Hello

I quite like Dr Rullan, goto him

I would get subcision, I don't know about Filler, your scars are surface (textural) so it could do bumps. IF you do filler do it after your subcision swelling goes down, there are many expert injectors in the SF bay area see my faq (top of scar sub / signature).

I would do your subcisuion ( you will need 3 more more of them).

He could also do a medium depth spot peel for your cheeks (TCA), then do your subcisions on one session. (you will need 3 or 4 of them).

I would also continue your microneedle.

Please discuss retin a cream to use when you heal nightly, and hydroquionone / vitamin c serum to avoid hyperpigmentation.

Tca cross for ice picks or any with clearly defined walls (slight atrophic) boxcar are usualy treated with subscision (beautifulambition) would probably recommend with other stuff.

i see most of your scarring is textural,its in the top layers so tca cross and tca peel would help.

if you got steady hand or sister or friend then diy it.done right you will be pleased,1 week down time with 4 weeks recovery between sessions.

every 4 weeks try a strong tca peel,round 25%,if your skin stands up to 80-100% tca cross then you should be good for 25% peel.wait 4 weeks recovery then another tca cross.

look after your insides and hygene,you got good skin condition overall so dont think thats a worry,means you look after yourself.

I would try full session of microneedling
before trying anything else

@beautifulambitionwould you recommend going down to san diego for each subcision? would you happen to know good ones here in SF? i'm making an appointment for next week with Dr. Lavanya Krishnan and Dr. Andrea Hui. Have any of you heard of them?

@QuadboyI'm too scared to do a TCA cross peel on my own. I know you recommend it, but it really freaks me out. Even doing microneedling on my own was a big step. I have the regular roller microneedle that I've been using with no adverse effects. Do you guys recommend the deminator over that?? Why so?

Thanks so mcuh for all your advice!

@fedup1983They are general Dr's you mentioned not specializing in acne scars, Sadly we have a shortage in the SF Bay Area. Most Drs will push laser, say no and be firm you want the above treatments andSubcision.

I do think microneedle will help you, but you have one, so derminator would be good if you regularly use it.

Acid tends to be scary,must give people nightmares of incredible melting man or sweeny todd.

But once you do it and its performed successfully and you see some improvement then its rewarding.

@beautifulambitioni am considering flying out to san diego to see rullan due to him being able to do subcision on the whole face. I was going to do novick but i think his prices are so high for my numerous amount of scars, while rullan charges per cheek/face. I'm just curious why you suggested to only get subcision done from rullan in this thread - is he bad at filler or something? I am looking to get subcision + filler for my rolling scars.

Rullan makes since for you, I remember your in CA or nearby. Novick is good but many people don't understand his pricing structure he's including filler while Rullan is not in his subcision price. You don't need filler for icepicks ... icepicks = tca cross, boxcars do well like this (surface) with infini rf and subcision. This is why I did not recommend filler, you don't want bumps, there is no deep fat deficiency ... now if you want some for aesthetics not scars that's different. (you have surface scar issues). Rullan can do all the procedures. 😉

Hi folks! I didn't end up going to Dr Rullan but just did microneedling at home (2mm needle) every month-6 weeks for the last year. Some improvement but not a huge amount. I'll post pictures in a bit. Question for @beautifulambitionand @Quadboy- what are your thoughts on microneedling with PRP? I read a study thatthis yielded very positive results. I think I could find someone in the bay area to do this, but wanted to know if you thought this would be as helpful as TCA cross or subcision?

I am not a big fan or prp and microneedling as a solo treatment for scars, but sure you can try this if you wish several times, if it helps you. Be careful of studies they don't always address the scars fully, handpicked cases. New data is more favorable for prp plus rf needling. Several people in the bay area have Infini and can do PRP, tca cross, fraxel, etc... I hear Dr ransom or randsom is good he's a plastic in SF, who has Infini.