Hi!Ive been reading this forum for a while and really respect the experiences of the posters here. Im hoping to get your perspective on my scar situation, even though its not directly related to acne. Here it is:
@CuriousNYCI cannot give full advice as I have not sceen the scar, like the various doctors you consulted with, who were also able to observe it in animation / movement. From your treatment history of CO2 laser and filler with nothing getting better, either the doctors treatment was bad or you were expecting a different result than what it provides. Even acne scar suffers never get truly perfect skin, it is softened and made more acceptable after sometimes 2 years of various treatments.
If you have been to 10 plastic surgeons and derms, they will all have various ways to treat your issue, depending on what they specialize in and are good at. Your questions when consulting with them should be what experience do you have treating scars like mine and how many have yuo done. Then of course asking to see pictures. 4 x 6mm is pretty small. This should be handled by filler and laser treatments. If thees did not work or you did not have enough (yes laser widens and soften the scars).
Why was TCA cross never tired to raise the scar bed?
I do think your best bet is a geometric or z closure of the scar (depending on how the skin pulls). This is typically done by a PS during scar revision. A tiny line is left and lasered for further reduction in appearance. This is probably your best bet at this point. Ask to see pictures of similar scar revisions and choose someone with the most experience.
Thanks for your response, @beautifulambition! Let me clarify: the CO2 laser did help in the sense that it made the scar more shallow, but in doing so it also widened it. It seems to take up more space now.
The biggest issue is the texture--the scar just doesn't look like regular skin, so I have a circle/oval of scar tissue in the middle of my cheek. Even if I lifted the base with TCA Cross or fillers or subcision, the top layer doesn't look right. Here is a photo. I feel like a well-performed excision could result in a much neater outcome.
@CuriousNYCYou look better than like 90% of the scar suffers on this site, one tiny imperfection which adds character. All that facial hair as well.