I do not recommend laser to start with for your case at all!

You have mainly rolling scars and some icepicks. Fat deficiency. PIE or wounding post acne that can be taken care of as well (reds).

1) Subcision, you need 4of these and you will need filler. You have fat loss so I would suggest something like sculptra as a bed injected throughout the cheek, before any HA filler is injected for individual scars.
2) RF Microneedling this is very important 4 sessions of this, you look like you may have some fibrosis, only a doctor can feel the skin and see if that is the case. You space these 3 months apart between your filler sessions with subcision when it runs out.
3) IF your not getting a good response after the above. Do co2 at 5-7% At full power. Hence Low density and high power, This is only if the above is not helping and you have fibrotic scars still. This is optional and can be saved for last.
4) You will need several sessions of TCA CRoss for your icepicks
5)You will need peels for texture. Do several TCA peels or a fully sedated deep peel for more drastic results and more down time. A alternative to this is fully ablative erbium resurfacing.
6) You have lots of wounding and red in your skin from acne. Vascular laser or IPL is necessary for the reds. This does not work on anything else.

Look at the FAQ below: Subcision Section, Microneedling Section, Peels Section, Skin section and PIE

[Media removed]

I have a question about redness. Is vascular laser the only treatment option for this? Or would treatment options such as TCA cross, subcision and Co2 laser help with redness while it heals from these treatments?

I have a few red spots, but I think this is from taking Accutane and hopefully it will lessen over time without action.

@ScarRightIt's called PIE, or wounding post acne. It's not a scar and is in the same family as hyperpigmentation. Hyperpigmentation is often various different colors but can also be red. If you press your finger on it and it goes away even quickly it's PIE. Laser is the quickest and most expensive solution as it acts on the blood vessels andHemoglobin. It heals over a year's time for some. The body again is very slow to heal. There are several other treatments for PIE/PIH I made a whole section in the FAQ Under the skin section, and PIE / PIH.

No CO2 would not work on wounding or TCA a acid so we don't put acid on wounds. No these treatments rely on your ability to heal. As you have seen from those who complain about bruising and subcision, this is different for everyone. Vascular laser could shorten this if one cannot wait.

Honey and Aloe are always a good way to start for wounds, or your can go with the triple antibiotic route which the Aussies don't have, I am sure you have something similar.La Roce makes some good products as well.

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Thank you for reply me but still Im confused you mean to say i will do all these treatments one by one ?? But my derm recommend me chemical peel but i will use filer with peel

@Haroon 786
I am advising a plan for you for your acne scars. If you would rather follow your dermatologist that is up to you 😉 Make sure they are a acne scar specialist and not just a general derm which have no idea how to treat scars properly. Many goto these doctors and they give poor advice. Peels and filler alone will do little for your scars.

BA

You mean to say peels and filler is best for my acne scar if i done this treatment and after in future did i done laser treatment and how long distance between peels filer and laser treatment?

@Haroon 786Depends on the treatment. 3 months between treatments is the healing time. If your doing things like at home peels and microneedling yes you can do them more often (once a month - more healing time is always better). Going to a doctor with subcision, rf needling, tca cross, and deep peels or fully ablative erbium resurfacing this will require you to wait 3 months in between.

No I do not mean to say peels and filler are best for your scars. I wrote out the treatments that would be most effective for your scars. If you only want to do "peels and filler" this will not get you the improvement you want. But some people only have time, money, or choice to do some things and that is your choice. Your scars are severe. As such they will take more treatments and work over a period of time.

But i have a alot of redness and these treatments also a clear redness in to my face and when i press my face on finger my face color will change mean redness is gone away and then again come back in my face what is that?? One more thing what about fractional Co2 laser i think this is effective for acne scar treatment

3 hours ago, Haroon 786 said:

But i have a alot of redness and these treatments also a clear redness in to my face and when i press my face on finger my face color will change mean redness is gone away and then again come back in my face what is that?? One more thing what about fractional Co2 laser i think this is effective for acne scar treatment

1) Redness is NOT a scar--they will go away over time. Pits are scars--they will NEVER go away, unless you treat them.

2) Your scars are pretty severe. Also they are numerous. Severe scars need surgical treatments like subcision.

3) CO2 laser is no good for you. Lasers cannot fix deep scars.

4) TREATMENT PLAN: Get (A) subcision and (B) Sculptra filler. Repeat (A) every 3-6 months.

1 hour ago, Sirius Lee said:

1) Redness is NOT a scar--they will go away over time. Pits are scars--they will NEVER go away, unless you treat them.

2) Your scars are pretty severe. Also they are numerous. Severe scars need surgical treatments like subcision.

3) CO2 laser is no good for you. Lasers cannot fix deep scars.

4) TREATMENT PLAN: Get (A) subcision and (B) Sculptra filler. Repeat (A) every 3-6 months.

Thank you for reply me i will talk about my derm but how much treatment i need and one more thing 20 March my accutane 6 months curs will be finish and after in April did i done for these treatments??

On 3/12/2018 at 5:36 PM, Haroon 786 said:

Thank you for reply me i will talk about my derm but how much treatment i need and one more thing 20 March my accutane 6 month™s curs will be finish and after in April did i done for these treatments??

It's SAFE to get subcision immediately after Accutane. You DO NOT need to wait for the washout period of 6 months. Actually, the sooner you begin the treatment, the better.

If your dermatologist disagrees, then show him or her the following article
 

Quote

[Link removed]

Patients treated with a variety of cutaneous surgical procedures while receiving systemic isotretinoin have been reported to heal without sequelae: 12 blepharoplasties, 9 liposuctions, 9 fat transfers, 9 facelifts, 8 skin biopsies, 7 subcisions, 2 excisions, and 2 punch elevations of scars.11,12 A 2016 systematic review of oral isotretinoin use and surgical procedures concluded that the current data on coagulation disorders, liver toxic effects, kidney toxic effects, arrhythmia, and infection associated with isotretinoin use indicate that it is safe to operate on patients taking isotretinoin (as long as they are healthy and preoperative blood test results fall within normal limits).

Make sure your dermatologist is up to date with treatments and current recommendations. A good method of assessing the current knowledge of your dermatologist is to as a simple question ' when can I start scar revision treatments after Accutane?' The answer should be straight forward as above.
BA has a extraordinary amount of dedication and patience. I have nothing more to add except this - a good dermatologist will always examine your scars, touch, feel, and examine in all forms or lighting to assess the amount of atrophy, take 2-3 minutes to REALLY examine your scars, then work in with you to understand what YOU see. She or he will then develop a treatment plan based upon mutual recognition of the scar that are most problematic to you, and not what the dermatologist sees. You are the patient, the dermatologist is just the technician. Success revision is only achieved if both of you are aligned with the end goals and realistic expectations.

19 hours ago, Sirius Lee said:

It's SAFE to get subcision immediately after Accutane. You DO NOT need to wait for the washout period of 6 months. Actually, the sooner you begin the treatment, the better.

If your dermatologist disagrees, then show him or her the following article
 

Thank you so much for giving me so much information next I have appointment with my derm and i will talk about tha but after subcision did i also done fractional co2 laser??

7 hours ago, Obi wan said:

Make sure your dermatologist is up to date with treatments and current recommendations. A good method of assessing the current knowledge of your dermatologist is to as a simple question ' when can I start scar revision treatments after Accutane?' The answer should be straight forward as above. 
BA has a extraordinary amount of dedication and patience. I have nothing more to add except this - a good dermatologist will always examine your scars, touch, feel,  and examine in all forms or lighting to assess the amount of atrophy, take 2-3 minutes to REALLY examine your scars, then work in with you to understand what YOU see. She or he will then develop a treatment plan based upon mutual recognition of the scar that are most problematic to you, and not what the dermatologist sees. You are the patient, the dermatologist is just the technician. Success revision is only achieved if both of you are aligned with the end goals and realistic expectations. 

Thank you so much for your motivation word for me 

On 3/11/2018 at 9:59 PM, beautifulambition said:

I do not recommend laser to start with for your case at all!

You have mainly rolling scars and some icepicks. Fat deficiency. PIE or wounding post acne that can be taken care of as well (reds).

1) Subcision, you need 3 of these and you will need filler. You have fat loss so I would suggest something like sculptra as a bed injected throughout the cheek, before any HA filler is injected for individual scars.
2) RF Microneedling this is very important 4 sessions of this, you look like you may have some fibrosis, only a doctor can feel the skin and see if that is the case. You space these 3 months apart between your filler sessions with subcision when it runs out.
3) IF your not getting a good response after the above. Do co2 at 5-7% At full power. Hence Low density and high power, This is only if the above is not helping and you have fibrotic scars still. This is optional and can be saved for last.
4) You will need several sessions of TCA CRoss for your icepicks
5)You will need peels for texture. Do several TCA peels or a fully sedated deep peel for more drastic results and more down time. A alternative to this is fully ablative erbium resurfacing.
6) You have lots of wounding and red in your skin from acne. Vascular laser or IPL is necessary for the reds. This does not work on anything else.

Look at the FAQ below: Subcision Section, Microneedling Section, Peels Section, Skin section and PIE

[Media removed]

Hi i how are i have a question please answer me and you can see my photo and my question is did i done Subcision co2 laser and filler combain or just first i done Subcision?? And what you think about thefat transfer in my scar with Subcision?

On 3/13/2018 at 6:20 AM, Obi wan said:

Make sure your dermatologist is up to date with treatments and current recommendations. A good method of assessing the current knowledge of your dermatologist is to as a simple question ' when can I start scar revision treatments after Accutane?' The answer should be straight forward as above.
BA has a extraordinary amount of dedication and patience. I have nothing more to add except this - a good dermatologist will always examine your scars, touch, feel, and examine in all forms or lighting to assess the amount of atrophy, take 2-3 minutes to REALLY examine your scars, then work in with you to understand what YOU see. She or he will then develop a treatment plan based upon mutual recognition of the scar that are most problematic to you, and not what the dermatologist sees. You are the patient, the dermatologist is just the technician. Success revision is only achieved if both of you are aligned with the end goals and realistic expectations.

Hi i how are i have a question please answer me and you can see my photo and my question is did i done Subcision co2 laser and filler combain or just first i done Subcision?? And what you think about thefat transfer in my scar with Subcision?

You can use fat but usualy first they subcise your skin,with needle.if you want fillers they inject that after your swelling gos down,so they can better fill your skin.filling can be done at same time by someone with lots of confidence/experience.

On 3/11/2018 at 11:28 PM, beautifulambition said:

Honey and Aloe are always a good way to start for wounds, or your can go with the triple antibiotic route which the Aussies don't have, I am sure you have something similar.

[Media removed]

I'm in the EU and can't get this without a prescription. When I'm in the US, I usually pick up a tube of Neosporin and bring it back with me.

@Haroon 786Sure Fat and Subcision is a good start. You need cannular subcision also called filling with a cannula.

You will still need 4 rf microneedling treatments after this 3 months apart. Follow the plan above 😉

On 3/13/2018 at 11:20 AM, Obi wan said:

Make sure your dermatologist is up to date with treatments and current recommendations. A good method of assessing the current knowledge of your dermatologist is to as a simple question ' when can I start scar revision treatments after Accutane?' The answer should be straight forward as above. 
BA has a extraordinary amount of dedication and patience. I have nothing more to add except this - a good dermatologist will always examine your scars, touch, feel,  and examine in all forms or lighting to assess the amount of atrophy, take 2-3 minutes to REALLY examine your scars, then work in with you to understand what YOU see. She or he will then develop a treatment plan based upon mutual recognition of the scar that are most problematic to you, and not what the dermatologist sees. You are the patient, the dermatologist is just the technician. Success revision is only achieved if both of you are aligned with the end goals and realistic expectations. 

Hi i how are i have a question please answer me and you can see my photo and my question is did i done Subcision co2 laser and filler combain or just first i done Subcision?? And what you think about the fat transfer in my scar with Subcision? 

1 hour ago, beautifulambition said:

@Haroon 786 Sure Fat and Subcision is a good start. You need both Nokor and cannular subcision also called filling with a cannula. One works on the pits individually, the other over the broad area of scars.

You will still need 4 rf microneedling treatments after this 3 months apart.  Follow the plan above 😉

But how much Subcision seasons i need and fat is permanent treatment? And did im not done combain season with Subcision like laser or microneedling and one more think my redness still in my face

And kindly please tell me what kind of scar in my face 

but how much Subcision seasons i need and fat is permanent treatment? And did im not done combain season with Subcision like laser or microneedling? and one more think my redness still in my face how they gone and what kind of scar in my face 

On 4/24/2018 at 4:48 PM, Quadboy said:

You can use fat but usualy first they subcise your skin,with needle.if you want fillers they inject that after your swelling gos down,so they can better fill your skin.filling can be done at same time by someone with lots of confidence/experience.

Does anyone speak German here??. Can you explain this better than me.

@Haroon 786

I already gave you a plan above. I don't understand what your asking 😉

You mainly have rolling scars. In the new picture the reds or PIE is from wounding post acne. Vascular laser is what works on this.
 

9 hours ago, beautifulambition said:

Does anyone speak German here??. Can you explain this better than me.

@Haroon 786

I already gave you a plan above. I don't understand what your asking 😉

You mainly have rolling scars. In the new picture the reds or PIE is from wounding post acne. Vascular laser is what works on this.
 

beautifulambition

• 
• Moderator
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• Posted March 11

  I do not recommend laser to start with for your case at all!

  You have mainly rolling scars and some icepicks. Fat deficiency. PIE or wounding post acne that can be taken care of as well (reds).

  1) Subcision, you need 3 of these and you will need filler (HA, PRP, Fat, Saline). You have fat loss so I would suggest something like sculptra, but if you rather do fat ....as a bed injected throughout the cheek, before any HA filler is injected for individual scars.
  2) RF Microneedling this is very important 4 sessions of this, you look like you may have some fibrosis, only a doctor can feel the skin and see if that is the case. You space these 3 months apart between your filler sessions with subcision when it runs out.
  3) IF your not getting a good response after the above. Do co2 at 5-7% At full power. Hence Low density and high power, This is only if the above is not helping and you have fibrotic scars still. This is optional and can be saved for last.
  4) You will need several sessions of TCA CRoss for your icepicks
  5) You will need peels for texture. Do several TCA peels or a fully sedated deep peel for more drastic results and more down time. A alternative to this is fully ablative erbium resurfacing. 
  6) You have lots of wounding and red in your skin from acne. Vascular laser or IPL is necessary for the reds. This does not work on anything else.