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Hendra aleand

My acne scars, it is severe and very bad

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No doubt, you have some serious scars. I hope you have enough time and patience because it's gonna be a long uphill struggle. But, for the moment, you would likely need at least 5 subcisions. That alone will break up the scar tissues anchored to the bottom, giving the skin a lifting effect. Then I suggest you get a permanent filler like Bellafill or Silikon 1000 from a qualified dermatologist or plastic surgeon.

You might also read up on the the " Scarless Healing", which deals with the possibility of skin regeneration for serious burn (as well as acne scar) patients.

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thank you very much for this suggestion is indeed a hard struggle for me after my previous I struggle against acne without my even realizing the former was much heavier.:smileys_n_people_15:

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1 minute ago, Hendra aleand said:
thank you very much for this suggestion is indeed a hard struggle for me after my previous I struggle against acne without my even realizing the former was much heavier.:smileys_n_people_15:
Yeah :( you think everything is awful when you have acne, but then you realize the acne isn't permenant, the scars are what will haunt you. 

I agree you need a lot of subcision work. You need filler for your volume loss. TCA cross work will be needed as well to raise thinner scars. You have darker skin so make sure you're using skin-bleaching cream anytime you're using an acid.

Yes your scars are severe, but this just means that any scar treatments you do will give you a dramatic improvement. 
You will be able to repair your skin a lot, though unfortunately it will not be perfect. 

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thanks for the suggestion, i would strongly consider all these inputs. for the repair of this scar I can only aspire 60% it is very enough because 100% is a real impossibility

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I'm sorry you are dealing with this level of scarring.   Yes it is severe and treatments will be imperfect at best.  The suggestions above are helpful.  I would be realistic with expectations.   Without question, this is going to take years of treatment.  I've dealt with severe scars as well, but mine were localized to only my cheeks, so they were more manageable.  

For me, what worked the best was hands down fillers for deep indentations and TCA cross for deep ice picks.   Half the battle is finding a good doctor who knows what they are doing, which is often a challenge. 

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3 hours ago, dazzed said:

Maaf, Anda berurusan dengan tingkat jaringan parut ini. Ya itu parah dan perawatannya akan menjadi tidak sempurna. Saran di atas sangat membantu. Saya akan bersikap realistis dengan harapan. Tanpa pertanyaan, ini akan memakan waktu bertahun-tahun pengobatan. Aku juga menangani bekas luka yang parah, tapi rambutku hanya dilekatkan pada pipiku, jadi lebih mudah ditangani.  

Bagi saya, yang terbaik adalah tangan ke bawah pengisi untuk lekukan dalam dan silang TCA untuk pengambilan es yang dalam. Setengah dari pertempuran adalah menemukan seorang dokter yang baik yang tahu apa yang mereka lakukan, yang seringkali merupakan tantangan. 

thank you your feedback and I can capture your suggestion I also feel finding the right doctor is also a difficult thing because one step wrong I just burn money without result
3 hours ago, arte90 said:

Silakan periksa benang Ernestoria. Kalian memiliki bekas luka yang sangat mirip.

 

yes it is more or less almost the same as my case with him and I also learned about the treatment he did for his acne scar. although it seems that it needs a lot of money and a doctor search which also seems difficult if we want satisfactory results on the outcome
21 minutes ago, Duperele said:

Hubungi dokter yang baik :)  Mereka bekas luka itu mudah diatur dan kulit Anda bisa terlihat agak mulus lagi.


I will try to pray I find it

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I'm sorry for the scarring but I have to be realistic

No doctor is gonna subcise 200 scars at once and you'd need more than one session. You're gonna spend so much money with no great results. 
Same for fillers, it takes more than one vial of fillers to raise all of them after subcision.....if you'll go down that road you need to be aware you're gonna spend tons of money and you'll probably still get dissatisfied. 

In my opinion, you should email your pics to SkinTE and ask them if you can be treated with their product. 
 

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14 minutes ago, SimpleMutton said:

Saya minta maaf karena luka parut tapi saya harus realistis

Tidak ada dokter yang akan menyuburkan 200 bekas luka sekaligus dan Anda memerlukan lebih dari satu sesi. Anda akan menghabiskan begitu banyak uang tanpa hasil bagus. 
Sama untuk pengisi, dibutuhkan lebih dari satu botol pengisi untuk mengangkat semuanya setelah subkutan ..... jika Anda akan menyusuri jalan itu, Anda harus sadar bahwa Anda akan menghabiskan banyak uang dan Anda mungkin akan masih merasa tidak puas 

Menurut pendapat saya, Anda harus mengirimkan foto Anda ke SkinTE dan bertanya apakah Anda dapat diobati dengan produk mereka. 
 

really you said i also feel the need of a lot of money to handle my case and I was worried about the bad result then from that I need many best advice. for your advice I say thank you for caring I will consider it

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@Obi wan Please Advise

___________________________________________________________________________________

You need stronger treatment my friend for your type of scars, they are severe. I think you can get 60% improvement. See the FAQ - top of the scar solutions sub, then goto the first post, tca section, click on the link, on the first page there is a case study and some have severe scarring. They had improvement with acid peels and subcision, similar skin type to yours.

I would do RF microneedling (you will need many), depending on the condition of the skin you might need high powered CO2 to drill down into the scar tissue with steriod drip.

Subcision and filler should be done but most of the skin has scarring and thus will be hard.

I don't normally recommend this procedure but for you I would look into deep phenol peels (sedated) with dermabrasion done to smooth out the dermis. I don't know what country your in, but Dr. Rullan specializes in this for dark skin types.

I would post your picture on realself.com and ask for advice from the doctors as well. I am sure they will say laser but worth some extra input for free. 





 

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I think a long term/permanent filler like a fat transfer or bellafill should be considered for this case alongside subcision.

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14 hours ago, beautifulambition said:
@Obi wan  Mohon Beritahu

___________________________________________________________________________________

Anda memerlukan perawatan yang lebih kuat untuk jenis luka bekas saya, mereka parah. Saya pikir Anda bisa mendapatkan 60% perbaikan. Lihat FAQ - bagian atas sub solusi bekas luka, lalu goto postingan pertama, bagian tca, klik pada link, di halaman pertama terdapat studi kasus dan beberapa memiliki jaringan parut yang parah. Mereka mengalami perbaikan dengan kulit asam dan subcision, sejenis kulit serupa dengan kulit Anda.

Saya akan melakukan RF microneedling (Anda akan memerlukan banyak), tergantung pada kondisi kulit Anda mungkin memerlukan CO2 bertenaga tinggi untuk menelusuri jaringan bekas luka dengan steriod drip.

Subcision dan filler harus dilakukan namun sebagian besar kulit memiliki bekas luka dan dengan demikian akan sulit.

Biasanya saya tidak merekomendasikan prosedur ini tapi untuk Anda, saya akan melihat kulit fenol dalam (dibius) dengan dermabrasi yang dilakukan untuk menghaluskan dermis. Saya tidak tahu negara mana Anda, tapi Dr. Rullan mengkhususkan diri pada jenis kulit gelap ini.

Saya akan memposting foto Anda di realself.com dan meminta saran dari dokter juga. Saya yakin mereka akan mengatakan laser tapi layak masukan tambahan secara gratis. 





 
I come from Indonesia, for all your suggestions I will learn and I follow because you look experienced about suggestions. thank you very much for the education
12 hours ago, QuanHenry said:

Saya pikir pengisi jangka panjang / permanen seperti transfer lemak atau bellafill harus dipertimbangkan untuk kasus ini di samping subcision.


thanks for your advice I will do because aggressive treatment just does not seem to need fillers for maximum results

 

thank you for your suggestions I will do because the fillers play a role for maximum results

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A good and realistic aim is 50% over 14 months or so. Always manual over other treatments as you have lots of fibrosis and attachments, I do agree that at least 5-6 subcision with PRP. Intensif POSSIBLY over Infini in THIS case because looking at your scars, without feeling, I think collagen is too thick for Infini solenoid to penetrate more than 1.75 mm. Suggest max 200/200 pulse duration 3 passes. I would suggest PRP over and under - this will maximise your gains and minimise your downtime. The type of RF microneedling is redundant in this case- just need a strong motor to drive the needles to 3+ mm and beyond. (scars sini boleh improve, apa ada manyak, manyak susa,). My Indonesian is so, so, I speak a few languages, more fluent in Indonesian spoken than written.  Re-evaluate. The idea here is to stimulate as much collagen as possible without the need for fillers. This may take special Co2 laser like the Ultrapulse- others simply do not have the power. Low density high power, as you guys know, 3-4 months for maximal collagen stimulation. If there is a lot of fibrosis, only Ultrapulse can penetrate the matted collagen. Yes one can cheat extending PD (pulse durations) of other lasers, but in this skin type, not ideal. If linear scars line in a good plane, simple excision can be a good modality for some of the scars I can see.  Final touch is fat transfer to larger areas of atrophy and fillers for more delicate areas.  I think Dr Lim is trying to organise some charity work in Singapore for mid 2018. Planning to treat patients like this with no charge, sponsored by companies like Lutronic, Lumenis and his time for free teaching Doctors in Asia. The problem is with, as always red tape with Medical Registration. For cases like this I think charity goes a long way. This really is severe scarring and medical in nature. The sad thing is that there is a will and way to treat cases like this at no charge or minimal charge for the patient, just the government red tape. 

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