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Amp2695

PLEASE EVALUATE MY ACNE SCAR PLAN AND LET ME KNOW WHAT YOU THINK.

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1 hour ago, Amp2695 said:
Is sculpture an HA? one that is injected deep like VOLUMA? What is the diff between sculptura and Voluma?

Thanks man

 


Don't get Sculptra if you don't intend to pair it with Infini. If you only want fillers, then by all means get HA which is more predictable in outcome than Sculptra. But if you want more collagen production, then pairing Sculptra and Infini will be the way to go IMO.

The most fundamental difference between Sculptra and HA, aside from their main ingredients, is that HA is a volumizer, whereas Sculptra is a collagen-stimulator. That is, HA adds volume; sculptra induces collagen by stimulating the production of fibroblast. With HA, the polymer remains under the skin for the entire duration of its shelf life. With Sculptra, most of the content injected, which is largely water and lidocaine, gets absorbed by the tissue within a matter of days. After a few days, you'll look the same as on the day you got your injection. What stays behind are the microparticles, which are responsible for the controlled fibroblast.
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OP here:
I thought this would be a good point to update w pics and further plan for anyone still interested and following. My last tx was infini 2 months ago. Read rest of thread to see what else i had done i have dates. remember that the first pics i posted was before getting anything done at all. The lighting is the exact same as first set of pics. This is the harshest lighting i could find.
My overall thoughts so far:
* i would put improvement this far at about 20%, sometimes my boxcars seem a bit shallower than before.
*my face is significantly less oily, still oily but less.
*the red i circled on one of the pics is some type of burn from the infini that is fading vvv slowly, they are not breakouts.
*The one pit the doctor nokored seemed to lift a tiny bit.
*some spots that he tca crossed seemed to get wider but idk maybe with time they will fill up and go back to how they were or even better, but for now one of them looks really wide. A WORD OF WISDOM; STAY AWAY FROM TCA CROSS 100%, START LOWER. TCA CROSS carries a long downtime and could possibly make things worse. 
MY NEXT STEPS:
After talking with moderators and doing lots of thinking here are my next steps
May 29: derma pen w prp (had groupon might as well take advantage)
june 13th: already scheduled to get full face nokored by dr rullan
june 26th: already scheduled to get fillers, whatever dr r suggests upon first visit. probably a good HA.
Early october: nook again plus filler

QUESTIONS ARE WELCOME.
20180525_075133.thumb.jpg.a39d133c4fd96f3611c7f54c925befae.jpg
20180525_075225.thumb.jpg.61c8dca9d016af3ba34e057818f09110.jpg

 
Edited by Amp2695
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49 minutes ago, ChildhoodDreams said:

That's a good improvement thus far IMO, assuming consistent lighting.

FLaTwWa.png

hey thnx i was trying to do this. yea the lighting is the exact same, even same bathroom lol. 
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1 hour ago, ChildhoodDreams said:

How many INFINI's + subcisions have you had?

its all in the thread.... but I've had one intracel, one infini, and a test subcision on that deep one. Im getting a more aggressive one w rullan on june 13.
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op here:

just giving quick update for those still following:
 
*did a derma pen w prp about 2 weeks ago. liked the results not significant enough for a pic,... but it may sound stupid but i feel like it soften texture a bit. 
* grid marks from infini gone except for those red marks on my left lower jaw they are fading but still there 
* the tca cross spots seem to be fading gradually i would say the redness has faded about 60% and it has been a bit over 3 months. i feel like it only made them wider, but some look to be lifting up... idk only time will tell, i can probably give a better result update when it has been about 8 months since tca cross, has only been 3.
*will see dr rullan this wednesday for subcision, i have started taking arnica pellets 5 days before and 5 days after procedure as a lot of docs say this helps w bruising and bleeding from sub. I will go back to dr rullan 2 weeks after sub for filler.
*i will post pics probably around early july to prevent swelling in before and after pics.
thnx

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op here:
can anyone give me links to people having negative reactions to slikon1000 fillers. at this point i think I've seen more people have positive reviews than negative ones. thinking about doing silikon fillers w rullan soon after my subcision.

thnx

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For your scarring, I would be VERY wary of permanent fillers.   Your scars are widespread, but not very deep.  In these borderline cases, you may end up overcorrected and get bumps.  If you decide to do it, do it only on your deepest scars and WAIT and OBSERVE.     

Remember, the volumizing from Silikon 1000 is only partly from the material, the other part of it is the collagen that your body produces to encapsulate / wall off the foreign substance.  That is why you have to wait 1-2 months to ascertain your immune response.  Also, while Rullan is a top notch doctor, there have been reports of people who were overcorrected or got lumps from temporary filler from him.

At least in those situations you can dissolve the filler.   Being overcorrected with permanent fillers will cause a life long headache.   

Do not do permanent fillers for your first time.  You have to KNOW first if your scar type even responds to filler.  Rullan can do an amazing job of filling your scars, but the unknown variable is your body's immune response.  Better safe than sorry.

Edited by dazzed
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I understand. I will do an HA first. Which one would be the best one to give me the best results for my type of scars?

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Since they're superficial you can try Belotero, Restylane Silk, Juvederm Vollure (apparently new).  Voluma is too thick and hard to be used that superficially.  

If you eventually want to do permanent, I would try Bellafill.   It's permanent and has the same risks as Silikon 1000 but at least it's FDA approved specifically for scars.   Also, I have read studies that show that lumps from Bellafill respond well to cortisone injections to flatten them, whereas Silikon 1000 lumps are very hard to treat once they form.  

Spend the money and be safe rather than sorry.  Money you can always make back  

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2 hours ago, dazzed said:

Since they're superficial you can try Belotero, Restylane Silk, Juvederm Vollure (apparently new).  Voluma is too thick and hard to be used that superficially.  

If you eventually want to do permanent, I would try Bellafill.   It's permanent and has the same risks as Silikon 1000 but at least it's FDA approved specifically for scars.   Also, I have read studies that show that lumps from Bellafill respond well to cortisone injections to flatten them, whereas Silikon 1000 lumps are very hard to treat once they form.  

Spend the money and be safe rather than sorry.  Money you can always make back  

ok do you think its a good idea to tell rullan to find the deepest scar he can find and just do silicon just on that one scar?
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He seems willing to work with patients.  Just tell him you want to do a test spot.  A test spot is always a good idea.  Give it a shot, the worst he can do is say no, but you have a legit and logical reason why you want to do one. 

This is why you should be careful with permanent fillers..

https://www.realself.com/question/fort-lauderdale-fl-desperate-silicone-microdroplets-removed-face#

Edited by dazzed
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OP HERE:

just got back from a subcision w dr rullan. Let me start off by saying that dr rullan and everyone on his team is REALLY AMAZING. THEY ARE SUPER NICE AND CONSIDERATE. Better and more knowledgable than any derm in Phoenix.
They were very professional. After taking before pics i was numbed. Doctor rullan later came in and introduced himself and explained i might need cross, he said he does not do TCA anymore since it causes problems, he did carbolic acid on only one that i picked as a test spot. He also said he does not do NOKOR anymore as it causes major hematomas, he used blunt needle, he only made one incision point per side and covered EVERYTHING including temples. Only two incision points on my entire face!!! (Thats awesome).I heard loads of popping so i know the outcome is probably better or the same as nokor. He mentioned that if he were to use a nokor i would be bleeding down to my neck. I virtually had no bleeding whatsowver even after being done. It was good. Only time will tell of the results. As of now pretty swollen.
qs welcome

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@ChildhoodDreams

I sort of like the fact that rullan is comfortable with the results from cannula.  IMO nokor sort of scares me unless it was on my cheek in a VERY safe zone.  I have a lot of scarring on my temples and feel I far more comfortable with a cannula near the veins + artery than anything else.  To know that one of the best doctors only uses cannula gives me a sense of relief.  
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I think what is important is that the bands are severed, and if he can do that more safely with a blunt instrument and minimize collateral damage, thats a GOOD thing.  I also like that he's only making one entry point now, which will minimize the potential for incision site scarring. 

Also, I think the use of cannulas will allow for more superficial subcision, something you can't do with a sharp scalpel-like instrument.   This is good for people with more textural scarring and widespread, but not deep pits.  

 To be frank, I think the incidents we've seen documented on here about his subcisions in the past causing too much hematomas prompted him to switch things up.   I think it's a positive development.  



Thanks for this info.

Edited by dazzed
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11 hours ago, beautifulambition said:
@ChildhoodDreams
  • A large percentage of his practice is Ethnic Patients, he is close to the border and specializes in peels for all types but especially said patients. These skin types tend to have more issues with hematomas, PIH, healing time, etc. 
  • The safest route is to not use Nokor thus avoiding said problems, we don't know the patient stories and difficulty he has had to deal with but logically this is the easier path. Cannulas causing less collateral damage.
  • Doctors all have choices of treatment, different methods, and favorite ways of doing things. Dr. Lim does 3 kinds of subcision (Nokor, Cannula, tiny needle / normal sub). In my personal view more "tools" allow you to treat more problems properly. Perhaps he does not have the bandwidth to deal with hematomas and other time consuming complications. We have all seen those type of patients post here, saying their life and face are ruined from aggressive subcision, or they have health issues ... not taking the proper time to heal / have down time. These patients often do not do a lot of research and instead think a singular treatment will solve everything (this is not how treatment works). 
  • For many patients I know cannula subcision would not work as they have thick fibrous scar tissue and big deep pits. Cannula subcision is best for shallow / smaller scars, ... Really cannula subcision is just "filling" / filler using filler with a cannula or whatever substance. Anyone in my oppinion who is a expert injector can do cannula filling, ... few can do Nokor. I remember calling some of the best Drs a few years ago to do some research. Out of hundreds only a "few" did Nokor subcision. It's not something that is readily taught anymore in Derm school to gen derm practitioners . It's a specialty.  
    • I had a Specialist Dr once say to me "we have lasers, why would we do a outdated treatment. Only old school dermatologists do this." So you see it does not have the glits and glamour of lasers (Money $$$$$, but serves a very real and important part of acne scar treatment. I have had some members here find alternative subcision sources by calling schools that teach dermatology and have a clinic.  
  • Some doctors only do standard needle subcision which they use for various procedures and buy in bulk. This too lacks the slicing / scalpel ability of nokor as your just jabbing around. We have had a few dough -nutting filler cases here from this. 
  • The OP's scars are shallow and thus are better treated with cannula sub. In fact many of the reports we had from Rullan lately have been shallow scars. 
  • I cannot imagine someone doing Nokor all over their face, ... it would be quite a mess for someone who has widespread scars. It's good for deeper pits. Perhaps this is what Rullan meant by "blood running down your neck" for widespread textural scars -it's overkill.
  • For large pits or even deeper smaller pits, hematomas can be good. They provide "natural" filler which is hidden under the skin. Of course for shallow scars this is not the case, no one wants bumps.
  • Cannula sub takes less aftercare, you don't have to be concerned with blood localizing and forming a hematmoa, wound healing, redness. You can fly in and out with just some swelling. You get more swelling with Nokor.
well said. i do believe some of my bands were thick though. the last sub i had was 2014. i have some deep ones on left side, thats where i heard loads of popping. he did use lots of force tho, i asked him since you don't use nook does that mean you have to slice harder w the cannula to break through the fibers  harder than w nokor? he said yes. He also mentioned theres this new thing better than pro called prf. 
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OP here:

post op day 11.

Things went pretty good. i was swollen for about 5 days. Bruising was extremely minimal, compared to other threads where people have like a green tint. I did not have any of that probably due to 2 things:
1. blunt cannula was used
2.i took arnica montana pellets 3x day 5 days before procedure and 5 days after procedure.
I did hear LOADS of popping during procedure tho. Incision site entrance closed up pretty darn nice, prob bc blunt cannula isn't as thick as a nokor. Scars are back tho (expected) they do seem a bit more plumped up tho like maybe 35ish%. i will be gong in for fillers w rullan this tuesday,  know I'm not going to get amazing results but i just want to see some difference maybe at least 40%. (sorry i know I'm a big % guy). so it has been about 4 months since i started this journey, tca cross redness has reduced maybe a good 60ish% sometimes it feels as the spots treated w tca cross are rising, sometimes it feels like no difference was made, and sometimes it feels like the pits are wider. one thing for sure it looks better than a month after i got crossed. I really do hope people would stop recommending tca cross 100% to people. It should be made very clear to start out low like 60%, i wish people warned me of this, but it seems everyone just says "yea go get tca cross it'll help w ice picks".
thnx guys.

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op here:

24 hr since my fillers.

Rullan and I decided on restyle lyft. He used a full syringe and mostly did both my temples and cheekbone area, which was ok w me. He did NOT do a silkon1000 test spot as he said my scars are not ready for silicon bc something about the scars being to jagged. There was some lumping a few hrs after procedure, today lumping went down a lot but there is bit of swelling and tiny bumps. Rullan said that if after day three there are still bumps i can massage them.

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I'm at a dead end here guys... don't know what to do anymore.

Fillers made no difference whatsoever. it was the end all be all treatment the one that i was hoping would give me some result. I'm not the type of person who wants 100% OR EVEN 60% but the fillers literally did nothing at all. I don't even know what to do anymore. why are scars so fucking difficult? even cancer is more godamn curable than this. fuck acne . fuck scars.

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I can try to help you. Please PM me recent pictures or post here ... with a close up of the issue. Using a flashlight is helpful for shadows. 

Filler will not solve all your issues. Acne scars take work! Each treatment you get a different percentage of improvement (small and incremental). It seems someone sold you perfection. It's also a very long process with ongoing "work."

I don't understand you had bumps and contacted me about this concerning filler and now say it did nothing, this statement is confusing to me. You were also the one pushing to do micro silicone injections right, good thing that did not happen.

I see from reviewing your pics above (May), that filler would not be most helpful to you, so I don't know who told you this. You have shallow scarring. 

These are box cars (below) and need tca cross (many treatments), cannular subcision (with prp, saline, or filler), ... filler won't do alot as they are superficial. Did you do 3-4 treatments of rf microneedling. This helps boxcars for many. You will need to slightly lift them through sub / tca cross, and rf needling and then you will need a quite strong resurfacing for texture - erbium (with a long down time)! Your issue is texture.

Have you responded 0% to all treatments, please go through everything and let me know what worked and did not. If you have seriously received 0% improvement then your healing is poor and treatments are not suited to you.

20180525_075225.thumb.jpg.61c8dca9d016af3ba34e057818f09110.jpg
 

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8 hours ago, Amp2695 said:

I'm at a dead end here guys... don't know what to do anymore.

Fillers made no difference whatsoever. it was the end all be all treatment the one that i was hoping would give me some result. I'm not the type of person who wants 100% OR EVEN 60% but the fillers literally did nothing at all. I don't even know what to do anymore. why are scars so fucking difficult? even cancer is more godamn curable than this. fuck acne . fuck scars.


Hmm... With HA fillers like Lyft, the result is immediate. That is, what you see is what you get. Of course, some minor swelling will be present, but for the most part what you see is there to stay. Also our body would not be able to naturally suck up or dissolve a whole syringe of filler in just 3 days. So if you saw a good result 3 days ago, but it all but disappeared since, maybe it wasn't HA filler. Could it have been Sculptra????????
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no I'm sure it was restylane lyft. I grabbed the syringe and inspected it as he left it in the room then left. He used the whole syringe on both temples and cheek bone areas. For the 1st day there was lumps and then after day 3 the lumps went down all the way. but the scars had literally 0-10% improvement. Ive had 2 rf micro needling as well. I think my skin is just shit. I'm sure i have the worst scars out of anyone here as they are on 80 % of my back and chest. i think i am well done w this journey. I know its a slow progress but jesus all that stuff I've done all that down time and not even a 30%?

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