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Hi guys, :smileys_n_people_21:
I'm new to this forum and I need some suggestions/opinions for possible treatments for my acne scars(please check the pics for details).
I gave a visit to my local derm last week and he suggested me doing subcision/filler treatment or laser for some of the boxcar type scars I have and TCA cross for ice picks(I know there is a risk of hyperpigmentation for darker type skin like mine). For the filler, I don't feel comfortable using anything that is permanent like bellafill. I'm also against doing any aggressive laser due to the risks and the cost. 
After reading some of the threads in this forum, it seems like my best bet is to go w/ subcision and TCA cross treatments together, but do you guys think I will benefit from using HA fillers together w/ subcision for my type of scarring? Or would just the multiple rounds of subcision be sufficient? If I do decide to use the filler, I'm probably going to use Juvederm, which isn't permanent.
Thank you and any comments would be appreciated. ;D

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It sounds like you have a competent cosmetic specialist because that is a good path to take. 

HA filler can help prevent retethering after a subcision is performed. 

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@klee4744 I agree with you filler at least initially is not good in your case. You have no atrophy, it looks like surface box cars, texture issues, icepicks. Raising spots might look unnatural and instead you need to even the surface texture out. 

I see subcision helping you, but would not do filler until you did a few sessions of subcision first. I also think TCA medium peels would help you and you will need several of them. TCA Cross for the icepicks and possibly some of the boxcars, and microneedling. 

Regarding hyperpigmentation in your skin type, please use hydroquinone aka skin bleach a few weeks before and after. Also Vitamin C serum and retin a aka tretinorin to avoid pigment issues. Have the doctor who is doing the cross also do your tca spot peels (you could get away with a full face peel in your case) over the cheeks and forehead scar areas. They can do a test on a spot, and see how you heal, building up to higher levels of TCA. This will take several treatments. over a period of year(s). 


For further pigment issues they have lasers such as V-beam, Quadrostar pro, and ipl photofacials for any pigment changes from treatment. 

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21 hours ago, QuanHenry said:

It sounds like you have a competent cosmetic specialist because that is a good path to take. 

HA filler can help prevent retethering after a subcision is performed. 

 

15 hours ago, beautifulambition said:
@klee4744 I agree with you filler at least initially is not good in your case. You have no atrophy, it looks like surface box cars, texture issues, icepicks. Raising spots might look unnatural and instead you need to even the surface texture out. 

I see subcision helping you, but would not do filler until you did a few sessions of subcision first. I also think TCA medium peels would help you and you will need several of them. TCA Cross for the icepicks and possibly some of the boxcars, and microneedling. 

Regarding hyperpigmentation in your skin type, please use hydroquinone aka skin bleach a few weeks before and after. Also Vitamin C serum and retin a aka tretinorin to avoid pigment issues. Have the doctor who is doing the cross also do your tca spot peels (you could get away with a full face peel in your case) over the cheeks and forehead scar areas. They can do a test on a spot, and see how you heal, building up to higher levels of TCA. This will take several treatments. over a period of year(s). 


For further pigment issues they have lasers such as V-beam, Quadrostar pro, and ipl photofacials for any pigment changes from treatment. 
Thank you for the quick responses guys!!
I scheduled my first subcision session for this wednesday. I have this Thursday and Friday off, so hopefully, it will be enough time for me to heal.
I think I will be doing multiple sessions of subcision and TCA cross & peels in between. 

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