing about isotretinoin in this situation is that its approximately a six month course and one must be off Isotretinoin anywhere from six months to a year because of the decreased healing rate while on the medication (subcision is all about healing).
If i can manage to keep my acne to a minimum, i plan on having at least one more subcision treatment (three total would be ideal) because if i start taking isotretinoin that means i'll have to put aside the scar treatments for about a year. I have my next appointment (follow up/consultation i believe ) on September 12th so I'll most likely know by then if I plan on having my second treatment possibly in October.
If I missed something, I apologize, but I have a question. Did you have the subcision done on the forehead, or did you just have it done on the cheeks/ temple areas? I feel like I have very similar scaring on my temple areas, I hope your results are permenant, as they look really good so far.
On 8/30/2016 at 1:32 AM, McPoopy Scoopies said:If I missed something, I apologize, but I have a question. Did you have the subcision done on the forehead, or did you just have it done on the cheeks/ temple areas? I feel like I have very similar scaring on my temple areas, I hope your results are permenant, as they look really good so far.
I did not have subcision on my forehead. i don't have too many scars on my forehead. The treatment was done primarily on my cheeks and temples.
September 1st 2016,
Thursday ,Day 24 post subcision Week 3 -SUBCISION UPDATE***
So far i feel as though i'm slowly seeing some progress but its no miracle for sure. I'm sure my skin is still remodeling itself underneath and improving the collagen production. I have not taken any pictures yet. When i went in to get the treatment done, pictures before the treatment were taken and i plan on having some taken on the 12th of september (when i have my followup).
its difficult to focus on the scar improvement because i get the occasional blemish here and there and right now i have them on my forehead. It seems as though my sleep schedule is causing me to produce more sebum. I feel if i had completely clear skin i would be able to focus on recognizing the scar improvement. I plan on having a second subcision treatment done in october this year (2016) which would be two months post first subcision but that may change as i also plan on taking isotretinoin to clear up my skin.
As far as the lumps go, the lump on my left cheek feelsabout the size of a dime. The larger lump on my right cheek feels about the size of a quarter and appears to be fading.
When i press on my skin it feels as though there is still some bruising underneath the skin which i feel is good because perhaps the skin is still healing and will continue to repair itself.
I'm not in any pain.
I will continue to update on a weekly basis and plan on taking a picture either at one month or two months to see the progress.
September 8th, 2016,
Thursday, Day 31, Week 4 Post 1st subcision for acne scars.
So far, I feel as though my skin has made some significant improvements in the past week. Perhaps its due to the build up of collagen over time or i could feel this way because my skin is clearing up and Im able to see smooth skin.
I have not uploaded any pictures which, again, purposely have left the pictures out because I would like to see the realistic results and not misleading micro swelling. I have taken pictures and video quite often with my galaxy note 5 (that I just got last week) to track progress because as we all know, its all about lighting and angles. We know that mirrors in front of our face is only from our perspective and is merely a reflection. To get a sense of improvement I feel one needs various perspectives in order to truly and honestly assess the improvement. So Ive been taking pictures every so often just to try to capture my worst sides and angles and surprisingly I find myself taking many pictures. When you begin to doubt the mirror thats one thing but when you begin to doubt your phones quality of capturing pictures and video thats another. Perhaps my skin has been making improvements and i need to stop blaming the mirror or phone for "false improvement". Im not going to expect much, as I do not wish to set myself up for disappointment but I will take whatever improvement comes with this.
I plan on continuing my journey to repair years worth of damaged acne scarred skin on the face to the best of my ability. Its important to be positive and not give up. I know that my skin is far from where I would like for it to be but Im honest about it and try to focus my energy on getting it to where it needs to be.
My sleep is decent, I do get bad nights of sleep at times but then other nights, (like last night) I get about 8-11 hours of sleep and feel much better when I wake up. Sleep is great for ones health as it repairs the body. My diet is strict as it usually is and my skin is showing and appreciating it. Once again, I stay away from high glycemic foods, sugar, milk, meat, oils, etc. I eat a lot of dry oatmeal and blueberries, pinto beans and lean chicken breast. Ive also been taking zinc (optizinc-zinc monomethionine complex), anywhere from 50-mg to 100 or so and I feel it too plays a huge role in my skins improvement.
The lump on the left side of my cheek is pretty much gone and the lump on the right side is almost gone as well. On the surface you cant see either one but you do feel them if you press hard enough and you do feel it underneath the skin. The lumps do not hurt. The lumps on the right and left side are about the size of a dime when I press the skin with my fingers.
As I move the skin around on my face, specifically my temples, I can feel some bruising underneath which is a great sign in my opinion as to me it indicates that it is still healing and have more room for improvements. I do plan on having another subcision treatment done in the future and planning on a month from now because I would like to start a low dose of isotretinoin two months after my second subcision.
I have my follow up next week on Monday, September the 12th, 2016, so Im interested to see what we will decide after that.
Tuesday, September 13th 2016,
Yesterday I had my follow up with Dr. John L Burns.
We took pictures of a month after the treatment which i will attach below. But most importantly, I was advised that having a subcision treatment next month would be too soon. I was looking forward to having another subcision treatment as I know my skin will need several treatments but it would be too soon as the subcision was very intense on the skin. He did however advise that i may have a subcision treatment in about six months from now. Although I would like to have another treatment, I also want to start isotretinoin. My skin produces sebum in excess i feel and i would like to try to addressmy skin problems to avoid causing any more scarring to the skin. I realize that i should have started on isotretinoin long long ago so that by now i may just treat the scars but i was not informed on the matter. Now i will be deciding on whether or not i would like to wait on the isotretinoin or take the isotretinoin however it will put me out for about a year til my next subcsision treatment. I will give it a few weeks to make my decision.
For now, i will upload two pictures, one before and one after to compare the subcision treatment. This is a month comparison. I wanted to try to give people honest results which is why i didn't upload any pictures until now. i understand that my skin may change with the following months but for now this is what i'm expecting. its not a significant improvement but i feel as though there is slight improvement. I will be patient and continue to stay on the path to improve my skin.
Tuesday, September 27th, 2016.
Day 50 i believe.
Initially my progress seemed to be apparent within the first month. I'm not sure if my skin will continue to improve but i know that now that some time has passed, its difficult to see the progress. I'm not sure how much improvement my skin has made. I will admit that I have been taking a large amount of Zinc to avoid breakouts. Along with supplementing with zinc, i would drink a lot of water and i feel that might have affected the quality of my sleep. While i was on Zinc, i slept fewer hours and that may have also affected the healing rate. Occasionally i feel some tightness on the areas that were subcised which may be a good thing. I'm hopeful that the tightness on the skin may be an indication that the skin is still healing. It's not quite two months after the subcision treatment but i know that i will need to wait til the six month to have my next subcision treatment. I'm aiming for around four treatments because i know my scarring will not fade with just one treatment. As mentioned earlier, i know this is going to be a battle and i will continue to be patient. Last week I ate a lot of popcorn which has a very high glycemic index. I feel as though the popcorn caused my skin to breakout. I'm taking Zinc again and i'm already improving and the breakouts are healing. I look forward to the months to come as I think i will delay the isotretnoin treatment for now because of the affect on wound healing.
On 9/10/2016 at 6:41 PM, mr. matt said:Great journal! I wish you great success with your recovery.
thank you. i know i have a long road ahead of me.
Matt,
I noticed you have great skin and have had treatments in the past. Your progress is one of the best out there. Do you have any advice?
how soon did you start seeing significant improvements? I want to have several subcision treatments but my doctor advised to wait six months before the next one. How frequent did you have yours?
My adviceis to be patient with the progress. Collagen and elastin production takes weeks and typically months.
I also recommend a healthy diet with lots of exercise. Why exercise? It forces the blood throughout your arteries,veins, and capillaries and allows the growth factors, hormones, vitamins, etc., to spread where they are needed.
Supplements such as zinc and topical vitamin c are also important to the production of collagen and elastin.
Consider needling if you are not already doing it. I also found that the chemical peels that I did also jump started the collage production. I knew that I was making major progress when my dermatologist and his nurse complimented me on my youthful looking skin.
Finally, wear sunscreen everyday to protect your skin. The collagen remodeling process is one that does not occur overnight, but takes months to complete. The wait is worth it.
Thank you for all of your replies.
I'll be honest, I'm ok with being patient as i know that it will take time. On that same note, in my opinion, its difficult to manage my acne, especially because acne is what gave me the scars to begin with. I would like to start isotretinoin to clear up my skin but there are a lot of cons to taking isotretinoin when it comes to treating the scars. I know what breaks me out; dairy, high glycemic food, omega-6, stress and lack of sleep.
I haven't been posting weekly because I don't think weekly updates are necessary because i'm aware that the collagen production is more of a gradual and long term process. I look forward to the next few months ahead to see what kind of improvement my skin makes. I plan on having my next subcision post six months after the first (sometime in february 2017).
Thank you for the reply Mr. Matt. I've noticed you're one of the few who have been consistent with your posts and you've made dramatic improvements.
I appreciate the support from everyone else as well.
Just a sidenote, I think you should prioritize acne control and start isotretinoin/accutane if you're starting to breakout. Take it from my personal experience, you don't want to end up having more scars because you were trying to treat your current ones and stopped your accutane or whatever you were doing.
15 hours ago, somethingsomethingagain said:Just a sidenote, I think you should prioritize acne control and start isotretinoin/accutane if you're starting to breakout. Take it from my personal experience, you don't want to end up having more scars because you were trying to treat your current ones and stopped your accutane or whatever you were doing.
Hmm. Ive been thinking about starting low dose isotretinoin. Ive been hesitant because although I do want to start isotretinoin, I also want to have my second subcision treatment simply because Ive read that one must wait 6 months to a year post isotretinoin prior to having any treatments done. My acne isnt breaking out severely, just your occasional breakouts here and there but it is annoying. It would be nice if I could be on low dose isotretinoin whiles continuing treating my acne scars.
55 minutes ago, Yola4 said:Have you considered doing the subcision with suction technique? The addition of suction seemed to be beneficial for some people. I believe Mr. Matt was one of them.
Good improvement so far. I hope you continue your journey and keep us updated.Good luck
53 minutes ago, somethingsomethingagain said:You know your skin better than anyone else so do what you think is best.
My acne, though, starts very mild and then goes full blown break out in a matter of weeks, so I know when to start the isotretinoin treatment. Low dose is what I was thinking, too.
Yola4:
Yes, I have, I may do that on my next treatment. The idea behind it makes sense. Mr. Matt did have a significant improvement. Do you recommend I get the suction tool from a specific website? I will probably update a new picture sometime soon. As I was telling other members, it would be nice to have multiple subcision treatments to increase my chances for improvement.
Somethingsomethingagain:
yes, that is true. I know when I eat high glycemic, sugar, dairy, or greasy foods my skin tends to break out. It doesnt break out bad but it does develop more sebum from my experience. This increase in sebum results in inflammation. Honestly, it would be nice if a low dose treatment of isotretinoin had no impact on healing from subcision. If so, I would definitely do so.
1 hour ago, mr.wantsgreatskin said:Yola4:
Yes, I have, I may do that on my next treatment. The idea behind it makes sense. Mr. Matt did have a significant improvement. Do you recommend I get the suction tool from a specific website? I will probably update a new picture sometime soon. As I was telling other members, it would be nice to have multiple subcision treatments to increase my chances for improvement.
I, personally, don't have experience with subcision w/suction. I'm just referring to some cases that seemed to benefit from it. Maybe PCT14, Mr. Matt, or someone else who saw improvements using suction can chime in on this subject.
There seem to be quite a few methods used for suction.Chinese cupping sets, suction from the heads of microdermabrasion machines such as the PMD, actual suction devices like the one sold on owndoc.com, and even the hand and vacuum technique.
Btw, I'm right there with ya when it comes to dairy, gluten, and sugar causing breakouts. No more indulging!! Especially when we know the consequences.
On 10/27/2016 at 7:28 AM, Yola4 said:I, personally, don't have experience with subcision w/suction. I'm just referring to some cases that seemed to benefit from it. Maybe PCT14, Mr. Matt, or someone else who saw improvements using suction can chime in on this subject.
There seem to be quite a few methods used for suction.Chinese cupping sets, suction from the heads of microdermabrasion machines such as the PMD, actual suction devices like the one sold on owndoc.com, and even the hand and vacuum technique.
Btw, I'm right there with ya when it comes to dairy, gluten, and sugar causing breakouts. No more indulging!! Especially when we know the consequences.
I feel like i've wasted my treatments because i didn't use the suction method =P but i ordered a suction tool from owndoc.com so i'll be looking forward to needling/suctioning before my next subcision treatment.
yup. its hard to stay away sometimes when you get those cravings. =/
do you have acne/scars? if so what treatments have you had?