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Horus

Thoughts on dermabrasion?

I've been treating my scars for the last couple years. I've had some microneedling, and I've visited Dr. Novick 3 times. I've had field subcision and some individual subcisions. I've had some improvements, but I'm still not happy with my skin. My next step was going to be rf microneedling, but I'm having trouble finding someone in my area with alot of experience, and I'm worried about fat loss associated with energy devices. Anyway I recently came across a surgeon in my area who has some impressive before and afters of dermabrasion on his website. I will probably at least have a consultation with him as he does rf microneedling as well. I know dermabrasion is kinda old school and not alot of doctors do it anymore, but I was wondering if anyone here has had dermabrasion with good results? (or bad results). From what I've read it can either help immensely or make things much worse. I think most of my scars are somewhat shallow though I do have some deeper icepicks too (I'm not that concerned with the icepicks). I realize dermabrasion has a long downtime, and I'm prepared for that if it means results. I know nobody can tell me how I will heal from a procedure but do you think these scars are suitable for dermabrasion? I'll attach some pics.Thanks in advance for any replies.

 

 

 

 

 

 

Edited by Horus

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@Horus Goto Dr Wiener in Florida, he is the east coasts top 1% acne scar Dr.     He is also the ambassador of Genius/Infini RF Microneedling, training other Dr's on how to use it.

I see the need for some filler and energy devices now like co2 laser. I see some areas that still need subcision.    

Dermabasion is so barbaric. Do you know you need 3 of them and the down time is months and months. Major pain from doing it. Photos are always best case scenarios of successful patients. If you search the forums there are those who had bad results from dermabrasion, because it has many side effects. I would research it more. Dr's gave it up when laser's became the thing. Dermabrasion softens the borders of the scars. It can make the skin shinny and thin. It really depends how you heal as well.

Dr Wiener could do tca cross on your icepicks and some energy devices for the large scarred pores, and skin texture. OR Rullan in San Diego could do Phenol Cross and a phenol peel which would give better results to dermabrasion.

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Thanks BA. I guess I kinda expected that answer. I didn't realize you need 3 of them. That's crazy amounts of downtime! I just feel I need some kind of resurfacing treatment and I'm afraid of fat loss (I think I already have some fat loss) I don't think I'll be able to go to Florida for treatment. I will probably have to find someone more local. I've already spent so much $$ traveling to Novick for meager improvements. I agree that I could still use more subcision, although the last time I was there he said I wouldn't need anymore subcision. I don't agree at all but with his prices I'll have to find someone else to do more subcision for me anyway. When you say I need filler do you mean for general volume or for the individual scars?  The texture is what really bothers me. I could live with the indents if the rest of my skin wasn't such a mess. Do you think I would be better off at this point with rf needling or co2 laser? I was planning on just alternating derminator and tca peels for a while, but I don't think that will get me where I want to be. I think the microneedling I have done has made things somewhat worse. I have alot of time off in the summers so that's when I get my treatments. I'm just trying to plan my next step for this summer. I could continue getting subcisions, but I would really like to do something about the overall texture of my skin. I will probably at least have a consultation with that plastic surgeon as it looks like he also does subcision, infini, and co2. Thanks again for the reply. Your advice is always appreciated.

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@Horus I had rf micro with Dr Weiner’s office in Florida and had a great experience. No fat loss. Fat loss occurs when an unskilled person goes too deep. Price-wise, he’s much more affordable that docs in big metro areas like San Francisco, where I live. 

Also, I’ve seen Dr Rullan twice now, in San Diego, and recommend him as well. Reasonable pricing as well, so it’ll make travel costs less of an impact financially.

My understanding is that demabrasion has  mega long recovery time. Rullan’s Phenol peel is a chemabrasion, and has much fewer downtime, though it still looks like an intense procedure. 

You might also ask him about subcision again, since every doctor has different techniques, and Dr Rullan used a very aggressive method, that could be more effective for you.

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Dermbrasion is what got me in the mess I am in today. I had it in 1993 to correct for extremely mild acne scarring (maybe 0.5/10 with 10 being worst) and it made me much worse, maybe 3/10. I cried at a follow-up and the doctor then gave me phenol, which made me 7.5/10. That was 30 years ago.

I didn't know anything back then. I started reading papers only after my face was destroyed. Make sure you go to someone who knows what (s)he is doing. Dr. Wieiner and Rullan are probably your best bets in the USA. Don't try to get somebody cheaper. Your worth so much more than that!

 

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20 hours ago, Horus said:

I've visited Dr. Novick 3 times. I've had field subcision and some individual subcisions. I've had some improvements,

Improvement from your subcisions in %? 10, 20, 5%?

Your skin is not that bad at all.

 

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@CoconutRough It's hard to say a percentage. maybe 20% to 30% decrease in the depth of individual scars, but it didn't do much for the overall appearance. I didn't notice a whole lot of improvement from the field subcision. But it may have added a little volume. I know on my last visit to Novick my scars looked much better than my first visit in his bright light he uses, but I don't really notice any dramatic improvement for the price. @arug and @superburrito Thanks for your input. I think I've already decided against dermabrasion after further research. I don't have unlimited funds by any means, but I'm not necessarily looking for someone cheap as much as someone closer (I'm in Ohio) I have a 4 year old daughter and Wife to consider so traveling that far for treatment is not really an option right now.

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@Horus with Dr Weiner, I flew in on a Thursday, had Infini on a Friday, and then flew back home on Saturday. This is coming from San Francisco. From Ohio, you might be able to fly early morning on Friday, and have the procedure the same day, and then fly out the next morning. Just a thought!

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@Horus I will have some possible subcision leads this week for Ohio. Check the FAQ pinned at the top of the scar treatments sub, under recommended providers. Will update there. 

"I just feel I need some kind of resurfacing treatment" You can always contact the Dr's in Ohio, especially plastics and see if they do deep phenol peels.

Don't be afraid of fat loss, you can always get some over dilute sculptra done throughout the cheeks. This will make actually more collagen.

I think your next plan of action should be more subcision, some tca cross, and rf needling even if's by a nearby med spa (several sessions, between the subs). Let yourself heal at least 3 months between treatments. You may have to add CO2 fractional laser in there for a boost. Do the peel last if you need it. Call around and ask if anyone does sculptra, have it injected throughout the cheeks deeply and over dilute (saline), plastics often do this or derms. A cannula could be used with it and some subcision done then. See under the FAQ pinned on the scar treatments main sub, successful treatments f93d's post.  

Start with rf needling, and then move to co2 only if needed, Lim uses both on tougher patients.

 

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I've found a few places that offer infini near me. I've got a couple consultations scheduled. So hopefully I will feel comfortable enough with one of them to let them treat me. I have found a couple plastic surgeons that offer sculptra near me not sure if I will be able to afford it right now though. I'm still looking for someone that does subcision and tca cross near me.  @beautifulambition Please do let me know if you get any leads for subcision in Ohio or Pittsburgh,PA area. I'm going to remove my pics for now just because I don't like having pics of my skin on the internet. If I get any improvements in the future I will be happy to share them though. Thanks again for all your advice.

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@Horus Cool - Infini, found a few places but am swamped with the FAQ recommendations to update, ... check back towards the end of the week or remind me. Texture for you is going to be a combo of subcision, Over dilute Sculptra, rf needing and possibly CO2 laser. Then peels at home or a peel with a derm. Price Wise treat over time when you have the $$$$$, no rush. 

I would do some more Subcision

** Please Note I offer to acne scar suffers a "more" "customized" (private) consultation than the above general advice. Analysis, answering questions, ongoing support by Private Messaging. Feel free to message me there. Be patient as I can get over 100+ of the worst acne scar cases to help, it "may" take me up to 48 hours to respond.

Checkout the main scar treatments sub, find the FAQ pinned on top there, goto the bottom, there are Dr's or call around and ask who does cannula subcision or nokor subcision (needle type) to dermatologists and or plastic surgeons, consult a few before you decide who you like, even if you have to pay as treatment is expensive, better like them. Ask how many subcisions they do a month and if they treat your skin type. If they just do laser run they will just blast you and not solve your issue.

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Disclaimer: Information and support is not meant to diagnosis, treatment, or cure any health or mental condition and is not a substitute for professional face to face medical care  (consult with a few Dr's and pick your favorite one). Posts are for informational purposes only, please consult your personal health care practitioner before engaging in anything discussed. 

 

 

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To the original question, I would not do dermabrasion.  Like you said it is one of, if not the most risky procedure you can have for acne scars.  There are too many variables and the results too inconsistent to recommend in 2019.   If you have ethnic skin or darker skin, prone to keloid scarring, or have general issues with healing I would avoid it.  

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