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getschwifty

Previously had two sessions of subcision + sculptra. For my third session, is it okay if I do just subcision or should I go with subcision + sculptra again?

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Hello everyone!

I've had subcision + sculptra + cooltouch laser twice before (I just got my 2nd one a 6 days ago).

I intend to get another scar treatment four weeks and I'm not sure what procedure to undergo. Please note, I still have one big lump and two small lumps on the subcised area. I am also using tazorac for acne & collagen renewal.

Option A: Just subcision. I'm really leaning towards this since it's cheaper

Option B: Get subcision + sculptra again

Option C: TCA Cross for Ice pick scars

Option D: TCA peel for general texture

Thanks everyone!

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If it was me.. I would do TCA peels and TCA spot treatments at home. I know nothing about sculptra but if the doctor is actually competent in subcision and puts in the effort to hit all the scars, I would skip the sculptra and go with using a venom suction to suction the scars right after the subcision treatments.

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@getschwifty
Please contact me privately by PM if you wish with a picture (shadows make scars - use a flashlight) if you need customized help.

If you had sub + Sculptra you need 3 to 6 months to heal, ... any other treatments besides microneedling / derminator at home is not advisable and can damage the collagen which is being built. The body is slow to heal and collagen is fragile. 

4 weeks is not advisable.

a: No we do not get subcision and sculptra again for many months

c: Sure you can do this it's on the surface and not a energy or surgical method under the skin. Several of these are needed

d: we do not peel to the end once the work has been done through several other treatments.

I forget your case... after tca cross your next treatment should be rf needling to stimulate the sculptra.  

BA

 

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9 hours ago, getschwifty said:

I've had subcision + sculptra + cooltouch laser twice before (I just got my 2nd one a 6 days ago).

I intend to get another scar treatment four weeks and I'm not sure what procedure to undergo. Please note, I still have one big lump and two small lumps on the subcised area. I am also using tazorac for acne & collagen renewal.


Did you get the sculptra injected on the same day you got the subcision? Just for reference, sculptra should be injected at least 4 weeks before subcision. It takes about 4 weeks for the PLL acid to kick in and start stimulating collagen production. Moreover, it takes approximately 6 months to see its full effect. So, in essence, if you were to get another subcision in 4 weeks, you will likely just screaw up the collagen renewal. Hence, as @BA suggested above, go with the flow and don't rush it. So if your doctor, who shoud know better, is suggesting you get subcision or laser every 4 weeks, it's in your best interest to fire the SOB and find someone else.

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20 hours ago, beautifulambition said:

@getschwifty
Please contact me privately by PM if you wish with a picture (shadows make scars - use a flashlight) if you need customized help.

If you had sub + Sculptra you need 3 to 6 months to heal, ... any other treatments besides microneedling / derminator at home is not advisable and can damage the collagen which is being built. The body is slow to heal and collagen is fragile. 

4 weeks is not advisable.

a: No we do not get subcision and sculptra again for many months

c: Sure you can do this it's on the surface and not a energy or surgical method under the skin. Several of these are needed

d: we do not peel to the end once the work has been done through several other treatments.

I forget your case... after tca cross your next treatment should be rf needling to stimulate the sculptra.  

BA

 

Ohh, I see! I didn't know that. My first subcision with sculptra was 5 months before my second one so I should be great on that end. My surgeon never told me about any time limitations in between subcisions after sculptra.

How long before I am able to do RF microneedling? My surgeon doesn't advise it because I have hypertrophic/keloidal tendencies.
15 hours ago, Sirius Lee said:

Did you get the sculptra injected on the same day you got the subcision? Just for reference, sculptra should be injected at least 4 weeks before subcision. It takes about 4 weeks for the PLL acid to kick in and start stimulating collagen production. Moreover, it takes approximately 6 months to see its full effect. So, in essence, if you were to get another subcision in 4 weeks, you will likely just screaw up the collagen renewal. Hence, as @BA suggested above, go with the flow and don't rush it. So if your doctor, who shoud know better, is suggesting you get subcision or laser every 4 weeks, it's in your best interest to fire the SOB and find someone else.

Really?? Yeah, he performed them on the same day.

He didn't really recommend it but when I brought up possibly doing subcision again, he didn't tell me about any time restrictions. This is the first I'm hearing about this.

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@getschwifty Your surgeon would not tell you this. It makes him more money to stack treatments. This is not how the body heals. Collagen takes on average 6 months to form, it's fragile, 3 months is a good min between treatments.  

If your prone to keloids I do not think it's recommended to do RF miconeedling. You can try but you will need aftercare and possibly get keloids and need steroid injections (it's a risk of treatment to be expected). See if your doctor can give you a anti-inflammatory drug while treating. CO2 laser is another option at 5-7% density and the highest power.

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14 hours ago, beautifulambition said:
@getschwifty Your surgeon would not tell you this. It makes him more money to stack treatments. This is not how the body heals. Collagen takes on average 6 months to form, it's fragile, 3 months is a good min between treatments.  

If your prone to keloids I do not think it's recommended to do RF miconeedling. You can try but you will need aftercare and possibly get keloids and need steroid injections (it's a risk of treatment to be expected). See if your doctor can give you a anti-inflammatory drug while treating. CO2 laser is another option at 5-7% density and the highest power.
Thank you very much! How long should I wait before getting TCA cross?

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16 hours ago, beautifulambition said:
@getschwifty  you typically wait 3 months, but you can do tca cross now if you wish. It takes several treatments of tca cross.

 
Wait, I'm confused. I thought you  mentioned it's typically after three months but how come it's safe for me to do it now?

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@getschwifty Let's recap. You know I said 3- months, that is optimal. You then ask again. This is your treatment and as such if you want to do something every day so be it. Dr's also tell you to do things often to get money, save time, or cause swelling to hide the healing process. 

IF your doing Dr's based treatments, often it's 3 or months wait between. IF we are treating at home (microneedling and light peels) then you can do things more often - monthly. When we start mixing things and healing times ... the healing of fragile collagen is often effected. I get it some people have time constraints, ... so be it have the Dr do treatments more often, but there is risk. 

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10 hours ago, beautifulambition said:
@getschwifty Let's recap. You know I said 3- months, that is optimal. You then ask again. This is your treatment and as such if you want to do something every day so be it. Dr's also tell you to do things often to get money, save time, or cause swelling to hide the healing process. 

IF your doing Dr's based treatments, often it's 3 or months wait between. IF we are treating at home (microneedling and light peels) then you can do things more often - monthly. When we start mixing things and healing times ... the healing of fragile collagen is often effected. I get it some people have time constraints, ... so be it have the Dr do treatments more often, but there is risk. 
Gotcha! Thank you!

My doctor actually doesn't like TCA cross so I won't be having it done by him, if ever. I'll have it done by another doctor.

Last question, so i'm planning to do TCA cross 3 times for the next 6 months with steroid injections for hypertrophic scars (2 months in between) and then after, another round of just subcision or would subcision with sculptra be better?

Anyway, does that sound like a good plan?

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It's fine to mix and match Dr's. That can get you the best results if they are good at the treatments. 

My concern with you and sculptra is it's not indicated for those with Keloids / hypertophic. As you know this is a concern as bumps can appear (scars), the body makes inflammatory excess tissue. Many won't even inject this in someone like this (they don't want the liability), or potential harm - bad treatment outcome. Sculptra in the pamphlet would stimulate your condition worse ( I have seen someone with Keloids and Sculptra, ... raised plaquing all over the face). For you I would do HA filler, as it's reversible, but you still could need something like Prednisone a steroid, speak to a Dr and make them familiar with this concern. Other ideas are PRP being used or your aware of the potential for more keloids to forum and thus more kenalog injections.

Your plan sounds fine, ... you just need to make sure your Dr is 100% at knowing about the Keloids and thus treating them (he needs to have a plan for this). Or you accept the side effects with treatment.

Thanks,
BA

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On 7/23/2018 at 6:27 PM, beautifulambition said:

It's fine to mix and match Dr's. That can get you the best results if they are good at the treatments. 

My concern with you and sculptra is it's not indicated for those with Keloids / hypertophic. As you know this is a concern as bumps can appear (scars), the body makes inflammatory excess tissue. Many won't even inject this in someone like this (they don't want the liability), or potential harm - bad treatment outcome. Sculptra in the pamphlet would stimulate your condition worse ( I have seen someone with Keloids and Sculptra, ... raised plaquing all over the face). For you I would do HA filler, as it's reversible, but you still could need something like Prednisone a steroid, speak to a Dr and make them familiar with this concern. Other ideas are PRP being used or your aware of the potential for more keloids to forum and thus more kenalog injections.

Your plan sounds fine, ... you just need to make sure your Dr is 100% at knowing about the Keloids and thus treating them (he needs to have a plan for this). Or you accept the side effects with treatment.

Thanks,
BA


Thank you very much! I looked into it before getting Sculptra injected and it seems a lot of doctors with years of Sculptra experience have never had problems with keloid-prone patient.
They would defer injecting it on patients that form deforming keloids but I'm guessing not mine as they appear to be more hypertrophic than keloidal.
Dr. David Lim also seems to agree so I'll just have my fingers crossed on this one! https://www.realself.com/question/new-york-ny-sculptra-keloid-scarring-people

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@getschwifty Just let them know about your propensity to "hypertophic scarring" so they can manage the care and possibly give you something. 

Just putting the facts out there.  

I read the link which the providers are contradictory to what the product flyer says, of course many are sponsored by the filler manufactures. The manufacturer provides this as a guideline in most filler boxes, or even pharmaceuticals in the flyers.  I am not trying to scare you but as your question says, it's a "possibility." The good thing about the product is it is injected deep (compared to HA) and you can have it over diluted to help with some of this. 

If it were me, I would do a test area(s), and then get the rest injected (top up) to be sure, ... just being safe. 

Please note Sculptra is not a traditional volumizer like a ha filler, it is a collagen stimulator and rf devices also help stimulate this further.

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Ive never been a fan of getting a filler and subcision during the same treatment. The reason is because your face swells up after one treatment and your scars are then very hard to see when doing the 2nd treatment, unless there is discolorization. 

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On 7/29/2018 at 7:12 AM, beautifulambition said:
@getschwifty Just let them know about your propensity to "hypertophic scarring" so they can manage the care and possibly give you something. 

Just putting the facts out there.  

I read the link which the providers are contradictory to what the product flyer says, of course many are sponsored by the filler manufactures. The manufacturer provides this as a guideline in most filler boxes, or even pharmaceuticals in the flyers.  I am not trying to scare you but as your question says, it's a "possibility." The good thing about the product is it is injected deep (compared to HA) and you can have it over diluted to help with some of this. 

If it were me, I would do a test area(s), and then get the rest injected (top up) to be sure, ... just being safe. 

Please note Sculptra is not a traditional volumizer like a ha filler, it is a collagen stimulator and rf devices also help stimulate this further.

Thank you for your concern. I appreciate it. Hopefully, I do not have any complications in the future.

Just a question --- would it be safe for me to do subcision + suction roughly six months after cooltouch + subcision + sculptra?

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@getschwifty Yes you can do Subcision and suction if you wish 6 months after. Stop suction if it causes you any issues,... you normally do not need subcision because you got sculptra is a spacer but I understand you may have areas that need spot treatment. 

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13 hours ago, beautifulambition said:
@getschwifty Yes you can do Subcision and suction if you wish 6 months after. Stop suction if it causes you any issues,... you normally do not need subcision because you got sculptra is a spacer but I understand you may have areas that need spot treatment. 
Thank you! I just sent you a photo of my scars. The one on my chin is very deep and is what I'm really self-conscious about. Hopefully, a couple more subcision + suction helps!

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