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Markyboy

Get rid of acne scarring

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You have mainly textural box cars, maybe a few rolling scars.

I would do 3 treatments of Infini / Intracel / Secret/ Vivance / etc... RF Miconeedling. Space them 3 months apart for healing.

Then subcise depending on the results and your body's ability to heal. Use filler if you have any pitting / hallows over a pencil eraser in depth or more, otherwise do saline inections (cheap) and chinese cupping (amazon) for 3 weeks after.  

Finally Do TCA cross for the icepicks and any light textural surface issues. IT will take a few medium strength peels.

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Okay are there any user reviews in this forum here for RF Microneedling? 
And is Intracel also helpful for rolling scars which are not deep? 

Edited by Markyboy

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I'm three weeks into my 2nd Infini. The 1st treatment was 6 weeks before that. It's been a pretty good journey with pretty good outcome. I'm seeng at least 50% improvement. Deep boxcar pits I had before look more shallow-to-medium rolling now. Most of the shallow pits are nearly gone. 

Infini is, I believe, the best treatment option for boxcars to date. I used to think subcision was indisputably the go-to treatment but now I'm of the opinion that subcision is only effective for deep boxcars and tethered scars. It ain't so good for shallow pits. With regards to rolling scars, especially shallow ones, the jury is still out.  That's because rolling scars are quite different from boxcar pits. With boxcars, the goal is to fill in the pit. With rolling, you need to kinda flatten out the undulating wave, and that's requires a complete different treatment. I dunno.

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Agree with BA, +1. Your scars are not hard to treat, and with his proposed program, with a good operator, you can expect to improve by up to and beyond 80%. You can also short cut by subcision and filler first, then RF later. A paper will be out (I read the manuscript ) in 2018 by a well known acne scar specialist that shows that high energy microneedling using RF does not degrade any filler. You have many sensible, well proven options with scars that are amendable to treatment. I wish you well. 

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Thanks for all the good answers yet :) I don't know what type of scars I have. For sure they are distensible and when I stretch my skin many of them smoothed out. But isn't this a sign for rolling scars and not boxscars? I'm confused :D

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Someones knows advice? I'm not sure what type of scars are mine. When the light comes from behind my skin looks kind of wavy. Don't know how to descripe :D Can Intracel help with this? Maybe in this picture you could see this "wave texture" better. When I pull back my skin most of them are away. Don't know what to do :D For a facelift I'm too young :D

_20171119_105136.JPG

 

_20171119_105608.JPG

Edited by Markyboy

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@Markyboy

They are textural box cars, ... I said that above ;-P I gave you a full treatment plan above, as well as many others ^. I know what kind of scars you have. Please shave 100% before treatments. We again said what do to above ^. You don't do a face lift for acne scars that is a bit crazy and overboard, your way to young.

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But I don't understand why they go away when I stretch my skin. I always thought that this is only the case for rolling scars :D Or is this also a sign for boxscar scarring? :P 
And one last question: Could Intracel also work to a certain degree if the scar is tethered down or should I do subcision first then? 

Edited by Markyboy

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Here is a picture in a better quality and in the badest lighting. It looks very severe there :o How much improvment could I expect? And is Intracel the way to go? Notice how it changes when I stretch my skin only light.

DSC_0239.JPG

DSC_0240.JPG

I was frightend how they look there. Never seen them like that :o Are they still easy to treat? Can't believe that 

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16 minutes ago, Markyboy said:

So you think subcision is the way to go? Honestly I've never seen them so bad :o


Try not to look at your skin in different lights now. I got obsessed when i started noticing how different things looked in harsh lighting and it ruined my life for the past 12 months. I now have to avoid almost every mirror just to get me through the day. If you have never thought they looked that bad until you took that picture then chances are nobody else has noticed either. I know your here for advice on how to treat them, something which im not experienced with to give any advice i just wanted to type this because thing can soon become an obsession. Good luck with any treatments you decide to have. Also just want to say that from an outsider they honestly dont look as bad as you think they do.

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Yeah, even when I look at them with a flaslight in the mirror they don't look so bad. I think this picture really shows everythink and not only my acne scars :D Furthermore this picture is taken very close, when I take one from a little bit further away and I stretch my skin it looks nearly perfect?! (same in the mirror with flashlight from under). Just like the following pictures.
Ok little all-clear and update: Because I can't believe that my scars looks like this I've tried the following: I've hold a pocket mirror in the exakt same position like my Ipad with which I've taken the picture (very crazy I know :D), but for sure they do not look as severe as in the display of the Ipad. Can't explain what's going on there :D

DSC_0233.JPG

 

DSC_0232.JPG

Can anybody say if subcision could improve them? 

3 hours ago, Markyboy said:

Yeah, even when I look at them with a flaslight in the mirror they don't look so bad. I think this picture really shows everythink and not only my acne scars :D Furthermore this picture is taken very close, when I take one from a little bit further away and I stretch my skin it looks nearly perfect?! (same in the mirror with flashlight from under). Just like the following pictures.

DSC_0233.JPG

 

DSC_0232.JPG

Can anybody say if subcision could improve them? Or at first try the Intracel? 

Edited by Markyboy

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3 hours ago, Markyboy said:

Can anybody say if subcision could improve them? 


Even after you stretched the skin (2nd pic), I can still see some deep pits on the cheek and chin. That means your scars and held down to the bottom and they need to be subcised using Nokor. So that would be the first step. After the scars are freed up, you can then proceed with other treatments like Infini, which in my opinion is the best option for treating boxcars (and that's what you have).

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Hi, according to my doctor, subcision is not just done by breaking the tethers on scars, but it can also be used "externally"... that is, Instead of going under the scar, as usually seen in rolling and tethered type scars, shallower boxcars are targeted by actually by subcising the walls of the scars, so that they break down and flatten into something that can be smoothed out through other procedures. Traditional subcision is not that effective for shallower boxcars with vertical walls, because even if you manage to subcise under the scar, the walls will still be there, so the main objective is how to flatten those walls. And this can be done via a different type of subcision.

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No one's shocked, they told you the scars and what to do and you didn't want to take the advice, so they don't know what to say ;-) Your scars are minimal and I see 100s of cases of scars monthly. 

Anyone who looks up their nose with a flashlight looks kinda weird too if you look at the shadows, it's angels in the extreme of finding something, the world does not see you like this.

Pulling your skin means absolutely nothing. That does not describe the scars or underlying structures. All it shows is filler would work on you. You need subcision w/ filler, multiple sessions, you need rf microneedle multiple sessions, and several medium strength tca peels. If you don't want to do this or can't afford it let me know and i will alter the plan.

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Okay then I'm calmed down, thanks :D Do you think I could also start with RF Microneedling or wouldn't improvme this anything bevore subcising? Honestly I think subcision is a dangerous treatment even most people here don't think it is, I know :D But personally for me it sounds dangerous :P So could I try Intracel at first and look how satisfied I am then? :D Yeah, I shouldnt take pics like this anymore. In real life most people didn't even noticed my scars till I told about them :D

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I'd fill and subcise first, you have deficeny. IF you cannot afford filler do saline injections and chinese cupping (amazon) for 3 to 4 weeks after. Collagen is slow takes 3 weeks to build so give yourself time to heal. Then you could do the rf microneedle. 

I can do subcision and have it done on me now tons of times (not for scars, ... also used for fillers). It's not dangerous at all, haha, its very superficial only under the skin not even deep. 

Yes that's fine if you want to start with Intra if you like also.

 

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35 minutes ago, Markyboy said:

Do you think also about traditionel subcision or only one with the NOKOR? :D I ask because my doc only offers traditionel :P


Traditional subcision is NOKOR. Your doctor can, however, elect to use the hypodermic needle while injecting the filler. Both works as long as the scar is freed up from underneath.

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Ok because in the Internet page of my doc is the descreption: "About milimeter slices a cannula is introtuced" (sorry gor the bad translation, don't know how to translate exactly :D)

Edited by Markyboy

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Cannula, which has a blunt tip, is also widely used these days for fillers, subcision, etc.
 

27 minutes ago, Markyboy said:

Ok because in the Internet page of my doc is the descreption: "About milimeter slices a cannula is introtuced" (sorry gor the bad translation, don't know how to translate exactly :D)

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