Hello all, Ive been on this site for quite some time, seeing other people make progress with their scarring treatments, soin early December I finally gotsubcision done with a dermatologist in Long Beach. I decided to take a week and a half off of work to heal.
I have all types of scarring:ice pick scars, some box car scars,rolling scars (with fat loss) and hypertrophic scars/sebaceous hyperplasia on my nose. The scarring affects my temples, cheekbone area and t-zone.My forehead,jaw/lower cheekarea and chin are unaffected.
So after I got subcision (nokor),my face gotswollen on both sides, but really swollen on my right side. I also had hematoma on both sides, as well as red marks from the insertion points from the needle on both sides.
On the days thatfollowed the treatment, the major swelling on my right side began migrating from the upper portionof the right side of my face to the middle/lower part of the right side of my face and that lower cheek area stayed really swollen up until it was time to go back to work.On my left side, the swelling went away fairly quickly, but on the front portion of my left cheek, what Ithought was a hematoma, turned into a red acne cyst that lasted from mid DecemberthroughoutJanuaryand early feb (it was excised a few weeks ago but now theres atrophy and pihwhere it was located).
More than this, there seems to have been noticeablefat loss on the right side of my face. There are just portions of my right side that are more hallow than before (not only where I had subcision done in my cheekbone area, but on the center of my right cheek where subcision was not done).
Isit possible that the fat loss has occurred from my face getting so swollen? Also, after the swelling migrated to the lower half of my right side, I firmly massaged the area,hoping that I could accelerate the healing process of the swelling before I had to go back to work. Could me massaging my face bethe reason for the fat loss?
I will update this thread w pictures soon for reference, but in the meantime can anyone tell me if subcision causes fat loss?
@Mr AndrewHi there.
If you could provide a picture of your scars(scars make shadows - flashlight or directional light), I can best help.
Sounds to me like it could be a few things. Not enough filler or as you state you have fat loss. I find over dilute sculptra really helpful in these cases injected throughout the temples and cheekbones. It stimulates collagen to be built. The beauty about Sculptra is it lasts for quite a while, and you can have it injected and then subcise without getting filler till needed. Perhaps some HA filler at the end.I
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Heres the before and after
Before: taken November 2018
After: taken Feb 2019
I can confirm that the cyst that was excised is now a hypertrophic scar (smaller circle)
Overall, I feel like the quality of my skin has not improved after my subcision and if anything, I think that it may have gotten worse with more volume loss having occurred. I will be adding more before and after pictures with different lighting in the coming days/weeks.
@Mr AndrewThank you for posting those pictures helpful. I know what is going on here. You did not have filler and in your case I would have used over dilute Sculptra. Because nothing was used, the scars simply tethered down worse than before to the fat layers / or the fat was damaged, ... this is the exact reason we use filler here, or this is what the body will do, especially in a case like your where there was already fat loss.
The term is called adhesion where a scar tethers to lower layers after a procedure, unless a spacer is used.
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17 hours ago, beautifulambition said:
@beautifulambition Was the fat loss due to the fact that I got nokor subcision? Because the derm was too aggressive? Or was it an inflammatory response to the swelling?
If I do decide to go with Rullan for cannula subcision, will there be the risk of more fat loss again from the swelling (without filler)? Can sculptra be done right after subcision? Also, once the sculptra fades will the scars look the same or possibly worse??
Finally, what should I do about the hypertrophic scar on my cheek? Should that area under my scar be avoided during subcision? Can it be excised (I would trade it for a linear scar)?
Your responses to all my questions are a huge help. Thank you.
@Mr AndrewThe extra fat loss potentially. I think it was more of a cascade. No filler, adhesions, the body tethered down harder than before. I don't think Aggressiveness was the issue, ... the lack of filler was.Inflammation is always caused by near anything and the body heals.
Perhaps I am having a hard time seeing the"hypertrophic scar" on the cheeks. IF you could provide a picture of this closer that could help. I only see Rolling scars currently. I do see some on your nose. They can be injected with steriod to flatten them. No I would not avoid that scar during subcision, Could it be excised, sure, but as you said there will be a linear scar instead. You could always try subcision and volume first there as it looks atrophic to me.
Again I feel that Sub without the filler was the waste of time and money...another proof...Dr.Chu does not do filler(against it) and does not use cannula(it does not cut the tethers)...diluted Sculptra? It migrates...basically everything what BA said here and in my thread he does not recommend and does not do...everybody who is thinking to go to Chu should be aware of this.
Mr.Andrew, thanks a lot forum post and the questions I had as well.
@Mr Andrew hi this is abhishek did u get ur fat back which u lost please reply i also lost my fat on my cheek and want my fat back