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Sonam@0892

Acne Scar surgery

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I'm 26 year old fair skin girl from India... I had long history of Acne on my face which are now clear after treatment but I'm left with deep pitted acne scars of all type mix on my forehead, cheeks ,nose.
There are tethered, icepick, box all kind of scar.

My Doctor has advised me for Acne Scar surgery in which scar is removed  using surgical instrument. And the surrounding tissue is raised and left to heal.

Please someone tell me if he/she is having any information about this method for treating scars.
will it give some bruises of surgery on my face? Does it has any side effects. 
??? Please help me
 

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I would need to see a picture of your scars to make a accurate assessment of what is going on. I normally never suggest surgery as you can end up with more scars, this is called scar revision and it leaves a linear scar where the other scar was, ... things can go wrong. I would not start with this.  

IF they are deep pitted, you need subcision and filler, multiple sessions. I have seen subcision in the Indian Derm journals so I know they do nokor and cannular subicsion there, ... call around and ask. 

I can better assess with pictures to individualize treatment. 

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iOSThank you so much Doctor for your reply... It's means alot to me. I'm sending you my pictures of scars.

Thank you so much Doctor for your reply... It's means alot to me. I'm sending you my pictures of scars.
Please reply me if you can see my pictures.

IMG_20181008_171142.thumb.jpg.37d40e06f73bdb8e8e4c6a4c5c6ca148.jpgIMG_20181008_171219.thumb.jpg.62343180fd3b76dfd98fa02cc3503baa.jpg
Please reply me if you can see my pictures.

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@[email protected] 

You do not need your face cut, or your scars excised, ... this will make further scars. 

There was a basic study with your skin type under the FAQ, goto the proof section (link in top of the FAQ - also in the acid section link to mega post), many had good results with microneedling and peels, further improvement with the below.

The scar plan will take work.

You have severe scarring, tethered rolling  and box car scars. Also hyperpigmentation. 

Subcision is necessary 3-4 sessions. This is available in India if you search (Google and call around big dermatology clinics in bigger cities), it's in the India Derm Journals. I would do cannular subcision if you can as you have scars on your temples and this is safer. Filler can be used as you have fat loss. Typically in situations like this I say use dilute Sculptra, throughout the face - why... because you have widespread scarring. HA filler can be used later on the individual pits. OR just do filler on your last subcision.

I would do Low density and high power co2 3-7% with the highest power multi-pass and have them smooth out the border of the box cars (Walls only not inside of the shap scars) or RF microneedling. You need a few sessions of this.

TCA Cross is needed on some scars, and A few of your spots can have paint on or spot peels with acid inside the boxcar. See what this means in the FAQ, top of the acne scar sub, first post, goto the acid section, mega post link, and paint on area. 

Because of your PIE/PIH I would do vascular laser or picosure for the discoloration.

You must treat nightly with tretinorin (Indian Pharmacy) and a hydroquinone or konjac and albutin cream to avoid further pigmentation issues. 

I would then do a series of lightening peels TCA or Glycolic for the texture or Erbium Fully ablative resurfacing.

Everything is optional, treat as you have time and money. 3 months between treatments. You can even do one thing a year. Some subcision and tca cross work/ spot peels will help a lot if you do nothing else. 

Dermaroller or Dermastamp at home between treatments for further improvement and do a series of glycolic or other acid peels. 


 

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I didn't expect so in detailed reply... This is so helpfull for me... Thank you... Thank you so much Doctor ... My Doctor dint gave me any of these details... I'll now look for new Doctor and also show him details given by you...GOD Bless you...Thank you.

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Do not cut/excise you scars. I cant believe Dr's are even offering that primitive procedure, it'll make things worse. Try subcision/filler !

Edited by Vidrar

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As adviced by you I went to a new Doctor  he performs subcision.

He adviced me to do subcision with PRP and fats from my own body. And after wards laser.

Can you please tell me if the fats injected during subcision will go after some months and I'll again have scar with same intensity. 
I also have concern that if I do laser afterwards will it cause to loose the fat filled during subcision?? 

HA fillers are costly and I can't afford them... As my doctor said you hv to take fillers again after 5-6 months as they are temporary? 

Please advise... Thank you.

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@[email protected] IF you wish to do fat grafting that is fine. Many find that this does not last past 2-5 years. One must do 3 sessions also making it much more than filler. I do not know the costs in your country but just a idea. IT won't hurt anything to try, ... if your body absorbs the natural fat. 

Laser won't go deep enough to hurt the fat unless they are to strong with the treatment, stack the laser (on one spot), use multiple devices at once and do not allow 3 months to heal between treatments, or have extremely high settings. We use filler as a collagen simulator not for volume like aesthetics. We want it to act as a spacer during subcision to prevent re-attachment and the body to replace the filler with collagen. Volume is done on the 3rd or 4th subcision to the individual pits with ha filler. But fat is fine if you wish.

No this is not true, some HA filler lasts up to 2 years. IF you like the look (of HA filler) you can get a permanent filler like Bellafill but I would never do this first due to complications and you may not like the look. You can always get this your last subcision (just once). Again we want collagen over time to replace filler and act as a spacer not for aesthetics. There is also suctioning see the FAQ, it's cheap using Chinese cupping, ... under subcision. First post of the scar solutions sub.

Treat as you have time and money, everything is optional, some treat over 3 years, 3 months between treatments is optimal as we heal slowly, subcision is most effective for many with pits. 

Thank you for the kind understanding and patience, due to Dr Lim's endorsement of this forum we have massive new traffic, it may take me 24-hrs to get back to you.

BA
 

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Thank you so much for your reply... I too got to know about this forum from Dr. Lim' s YouTube channel... I found this site extremely useful and got to know alot of information about Acne and scars from this site.

Very trustworthy and useful forum...
Yes I'll wait for 3 months between treatments to let my body heal.
Thank you for your valuable advice.

 
 

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