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SupremeNot

How Much Improvement is this?

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This was done by Dr Lim. This case particular intrigued me as I have scars very similar. I am willing to say it's about 80-90% improvement? Barely see any scars on her afterwards except maybe one or two.What do you guys think?

BTW: This was done with a single treatment of laser. A lot of people on here are against laser, but I believe it is beneficial if used by someone like Lim.

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I swear @beautifulambition, your the most negative person. Instead of being optimistic about seeing real results you automatically discredit it and say it very rare and she's "unusual". Just cause your treatments never worked don't get other people down. I'm done posting on this forum all you guys are too negative and that's probably why you don't get results. 

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That looks to be an undeniable 90%+ improvement (assuming no lighting magic tricks, swelling, etc) I believe the  person has an easy-to-treat scar type; comparing to severe major fat loss, texture and box scar cases like mine.

BeautifulAmbition is not negative, but his posts are dropping in quality. They are generic, like a robot. He should retire perhaps?
 

Edited by ChildhoodDreams

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@ChildhoodDreams I agree, he makes everyone who comes here looking for solutions feel hopeless. Advises everyone the same things and always says 3+ years will MAYBE get you 50% improvement. That's just not true at all, there are MANY cases where 70-90% improvement is achieved in a relatively short time span (6mon-1 year). I feel like he just doesn't get results and then tries to base his suggestions around that. This lady is not a case of someone who can "heal unusually" because if that was the case she would never have scars to begin with. This is a lady who went to a doctor that knows what he's doing and got her results. 

 

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Being realistic its best to not get peoples hooes up to high,telling them that they are going to get same results as someone else simply isnt true.telling someone,yes you will get results but how much improvement who knows is more realistic.

also being asked the same questions time and time again,its like people want to be treated individualy.ok,you want an answer to your question,then heres your answer,even though its the same answer as everyone else who asked same question,you get a personal answer.
:)

 

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@Quadboy Thank You exactly. No one else is doing this except yourself. Helping others with customized solutions. 

@SupremeNot Please edit and remove all mention of me. 

Rule "  While you may quote other members, you must remove those quotes if/when you are asked to. People who want their quotes taken down should make the request themselves."

I will continue to help those who need help, I am not here to bicker. I am a volunteer who has helped thousands here and don't need to be bashed. IF you don't like my advice lets have a open dialog, feel free to PM me.  Seems we have to simply ignore each others posts, this is not productive to the community.  I will not be responding to your posts.  I set realistic expectations as any doctor does including Dr. Lim, ... I say you will get most likely 50% and "if " you get more great,  that is very optimistic. Any device manufacturer will make a white paper saying their gadget will cook, clean, do your dishes and give you 100% improvement. This is not clinical experience in the real world. Look at the posters here, it's much different than hand picked photos of the top treatment beauty shots.

 I do not need treatment, I am here to help others, I have first hand experience of doing acne scar revision in a clinic as I have stated before.  Dr. Lim uses infini on "most" of his "acne" scar patients. that is the point you missed.  Of course he has lasers, but he uses Infini the majority of the time.

@ChildhoodDreams I repeat the same content because people have the same issues (there are only so many scar types), my advice is customized to their needs. If you would like to help others please do so, it takes a lot of time and effort.  As you know most people are new here, need advice, and move on with their lives in happy bliss after successful treatment. 

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In the pics shown above, i bet Dr Lim has used TCA CROSS. Its impossible to get that kinda improvement with lasers.

And yes BA is right, Dr Lim has switched most of his procatice from lasers to Infini after DR Steven Weiner did a presentation of Infini in Australia.

This is what Dr Weiner said about Dr lim on realself:
"After my presentation in Australia this summer, he has converted all his laser treatments to Infini for acne scars."
Link:

https://www.realself.com/review/infini-rf-fraxel-co2-asian-skin-type#comment-5160660



No doc will give you an honest opinion on acne scars, this is the only place where you get the most honest opinion from experts like BA, Quadboy anf other acne scar sufferers, so show some respect

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@keving100 Actually no TCA cross was used in his procedure. I'm always gonna discredit someone when what they say is a lie. All BA says is how lasers are a money scheme and how scars can never be treated. That's just flat out delusion, the top acne scar doctor in the world uses lasers, many people have had success with laser as well. Science didn't put in all this time and create something like lasers for absolutely no reason, they work in the right hands. And I'm tired  of the  negativity here, everyone here just complains about not being able to treat their scars and then tells other new hopeful people that they shouldn't even bother treating theirs, that's just evil. And BA is the main source of that. 

 

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2 hours ago, SupremeNot said:

And @beautifulambition if you know so much about scars why have we never seen a pic of your before and afters? I'm sure you should get some results with all that "knowledge".

Oh come on, that's a matter of his personal choice and guys please stop this, it really isn't good for the community, if you have anything to say to BA, you can always msg him.

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Although i appreciate BA his presence on this board, i also like to read posts from people back in the old days. Denise2, Maya, Rossignol and some others are def my favourites. 

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Dr Lim did not use any other method than laser in this one case. These are monomorphic box car scars in the same plane. Note how deep he went with this. Type 1-2 skin with PIH.  Laser ie. fully ablative erbium or CO2 is still a useful tool for patients with this pattern of scarring. If you look at his sites and descriptions, he still advocates fully ablative lasers for "certain" cases. "Most patients" have mixed scars, rolling, atrophic and tethered, as well as deeper ice pick or broad box car scars at different depths (this is only one depth and is rare). Some patients have darker skin type (Infini does not effect darker skin types), so the challenge is finding the correct combination.

Personally I do not think Dr Davin Lim is the best laser dermatologist in the World, there are many Dermatologist he has learned from that really do push the limits safely- people like Dr Sue Kilmer and Dr Chris Zachary, both in CA. Fully ablative lasers are a lost art. 
 
As for lasers and Infini- Intensif have their own role. Fibrotic deep scars can not be penetrated by the weaker solenoid in Infini. Instensif has a strong solenoid, but non insulated, has limited power and a PD (pulse duration) of 200. More powerful lasers like the Lumenis Ultrapulse can deliver 240 w in a vvvvv short PD of 0.8ms, getting to a depth of 4 mm without pulse stacking.

Bottom line, lasers can still be useful in a "minority" of scar types.

You still see majority of scars that Lim, Novick, Rapaport,  Chu, Emil do are manual - subcision, filling etc... they look at the scar type then target them accordingly. 

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In the future i might go to Emil Hemmingsen. It's a 7 hour drive from my place. Dr. Chu is closer, but i need to travel by air to go there. I prefer driving my own car :)

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 ^ It depends on the scar type. If its shallow and reachable by laser, then no reason to think why it would come back.

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I just ask new users to search the old posts (2006 and before) if you plan to have fully ablative laser done. This treatment was popular back then. There is a big number of horror stories, even with fair skinned people. This treatment rarely worked. I even posted a picture of my forehead here and everyone could see the kind of damage laser may cause. My skin was ok for 2 years after that fully ablative CO2 laser, and then it gradually became similar to the skin of a burn victim: uneven color, hypopigmentation, demarcation lines, orange peel texture, large pores, sensitive skin, new scars. It softened the edges of the scars, but the overall improvement was small (10%).

A combination of skin needling and TCA peels I did myself during the last 4 years reverted that laser damage significantly. My scars are also 50% better now compared to 4 years ago. 

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Side effects aside, from watching Dr. Lim's videos I think ablative lasers work for a very, very specific kind of scarring: shallow boxcars and icepicks that are basically at the same level. Tethered scarring, deep scars, deeper rolling scars = will not work. So essentially, surface scarring that isn't very deep.

I always wondered why some doctors in realself call certain scar types "difficult" to treat despite looking like they're very mild, while others with extensive scars on the face can expect maybe 90% improvement. Apparently, it's not how your scars look, or even how many scars you have. It's the TYPE of scars that you have that will dictate how much improvement you can expect. So someone with a face full of shallow boxcars and ice pick scars can expect better improvement than someone with a few, but fibrotic or "hard" scarring. 

Basically, something that looks like this:

238393ad7d29bdef8b579dd8cce130a6.jpg

is actually easier to treat than this:

https://fi.realself.com/full/42fe013ab21adaf9a29df87a8dec5ea3/c/6/1/userimage-2593436.jpg


Despite the latter looking less "severe".

(correct me if I'm wrong of course, as this is based purely on my research).

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@Raster From my research as well it does seem that Ice picks and boxcars are easier to treat. I believe this is because in an icepick scar only a focal amount of skin is damaged rather than  larger area. Each one comes with certain benefits however (if there's such as thing to benefits when it comes to scars lol), icepick scars and boxcars are easier to treat, however they in my opinion look worse because there's a literal hole or indent in the skin. Rolling or tethered scars are harder to treat but also don't look as bad, they mainly just look like rough skin texture or unevenness but don't really look as bad as ice picks or boxcars. However at the end of the day acne scars are acne scars, 80-90% of the time other people don't even notice our scars and they just affect us. I believe that no matter what scars we have, with proper dedication, repetitive treatments and the right hands we can all achieve our goals, I hope nothing but the best for all of you. 

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Spot on... face full of ice pick scars and or shallow box car scars are easier to treat than deep fibrotic scars. Esp. scars that you can just see, but not so obvious but you can actually feel...ie. fibrosis. If fibrosis is deep one needs very special lasers to get the job done PROPERLY namely short duration, high energy lasers- the  stand out is the Ultrapulse. Low density but vvvvv high energy. PD or pulse duration has to be v short to minimise collateral thermal damage to normal surrounding skin. This refers to fractional ablation. Fully ablative for fibrotic and tethered scars are virtually useless- so much risk, downtime, and side effects for so little gain. @Raster and @SupremeNot has got the idea..... spot on guys, fully ablative now a days is done v differently compared to the 80s. The good guys raise up the deep scars to minimise side effects from fully ablative lasers. In the 80s, it was deep as possible, and hence the dreaded MILK MO i.e. permanent whiteness from fully ablative lasers ladies use to get for smokers lines. You don't see many of those now a days- unless someone went to someone who lived in a cave. 

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