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hilalela

Atrophic scars - Diary

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Hi there! A long story short: used to have acne not even so bad but very scarring. Every spot would leave a depressed mark later becoming a scar obv. (Why this ?) went on accutane last year not because my acne was so severe at the time but with any zit I would get a new scar. I had a 3 RF session 4 weeks apart in 2015. (Don’t think they did anything) and I have had filler injected in my right cheeck as the depression in the skin was massive. Now that I’m off accutane I suffer this extreme Oiliness I can’t deal with. Genuinely I think I’m the most face-oily creature on this planet. It’s f revolting. 
Going back to the scarring I am planning on flying from Poland to dr Emil to get subscision and fillers. Would I benefit from subscision with those kinds of scarring? I roll my skin using 1.5 mm dermaroller and (kill me) I also do 100% tca cross for my ice pick scars every 6 weeks. Thats why they’re red. They are not a fresh scars. They vary from 1-10 years old.  I would love BA to have a look at my ugly ass face and share some opinion what can be done.

Edited by hilalela

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@Olqa9229 Thank you for your patience, because of our recent endorsement by Dr Lim we have high traffic to answer questions. Please be patient. I will try to respond to you in 24-hrs.

Your main issue is PIE or wounding post acne (redness), you need a few sessions of V-beam to blend the skin color. - I see your causing this with TCA Cross.

Regarding scars You mainly have surface rolling scars with some boxcars. I do not see fat loss. Filler would be hard to use for these type of scars. Consult with Emil when you see him on this. The second pic looks like there might be deeper depressions but I am not sure, .. .If so filler will help. 

3 rf treatments alone would not help your scars (you don't want to start wit this).

You need Cannular Subcision (3-4 sessions) throughout the cheeks. Good you are seeing Dr Emil. Yes you need subcision. 

I would do tca peels instead of tca cross after your subcisions.

Emil will also uses laser. He could do fractional laser. If he angles the laser to the border of some of your boxcars it will smooth them out.

After a few subicsions I would have him do a deeper peel with his erbium to do a resurfacing of the cheeks.  

Start with subcision. 

Are you using retin-a/tretinorin/differin nightly.

I think we have to get your acne and oily skin under control as well is important to avoid scars. Have you considered Spiro for Hormonal acne, speak to Emil about this or a local derm. 

BA

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@beautifulambition Thank you very much for your comprehensive answer. 
I have been using topical tretinoin 0,05%(its called Atrederm in my country) before Accutene. I am planning on going back on it (even got a fresh bottle last week)I just had to prepare myself mentally for this constant flakiness. Regarding spiro -I have heard about it although didn’t dive in the subject as I I have read somewhere that it might be cancirogenic. 
I feel so uplifted knowing there is a hope to improve the appearance of my scarring although it’s such a long run. It’s funny how doctors in Poland dont do subscision they only offer you fraxel or fillers. Kind of logic -subscision won’t pay them back for the laser.
I will make an appointment with dr Emil tomorrow. 
Thank you! 

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@beautifulambition Hi again! I am waiting for dr Emil office to get back to me and in the meantime I have contacted dermatologist (where I live in Poland which is obviously more convienient) regarding my acne scarring due to the fact he owns SMARTXIDE2 Deka laser that dr Davin Lim recommended but he advised against it. He offered surgical dermabrasion + TCA ( I have never heard about these two combined). Price for this procedure is twice as laser. I would like to know your opinion about surgical dermabrasion procedure. I have a free time (about 3 weeks) that I could spend on longer downtime that's why I am seriously taking this option under consideration. My concern it is not the first or second treatment of Davin's or Emil's choice so is it even worth the fuss and money? 

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@Olqa9229 Atrederm ... mix it 50:50 with moisturizer for the flakiness, or you can skip every 1 or 2 nights if the flaking is to bad.

You can try a tca peel with him and dermabrasion if you wish, ... lots of down time. If he is not a good Dr he can make things worse so research his experience. Ask him questions about this.

You need v-beam or picosure regardless this is vascular laser for the redness after treatments are done.

I always would do subcision first, perhaps you could do this with someone local or emil,... Then worry about peels and dermabrasion or laser resurfacing. Have you tried calling Polish Dermatologists and dermatology schools or plastic surgeons and looking for subcision. I can't speak Polish but perhaps you can search for the word on Google or a video with that in a title. 

If you have the down time and are comfortable perhaps the TCA peel is fine. Many Drs do fully ablative erbium peels for your type of scarring but perhaps he is as skilled at his peeling method.

Regarding fuss and money, Your scars seems to be monomorphic so peel like treatments or laser resurfacing will help. You can always go this route first if you wish fo your scar type, ...there are no deeper pits it looks like.

BA


 

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@beautifulambition Thank you for your time! I have decided to go on with that dermabrasion + TCA for now. Procedure is scheduled on Monday ( 19/11/2018). I have some spare time till December so I want to go agressive now.
Thank you again!

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Sooooo I went through that dermabrasion + TCA procedure last Monday 19.11.. My face is severly swollen and the pain during procedure was revolting. If I'd only knew there would be so much pain involved I would never decide to go thru this. I am still in shock why was I not sedated. I am taking antibiotics and areas that were literally skinned off  and then soaked with TCA peel are covered in bismuth subgallate powder. I have developed strong anxiety that I would get stretch marks on my cheeks caused by this enormous edema. Is it even possible? uch......

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Hello Olga,

thank you very much for your report. Plese let us know how it looks like with you. Im really very curious.

I wish you fast recovery !

best regards

Andy

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Hey @andys_01 Ok, I will. I am waiting for scabs and rest of the skin (where I had only TCA done) to come off and edema to subside. I will keep you updated. Will also post some pictures then. 

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Posted (edited)

I need an advice. Last November I decided to treat my cheeks and temples scarring with surgical Dermabrasion..which I kind of regret now..think I should start off with subcision..my scarring is definitely more shallow now but area where doctor performed dermabrasion outstands from the rest of the skin and is lacking pigment.. and that area is more shallow as a whole.. especially my left temple looks very thin and scarrish-white.6 months after dermabrasion I went to the same doctor for fully ablative CO2 laser (Deka SmartXide-one of the Davin’s Lim recommendation). Now 3 months later after the laser I still got visible little dots where laser penetrated the skin. Doctor’s recommendation was to start brushing my face with a face brush that he gave me starting 3 months after the procedure which is now. (Anyone heard of that?) feeling weird using harsh brush on my poor “been thru a lot” face skin..
Do you think laser dots will go away eventually ? 
I got mixed feeling about the whole process and results..now I see my expectations were to high and dermabrasion wasn’t the best choice.. I decided to change the doctor as he can’t offer me anything new besides another laser treatment in the future. He’s not skilled with subcision and after he evaluated my scarring before dermabrasion he was opted against it. Back in November last year I have also consulted with dr Emil’s office and he did offer subcision.. l regret I did not decide to go to Denmark at the first place. At the time when I was looking for a doctor that performs subcision in Poland where I live I couldn’t find any. Now there are few who offer subcision together with filler. (one of them advertises it as a new procedure on the market..lol) anyway I booked the treatment with one of the female doctors (Hope she won’t be too gentle with that cannula)
It is scheduled on 24th this month. 

 I don't think old photos I got give justice to the depth of my scars before treatments..  I think they looked worse in person than on those pictures.. and now I think my skin looks better in person than on pictures..It is that indirect lighting that fuc*&s everything up for us scarred humans.  My left side is definitely my worse side.


I just don’t know what to do acne wise.. I have been on one course of accutane, finished mid 2018. Still getting random deep pimples that leave new scarring and my skin is extremely oily.. Just came back from dermatologist office with prescription for accutane.. 
On first course of accutane I lost 2/3 of my hair.. I am not even joking. That was one and only huge side effect I have experienced.. now they kind of growing back but overall are very brittle and thin.
If I start accutane now I won’t be able to continue my scarring treatment for another year or more..I am also mortified when I think I could lose more hair.. I am just exhausted living in fear of another cyst that might pop up out of nowhere and leave another scar.. I loved the time when my skin was normal while on accutane.
Today I have seen dr Davin’s story about taking accutane for oily skin (3 x 20 mg tablets per week) maybe that’s a route for me ? 
Can I still be getting subcision and fillers while on such dosage ? What about lasers?

I have also ordered derminator and topical tretinoin (from Spain) as you can get it anymore in my country. 

Can I use low dose of accutane toghether with topical tretinoin?

 

 

Kolaże.jpg

Kolaże1.jpg

Edited by hilalela

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Your skin looks much better :)

As for acne, if it's an option for you, you could try birth control pills. They did wonders for me, pretty much the effect of accutane without the bad side effects. Consult your gyno, of course, I just thought I should mention this.

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@hilalela Wow lots to respond to here.

You need to see a top aesthetics Dr who you trust, pay, and provides monitoring of your care. Your asking for pharmaceutical advice. I do not know your vitals. They need to prescribe low dose Accutane to you if they feel it's appropriate. You speak of loosing hair and want to go back on Accutane. You do not do a retinoid if your on Accutane. This is a strong drug you do not play around with. 

This is normal for dermabrasion to be outdated and some Dr's still offer it ... there can be months and years of prolonged redness and textural issues. Perhaps do some peels to even it out. They stripped away portions of your skin after all. Fully ablative laser can be used to resurface if there is major differences from the dermabrasion. This is why we don't use it anymore. When they do something like this they must feather the edges.  But you still will have some differences in tissues. Pulse dye laser for the redness. 

If you want to see Dr Lim, go see Dr lim ;-) He treats people in his own way.

Good you found someone in Poland, ... let me know if they are good so I can offer them to other's who live near there. 

No it's not a good choice to be doing treatments while on low Dose Accutane. Speak to your practitioner, they are responsible for your care. If you do laser or any aggressive procedure while doing so you will cause damage to your skin. Subicsion is ok while on it. OF course if they take the risk it's on them and yourself to decide that for your care.

 

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Well luckily, I think your scars did improve based on these pictures, so the dermabrasion was not a total disaster.   I think for now, you should not do anymore aggressive ablative skin procedure (removing skin like dermabrasion, laser).   I did 2 spot dermabrasions, the first went well, the second was a disaster so I know how you feel.   I had intense redness that lasted for over a year until I had enough and did a series of Vbeams.   Honestly, if you looked at me at 6 months, it looked like I had dermbrasion 2 weeks earlier.   

That said, you are right.  The correct course of action is usually to raise the indentations as much as possible first before you do resurfacing procedures.  That way, they don't have to go as deep.  The old school dermatologists just literally sanded your skin down to the level of the deepest scars, and as you can imagine that is extremely aggressive.   

Go through with some subcisions and filler and see how far that gets you.  I love how doctors re-brand something that's been around forever with a fancy new name and claim they "invented" it.  

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Posted (edited)
4 hours ago, General_Rommel said:

How was your experience with TCA cross? Do you recommend it?

Well if you go to the skilled professional yes. Do not ever do it yourself. I did and it was extremely stupid of me. Luckily I haven’t burned my face.

Edited by hilalela

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10 hours ago, freshman said:

Your skin looks much better :)

As for acne, if it's an option for you, you could try birth control pills. They did wonders for me, pretty much the effect of accutane without the bad side effects. Consult your gyno, of course, I just thought I should mention this.

I did try contraceptive pills.. had awful side effects.. extreme water retention and terrible headaches. I also got Graves’ disease I don’t want to mess up my hormones more..

All my hormones levels are fine.. I have no idea what causes that oil production..genes I guess.. I am very strict with my diet as well. No diary, no gluten (thyroid), low carb.. 

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Soo I had "subcision" done yesterday... I feel like that lady Doctor just injected the product  with a tiny bit of subcision before hand. She used the same small cannula needle that comes with filler. She did not move the needle in all directions or anything like that. I am pissed off. I should leave the office when she said something like she opts for less invasive procedures while treating scars.. 

Obviously there is a swelling now.. I live for the swelling after treatments hehe

Anyway, I don't expect to see much of a results after swelling come down as she barely subciside anything. Filler she used is Restylene skinbooster, it's more diluted or something so it won't create any lumps. She is also Restylene representative injector or whateva.. I feel like she just sold me the product.. 

I have recently started using 0,05% tretinoin cream 3 times per week and my plan is to go on with that and derminator every 4-6 weeks. 

I am done with them polish random derms. In 3 months I am gonna see dr Emil for some proper subcision. 

 

 

 

 

lef.jpg

right.jpg

Edited by hilalela

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35 minutes ago, General_Rommel said:

What was the wait time to see Dr. Emil? 

I haven't scheduled my appointment yet but when I spoke with the reception couple months ago they seemed to be flexible and said there is no much of a waiting time. It's best to send them an email.

It is just my personal decision to go and see Emil approx. in 3 month as I want that filler to settle and take my acne and spots under control.

Edited by hilalela

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