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mimitran

Atrophic scarring advice, Bay Area dermatology recommendations/reviews?

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I hope this post is allowed and appropriate here. I'm almost 30-years old and have been dealing with acne since I was 11 and have been bullied for it by my family and peers. I've finally come close to a routine and diet lifestyle that seems to help keep most of my acne at bay. I still do get cystic break outs on my neck and along my jawline every now and then, which is upsetting. I'm also on Tri-Sprintec, an OCP which I think has helped me with my hormonal acne.

Despite being more happy with how my skin has been lately, I had a huge set-back moment recently. Back story: I have 2 sisters, 1 older and 1 younger, who both have crystal clear glass skin. They get asked "what kind of foundation they wear" when barefaced all the time. Throughout childhood, I've always been the sister left out of the "oh you have such beautiful daughters" compliment.

I was recently just home for a family gathering (since Chinese New Year's is this week). A cousin's mother-in-law was visiting and completely mistook me for being the oldest. The woman apologized, but explained that it was because I was born with not so great skin. Then my grandmother said something that really bothered me: She told me that I was named wrong, or ironically. My Chinese name translates to "white glow of the snow", which is a beautiful meaning. But she said that all the other grandma's in the community always tell her I was named wrong because I'm ugly, and don't match the name at all.

Now I know things like this shouldn't bother me. Not anymore, at my age. I should have more of a frontal cortex and years of therapy to deal with this better. But I just got into my car later and cried the entire hour drive home. I just feel like there's no winning. Maybe I do look old because of all my scarring, which makes my skin look old and tired.

Now I really want to try and address my scarring. I've personally done some localized CO2 laser underneath my eyes to treat syringomas (yet another skin issue of mine) and never saw huge results. I ended up treating my syringomas with hyfrecation, which seems to have shrunken them a bit but I just haven't had time to go back and complete more sessions. But that's off-topic. Back to acne scarring. 

I'm interested in hearing experiences with CO2, Fraxel, and INFINI or any others. I live in the northern Bay Area of California and have looked into a couple places, just not sure if anyone can offer their reviews with certain doctors/providers or at least which treatments you've had success with in the past?

- Palo Alto Laser & Skin Care: http://www.paloaltolaser.com/, this is the place I've gone to get CO2:RE and hyfrecation for my syringomas. I see the PA, who I really trust and like. I had gotten my package for CO2:RE 2 sessions for just the under eye area for about $450 because they were having a sale.

- Dr. Jane Chung at Jenesis Lipoplasty, https://www.jenesislipoplasty.com/. I did a consult with them and saw some really promising photos of improvement of their previous patients with similar scarring to mine. Pricey, they quoted me a package of CO2 with INFINI w/ PRP at $2000. Would likely require more than one of these treatments. 

- www.refinedmd.com - I haven't gotten to do a consult with them yet. Would be interested in the INFINI treatment. 

- G2J clinic - Profractional laser treatment, I haven't done a consult because they charge $100 for it. Full face runs between $1000-1250.

- Clarity Medial Spa - I personally had a bad experience here when I tried to get my syringomas treated. I know they do CO2 though, but I'm not sure if I trust the provider based on my own first experience with her. 

- Fremont Laser & Skincare - Has the Alma CO2 laser. I'm not sure about pricing or their providers. 

- Karen Struck/www.struckmd.com- Fraxel laser treatments, planning to call about a consult/pricing. 

I also personally have dabbled into dermastamping at home (2.5mm) once monthly (have done it consistently for about 3 months only) but not sure I see much results yet. I know there's a wealth of information in this forum alone and will spend time combing through it too. 

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I live in the Bay Area and chose to go to Dr Weiner in Florida for Infini. Even with travel costs, is cheaper than anyone who does it in the Bay Area. 

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@mimitran I am very familiar with the bay area. Many Dr's are terrible in the Bay Area. Take a look there is another post on the first page of the scar treatments sub main forum talking about the bay area. Many travel as @ Superburrito said for treatment to Rullan in San Deigo because it's more cost effective, he is a good Dr, and it's priced cheaper than Bay Area Rip Off Derms. 

Here is what I see you needing. Phenol Cross with Rullan he is familiar with your skin type for the icepicks, scarred pores, and small box cars. You could do TCA Cross but this will make the pores / pits larger before we resurface them after many treatments. This is by design. Phenol does not do this but hardly anyone besides Rullan uses this Acid, he is a master with peels. You will need some laser after and he doesn't really do this.

Sadly I know all the Dr's above and they are not that great. Blast it with laser types. Refined does do Infini but it's expensive. Fremont laser has lots of lasers, and is the blast the patient $$$$$$ type of operation. Dr. Jane Chung - typically does not have good reviews. Many of them can do laser, but are not the best to see. 

There is Dr Gladstone or Dr Ting (price fixed $$$$$ as part of all the bay area Dermatology branches - California Dermatology ""Factory"").

** 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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Thank you @superburrito and @beautifulambition for your input! That's so unfortunate to hear that there isn't very many good options (or any at all) in the Bay Area. I see Dr. Jane Chung with pretty good reviews on RealSelf and Yelp, but it's usually in relation to other procedures she's done. When I went for my consult the before/after photos they showed me of patients (?whether their real patients or not I know I can't confirm) was promising. I was a bit put off by her though, just because she didn't seem to really want to listen to what I had to say, just pushing her routine package of INFINI w/ PRP and CO2. 

You are not the first one to recommend CROSS procedures instead...2 of the docs off RealSelf that I submitted pictures too also said that I might have more success with TCA CROSS and INFINI instead of any CO2 lasers.

I'll definitely take a look through that list of recommended doctors and try to do some pricing. 

Edited by mimitran

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I'm also from the bay area and just went to refine in los gatos for a consult.  A nurse recommended either 6 microneedling treatments for $2800 or INFINI for $1800, which seems pretty high.  I am going to see Dr. Rullan later this month for his combination treatment (subcision/cross/microneedling).

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@lovescars3 damn that price is so steep! I’m doing a consult with dr. Rullan by sending the photos of my scarring above. If you do end up going through with treatment would you mind keeping me in the loop about pricing and your experience?? I’m aiming to do some treatments sometime after August this year. Right now I have full time work and graduate school and it’s hard to get time off for healing.

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Hi,

As an update I just got my own quote from Dr. Rullan. He had quoted me for the subcision/phenol cross/microneedling package as well but also actually recommended that I'd get better results from a phenol peel. I remember reading somewhere on here that peel isn't what I should be looking for?? So I'm a bit confused.

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@mimitran Please be aware when you communicate with Rullans office that is not Rullan. It's a sales person. As such they have no idea sometimes. If you want phenol cross tell them you are booking for that. Yes I would correct icepicks, and pits before doing a phenol peels. Also be aware Rullan does not do energy devices. As such if you need rf needling or co2 laser you go elsewere nearby for this (med spa or derm). Normally people start with Rullan's set package of treatments including cross, sub, needling, and then they either treat with energy devices between or after that. Finally they might do a phenol peel lastly for texture or you can do something locally with a derm (laser peel). He is a good starting point. Just tell them what you want to book for. I have had the sales guy do this a few times, and no we don't want to start with a phenol peel.  

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@beautifulambition Thank you so much for your feedback! I think I'll plan to tell them I'd want to do the Phenol Cross/subcision/microneedling combo and hopefully when I get there Dr. Rullan will be able to really give me an idea of what needs to be done? I've seen on these message boards that for some people, he'll say that they actually don't need subcision. Should I be concerned that Dr. Rullan will do unnecessary treatments or is he pretty honest in telling you exactly what he thinks when he assesses your skin in person? 

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@mimitran OF course when Rullan see's you that is the best way to communicate. I wold book a standard session with him for sub, cross, etc and discuss a peel etc. 

See ScrewScars recent post on a Phenol Peel With Dr Rullan. I Think that gives a good idea of the end goal when the scars are superficial enough. Perhaps yours are I cannot say. Many have icepicks and rolling / box cars to take care first before we get to surface texture (do this at the end with a peel). 

He does not say this per say, don't need subcision, his sales electronic office staff does. They are not trained in the intricacies of scarring. Also one cannot know how bad scars really are until they are touched, and looked at with directional light. I have had people who sent perfect pits, and needed filler as the shadows show everything. 

Nah I would not be concerned with Rullan, if anything ... and you have boxcars or rolling scars, his treatments may not be enough before that peel and I say get some rf needling or co2 laser to the scars. But if it's textural you can see him for everything. 

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@beautifulambition Hi! I'm curious if you know any news whether Dr Rullan is still planning on retiring sometime soon. I know his daughter is supposed to take over but hoping to get a chance to go down there. Had a subcision session with him in late 2016. Definitely want to come back again! 

 @mimitran, I have similar scars and I'm in the bay area as well. Not so many good doctors here. Did the research back then and realized it's worth the trip to SD. As of lately, it's just trying to get back into 1.5mm Dermapens, 50% glycolic acid for hyperpigmentation, and hoping for the subscision + suction method. I didn't do suction the first time around but I plan to do it this time. 

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@LotsToLearn He won't retire for many years I am told. He is also training other Dr's in deep peels through his society currently. Regarding subcision, I do not know if his daughter will continue this on, she seems more interested in general aesthetics. But you have time to see him, if you learn anything let me know will you so I can advise others, he is very popular right now.

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