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Help with scar identification

MemberMember
0
(@tidus95)

Posted : 01/28/2017 7:07 am

Hi everybody!
This is the first time I write on this forum. Like most of you I struggled with acne when I was younger and I was left with some scars. Now I am 25 years old and I live in Italy.
Could you please help me identifying the type(s) of my scars? I think I have rolling on my cheeks and 2 boxcars on my forehead but I'm not sure. Also what is the severity of my scars (mild/severe)?

I took the photos after shaving and in the worst possible light (normally they don't look that bad). Which treatment do you think is the best for my scars?
I already had 3 Fraxels (with no noticeable result) and a C02 full face resurfacing (which was really expensive and gave no result, except for a downtime of 3 weeks and a red face for months... It was really an aggressive laser, a bad idea ) .
Now I was thinking about trying subcision+suction or subcision+filler. What do you think about these two treatments? I know that a 100% improvement is impossible but maybe I can have some improuvement.
Also does anyone live in Europe (or better in Italy/France) and could suggest me a good derma/plastic surgeon for the subcision?
Currently my long term plan is going to Australia to be treated by Dr. Davin Lim, he really seems an expert in treating acne scars. Do you know somebody who was treated by him?
Thank you very much for your help, it is really appreciated. All the best!

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MemberMember
1750
(@beautifulambition)

Posted : 01/28/2017 8:45 am

You have multiple type of scars : rolling and box cars.
You cheeks are mid severity and the forehead is mainly clear so very mild. You don't have terrible scars as I have seen with others.

Thank you for taking the pictures correctly, otherwise we cannot see the shadows the scars make.

You will need several treatments: scars are never one and done. IT will take a few years to treat unless you do very aggressive treatments with a doctor, but the body must heal and repeat again the procedures. I'd figure on a few years. Each time getting a percentage better until your happy enough to quit and just live life.

Subcision and filler would be a great procedure for you. It will only fixes depressions (areas with tethering or fat loss) of the skin. I can see doctors wanting to do several lasers on you even Davin because of the texture issues (the surface), they have to do this first because of potential for loss of filler with the lasers. I would skip any doctor who pushes laser and tell them noas you have done a few treatments. This will be the standard thing they do as it makes them $$$.

You could so several subcisions with filler. This will fix the depressed areas. Then do microneedle. The derminator is what most of us use (link is in the faq - made in Europe). You could have the doctor do acid peels (or do them yourself on the scarred areas)... TCA or Phenol (this will treat the top and not hurt the underlying filler) You'll need a stronger acid peel for the bumpy texture. Or instead you could start with traditional dermabrasion. I've seen really good results of ths on (realself.com). It's likesanding the top layers of the skin, it's bloody and has down time but it is known to work relay well if you get a good doctor who has done tons of them and experience with ace scars. This is because it works on the surface layers of the skin to even them out, like a harsh acid peel would of high strength.

Never figure you will be perfect, but you will get some improvement, many get their hopes up of glass smooth skin, this will not happen. Being honest, I suffer with scars also and have done it all.

I don't know about Italy, but I know several members have gone to Dr. Chu in the UK a quick Ryan air flight away, maybe someone else can tell use somewhere closer. You can always call the dermatologists offices you know and ask if they do subcision.

https://www.realself.com/find/Italy/Plastic-Surgeon

https://www.realself.com/find/Italy/Facial-Plastic-Surgeon

https://www.realself.com/find/Italy/Dermatologist

Many were treated by him (Dr. Lim) some good and some bad, we all heal differently. He uses lasers mainly. There was a post of someone who just went to him Did Infini ruin my skin or something, look for that one. And a success story also called.

http://www.acne.org/messageboard/topic/365515-acne-scars-before-and-after/

[Edited link out]

Finally check out the link in my signature below its for the faq, look up subcision, filler microelectronic, TCA Acid Peels. Please keep us updated with pictures and the treatments that did and didn't work for you.

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MemberMember
0
(@tidus95)

Posted : 01/28/2017 12:12 pm

Thank you very much for your reply.
Actually I am not very concerned about my texture or the quality of my skin, the only things that hurts me are the holes and the shadows. I know I will never be perfect and I'm pretty comfortable with that, but the holes sometimes make me crazy. That's why I would go for a subcision.

Personally I had a really bad experience with laser and I would prefer not to do more, also because I wasted a lot of money.

I read all the threads you told me and I must admit that there is a lot of knowledge in this forum. But it is very hard to understand what can work and what can't in my case. Sometimes I feel so depressed about my scars I think I should seek for a therapist ehehe. My friends says they don't even see the problem with my scars, I know it's something more psychological than objective.

I will consider buying a Derminator. Do you think you can use it with short facial hair (2mm)? Do you need a dumbing cream before use it right? And what kind of cream do you use it right after?

As for the TCA peels, do you do it on your own at home? If yes at which percentage? Do you just put it on the scars or on the whole face? I would be rather scared to do it at home because I think that it can be a very invasive treatment and I would be afraid to burn/damage my face even more.

It is nice to know that I am not alone in this struggle. I really hope we can all find happiness and life our life in the best possible way :)
I will keep the Forum updated as far as I decide what to do next. Thanks again

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MemberMember
1750
(@beautifulambition)

Posted : 01/28/2017 1:29 pm

Yes you can derminator at home, if you have facial hair that is fine, I have facial hair ;-P Numbing cream is a preference, I use it, some don't you can get it like on ebay.

You can also throw in subcision somewhere in there.

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MemberMember
0
(@tidus95)

Posted : 01/29/2017 5:16 pm

Thank you again for your reply.
I guess you have facial hair :P  But do you shave completely your face before the dermastamping? Because I really like to wear a 1-3 mm facial hair as I think it covers my problem a lot ehehe In this sense we guys are luckier than girls.
As for the TCA, which percentage of acid do you use? Do you get a red mark which peels and then heal in some days?

Also I would like to share my experience with lasers and surgery with the forum to ask for your opinion. I first had those acne scars 8 years ago. They really affected my mood so I went to see a dermatologist who suggested me Fraxel laser. I had 3 treatment for 400$ each. I did not obtained any results. Then I went to a plastic surgeon who told me that I had to go for a stronger laser. That's why I did the full face CO2 resurfacing for something around 3000$. But the result was none to little... And the downtime really huge. I am not considering laser any more and now money has become an issue.
Finally the surgeon told me that since my cheeks were quite skinny (like this guy for understanding) and this increased the crater-like appearance of
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my scars (as scars are mostly on the cheeks), we could add some fat with a lipofilling. So I added some of my own fat to my cheeks (in the whole cheeks, not like a HA filler for scars) and this was expensive too =( It improved a bit my scars but it also changed my look, which I did not like.

The problem with the fat injection is that my face now looks a bit too fat in my opinion, especially when I smile, because of the extra fat I added. Maybe the surgeon just add too much fat. Now I also would like to remove part of this fat with a small liposuction (done with a needle, so the procedure itself its very similar to a submission, only he will also be sucking some fat away). Do you see any downsides?

Voil , here is my experience with aesthetic surgery, a complete disaster. I know it can sound a horror story. Beside all that happened to me people still say to me that I am good-looking and I have no problem with girls when I am in good mood, that's why I say that my problem with my scarring is mainly physiological.

I really would like to look some improvements with my scars... Beautifulambition, since you are fighting this imperfection more consistently than me could you please tell me in what % did your scars improve over the years? Are you satisfied? Do you still suffer from psychological bad thoughts (I mean when you are too concerned about your scars)?

I will also consider buying Retin-A cream for the texture, and the skin appearance, even though I am sure this will not fix my holes =)
If I made any English mistakes it's because it's not my mother tongue :P
Thanks a lot for the supporting, I am learning a lot through this forum. All the best to you all

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MemberMember
10
(@rdnhey)

Posted : 01/30/2017 7:02 am

Io sto facendo sessioni di subcision pi¹ HA filler a Milano,  quindi se sei di queste zone ho un consiglio molto prezioso ;)
Anche io ho provato il co2 con risultati pessimi. 
ˆ meglio se ti radi prima di usare il derminator o altro dispositivo microneedling.
Il TCA per il peeling lo puoi usare a qualsiasi percentuale basta che non superi il 20%, io sinceramente preferisco usarlo al 5-8% per peeling pi¹ frequenti. Ovviamente stiamo parlando principalmente di texture, mai un peeling risolver  le cicatrici depresse. (Invece per il tca cross non meno del 50% ma vedendo le foto non ne hai bisogno.)
Sto utilizzando da qualche mese una crema base galenica con lo 0,025% di tretinoina (lo stesso acido retinoico che c'¨ nel retin A) e devo dire che mi sto trovando abbastanza bene ;)

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