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Advice for my scars (pics)

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(@edie9598)

Posted : 02/18/2019 12:40 pm

I have scaring on this one area of my face. See photos. I think these are rolling scars? Is subcision and filler my only option for improvement? 

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(@beautifulambition)

Posted : 02/19/2019 10:03 am

@edie9598Yes I would do several sessions of subcision with filler or chinese cupping(Amazon). Perhaps some rf needling or co2 laser afterwards for texture. You can try to Derminator them at home if you wish or Dermastamp them. There are other surgical options but not appropriate to start with because of side effects.

The pit's are fat deficient and tethered. So yes I feel that would be the best option you stated.

 

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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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(@edie9598)

Posted : 02/19/2019 11:08 am

@beautifulambition Thank you for your comments. Would the Derminator / Dermastamp be in addition to subcision?

Of course these questions will be asked of whatever Dr/nurse I see, and I have been reading the FAQ on scars, but generally is the filler done in the same visit as the subcision? Or filler may not be done until it's healed, or after several sessions of subcision? I wasn't quite clear on that.

I have looked at the list of Drs on the links, but wondering if you have heard any input on a Dr. Jason Emer in Beverly Hills, CA?

Also, I have just signed up with Curology, and oddly the recommended formula did not have tretinoin. I was shocked. It has 4% Azaelic Acid. Does that offer any of the same benefits of the tretinoin? Not that I can find. I have asked them but curious what you know.

Thanks again!

 

 

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(@beautifulambition)

Posted : 02/20/2019 9:20 am

@edie9598Your welcome. Yes I think it would be good(Derminator), ... perfect for at home treatment monthly in between. Say in the .5mm to 1.5mm range depending on your sensitivity /thicknessand how you heal.

I would not personally do filler in the same session as the subcision as bumps can be created when swelling occurs. We wait for a week or two until the swelling goes down and get some filler. The only exception is if you get overly dilute(Saline) sculptra it can be directly after the procedure as it's not a spot filler but for widespread volume loss, scarring. At a latter time one can do ha filler directly to the pits(as your doing 3-8 sessions of subcision). You can also do that, wait for filler until a latter subcision, and do Chinese cupping amazon at home with slight pressure over the scars. This is why I like Sculptra, ... you get it at the beginning and then you can subcise without doing it again unless you want more. Lasts for a long time. Many ladies with aging issues get it.

 

I would never see Dr Emer he is probably one of the worst Dr's in the world. I am updating the FAQ currently, spent hrs on it. Dr Rullan is much better in San Diego and is a top 1% acne scar Dr. But I will have some general Derms I will add soon who do subcsion.

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Dr Jason Emer
United States, California, Los Angeles, Hollywood
Specialty: Not recommended. He is not as experienced as top 1% acne scar practitioners, General Derm.Laser Dermatology,Bellafill, Overpriced $$,$$$, markets, Stacks 5 Treatments at Once (we do not heal this way, have had to help more patients who have seen him with botch ups than anyone else). He uses Hollywood glits and glamor to do the hard sale. Many reports that he does not seem like he cares for his patients. Charging a few patients with severe scars $60,000 (crazy I know) for treatments and telling them they had to treat with him for life, the person was worse off then when they first started treating with him. Sponsored by energy device manufactures.

That is strange about Cureology they can mix in a retinoid easily if asked. You can always goto the store and get differin(any drug store), or the ordinary has a cheap product.4% Azaelic Acid does not have the same benefits as topical vitamin a - retinoid for skin turn over.

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Wikipedia -

Azelaic acid is used to treat mild to moderate acne, both comedonal acne and inflammatory acne.[6][7]It belongs to a class of medication calleddicarboxylic acids. It works by killing acne bacteria that infect skin pores. It also decreases the production of keratin, which is a natural substance that promotes the growth of acne bacteria.[8]Azelaic acid is also used as a topical gel treatment forrosacea, due to its ability to reduce inflammation.[7]It clears the bumps and swelling caused by rosacea.

 

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(@edie9598)

Posted : 02/20/2019 12:49 pm

@beautifulambitionThank you so much. You are an angel. I am SO glad I asked about Dr. Emer. I was a little put off by his overly slick website, but I had no idea it would be that bad. I will call Dr. Rullan. I live a bit north of LA, so was hoping to find someone in LA, but I could do San Diego if need be.

I contacted Curology and asked them to include some tretinoin, and they were good with that. I guess they excluded it because I had mentioned Retin A made my skin red when I used it previously. Just deciding between a formula of tretinoin, clindamycin, and azelaic acid, or tretinoin, azelaic acid and niacinamide. I am leaning towards the .04% tretinoin, 1% clindamyacin, and 7% azelaic acid, since I still get random breakouts, then just using The Ordinary Niacinamide in addition to that.

So re: the filler, if I understand your explanation correctly, having the Sculptra might be beneficial for overall age related volume loss (which may give some minor help to scar appearance) but then I might do an HA filler for indentations later on after getting improvement from several subcision sessions.

THANK YOU!!!

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(@beautifulambition)

Posted : 02/21/2019 9:30 am

@edie9598Your very welcome! Added a bunch more practitioners in the FAQ - pinned at the top of the scar treatments sub, you could do a few consults and pick one, you feel comfortable with. Rullan is available for manual scar treatments, you can do the filler and laser locally is another option.

If your getting redness then there is too many products effecting your sensitive skin. Best to keep things as simple as possible. Yes keep the niacinimide separate, and the tretinorin effects some people with dryness / red, so skip a few days between using it and moisturize first. I wish they would separate out the ingredients for sensitive people, but you can always have them take out things to try it out. It could be any of those things, ... tretinorin, azelaic, probably as they are acids probably. Skip some days.

Yes your right about the filler. Over dilute Sculptra throughout the cheek area to refresh it. HA towards the end subcisions for individual pits. Filler you can get anywhere locally after you get the subcision done if that is better for you.

 

 

 

 

 

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(@edie9598)

Posted : 02/21/2019 1:39 pm

@beautifulambitionThanks again. Good advice. I will have a look at the updated list of Drs. in the FAQ. I also sent some pics to Dr. Rullan for an email consult.

With Curology, I decided to start withtretinoin 0.018%,clindamycin 1%,azelaic acid 8% and see how that goes.

So you think Dermastamp or Derminator is better than a roller type device? Is that due to potential micro-tears?

I am a very healthy eater, but the past year has brought a lot of stress and while I've always been very thin, I lost about 5 lbs and also have a very young child keeping me up at night and running around after him all day. I'm going to try to gain back the 5 lbs and become more invested in other healthy habits like stress control and sleep. Hopefully that will help me on this scar improvement journey as well.

Heard back from Rullan - and he suggested (2-3 sessions) subcision and sculptra for volume loss.

They said I could do the treatments 3 weeks apart, but I think I've seen it recommended here to wait 3 months?

A little nervous after reading about potential for hematomas with the procedure. Is this a rare / common occurrence? I found a thread here where someone was dealing with "lumps", I assume those were created by a hematoma.

Thank you!!

 

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(@beautifulambition)

Posted : 02/22/2019 12:48 pm

@edie9598

I do like the derminator, ... it's cheaper than any Dr based microneedling treatment, and you can treat at home. Various size needles. Rollers yes, micro tears, and they are better on the thick skin of the body, also harder to just treat the scars.

Those who gain weight, it often does hide the scars, skinny people - it shows more. I am sure sleep and stress control will help.

Yes I knew Rullan would 😉 There recommendation is from a sales person, ... his or her job is to sell sell sell. As such they are clueless, they want to get you in. Rullan might say a month. But I have people only doing subcision once a year, as that is all they can afford and are quite happy. Our skin heals very slowly. I think perhaps they want 3 months apart for the loading up part on a traditional sculptra treatments, it takes 3 sessions. You do not have to do it so close together. Tell them you will call back when you want to schedule. There is no rush.

I get this all the time. Hematomas are rare, small percentage. Mainly from cupping or with Nokor, more aggressive sub he does not do anymore. You will be fine. Have him inject the sculptra deep and very dilute. You will have to massage the skin with Sculptra for a few weeks. You will be fine.

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(@edie9598)

Posted : 02/23/2019 6:35 pm

@beautifulambition thanks again for the insight. I made a small donation to you :)

So I have heard that Sculptra needs to be massaged a lot to not get lumps. Not sure if that is true, but if so, if I got it at the same time as subcision I assume I could not massage. So could I get subcision then get Sculptra at a later time? Or get the Sculptra first? Hope that makes sense.

Also, I was looking at the Derminator. Just curious, have people had any improvement to rolling scars using their suction device in conjunction with the Derminator? 

 

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(@superburrito)

Posted : 02/24/2019 2:59 am

@edie9598I have had two subcisions so far with Dr Rullan and have not had any hematomas, so you are in good hands. He also does not use a Nokorneedle, which has a greater risk of hematomas.

As for Curology, the first formula they created for me did not have Tretinoin. I requested it later and they started me on a very low percentage and once I tolerated, I was able to increase it. From what I gather, they will default to an initialformulation that minimizes irritation, which is likely why you did not get it at first.

Good luck on your journey!

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(@beautifulambition)

Posted : 02/24/2019 10:59 am

@edie9598Hi Again edie, you can message me privately if you wish with questions. Thank you so much 😉 !

Yes Sculptra is massaged for a few weeks after, it's really easy, there is aftercare for sculptra instructions on Youtube.

You can get it injected at the same time as sub, or a week after when the swelling goes down, both work, ... either way swelling goes down and we massage 😉

It does make since, ... yes you can massage in a week after it, or do a very light one as your healing. Nothing is going to happen in a week's time.

Derminator your noting going to see massive improvements, ... it's great for at home treatments, it's cheap, cheaper than a Dr's apt actually. I find it works best on smaller scars, ... you can use the single needle attachment as well on the borders of the scars. IT's just something to do in between Dr's treatments that stimulates collagen. RF needling is more like a laser but it protects your epidermis unlike lasers so they are different things - purposes.

 

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(@edie9598)

Posted : 02/26/2019 11:12 am

@superburritothanks so much for your input. I'm glad things are going well with your procedures. Did you have any filler with Rullan?

@beautifulambitionthanks again for info. So from various threads, Iam gathering that Dr. Rullan is maybe not the best choice for filler. Does Sculptra require the same precision and artistry that HA fillers might to get the best result? Could placement of Sculptra change the shape of your face? Or is it intended to get your body to create some collagen in places where it was lost? Thanks for any insight you can provide. I do have some extremely good injectors more locally who I could use for any filler, including Sculptra.

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(@superburrito)

Posted : 02/26/2019 1:34 pm

@edie9598I have not had any fillers yet with Dr Rullan, but will consider it after a few more rounds of subcision/cross/microneedling

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(@beautifulambition)

Posted : 02/27/2019 8:41 am

@edie9598He again Edie. Rullan is ok with Sculptra, ... it's HA filler under welling that I never suggest to do. But you can also go anywhere even to a Dr by yourself for Sculptra when the swelling goes down after a Rullan trip.

No Sculptra is a mass filler injected over the cheek or areas of concern, it's not a volumizer that takes a bit more skill.

I don't think it would change your face much. OF course if over injected possibly, tell them you do not want this, mainly under your scars and fat deficient areas of concerns is best. Be aware that under swelling everything looks different, this goes down. Same with Sculptra, ... you have a period of puffy cheeks, then it goes down as the saline is absorbed and a slow build up with collagen, ... this is why many between subcision sessions do rf needling to stimulate it, 3 months between Dr's treatments. Rullan does not have rf needling, that I am aware of.

Yes it's used to create collagen in deficient places. Perfect your all set for injectors then.

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