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HopeNew

Is CO2 Laser too old school for scars? Should I get another type of Laser?

My doctor is going to use a C02 laser after performing my second subcision next week. Is C02 Laser considered an old type of laser that is not as effective as newer lasers? 

Should I reconsider? I hope someone knowledgeable can respond ASAP.

 

Thanks

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@HopeNew I can give you a acne scar treatment plan if you wish. I need directional light or use a flashlight so I can see the shadows. 

Typically we do between 3-8 subcisions. So only doing 2 is interesting, you might need many more. There is a healing period post subcision when you see swelling and it can go on for many weeks. Then after that you have 3 months total time including what I mentioned as the skin heals, and produces more delicate collagen. Many Dr's over treat in this period as swelling hides mistakes and does not allow you to see what's going on. We heal sloooooooowly. 

CO2 in a fractional configuration might be fine I would do it high power and very low density - 3-7% multi pass. It all depends on the kind of scars you have the solution you are given.

No CO2 is very much used and is one of the most powerful lasers for treatment. It all depends on the Dr's skill and the settings he uses. The device is just a tool. 

What is the reason for the CO2 that he suggests using it now. Extensive Subcision and filler should be done prior to laser as laser acts as a textural treatment. We raise as much as we can then laser or rf needle. Some do co2 laser or rf needling between subcision but again 3 months between. 

It takes me 24 hrs to respond as I am flooded with the worst acne scar cases often getting 50 PM's a day to help, please be patient, Thank you. 

 

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Thank you. So he should do just the subcision alone at first? 

I think he's going to do the subcision, prp and laser together. 

It's going to be done Friday... I am nervous. Praying....

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@HopeNew Responded to your other post. I would never do a combo treatment like this. This is how things get messed up. We should wait 3 months between treatments. Doing manual things first. But follow the care of your Dr. I do several sessions of subcision first, and filler, then do some rf needling or co2 once we great response from that later on down the line, 3 months apart for everything. 

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1 hour ago, beautifulambition said:

@HopeNew Responded to your other post. I would never do a combo treatment like this. This is how things get messed up. We should wait 3 months between treatments. Doing manual things first. But follow the care of your Dr. I do several sessions of subcision first, and filler, then do some rf needling or co2 once we great response from that later on down the line, 3 months apart for everything. 

Now I'm concerned. My TCA Cross and my excision came out well. 

I have to call to see if the Laser should be held off. 

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Now I'm worried. The receptionist called to confirm tomorrow's appointment and I told her about my concerns about the c02 Laser and PRP with the subcision the same day. She said that's absolutely the way it should be according to medical books.....

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@HopeNew You may be fine, ... I cannot say. This is your plan with your Dr not mine. 

  1. We do not combine treatments especially combo treatments as the body does not heal like this. When Dr Emer, who is notorious for doing this, does it all at once... people have "potential" side effects, do not get any improvement, sloppy treatments, areas are missed, done as quickly as possible to maximize $$$$$$. 
  2. When you do all that it increases $$$$$$ for the Dr, he can do a large charge for a package treatment, ... this does not address your individual scars needs. Blast everyone who comes through the door with laser is the plan. They are just doing as much as possible to see what possibly works.
  3. Swelling, ... this occurs when many things are done at once, often the Dr says come back monthly for the package procedure including laser. They are hiding the true acne scars behind swelling and telling you, that more treatments are needed to see results $$$$$.
  4. Side effects, when more things are done at once there can be side effects, see the FAQ pinned at the top of the scar treatments guide for possible laser side effects. 
  5. The only one most people would trust to do multiple things at once like this is Dr Lim and even he says do your manual treatments first, heal and observe the changes with your scars, then do laser and energy devices as part of your plan. He also get's international patients that fly in. In that case he will do multiple treatments at once but he says this is not optimal to healing or treatment and they are taking the risk of side effects to be seen quickly during a short vacation. 
  6. The receptionist telling you the white papers says this is bogus. Most medical papers are sponsored by laser manufacture's, Dr's buy into the machine and sell it for a profit to pay off the machine. They give talks for a speaking fee. It is advantageous to them to use laser on you as much as possible for profit. Many won't even do manual methods and if they do, they do them poorly as they rely on energy devices. We also have medical papers linked on the top of acne scar treatments that say manual methods are best for treatment. Thousands of people posting that say they wish they tried manual methods first and felt pushed into laser. You do laser as a last resort not a first line of action. We don't need to blast our face the first thing we do. This is again a package Dr and not a top 1% acne scar specialist. ... Your in New Jersey is this Rapaport... If so he is notorious for using energy devices now for profit. 
  7. Laser is for texture, ... as such why rely on it this early in the game instead of seeing if cross, subcision, filler, and other manual methods can raise your skin as much as possible. Then consider laser.

You may be fine to do everything at once. I would not personally tell anyone to do this unless they had no time to treat, were far away from the Dr, and were willing to take the risk. 

You may do laser between treatments - 3 months is advisable between treatments. Why back to the swelling part, slow healing of collagen, maximal benefits of manual treatments. 

The solution is very simple call up and say you want prp and subciion with needling or whatever and want to wait on the laser. IF they won't listen to you then the Dr is not a good fit. Or you can keep the appointment and give it a try, that may be fine for you, laser this early in the game won't give maximal benefits compared to proper healing and observation. Getting as much improvement manually as possible. Not trying to scare you. Have dealt with thousands now both good and bad. I want posters to be educated before they just do laser laser laser many derms try to sell them as a fix all for everything. 

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Thanks for your feedback. By the way, the doctor is not rapaport... this doctor is someone I know personally and he's giving me a discount. He has done this to me a few years back.

Perhaps I will only get the subcision and prp tomorrow and tell him to wait on the laser. I don't know... sigh....

Right now I am between jobs so I have the downtime.  

Are you saying that if I have laser done on the same day it will reduce the improvement?  From what I am gathering, you're saying it won't help, but not necessarily reduce it... just cause complications.

I appreciate your feedback.

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@HopeNew Sorry I don't have a lot of time 50+ PM's daily to help the worst scar suffer's. If it's free/ or discounted go for it. You know the risks. I took all that time to type that out. I just got through responding to a post where the guy had small improvement because he was sold packages where they did laser, prp and sub at once and wondered why. Again his scars were not addressed individually with a plan, but instead blasted. Since you have done it before, and you seem ok, go for it. Sounds like this person is a general derm and not a specialist.

I don't want to debate or force you, I have provided this information so many times it can get tiring, see the pinned topics at the top of the scar treatments main sub. I am also a subject expert - author in this area, but I don't need to get in a p_ contest with a Dr. Do what he feels is best he is treating you, not me. Disclaimer I am giving my educated and well founded opinion. Any choice is yours alone. 

Many just want to get it over with and want the combo treatment so I understand, see if that works for you. 

Have I given you a plan for your scars before you started this based off your pictures with directional lighting or a flashlight - scars make shadows. IF so that was based off your scars and not a package. 

Down time is never a concern when I help patients, that is up to them to figure out. 

I am saying doing all those treatments at once "CAN" not be optimal to healing. But it's free/discounted man, ... go ahead and do it. 

You do know that 6 months after treatment (laser) your healing - making new collagen under the skin. Also I don't know enough to know his purpose for laser in your treatment. Subcision is for the pits obviously. PRP is for quicker healing, even though Dr's promise otherwise. IT's not like it's a filler for the pits. 

You sound ok with the risk which is fine.

Anyways goodluck with your treatment.

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@beautifulambition I very  much appreciate your time and feedback. I am concerned. I am wondering if I will tell the doctor to old off on the CO2 Laser tomorrow. Focusing on the subcisions does make sense... 

By the way, where do you practice?

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My wife thinks this doctor performed the procedures on me so inexpensively because he was practicing on me. Here's to praying everything turns out great. 

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