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TheBean

First INFINI RF microneedling!!!

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I went to my cosmetic derm appt today. They recommended INFINI. They recommended 3 to 4 treatments, every 4 weeks. They can treat just the scarred area--not my whole face. I start in two weeks. 

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@TheBean I would not do every 4 weeks, as your in a constant state of swelling. I would do every 3 months (collagen is fragile and slow to develop 3-6 months), that way you can really see the results. Please be prepared for possible down time like any treatment. You want a experienced practitioner doing this, that feels the thickness of your skin and adjusts based on your needs and not pre-settings.

Make sure you do your filler and subcision first if you need it as they work together, ... you do not want to start with RF microneedling. 

BA
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Yes. I chose to go with a practitioner that I have to drive a ways to get to. I chose them over closer available ones because they are way more experienced. She specifically said that she would be adjusting her settings according to what she sees on my skin and doing custom settings.

The only thing is the time interval...4 weeks? I'm confused on this--It seems to be the industry standard? Why? I've heard the argument for why to wait longer between and I understand that. What I don't understand is why it seems that all (or nearly all) the practitioners recommend 4 weeks? There has to be more to that than just greed...anyone??

 

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@TheBean You can do the "standard protocol" of every 4 weeks if you wish. Your face will be in a constant state of swelling and this is how they hide the results of treatments. Again the body takes about 6 months to develop collagen, it's fragile, and over treatment can damage the results. 3 months is the minimum to treat on a safe side. That way you see what works and what does not, ... your body has the ability to heal. It's one thing if they do the 4 weeks thing with someone with almost perfect skin ... who wants a treatment. Quite another if we are doing it for acne scars. This is why if you have pits your should start with subcision and filler, as it stimulates collagen with the treatment, especially sculptra for widespread scarring, but HA filler also works.

Dr's will do whatever you allow them to get away with. Weather that is 5 treatments at once or thousands of dollars of stacking treatments,... a constant state of swelling hides the results and keeps you coming back. Dr Emer in Hollywood is famous for this (not in a good way). They figure the sooner you come back the more treatments they can do, ... if you think about it you may change your mind. Also many do not have time to do the ongoing work acne scar treatments take or they fly in from another country so it's understandable. 

But your right this is your treatment plan, if you want to do the standard Infini recommendation of 1 month apart that is fine. I know many people who wished they put more time between treatments, assessed what worked and didn't and allowed more healing time. 

Perhaps assess the far away person and then look into the nearby Infini operator. She can always do a test on a smaller portion of your face. 

Ba
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Okay...well, the good news...No one can force me to do the treatments sooner than I want to, I'm scheduling them myself. So if I wait--it's not like when I'm ready to do the second treatment they'll say "no", lol. 

I would like to hear from people who have had it done, what they would suggest based on their experience with it? 

I am not having my whole face done anyway...my skin texture overall is pretty good and it's only the cheek scar and one other tiny spot near my smile line, so two small spots. 

And, has anyone seen results doing fewer treatments than they recommend? Do you feel they are throwing in multiple treatments that aren't necessary?

I'm trying to decide if they are attempting to take advantage by making people feel like they are doing something besides just sitting around and waiting for results to finally show up.

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As Beautiful Ambition has mentioned, I would wait three months to allow optimal time for healing and collagen production. If your dermatologist argues with this, then I would give her the flick and find someone else. 

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On 7/26/2018 at 7:54 AM, beautifulambition said:

Dr Emer in Hollywood is famous for this (not in a good way). They figure the sooner you come back the more treatments they can do, ... if you think about it you may change your mind. Also many do not have time to do the ongoing work acne scar treatments take or they fly in from another country so it's understandable. 
 
Emer is notorious for mega treatments. But even good doctors like Rullan suggest 4-6 weeks. 
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Not to over discuss this topic... My point being is be your own advocate. That is the only person you can trust. Do the research. Dr Rullan while good is looking out for his and his business's best interests. You need to look out for your own. My interest is to empower you.

Laser treatments (In this case rf - microneedling, same pathway to regeneration) can have standards of care of every 2 weeks to 4 weeks being treated, some Drs do multiple laser treatments in a month. Then the patients come here distraught that they lost fat and collagen from their procedures, ... they were never made aware of the side effects, nor did they have time to observe what worked and what did not. Being conservative is best in these instances and this is rarely done. The patient needs to know how they heal, if they are sensitive, what is effective, the desired outcome of treatment (often different than a Dr),  the side effects of treatment, and Risk Benefit analysis of the proposed treatments. When we blast 5 treatments at once, it's flashy, sounds great, ... pushes unnecessary stress on the process of healing with possible side effects, can cause damage. The body does not heal like this, nor was it made to deal with these excess stresses.

What do patient's do when Dr Emer says oh you just need more treatments or we will wait and see ... " your face is messed up, oh that is normal." They say to wait for improved appearance, yet they want to push treatments, ... do you see what is wrong with that thinking, it's reverse. Patients often trust the word of the Dr and buy thousands of "more" treatments, ... this is not in their best interest. Example. Ongoing Swelling, hiding the damage done, or inducing necrosis of the skin excessively.  What worked and what does not, ... who knows. 3 different types of filler reacting to other topicals,... who knows which is it. Often the patient is blamed for negligent care. Dr's these days do not have time to monitor your situation. Let alone a med spa or general derm who goes by standards from the equipment manufacturer. These are not customized to your situation. The same standard is used for those who have perfect skin and want "a little something" for cosmetic purposes as the worse acne scar patient. Collagen is developed in 6 months, with 3 months being the minimum of re-treatment, I would not want to damage gains in collagen. Again we are not talking about someone with perfect skin who want's a little something (w/ no fat loss, no collagen destruction, no auto immune like response to bacteria - acne- causing scarring, excessive PIE, breakouts, complications, sensitivity, slow healing, complications from other procedures).

It's a risk, and the risk is on you if you allow it to happen. I think that is the biggest error a patient can possibly can make is not being able to say "no," or at the very least saying I will call you back to schedule a appointment after I check my calendar.  Dr Rullan get's paid to offer you surgeries and services.

Read Real Self, one of the biggest complaint's with Infini (I own one - but don't go by standard of care), is using the "wrong settings" and "excessive treatment leading to fat loss, or on someone who has no fat." Or "grids" when the patient was told it was a no down time quick procedure (often they have perfect skin and no need for these procedures), ... the body takes time to heal.

BA

POSSIBLE SIDE EFFECTS (Laser or Infini - RF Microneedling) - (From The FAQ, Why Complicate the possible side effects...)

  1. Pain

    Post-operative pain is not as big a deal as the pain you experience during the actual laser skin procedure. Topical anesthetics are usually applied to your skin before a cosmetic laser treatment to minimize as much pain as possible. However, you can still feel discomfort after the procedure. For more invasive laser skin treatments, doctors may even prescribe pain pills. It may also be mentally "painful" to wait for your skin to recover. 
  2. Redness, swelling, and/or itching

    This is a very common side effect of laser skin treatments. Traditional ablative lasers  would physically vaporize the top layer of your skin, leaving it red and raw for months until it healed on its own. Non-ablative lasers, while less intensive, claim to have no downtime, but facial redness (erythema), swelling, and even itching are common post-laser side effects. These symptoms will usually subside after a few days, though "pink" skin may linger for many weeks later. 
  3. Sensitivity to the sun

    Since cosmetic lasers pretty much heat or damage your skin to encourage it to heal, it is no wonder that laser skin treatments will make your skin more sensitive to the sun. After you get laser done on your face, it is extremely important to stay out of the sun during peak hours and wear proper 

    Changes in skin pigmentation

    Not everyone's skin is suitable for laser treatment. Generally, cosmetic lasers work better on people with lighter skin tones than on people with darker skin tones, but both kinds of skin tones have a risk of hypo-pigmentation (lightening of the skin) or hyperpigmentation (darkening of the skin). Asian skin is particularly prone to hyperpigmentation, especially with high strength or deeply penetrating cosmetic lasers. Although some laser skin procedures, such as those that treat pigmented lesions like sun spots, will make the pigmentation spots darker before they get better. 
  4. Bruising

    Depending on the type of laser skin treatment, bruising could be one of your side effects. This symptom is more common in pulsed-dye lasers where treated areas can develop purpura, or purple spots in the skin when blood vessels under the skin leak. The bruising will usually fade on its own, however the process can be sped up with the use of KTP lasers. 
  5. Demarcation line / Grids

    A demarcation line represents a change in your skin color where the cosmetic laser was applied and where the laser was not. If this happens, it usually shows up around the eyes, lips, and jaw line of your face. Demarcation occurs when you experience a loss of pigment in your skin from the laser in the treated area compared to the untreated area of your skin. There is not much you can do to treat demarcation lines other than trying to depigment the rest of your skin to match the lighter color, though this is a difficult task. Makeup is usually the best (yet cumbersome and impermanent) solution for demarcation lines. 
  6. Infection

    Infection is not a very common side effect, but it can happen, especially with some of the more invasive cosmetic laser procedures. Most doctors will prescribe antibiotic creams and pills to take post-op to prevent any kind of infection from occurring. If your skin scabs post-laser, you must also resist the urge to pick them off or you will risk infection as well. 
  7. Scarring

    It's funny how cosmetic lasers can be used to These are moderate to severe side effects of cosmetic lasers and light-based facial treatments like IPL. Most of the time, you will seem like you have a sunburn post-laser, but sometimes blistering, scabbing, and even crusting can occur on your face. These symptoms must be left alone to heal on their own. 
  8. Blistering, scabbing, and/or crusting

    These are moderate to severe side effects of cosmetic lasers and light-based facial treatments like IPL. Most of the time, you will seem like you have a sunburn post-laser, but sometimes blistering, scabbing, and even crusting can occur on your face. These symptoms must be left alone to heal on their own. 
  9. Fat Loss

    Fat loss, especially facial fat loss, is more common with radiofrequency treatments like Thermage. Because radiofrequency constricts fat cells, many people have experienced a gaunter looking face post-op. There is nothing that can be done to reverse the effects of fat loss short of fat grafting surgery. 
  10. Recurrence of the skin issue

    It usually takes more than one laser skin treatment to get your desired results. However, even after multiple treatments, some skin conditions will come back. This is more common with cosmetic lasers that treat vascular lesions and remove hair. With broken capillaries, for instance, lasers can destroy the blood vessels, but a laser treatment will not prevent your skin from growing more blood vessels. 
  11. Breakouts

    Some people experience "purging" or minor breakouts post-op. This could be from the stimulation of your skin by the laser treatment or from the emollient healing creams you apply after the procedure. In general, you should not get laser treatments if you have active acne or irritated skin. While some cosmetic lasers claim to treat acne, it is my belief that lasers best treat acne marks and scars, not active acne itself.  
  12. Destruction of New Collagen

    Over or excess treatment can lead to destruction of collagen which is very fragile often developing over 6 or more months. Excessive wounding or induced healing can lead to poor results as the body cannot give the best benefits from the regeneration process of the skin.

_______________________________________________________________________________
 

Fraxel provides increased improvement six months after the last treatment

 

When any wound is created, whether traumatically, or surgically, there is a wound healing cascade that is initiated. Multiple things occur underneath the skin that are not visible to the naked eye.  An infantile form of collagen is first formed and then as the wound matures, the body dissolves that collagen and lays down a mature form of collagen. Then this collagen over many months integrates in a stronger formation, similar to pick up sticks falling on the ground and then someone laying them neatly together in parallel groupings.  Inflammatory cells are also recruited into the area to keep it clean and new blood vessels form, microscopically, to bring in more oxygen that is needed for the new collagen to form.Typically there are biochemical and clinical changes in healing scars that are seen even up to 18 months after surgery, but this is why with Fraxel, that there is continual improvement in collagen build-up and even tightening possibly, for six months.

-- Ronald Shelton, MD [Link removed]
Edited by MadsKeystone
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UPDATE: I've been discussing this with a trusted friend and we've been monitoring the healing of my scar... my friend REALLY thinks I should wait a little longer because my scar is continuing to look better at a steady rate and we can visibly see the collagen has been filling in. Among the risks of RF microneedling is the possibility that it could damage this new collagen and actually make the scar look worse,  or arrest the natural healing process. 
At this point,  I think my friend is right. It's hard to have patience with the collagen building process.  Grass grows WAY quicker...I am going to postpone my appt. 

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@Thebean  Yea slow and steady is definitely the way to go here.  That being said I think the RF microneedling treatments add onto each other so I think maybe 1.5 - 3 months should be the timeframe for your second treatment.  I've read a few places that the RF treatments sort of snowball each other.  I know you hear 3 months constantly for treatments but I think that's to let the skin/collogan remodelling fully take place.  I think the RF might be different where you are actually looking to have your skin in a constant healing state and therefore receive treatments in a shorter timeframe.  I'm not qualified by any means to give advice, but I figured I'd share a different angle that I've heard a few times.   

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FYI... I put this above (energy devices...): Fraxel and Infini or rf microneedling both work under similar time periods for regeneration of collagen.

 

_______________________________________________________________________________
 

Fraxel provides increased improvement six months after the last treatment

 

"When any wound is created, whether traumatically, or surgically, there is a wound healing cascade that is initiated. Multiple things occur underneath the skin that are not visible to the naked eye.  An infantile form of collagen is first formed and then as the wound matures, the body dissolves that collagen and lays down a mature form of collagen. Then this collagen over many months integrates in a stronger formation, similar to pick up sticks falling on the ground and then someone laying them neatly together in parallel groupings.  Inflammatory cells are also recruited into the area to keep it clean and new blood vessels form, microscopically, to bring in more oxygen that is needed for the new collagen to form.Typically there are biochemical and clinical changes in healing scars that are seen even up to 18 months after surgery, but this is why with Fraxel, that there is continual improvement in collagen build-up and even tightening possibly, for six months."

-- Ronald Shelton, MD [Link removed]

____________________________________________________________________________

Regarding Filler - Sculptra:

"Sculptra's full effect takes about 6 weeks to fully appreciate. It will take about 6 weeks to get the effects of collagen building.  There are some subtle changes over the next 7 mos or so, but not much volumizing effect.  If you are too full, you just have to wait it out and let the effects gradually diminish over then next couple years.  It is extremely important to choose the right doctor for these long lasting fillers.  "

-Dr Steven Weiner

Edited by MadsKeystone
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