@CleanSlateI had the same procedure done (my first) a month ago, Im completely healed now, I used ice for the first few days to minimize some of the swelling, I also took arnica orally and topically which helped my body heal quicker as well, and I gently massaged some of the lumps but very very gently. On a side note, if it wasnt for the lumps you have gotten how much improvement have you seen after getting this procedure done 4 times?

@CleanSlate I would compress the scars, do not use the Chinese cupping method if you are. Once the wound closes you can use blood thinners if you wish or vasodialtors like topical asprin. Sadly if so many things cause dents and issues, they may need to use a tiny bit of filler if they inject them.

I am surprisedthey did not give you a steriod pill to take, for the swelling.

Consult with your Dr before doing anything as he is responsible for your care.

In your case your bound to get hematomas because of your sensitivity, Treat as much as you can and then worry about lumps. If it does not show it's natural filler under the skin.

Thank you both for your replies, mypost didgo through after all! As for the swelling the MA did give me a kenalog 10injection in my bum, I was very reluctant but after I saw my face I said no way can I allowthat much swelling to be presentlonger than it needs to be.. I was afraid of the adverse affects of that much swelling. Swellingis much better now.

I have been using cold compresses and applyinglight to moderate pressure as I press it on to my face in hopes of prevention. Beautiful ambition,you are correct about avoiding Chinese cupping method & I havebeen avoidingthis time aroundalthough I've done it 2 other times in the past.

The other thing I'm noticing is the stiffness (maybe hematomastrying to form?) inthe face that's present from the procedure/healing process... so today I have been stretching my facial muscles by smiling; puffingout my cheeksand making O'swith my mouth.I can feel a release of tension in my face &somethingdefinitely gets loose so I am hoping this is helping.

I'm also applying McKesson's skin ointment as I read this wouldhelp with the wound healing better.

@49ersFanI am also doing the arnica pills, thank you for the suggestion. I would say there are definite improvement in the acne scars after the previous subcisionsbutit's only as good as the scars don't reattach and in my experience the reattachment has been inevitable although not to the degree it was prior to the procedure.IMOit's the combination of treatment methods thatgive the best outcome. My scars were more on the shallow sideso they weren't all too noticeable except under certain lighting.

Day 3 s/p subcision: generalswelling is virtually gone now. @beautifulambitionDo you think switching to a warm compresses and massage would be OK at this point? I took a few pictures but the lighting isn't too great but you can see one of the lumps more clearly than the otherif it helps. I can't tell thatI got new lumps at this time, although there is maybesome swelling around the initial lumps.

@CleanSlateHot compresses would be fine w/ massage. The pics did not attach, perhaps a extra step was needed of insert.

@CleanSlateThe lumps should resolve over time. Some have this for weeks after subcision it's normal.

IF they don't resolve dilute steriod. Or subcision with saline flush to the lump. evacuate any blood etc...

Vitamin K ;-P

You can check this link. It shows several supplements you can take to reduce time and improve the wound healing. You can find woundvite but it is very expensive IMO.

https://www.lifeextension.com/Protocols/Health-Concerns/Trauma/Page-03

https://www.lifeextension.com/Magazine/2010/9/Heal-Traumatic-Degenerative-Skin-Lesions-Naturally/Page-01

@FredMthank you for sharing those links, that is very helpful information!Luckily I don't have the other systemic factors that could lead to impaired wound healing but I'm sure topical vitamin k would still be helpful in any case. I have been taking vit K2 internally though not regularly. Since the skinis pretty much healed, I'm notsure if I can get any added benefit from the topical K at this point but I would give it a try.

Just an update, I haven't had any new lumps aside from the2 lumps from the previous nokor subcisions although one of the lumps is still overall bigger & very tender with numbness on the skin overthe lump.

Additionally, I've noticed deeper scar pits which I think is from the cross, but I'm hoping this is part of the cross remodeling, looks worse before it looksbetter? Weren't too noticeable before but definitely noticeable now.

I have one small atropicarea right just abovethelump on my R cheek that literally showed upyesterday& not sure what that's about.

Overall, it's not better that before, in fact looks a bitworse at this point but I think it's too soon to judge....so I hope.

On 1/2/2019 at 7:47 AM, beautifulambition said:

@CleanSlateThe lumps should resolve over time. Some have this for weeks after subcision it's normal.

IF they don't resolve dilute steriod. Or subcision with saline flush to the lump. evacuate any blood etc...

Vitamin K ;-P

 

My first follow up will be on the 16th, I'm thinking to just go with the dilute steroid (though even this results in atrophy in surrounding areas) but I would rather do weekly saline flushes to reverse the atrophy fromthe steroid then endure the painful lump.

Dr. Lim had mentioned in response to another physician's question regarding a persistent lump that he would recommend doing an ultrasound. Dr. Rahimi from LA also mentioned this. Anyone know what the point of the ultrasound would be?

@CleanSlateUnltrasound would show them the depth under the skinand what is going on with the veins and artery's that is why.

8 hours ago, beautifulambition said:

@CleanSlateUnltrasound would show them the depth under the skinand what is going on with the veins and artery's that is why.

I will ask if this is something the doctor would orderfor me. I just wonder how the info would change or help guide tx. Any idea?I'll ask during the follow up and update. Thanks!

@CleanSlateNo it's not typically something they order you, ... perhaps they could. Typically plastics or derms might have a probe/machine in the office with a laptop to show the depth of what is under the skin with a probe over it. But I am sure they can order Ultra sounds from a radiography place if needed.

@beautifulambition  that makes more sense.. if they have the ultrasound machine at the place, they can see in real time what's going on.  I do know that the lump has changed since the last subcision  procedure on my left cheek.  

It is definitely much more tender & more firm to where if I accidentally touch it it's super painful.  With this said and the numbness I'm experiencing right over the area I am sure the scar tissue or whatever the lump is made of has enwrapped a nerve.

 The really weird thing is right above the lump I'm starting to experience fat atrophy. I don't think it's reappearance of scars it's a feeling of hollowness right above the lump which wasn't there before and this is without any cortisone injections. 

 I am continuing to do hot compresses plus massage as painful as it is to touch it.  Hopefully being more consistent with this helps.

Day 12 (Picture was taken on January 8) in addition to the lump you can still see some depressed areas that is actually from the cross. And pls excuse the peeling skin,  not sure if this is a result of the cross so micro needling but skin has micropeeling 

 Lump on on the right side of my cheek is mostly visible when I smile. Looks like a mini cheek on my cheek. Not flattering 

 This was also taken on day 12.

@CleanSlateI get these issues often, ... especially in ethnic patients. IT could take months to heal. Your right about nerve damage this can happen when they slice things up. A Dr will have to intervene most likely to clear/treat the hematoma, and then filler perhaps. Hence the ultrasound to see the condition under there. Subcision is great but there is risk and reward, some get side effects and you had some unfortunately.

@beautifulambitionthank you so much for your input. I'm pretty sure that was the last subcision for me. Not sure I could expect more evenness if I do more anyway. I will continue treating scars but will limit it to external methods, except for the fillers which at this point I think I don't have an option but to do.

I believe my acne scars are shallow enough where I can now"resurface the road"

I'm sure this has beenaddressed before but any significance in the order of filler/micro needing/peels? I'm thinking to keep up with microneedling and peels. I've read tca peels are a good choice. If you have any suggestions I would love to hear it.

Thank you again.

I forgot to mention, I have retin-a microspheres gel that I have been using on and off to help prevent/treat acne/scars. I haven't used since my procedure. But since theremodeling hasn't completed from the cross procedure would it be wise to resume at this point or wait?

@CleanSlateYes it's very important the order. For instance as you said with ""resurface the road,"" we don't resurface the road before the pits or potholes have been filled enough and raised. As such I am not a advocate of blasting the face with laser first. You have done your manual methods first so your good with that. Perhaps you could do some rf needling if you wanted to deal with some of the box cars(a few sessions) or some laser to deal with the smaller pits - if you want to skip this you can. The peel(s) aretypically done at the end of treatment for surface texture.

That is different if you mean at home peels as they are a lower %, and yes that can be done 1 month apart to 1.5 months apart, ... depends on how you heal. Some don't have the down time for peels so they do 2 of them or 3 a year at home. The acid peel guide pinned to the top of scar treatments would be helpful as well.

Sure you can start the retin-a, if things are healed up from the cross(Scabs gone), to regenerate the skin a bit.

@beautifulambition I guess I'll have to look into how RFmicro needling is advantageous over a micro needling alone as I have been doing micro needling for quite some time now and it definitely helps with scarring but feel it's something you have to keep up with.

I most likely will stick with @ clinic peels with the dermatologist for now. I am reluctant to do lasers because ofpossible adverse effect of fat atrophy.

I had my appointment with M.D. and had ILCSdilute w/ saline injected into it prior. He used the saline needle to poke holes at it like manual micro needling.

The lump is no longer round but irregular sic part of it shrunk down. He was able to squeeze some liquefied blood but don't think it was much. I think time is of essence with this one and since it had already been two weeks probably too coagulatedto drain.

He did mention thatmyacne scars are distensibleso that if you gently pull on the skin is the scars disappearso I think he will be recommending fillers.

Definitely will wait until those lumps completely disappear, fingers crossed, then consider fillers although not sure the advantage of sculptraversus silicon whatever or juvaderm/Restylane. I'll see what he recommends.

I'm just hoping that these things will help make my skin appear better and not give me more things to worry about.

@CleanSlateRf microneedling is like a laser without damaging the epidermis like a laser with energy, hence insulated tips. Thus it's safe for ethnic skin types. One has to do prior work before doing it, we don't pave a road before the manual work has been done to fill those potholes as much as possible.

Manual microneedling is well manual, slow process, and for some if they heal poorly or have sensitivity can make the scars worse. You know your skin best. If you do fine with microneedling then you can do it monthly. It's a slow process. Without also doing acid peels in conjunction (varying months or a few times a year)you won't see much improvement.

Yes you have to keep up with microneedling, as it's doing only a few channels, and the body is slow to heal, thus it's not like energy stimulating faster results, but it is devoid of many side effects.

See someone good if you get rf needling done, they should have treated hundreds if not thousands of your skin type. You can always do a test spot on one area of the face first before doing the whole thing.

Sounds good that it shrunk, maybe repeat whatever shrunk it before with the protocol of your Dr. If it's hardened the act of needling it to break it apart is also helpful, ... does not have to be liquid.

Filler is great if the scar is distensible 😉

If you are prone to lumps, or hypertrophic scarring please please consult with your Dr before discussing Sculptra, it must be dilute and injected deeply or guess what we get more lumps in those with this condition. Discuss this with him or her.

Well if the lumps do not show, leave them, they are natural filler.

@beautifulambitionTY so much for always getting back to me! It takes a lot to keep up &it's greatly appreciated.

I will look into doing RF microneedling & for those qualifications you mentioned, doesn't seem box scars respond all that great to subcision, have a few in my temple area, overall scars aren't so bothersome.

So I went back to my dr today for another dilute 1 kenalog for that lump in the L cheek which I think became more condensed over this past weekbut still very noticeable...definitely causing a social obstacle for me at this point.

I have to say though, recall when I mentioned that when the lump becamemorefirm after my subcision,that I noticed atrophy/hollowness rightabove the lump?Even the dragreed that he saw atrophiclike changes but was convinced it can't be atrophy which is understandable but the fat cells definitely were displaced. Well I find out today as he injected that area with saline that the lump below the area had formed a contracture pulling in the area above it causing a dent. So for anyone else reading this, this can happen for the aforementioned reason.

So what did he do? He basically did a mini subcisionwith that same saline needle to release the teathered down skin, heard a lot of snaps as he was doing it and I think he was surprised himself to see how much had formed.

My concern is, if my body is responding to subcision (or maybe just near the lump)byincreasing its hold on to the scartissue (like instead of strings holding down creating acne scars it's turned into ropes making the pull create more like a dent than a pit, then can repeated subcision (even a mini one to realease the newly formedcontracture) be the solutionif it keeps responding this way??

Just a thought... I guess I will find out, at least I know why I was seeing "atrophy" I hope it doesn't keep retethering & at the same time I don't know how I can prevent it aside from suctioningwhich I would say would be contraindicated for me.

@CleanSlate

Any update? I'm day 3 post subsicion, and still have swollen bruises on my jowel areas, but I can feel nodules. I hope its just swelling and they go away. We did use a filler, but i'm hoping an overcorrection didn't take place (i.e. too much filler)

Hi everyone,

i am 11 days into my subscision and im not sure if i have nodules or haematoma? How can you tell the difference and are both curable?

Hi, I know this is a super late reply and I hope you have recovered well and no residue selling or lumps. I think my case is not the typical with the lump formation.
Update: The lumps are still there and while steroid injections helped shrink it in the past it also resulted in atrophy in areas outside of the lump (yes even though it was dilute and injected right into the lump). The lump is noticeable when my face is reflected in strong light, otherwise not as noticeable, but I would take my shallow acne scars any day over these lumps.

For anyone else looking into this, I hope this helps.