You have mainly surface textural scars. Some rolling, box cars, and icepicks. No major fat loss or deep pitting.

There are some options in the bay area but Rullan is also great.

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On 12/11/2017 at 9:08 AM, beautifulambition said:

You have mainly surface textural scars. Some rolling, box cars, and icepicks. No major fat loss or deep pitting.

There are some options in the bay area but Rullan is also great.

Filler is only used if you have a pencil eraser depth pit or more. I do not see anything to deep on your face.

I would have Rullan Nokor the scars (subcision) , a few times. This is normally done with Chinese Cupping (for surface scars) for several weeks after.

I would get 3 treatments of RF Microneedling. We have Infini locally you could goto multiple Drs for (Don't believe Rullan has this).

You have icepicks, I would have Rullan or a local DR / Med spa do TCA CRoss on those spots and raise them (several treatments are needed). You can also do this yourself see the FAQ guide for peels.

Finally you would do multiple acid peels for the surface texture, or have Rullan do a sedated Phenol peel to get under the texture. You could have TCA or Phenol done for the nose or Do laser instead for a resurfacing a few times for the final step.

To learn about all these procedures goto the FAQ - first post of the scar treatments sub. Then goto subcision and TCA Peels.

I finally had first procedure done with Dr. Rullan today! Can't believe it took me 1.5 years to get started but better late than never.

Dr. Rullan did the standard phenol cross, subcision (with cannula I think), and microneedling. The subcision was pretty rough, however I didn't hear any rubber band breaking. This may support the advice that I don't have deep pitting or tethering.

@beautifulambitionwhat do you recommend I do next? I've only had 1 subcision combo treatment with Dr. Rullan. I'm Asian so maybe I shouldn't do the cupping. Should I get filler? Is subcision still useful if I don't have tethering?

@Stardust123You wait 3 months for you next subcision with him. Yes you can get filler a week or two after when the swelling goes down at any expert injector (Dr or med spa).

Yes subcision is still useful if you don't have tethering, if you need to make new tissues under the area of atrophy.

I see from my above recommendation that you have textural scars. Get rf microneedling at any practitioner(Rullan does not have this) in 3 months, then do another subcision with Rullan 3 months after that. 3-8 subcisions with cross are often needed. For Textural scars the cross can be more helpful than the subcision sometimes.

We then do co2 laser optional as needed for textural scarring on a low density setting to soften them.

Finally Rullan can do a deep peel for your texture at the end.

On 4/26/2019 at 11:19 AM, beautifulambition said:

 

Yes subcision is still useful if you don't have tethering, if you need to make new tissues under the area of atrophy.

How does this work if there is no tethering?

@perfectnycAs field subcision or creating a pocket under the scar with filler to stimulate new collagen to grow, the scar is depressed thus subcision. The technique is different. Some Dr's do some sort of subcision when they do a normal filler job to create space for the filler.

Hmm. Most of the swelling from the procedure was from the painkiller. With the shot it went away after 12 hours. The subcision and microneedling made my skin tender for about 3 days but afterwards there was mostly no visible effect. What I'm left with are scabs from the cross.

Personally if I didn't have to do subcision that'd be great, it's not a pleasant procedure. I feel like the phenol cross + some collagen stimulation procedure will have the best effect for me. The cross has the longest downtime though with like 5-6 days.

@Stardust123This is a common response for someone who does not get filler or does not get"enough" filler. The swelling subciseds and they go back to normal"retethering."

Everything is optional, but you will not get optimal results of course if your scar type requires certain treatments and you skip them.

Goodluck on your treatment journey, ... you know what works best for you.

@beautifulambitionI think there are a couple of spots that may tether and Sculptra might be a good idea. From other posts, you're recommending over dilute Sculptra as a foundation layer beneath the scarring? Do you know of any good places in the Bay Area that does the above? How much would this cost?

It's been 7 days so far and I'm mostly healed. Improvement seems to be 20% ish? The CROSS helped raised the scars a bit and the swelling is making the texture and skin surface look better. I'll look into using the Derminator for the next 2 months and go from there.

@Stardust123Ok ... Sculptra is not good if you have a few scars, tiny scars, or overly superficial superficial scars. It's used for deep fat atrophy and widespread scarring over the cheeks or temples.

Cost $700 to $3000 depending on how many sessions you do. Most places can do this. When you call say , do you have Sculptra filler. IF they try to dissuade you either they don't use the product or they don't want to use it for your condition. I would not tell them your using it for your acne scars, ... It's injected deeply with the above conditions, ... we are not injecting like a HA filler for individual spots, nor do we want to deposit it in the scars. IT won't give you instant volume like a HA filler. It's a foundation filler with the above stipulations. All other scar types should do HA filler only. Dr. RansomI believe does it in SF.

20% is great, you need between 3-8 subcisions and all the other procedures in your plan. If cross helped sounds like you have icepicks and that is the best thing to continue for that. Swelling is like filler it helps hide the scars and gives temp volume, ... this is when I know people like filler volume.