Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
f93d

Subcision/cross progress - before/after - Success Story

Recommended Posts

This post includes all updates in this thread.

Baseline Photographs
I've had a lot of treatments done prior to starting this journal - 4 mixto CO2 laser treatments, 10+ micro needling sessions, juvederm (2 vials), 2 venice viva, cooltouch, and 2 spot subcisions. Today I know those treatments were more or less a waste of time and money. 

These baseline pictures were taken many months after I had those treatments.


before.png.47c3c357eb0087f168fe770b4c0709f8.png
Image 1: Baseline photograph

before.thumb.png.4b6f2a4e04dacf1bb9c306e144a08542.png
Image 2: Baseline photograph

Visual improvement estimates are based on how I feel my skin has improved overall relative to the baseline pictures. As my scarring is widespread, I don't care so much about the improvement of any individual scar but rather how the skin looks as a whole.

My goal for this log is to discuss the results, lack of results, & side effects.

Doctors:

Dr. Rullan (256 Landis Ave #300, Chula Vista, CA 91910)
Dr. George Anterasian (2336 Santa Monica Blvd Ste 209, Santa Monica, CA 90404)

Estimated Prices SoCal 2019

This journey is expensive. Here are approximate prices for the area for an experienced doctor:

Subcision: $750 / session
Infini: $1000 / session
Filler: $500 / vial
Sculptra: $750 / vial
Cross: $250 / session
Needling: $250 / session

Add in transportation cost and vacation.

Year 2018

Treatment #1: Early January, 2018 - Nokor Subcision, Phenol cross (Dr. Rullan)

Downtime:~ 2 weeks (out in public after 1.5 weeks)
Total Visual Improvement (compared to baseline) 0%
Comments:
This phenol cross was much weaker than round 2 (peeled within 2 days vs 6 - 7 days). I could feel some areas lifted up as they were no longer tethered. Subcision worked great for jawline tethered scars.

Treatment #2: Mid February, 2018 - Nokor Subcision + Suction Method + Aspirin, Phenol cross (Dr. Rullan)

Downtime:3.5 + weeks (out in public after 2.5 weeks), full downtime ~ 2 - 3 months
Total Visual Improvement 15%
Comments:
The aspirin and suction significantly prolonged bruising. Aspirin was recommended by another doctor, taken daily 1 week prior to the procedure. This was the most effective treatment I’ve had up to this date, however, the downtime was very long. One of the insertion points left a scar that eventually resolved.

p1.png.51bfb483ef51172dabb5650b46e59e6e.png
Image 3: 48 hour picture, swelling has died down significantly from day 1

20.png.d5cceb78477f594eafcc77d81d7e9275.png
Image 4: Day 20, skin is swollen. Beware of suctioning incorrectly. It'll leave a dark circular mark (left picture) for a week.

day30.png.98676a4ece9dfdfd30c291640c062a64.png
Image 5: Day 30, skin is still swollen. You can see many of the scars coming back.

Treatment #3: Late April, 2018 - Infini (Dr. George)

Downtime:~ 1.5 weeks (out in public after 5 days), 4 - 5 weeks to fully heal
Total Visual Improvement: 15%
Comments:
Left many pinhole wounds that took 1 - 3 weeks to heal. Some wounds appeared to disappear only to reappear a week later and bleed. The skin was extremely tight for about 3 weeks. It made my skin feel sunken in and weak at the one-month mark. Cannot comment on improvement as I had Sculptra shortly after.

Treatment #4: Late June, 2018 - Sculptra 1 Vial + 0.3 vial HA Volbella Filler (Dr. Rullan)

Downtime:~ 1 week for pigmentation issues (out in public after 3 days), chipmunk face ~ 3 - 4 weeks
Total Visual Improvement:25%
Comments:
My skin felt terrible all the time - always wanted to touch it - prior to Sculptra. It was as if Sculptra gave me my skin back. My skin felt plump rather than saggy. It was great for widespread superficial scarring (neck and jawline area).

The HA filler was injected at the temple and also slightly below the temple. You can see all the scars still, but it’s more level with the surrounding skin.

R-progress.png.eb7efc8240a691d8ec61d5578366f612.png.c23445e3f31e4eacad678c9de79416f2.png
Image 6: Right side, 2 different angles, 5 - 6 weeks after treatment #4

Treatment #5: Mid August, 2018 - Cannula Subcision, Phenol Cross, Micro Needling - Electric (Dr. Rullan)

Downtime:~ 1 week (out in public after 6 days)
Total Visual Improvement: 25%
Comments:
Bruising from cannular subcision lasted about a week, nokor was ~ 2 weeks. Cannular subcision has an advantage over Nokor subcision in that it can hit all scars in one treatment. Cannular subcision also only has 2 incision points, reducing the possibility of scarring. 

s1.png.cd07497a3f09a20cf731d39878e147b2.png.1c0a2110a325892a13ff6979e80c60d1.png

Image 7: Downtime timeline

Treatment #6: Mid September, 2018 – HA Volbella Filler 1 Vial (Dr. Rullan)

Downtime:~ 1 week (out in public after 3 days), 2 – 3 weeks for pigmentation to resolve
Total Visual Improvement: 40%
Comments:
Filler delivered good results but it also had its side effects. My skin was itchy for the first 1.5 months, and it looked unnatural and lumpy in certain angles. The filler constantly shifted since the time it was injected. Massaging lumps for 2 weeks made most of the lumps go away. There was the donut effect primarily on my right side for many scars. The filler worked better on my left side. If the filler moved slightly off the scar (resulting in a mountain and valley), I would simply “push” the filler back over a week.

Treatment #7: Early October, 2018 – Infini (Dr. George)

Downtime:~ 1.5 weeks (out in public after 5 days), 4 - 5 weeks to fully heal
Total Visual Improvement: 50%
Comments:
No improvement for the first month and a half. 

ls2.png.ea0d608b6287c32296dd08e24dcc3ccd.png.9864749fb30175b3858754d76868374a.png

front_view.png.08112c4bbc771eb7b10d6acdf3e885a2.png.971a3b8b4d0163ced2212931c254062f.png
Image 8: LED spotlight in darkroom - 4 weeks after Treatment #7. In person, the above results look unnatural (lumpy).

dec2018.png.f532bcbc38ea7bc5009ce603fa4f754a.png
Image 9: Florescent lighting, 2 months after Treatment #7. The improvements appear to be holding up, although some of the filler has dissipated and swelling has reduced since Image 8. However, the appearance looks much more normal.

Treatment #8: Early December, 2018 - Phenol Cross, Cannular Subcision (Dr. Rullan)

Downtime:~ 1 week
Total Visual Improvement:50%
Comments: This treatment was another attempt at breaking down the tethered scarring. Scars were reshaped, existing filler redistributed.

---

Yearend summary

My skin has improved this year - the baseline pictures do not show how bad I saw it in the mirror. Skin is far from perfect, however, people who have been critical of my skin (unsolicited) have told me this month (unsolicited) my skin has improved a lot. There are still lighting conditions that shock me where I see terrible skin.

Total cost of treatments for 2018 was $520 / month, which I think is reasonable for the expertise of 2 highly experienced doctors in SoCal. I'm thankful I did not have any permanent complications. Logging my 2018 improvement as roughly 50% improvement from baseline.

t12-35.thumb.png.2193779e0c2ad9fccd0aa6c9d79015af.png

Image 10: 3 - 4 weeks post Treatment #8, 2018 year-end results.

Year 2019

Treatment #9: Early January, 2019 - HA Volbella 1 vial, Sculptra 1 vial (Dr. Rullan)

Downtime: 3 days
Comments:  Slight swelling ~ 6 - 10 days. Sculptra was mainly injected into the cheeks.

Jan 30: Noticeable donuting (filler moving around the indent) on the right side, especially at night. In the morning it seems to revert. Donuting most likely caused by tethered scarring; the scars are prone to retether. Right side has lumps from filler, making for an unnatural lumpy texture. Left side is fine, no donuting, filler is smooth.  Noticeable thickening of skin felt at the 3 week mark where sculptra was injected.

---

lt-9.png.7b9100632287e9e1c2f9b81af6e7c449.png
Image 11: ~ Jan 20, Angled sunlight view after swelling resolved (~ 12 days) from Treatment #9. I've a lot of redness and pigmentation issues. Right side shows jawline scarring also.

Jan 25: Began daily use of Retin A, moisturizer w/ SPF 30 and niacinamide. 
Jan 30: Began daily use of 2% hydroquinone, azelaic acid, phenylethyl resorcinol, and kojic acid. 

No topicals except sunblock were used prior.

s1-23.png.39d5c217b36d9f84a3ce17c781b277aa.png

Image 12: Feb 3. Filler is causing a lumpy texture, even moreso now that the sculptra seems to have started working. The red arrow points to a line caused by excess filler. 

 

Treatment #10: Early February, 2019 - Infini

Downtime: 5 days
Comments:
This sculptra + infini combo showed the best results yet. I had massive volume build on both sides, resulting in many filled scars. 

021519.thumb.png.80959341eb27b8ee49f3c901dd3ba660.png

Image 13: 1 week post Infini (Treatment #10). Skin currently feels extremely tight.

040819.png.7840bfda45adfd9bb725480db06c646b.png.d1d5c3f803189f72c9bc7cf9528f4c8e.png

Image 14: 2 months post. Texture overall has improved. Scars have gotten much shallower.

Treatment #11: Early May, 2019 - Cannula Subcision w/ Suction Method

Downtime: 6 days


051419.png.cff7164d0930d2514055bf91d81eff6d.png

Image 16: 12 days post Treatment #11

before.png

m3.png

Share this post


Link to post
Share on other sites

I would love to see how your temples turned out.  They are my biggest concern ATM and I've been hesitating wayy too long to get my treatment. 

Share this post


Link to post
Share on other sites
Guest

Your skin will/should just get better,you heal for months.
:smileys_n_people_82:

Share this post


Link to post
Share on other sites

Not expensive relative to laser treatments - I'd call in to get the quote. Dr. Rullan's office is open about their pricing model.

At this point one session of subcision + suction has shown probably equivalent improvement to all treatments I had in the past. Here's where I'm at with my right side around day 60. I made a mistake on my downtime - I didn't see that I was still quite bruised under certain lighting conditions; I was bruised to the cheek bone. Massaging it daily has helped and the real downtime was around 50 - 60 days. 

Below image shows where I'm currently at. I don't think this picture shows it, but my scarring has improved substantially, especially in the temples. The scars are all still there but a lot has flattened out. It didn't do anything for non-tethered scars.

I've an infini scheduled and will post every month or so. If someone can comment on whether or not I could benefit from another subcision, much appreciated. 

day60.png.4ccef4cd667185f34ccfa31f9105f2b6.png

Share this post


Link to post
Share on other sites

Lots of improvement, congrats! How long does it take to heal completely? Like as in how long do I have to wait before scheduling an interview with a job or say, a date  for the skin to look normal (no bruising etc). I have the same skin tone, etc

Edited by Scarredtodepression

Share this post


Link to post
Share on other sites
@Scarredtodepression Hi there, as I have mentioned many times on the board, healing times vary per person. They are not universal. He may be quick and you may be slower. I would use a concealer or something like dermablend to cover the bruised areas or a tinted moisturizer (yes guys use this too after medical procedures). After a few days you could go back to work and go out. Your just covering the treated area. I don't think most people would go on a Date directly after treatment as the body is slow to heal and we would not naturally look our best. You have to do a few treatments to gain the level of improvement you desire. 

Share this post


Link to post
Share on other sites
21 hours ago, labellavita1985 said:

Are subcision and phenol cross done at the same time to the same scars?

Phenol first, then subcision, same procedure. The phenol was as advertised, improved certain scars by maybe 15%, didn't make any scars larger. Will need several more. It has helped reduce some of the shallow, sharp border edges of certain scars.

 
3 hours ago, Scarredtodepression said:

Lots of improvement, congrats! How long does it take to heal completely? Like as in how long do I have to wait before scheduling an interview with a job or say, a date  for the skin to look normal (no bruising etc). I have the same skin tone, etc

I'd go with beautifulambition's rec of using make up. It takes forever to go away. 

Share this post


Link to post
Share on other sites
On 4/16/2018 at 7:19 AM, f93d said:

Below image shows where I'm currently at. I don't think this picture shows it, but my scarring has improved substantially, especially in the temples. The scars are all still there but a lot has flattened out. It didn't do anything for non-tethered scars.

I've an infini scheduled and will post every month or so. If someone can comment on whether or not I could benefit from another subcision, much appreciated.


Has it been 3 months yet since the last subcision? My view is that it's better to milk the cow to the last drop before getting another treatment, otherwise you just might mess up the milk flow. 

It appears that a few scars on your cheek are still relatively deep and you would be better off getting another subcision. You'll want to fill those pits as much as possible before switching to Infini, which doesn't do much for deeper scars. If you have the money, I also encourage you to get some dermal filler, at least for those deeper ones. Fillers can also stimulate collagen production.

Share this post


Link to post
Share on other sites

These improvements were definitely worth it, if you respond this well to treatment, i think youll be set after a few more. Thats awesome. Super jealous and happy for you!

Share this post


Link to post
Share on other sites

Is phenol cross the same as tca cross? Im having a hard time finding anything on phenol cross. Wit so you were bruised for about 60 days from a subcision??

Edited by Amp2695

Share this post


Link to post
Share on other sites
On 4/28/2018 at 8:06 AM, Amp2695 said:

Is phenol cross the same as tca cross? Im having a hard time finding anything on phenol cross. Wit so you were bruised for about 60 days from a subcision??


It's supposed to have less adverse effects and produce better results. However I read that publication a while back and remember thinking the sample size was small. Originally I was scheduled for tca cross, however the doc was confident w/ phenol, so I agreed. 

For the bruising, I can still see a tint today on a portion of the right cheek; it mostly died out by day 60 but was still somewhat noticeable. From reading other subcision posts on this forum, it seems my bruising duration is on the upper end. 

--

I went ahead with an Infini treatment Thursday, 2.5 months from last treatment; downtime is looking like around 6 days.

Going forward I plan to wait 3 months and get subcision/cross followed by filler.

Share this post


Link to post
Share on other sites
58 minutes ago, f93d said:

It's supposed to have less adverse effects and produce better results. However I read that publication a while back and remember thinking the sample size was small. Originally I was scheduled for tca cross, however the doc was confident w/ phenol, so I agreed. 

For the bruising, I can still see a tint today on a portion of the right cheek; it mostly died out by day 60 but was still somewhat noticeable. From reading other subcision posts on this forum, it seems my bruising duration is on the upper end. 

--

I went ahead with an Infini treatment Thursday, 2.5 months from last treatment; downtime is looking like around 6 days.

Going forward I plan to wait 3 months and get subcision/cross followed by filler.
hmm I'm going to do more research on phenol cross, was there a % ? for example i had tca cross w 100% tca. 
yea 60 days of bruising is quite a lot. i remember getting an aggressive sub + a co2 back in 2014 in one day and i was all well a week later. hope you see awesome results from the sub tho. yea your plan sounds solid.
yea i had an infini rf about 1 month ago. (deepest at 2.5mm), i was swollen and red for about 1 week. Grid marks are still slightly visible. One or two burn marks also visible. still hopeful tho. Would you say the phenol cross did "fill in your ice picks" considerably or no?
Thanks bro

Share this post


Link to post
Share on other sites
@f93d   How would you describe the current state of your skin?  Is the improvement still holding mostly?  Those pics were impressive, but of course there was still swelling present.

Share this post


Link to post
Share on other sites

Don't give up on us. let us know what worked and what didn't. I understand sometimes people (myself included) can get very any and skeptical, etc. but its the nature of having these damn scars. 
Thanx ,man.

together united we can do great things (lol cheesy i know but true)

Share this post


Link to post
Share on other sites
On 6/4/2018 at 3:14 PM, Amp2695 said:

update?


Experience with Infini:
Final downtime was about 10 days, back out in public after several days. ~ 2 weeks later it seemed like many of the scars were more sunken in. Since then my skin has restored back to normal.

Temple improvement not as good as I originally saw - unfortunately it may have been long term swelling. Subcision bruise right side hasn't healed yet - still see a tint with a camera picture. Left side still has a brown mark from a subcision incision point. 

Overall I like the direction my skin is headed in. On my left side, I think sculptra and a few peels/cross for texture will achieve my desired results (large shallow pitting/volume loss + terrible texture).  On my right side I need to figure out how to fill those pits in. Subcision/suction helped significantly on the cheeks, the jaw/neck area, but not so much on the temples nor areas close to the mouth. Some scars have changed shape but visually do not look any better. Texture is slightly better but needs work. It's hard to gauge as some days the skin just looks worse than other days. I'm not sure the improvement is substantial enough that it'll show up on camera. Will see how the skin builds over the following months.

I'll update again in several months. Plan is to get sculptra, subcision + filler (right side only), RF needling, cross in no particular order but will start with a session of sculptra next week. I'm done with subcision/suction and will opt for HA filler instead; this will likely be my last subcision.

Share this post


Link to post
Share on other sites

Got pictures today. Had Sculptra 1 vial 5 - 6 weeks ago + 0.3 vials HA filler placed in temples.

I don't like these pictures but I do like the progress I see in the mirror. Still a long way to go.

R-progress.png.eb7efc8240a691d8ec61d5578366f612.png
 

Share this post


Link to post
Share on other sites

its hard to tell of the progress from these pics but i do understand that in person they are probably way better. How much % would you say you got? 

Share this post


Link to post
Share on other sites
4 minutes ago, Amp2695 said:

its hard to tell of the progress from these pics but i do understand that in person they are probably way better. How much % would you say you got? 


In this lighting condition (dark room + spotlight LED) little to no improvement. The problem with this lighting in my opinion is a shallow scar casts a deep shadow, just like a deep scar. 

In other lighting conditions like @ work in the bathroom (florescent), huge improvement - I was ecstatic after looking at it recently. I wish there was a better way to measure scar depth and size for the layman.

Share this post


Link to post
Share on other sites

Had cannula subcision, phenol, needling 2 weeks ago. It's unlikely I'll ever want nokor again; cannula subcision hits all the scars in one treatment rather than just certain areas, and I'm not bruised for months. Also only 2 incision points!

I figured a downtime timeline might help some people here plan their treatments around school or work, so here is mine. To those who are flying in for the procedure and flying out same day - :smileys_n_people_105: :smileys_n_people_9:. The face looks absolutely terrible right after treatment. The 24 hour picture, swelling has already reduced considerably.

s1.png.cd07497a3f09a20cf731d39878e147b2.png

It may be early to post results but here's where I'm at. Same lighting, different angles.

082618.thumb.png.53e137c006926bca74b71f7627043f3c.png

Best,





 

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×