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firefish

What is the problem with my skin?

Hello,

I know I have acne scars and I also lost some volume on my cheeks but one of the problems is that it is very rugged. The ruggedness is mostly visible under certain lighting. Why do you think that happens and what would be the best treatment for it? I have tried twice subcission with fillers for specific scars.

Thank you for your answers

 

IMG_4482.thumb.jpg.037c5ebdc3b93732252fe86db5a507fb.jpg

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Hello firefish,

Did you saw improvement with your subcision+ filler treatments? What type of filler was used?

I know this is the worst lightning possible : I see scars with very sharp shoulders, this type of scarring is generally super hard to improve.

Are you able to travel? (UK, Denmark?)

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3 hours ago, firefish said:

Hello,

I know I have acne scars and I also lost some volume on my cheeks but one of the problems is that it is very rugged. The ruggedness is mostly visible under certain lighting. Why do you think that happens and what would be the best treatment for it? I have tried twice subcission with fillers for specific scars.

Thank you for your answers

 

IMG_4482.thumb.jpg.037c5ebdc3b93732252fe86db5a507fb.jpg

Hello

On your right cheek you need more than subcision and filler

I think its better do subcision and fat transfer there

Edited by Nemesis 89

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@firefish Hi there, you have severe atrophic rolling scars on your cheeks, perhaps some box cars as well. 

If that is the after effects of filler and subcision twice I can deduce the following, you will need 8 sessions as I say below of sucbicision. Whoever did it is not good and find someone more agressive to do the work. You did not have enough filler and did not use sculptra first to stimulate your own collagen... 

I would look into 3-8 sessions of subcision. You need it aggressive. For your case I would suggest over dilute sculptra as you have fat loss in the cheeks. This can be done right after sucbision. In later subcisions once things are raised a big more and the sculptra produces more collagen then you can do HA filler to the individual pits. 

Do not think of starting with energy devices, this is not how it works, ... they blast you with energy devices and you will loose more fat. You need to lift the skin first before considering rf needling or co2 laser which you can do latter.

Then you would do a few tca peels for texture or erbium laser resurfacing of the texture of the skin.

This is a long process, many do it over 3 years, ... you need to wait at least 3 months between all treatments. Use tretinorin or retin-a nightly. Because you have ethnic skin consider as well a whitening cream with licorice and or kojic acid - the pca gel one on Amazon is good. You use this as well nightly. Why because you will hyperpigment with treatment otherwise, and we want cell turnover. 

 

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Thanks for your answer. I had an appointment for RF microneedling, so I should cancel it I suppose then? Nokor subcission actually helped with some scars, especially on my temples. But there are a lot of smaller scars, below is a more clear photo.

Is it possible to get sculptra separately at this point? It is a bit of challenge to find practitioners specialized in scars around where I live.

Any other recommendation is welcome.

 

 

IMG_4485 copy.jpg

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@firefish Thank you for your kind understanding, I get so many PM's a day of people to help.

I would cancel rf needling. Again back to the analogy. Do we pave a road or resurface it before dealing with the potholes and raising them as much as possible. You must do the pre-work of Subcision (possibly 8 of them), and some Sculptra or HA filler to get things raised. I know you tried sub in the past, ... reasons above why it failed. ""More Filler,"" you have severe fat loss. 

Then worry about rf needling and even co2 laser once you do the manual work. 

Yes Nokor will not help the small scars. It will help those huge pits if you get the proper Mls of filler, hence Sculptra in those cheeks for your case, and ha later on to the individual pits. Small scars need a combo of some tca cross, rf microneedling, laser, and peels. Worry about all that once you lift things. I Want aggressive subcision. While I do not like This Dr ( to recommend to most people - this is a end of the line, if everything else fails DR....) as he does 5 things at once and some people have had terrible results or side effects without healing 3 months between treatment over a extended period of time. Look how aggressive he is with subcision! They can do this to you. Perhaps your practitioner does not know what he is doing. The tool does not matter so much, they can do this with Nokor, just more work needed as you know over time - 8 sessions. Quicker is NOT better with scars. She will have down time for months, and she is Caucasian so this could be worse on anyone with ethnic skin. 

My recommendation again with the plan above is to travel to a practitioner who will treat you if no one else locally can do proper subcision and sculptra.

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I believe that Dr. is wrong in saying entry points from subcision cause scars, that can happen as a side effect but is very rare from what I have read.

 

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Hello I couldn't find any doctors doing subcission in Berlin, the closest I could find was in Munich which I visited twice for Nokor subcission and filling. @beautifulambition

Couple weeks ago I have visited a doctor in Berlin to talk about Sculptra and she said she has never tried it on someone with acne scars but that it can be done. She said she prepares the solution a day before the operation and she would use 1 vial in dilution (1:7) for treating both sides of the face (cheeks and temples).

Do you think Sculptra would be useful without subcision and should I get it from this doctor who hasn't tried it on someone with acne scars?

Thank you for your response :smileys_n_people_114:

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@firefish I hear this quite often, people cannot find a good subcision Dr in Germany or do not have good results so fly to Emil in Denmark a top acne scar specialist. 

He does all types of subcision - sculptra for acne scars, etc.

The protocol for Sulptra is my invention. I have helped thousands, this provides the best solution for someone such as yourself. All the top acne scar Dr's now use this. It was originally indicated for severe atrophy - aging, ... we have since used it was great results on acne scar patients. Makes since right. The indicated studies -approval were for the aging face. It's thus up to the Dr to do the treatment or not. IF she is competent (ask her how often she injects this - and how many cases she has done), then she should be fine. She is simply not a acne scar specialist and be aware of this - but that is fine for a expert injector. Get your subcision done.when the swelling goes down a week or so then do your sculptra with her. Make sure it's over dilute (dilution) as that is best for scars. We do NOT spot treat scars with this method, it's put all throughout the temples and cheeks as she said. In latter subcisions ... remember we need 3-8 of them 3 months apart of more. You do a HA filler on top (after your subcision) in latter sessions for individual pits. Sculptra is the foundation, make since. 

You could always give it a try, ... if you don't like her work, see Emil. 

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@beautifulambition I think at the moment I can not afford to get subcission in Denmark and Sculptra in Berlin at the moment at the same time. I will contact Emil to ask about his availability, would also prefer to continue with just one doctor.

Is it vital to get subcission done before the Sculptra treatment? I was actually planning to get Sculptra and microneedling treatment.

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10 hours ago, beautifulambition said:

@firefish I hear this quite often, people cannot find a good subcision Dr in Germany or do not have good results so fly to Emil in Denmark a top acne scar specialist. 

He does all types of subcision - sculptra for acne scars, etc.

The protocol for Sulptra is my invention. I have helped thousands, this provides the best solution for someone such as yourself. All the top acne scar Dr's now use this. It was originally indicated for severe atrophy - aging, ... we have since used it was great results on acne scar patients. Makes since right. The indicated studies -approval were for the aging face. It's thus up to the Dr to do the treatment or not. IF she is competent (ask her how often she injects this - and how many cases she has done), then she should be fine. She is simply not a acne scar specialist and be aware of this - but that is fine for a expert injector. Get your subcision done.when the swelling goes down a week or so then do your sculptra with her. Make sure it's over dilute (dilution) as that is best for scars. We do NOT spot treat scars with this method, it's put all throughout the temples and cheeks as she said. In latter subcisions ... remember we need 3-8 of them 3 months apart of more. You do a HA filler on top (after your subcision) in latter sessions for individual pits. Sculptra is the foundation, make since. 

You could always give it a try, ... if you don't like her work, see Emil. 

As far as I know Dr. E.H. doesnt do sculptra , he uses bolatero

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@firefish Ok stay with 1 Dr, was just trying to give you some options, for some it's cheaper to do certain parts of their treatment locally. 

For you yes it's vital to get scrulptra, you have severe atrophy in that cheek. IF you wish you can get only HA filler though. Best results with S... Regarding subcision, you must get subcised and the filler placed, this is how we treat acne scars, otherwise I cannot say how your outcome will be - as it's not a "Acne scar treatment." 

@Miro I am in contact with all the top 1% Dr's - check again ;-)

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Looks like you need subcision bad.  you have mix of boxcars and rolling scars. The good news is it looks some of your biggest scars look like rolling scars which can be improved with subcision quite dramatically. I know it has for me. 

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8 hours ago, beautifulambition said:

 

@Miro I am in contact with all the top 1% Dr's - check again ;-)

I may be wrong, of course,  firefish just write e mail to Dr. Emil and you ll know.

 

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Emil does sculptura Filler now, was there to get it ;) 

i think Till may or june he does sculptura

Edited by Liloo

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13 hours ago, Liloo said:

Emil does sculptura Filler now, was there to get it ;) 

i think Till may or june he does sculptura

@Liloo do you mean he started doing sculptra in may or June? Did not exactly understand what you meant.

Edited by SaraTheGerman

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Hello,

I have decided to visit Emil's office next February when I have more time to travel and money. In the meantime, I would like to go to local dermatologist to get my first Sculptra. 

@beautifulambition

Does that make sense? I can't afford the procedure until February but I also don't want to sit and wait.

Also if I can get the Sculptra locally, is 1:7 right ration for dilution and should it be mixed with saline or sterile water?

Last question, should I also get RF Microneedling and how long should I wait after Sculptra?

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On 8/20/2019 at 9:03 PM, joeysk said:

Looks like you need subcision bad.  you have mix of boxcars and rolling scars. The good news is it looks some of your biggest scars look like rolling scars which can be improved with subcision quite dramatically. I know it has for me. 

how bad were yours before subsicion ? and how many subcision or treatment did you have for it to improve?

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4 hours ago, daelz7 said:

how bad were yours before subsicion ? and how many subcision or treatment did you have for it to improve?

1 treatment did the trick for me. I did subcision and suction for 3 weeks. I got lucky and found a doctor that 's trained by Rullan . I don't have time post side by sides but I had what looked like "hollowing" of my left cheek (you can see my post history to see what I mean hard to explain). It instantly improved that by 50% and now my face looks symmetric. Look at the FAQ and see Mr. Matt's post, if your scars look like his there is a good chance of improving (basically round rolling scars, deep, any size). However, the jagged boxcars that I have did not improve at all, and neither did icepicks (you have to TCA cross/needle)

 

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@firefish It may not make since, depends on skill. Also if they are aggressive. Not going to instruct a Dr how to use a complex filler, ... that would be silly. You wait 3 months between all sessions w/ Dr.

I respond now only by PM (private message) to questions and to do a customized treatment plan for to your Acne scar. Better for privacy & confidentiality / easier maintenance of senders / less confusion / ongoing dialog / and a better use to prioritize my time to the 100's of severe acne scar cases I help a day by PM. Include any pictures or extra information you have by copy-pasting that into the message. Please be patient, everyone receives a response.

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On 9/5/2019 at 6:47 PM, joeysk said:

1 treatment did the trick for me. I did subcision and suction for 3 weeks. I got lucky and found a doctor that 's trained by Rullan . I don't have time post side by sides but I had what looked like "hollowing" of my left cheek (you can see my post history to see what I mean hard to explain). It instantly improved that by 50% and now my face looks symmetric. Look at the FAQ and see Mr. Matt's post, if your scars look like his there is a good chance of improving (basically round rolling scars, deep, any size). However, the jagged boxcars that I have did not improve at all, and neither did icepicks (you have to TCA cross/needle)

 

wow you are incredibly lucky, these are some great results. I underwent subcision on august 1st. will be doing it again in late nov or mid december.I plan on doing 3 subcisions. 

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Hello,

Here is an update. I have had one session of Sculptra treatment in September and I believe it has helped my face to plump  up a little bit. Hopefully it will show its effect more in the following months.

I had two sessions of Nokor submission last year with fillings. However, at the moment I can not afford to travel both financially and time wise to do it and unfortunately there is no one reliable in Berlin to perform it. 

I was wondering if it is a good idea to get RF Microneeling at this point. However, I am worried about the risks of RF Microneedling and if it might lead to hyperpigmentation on non-white skin. The dermatologist suggested regular microneedling to avoid hyperpigmentation. What do you think?

The dermatologist also suggested another session of Sculptra 6 months after the first one. Do you think it is a good idea?

Any comments are appreciated.

Thanks

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Hello Firewish, 

Wow! I don't know if it's the different lighting but your scarring definitely looks raised a lot on your latest photos. What impresses me more is that this is a result more than 1 month post procedure. Amazing.

I just found your thread but subcribed immediately as I have similar scarring to yours. Like you I'm thinking of seeing Dr. Emil in December. So far I have always stayed away from HA fillers or sculptra on recommendation by Dr. Chu but your results make me want to seriously look into Sculptra. Did you have any allergy/ inflammatory reactions after Sculptra? How long did it take to look normal again after the injection?

 

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19 hours ago, NuageBlanche said:

Hello Firewish, 

Wow! I don't know if it's the different lighting but your scarring definitely looks raised a lot on your latest photos. What impresses me more is that this is a result more than 1 month post procedure. Amazing.

I just found your thread but subcribed immediately as I have similar scarring to yours. Like you I'm thinking of seeing Dr. Emil in December. So far I have always stayed away from HA fillers or sculptra on recommendation by Dr. Chu but your results make me want to seriously look into Sculptra. Did you have any allergy/ inflammatory reactions after Sculptra? How long did it take to look normal again after the injection?

 

 

Hello, the lighting certainly is not the same. The previous one is much more vertical, florescent light but I can send some photos with the same lighting for better comparison. Despite the lighting, I think the areas with fass loss are fullier, which overall makes my face look more plumbed up. 

I didn't get any allergy or inflammatory reactions to Sculptra or HA fillers, they were both pretty easy and it took only couple days to recover. 

 

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