@beautifulambitionthank you once again for your amazing response.

Should I getover dilute Sculptra(is that the correct way of saying it)? injected during or around the same time of the subcision? Or can I get it weeks or months later? Does Sculptra grow collagen permanently? Or is it just a filler? How long does it last?

Thanks again

EDIT: After rereading your response above it looks as though you think I should have done the Sculptra along with the subcision. So I need another subcision along with sculptra? Or can I just get sculptra?

The doctor said I should hold off of the tretinoin for a while after the laser.

Edit: @beautifulambition I know my photos look much better after the subcision and laser procedure. But now I look horrible. Of course, that's me under a strong light. I know I look better without that strong light. It's absolutely horrifying, because I had no idea my acne scars were that many and that bad until I took these honest photos. My partner cannot understand my obsession. I can.

@HopeNewAfter my subcision, I have one noticeable small mark where the needle entered on one side. It doesn't bother me too much, since I know it will get better over time, and it's very small. It looks a little worse because it's hyperpigmented.

Subcision takes a lot of time to heal. I still had some bruisingand slight pigmentation issues one month after subcision. I know it's hard, but definitely try to chill a bit. Otherwise, you'll just drive yourself (and your partner) crazy! 😉

3 hours ago, superburrito said:

@HopeNew After my subcision, I have one noticeable small mark where the needle entered on one side. It doesn't bother me too much, since I know it will get better over time, and it's very small. It looks a little worse because it's hyperpigmented.

Subcision take a lot of time to heal. I still had some bruising and slight pigmentation issues one month after subcision. I know it's hard, but definitely try to chill a bit. Otherwise, you'll just drive yourself (and your partner) crazy! 😉

@superburrito oh my goodness! My friend,  you have no idea how much I needed to read your reply right now. My wife has been so mean, she has no empathy, no understanding of my pain over this. She can be just so cruel over my obsession. I know it's not healthy to have an obsession over this but I do. I have tried so hard since I was a teenager not to get scars from acne. I should have never stopped taking antibiotics. If I didn't stop I would not have acne scars on my face. Yes, they would have been on my chest and back. But not on my face!

So tomorrow I go to the other dermatologist and decide if I will get a new tca cross on my nose. Should I?

I called the doctor who gave me the subcision and they said the indentations from the cannula go away. I hope they are right. I don't know if these marks came from the subcision or not. All I know is that the well known doctor who saw them kind of told me the other doctor did my subcision wrong. And now I am going nuts! My wife doesn't understand. Maybe he didn't do it wrong. 

So I have to wait? Then I will wait! I will chill. Keep talking to me cause I need someone  who understands.  

@HopeNew glad I could help! For TCA cross, since its only been a few weeks, definitely wait awhile for the next session.

It takes months for skin to fully heal and collagen to form. Keep in mind that with TCA cross, it can temporarily make the scars appear bigger, so it'll lookworse before it will lookbetter. Phenol cross doesnthave this same issue, but I only know of Dr Rullan in San Diego that does this.

Obsessing over scars is definitely understandable. Ive been there. One thing Ive done is to set my expectations relatively lowish with a goal for modest improvement, rather than a miracle. Im not expecting my skin to ever be smooth like a baby butt, but I think it will look better with patience and time.

The other thing I realized is that managing uneven pigmentation, acne breakouts, and generally taking better care of my skin has helped my face look better overall.In other words, Ive started to work on other things that can be easily, cheaply controlled, in addition the expensive scar treatments.

Heres my basic skin routine:

Evening

• Sam Bunting's facial cleanser (it's non-foaming and fortified with 5% Niacinamide)
• Curologywith the following formula:
  • Tretinoin 0.05% (prevents and treats blocked pores and improves skin texture)
  • Azelaic acid 4% (reduces bacteria, helps to keep pores clear and also fights redness and hyperpigmentation)
  • Zinc pyrithione 0.25% (antimicrobial with dual action against bacteria and fungus)
• The Ordinary'sAlpha Arbutin 2% + HA (for additional control of hyperpigmentation, I may try one of PCA pigment gel's instead)

Morning

• Sam Bunting's facial cleanser (face is already clean from the night before, so I use just a little bit of product here)
• The Ordinary's Vitamin C 30% (I skip this sometimes if I'm lazy or in a rush)
• LaRoche Posay's tinted mineral sunscreen (the tint helps the skin lookmore even)

A few questions. I am stoppingalastin restorative skin complex because it makes my skin turn red as if it's having a rosacea flare up, and is making me break out a little. Does this stuff really work in cleaning out old collegen? I can try to take it less. I there something else I can take? Remember, I had subcision, prp, and c02 laser.

Is it normal to break out after subcision and laser? I am starting to do the suctioning less because I feel my skin needs a rest. It looks like the scar under my mouth got larger? Maybe it didn't I don't know.

Maybe I will be very happy after months go by and collagen grows in. I hope so. I do believe the doctor did not have much experience doing subcision. So I don't know if the other doctor, Dr Rapaport, who claims I only need two subcisions along with prp and infinity is right or not. I'm confused. Do I go to the doctor I know who has less experience or the much more experienced doctor who might just want my business? I don't know... I'm confused and concerned.

@beautifulambitionI got my subcision on February 8th. The doctor who performed it looked at me about a week later because he was going away. I originally had April as a follow up, but am concerned so I made May 6th as a follow up. Is this too soon? Should I wait for him to look it?

I also want them to take the same type of photos from the same lighting they did in their office before I had the acne scar work done.

@HopeNew

You can get normal sculptra, I just call it over dilute sculptra because of the dilution of the saline in the product.

You can get it directly after subcision, unlinke HA filler which the swelling must go down first, or wait till the selling id down and do it, ... choice is yours. I would not get it months later or it will retether in a few weeks after.

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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.

@beautifulambitionthanks for your valuable feedback.

By the way, the doctor who worked on me is board certified in Cosmetic Laser Surgery and Internal Medicine. He works in this field. Sorry if I miswrote and made it sound that he was a general practitioner. Maybe he is I don't know. He's not a plastic surgeon or a dermatologist...

I just got back from the dermatologist. It was a positive experience. This dermatologist did a TCA Cross on my nose, and a punch excision on the side of my nose in late January.

She said the TCA Cross on my nose did work. I hope I can believe her. She did see growth. She also said I should hold off until I am fully healed from all of the work I have had done from the subcision, prp and co2 laser. I was still swelled up and red. She also said I don't have to worry about cannula insertions like the other doctor got me all panicked up about. She did see one insertion point on one side. The other side was a valley that was already there according to the photos above.

She said she could definitely see an improvement in my acne scars on my temple areas. She took photos of my first visit there, before I had the subcision, prp and c02 laser done on the first week of February. It made me so happy to hear her say she could definitely see an improvement, and asked her to reassure me she was not just saying that to make me feel good. She assured me the improvement was good. She also encouraged me to go back to the doctor I used to have more subcisionsperformed for more improvement. This was a relief because the other doctor only had negative things to say. It's funny how that works out sometimes.

She had her assistant take photos today so I could compare them with the photos she took in late January. They are posted below.

I do see some improvement in the temple area, where is which my acne scars are the worst. However, I'm not at all happy without my skin looks.I would imaging I will need several more subcision done there. In addition to the subcisions, I need a way to even out the pigmentation. First, I would like to eliminate the age spots. Second, I would like to eliminate the redness, if that's possible. I believe I have rosacea so I am not sure how realistic that is. I know I can get laser done to eliminate the veins in my nose, which I hope to do in the right time. But that rough, ruddy complexion, hmmmm... I'm wondering if that is reversible at my age. I hope so. Staying out of the sun is key.

So now the questions are, when do I get my next subcision?

Oh yeah, she did not encourage me using the Sculptra in my temples because she said that area might not be deep enough, thus creating an overfill. Who knows...

She also said she will wait to do another TCA Cross and Punch Excision after I am fully healed from the rest.

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Not so sure of the improvement here. The doctor said she could see it.

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@HopeNew, for rosacea, try topical niacinamide. You can get this very cheaply via The Ordinary. I think it's about $6 a bottle.

18 minutes ago, superburrito said:

@HopeNew, for rosacea, try topical niacinamide. You can get this very cheaply via The Ordinary. I think it's about $6 a bottle.

Thank you @superburrito and now for the reassurance... do you see improvement with the scars? Be honest.  I have a few more subcisions to do. My partner will be angry. But I have to do this.:) 

15 hours ago, superburrito said:

@HopeNew, for rosacea, try topical niacinamide. You can get this very cheaply via The Ordinary. I think it's about $6 a bottle.

Thank you @superburrito and now for the reassurance... do you see improvement with the scars? Be honest.  I have a few more subcisions to do. My partner will be angry. But I have to do this.:) 

@beautifulambition question about suctioning. Should i use the smaller suction cup that fits into the scar or a larger suctioning that fits more outside the scar?

How do I best protect my skin from getting more red?

After a few more subcisons and I hopefully get the results I want along with sculptura perhaps, what's the best way to eliminate the dark spots?

Thanks  

@beautifulambition question about suctioning. Should i use the smaller suction cup that fits into the scar or a larger suctioning that fits more outside the scar?

How do I best protect my skin from getting more red?

After a few more subcisons and I hopefully get the results I want along with sculptura perhaps, what's the best way to eliminate the dark spots?

Thanks  

@beautifulambition sorry for the error in post above... Don't know why that happened. Please see my questions above... or anyone else who cares to answer for that matter.  

I really am starting to believe that the appearance of my skin is contributing to my inability to get a new job.

The left set of photos are slightly out of focus, so Im having a hard time comparing. The lighting is also a little different too. When were the left ones taken? And the right?

Since you had the procedures very recently, the redness and pigmentation issues are expected, and it could take many weeks or a couple of months to resolve. With scar treatments, its often trading filling in if scars for temporary pigmentation and redness.

Prior posts in this thread had suggestions for your concerns around redness/pigmentation.

Niacinamide helps with redness, pigmentation, and also shown to aid in wound healing. For pigmentation, get a skin brightener. Hydroquinone is often the first line of treatment here, but it can be very irritating, so it can make redness worst. You can try other things like kojic acid, alpha Arbutin, azeleic acid.

PCA pigment gel comes in a version with hydroquinone and one without.

Again, this will take time to resolve, so be patient!

@HopeNew I think again this is not only scars your dealing with, aging concerns, but also internal scars that need to be addressed with a Therapist. Some people are not cut out for the long arduous journey of acne scar work. 3 years of ups and downs, ... lots of healing time.

To recap as this is getting confusing with PM's and private posts, and concerns. You need time to heal 3 months after a procedure, we are talking about a single multi treatment you just had, I discussed what to do above. I help some of the worst scar cases in the world daily, and if you were to come to me and ask what the issue is I would say mainly age related fat loss. This can be fixed.

I have spent a long time above telling you how but I cannot support your emotionally in the ways you seem to need. Talkspace is a therapy app on any smart phone with unlimited therapy by multiple ways to connect not just texting. Inability to get a new job could be from various reasons, ... not your acne scars.

I just had my new drivers license photo taken because I had to renew my license. My skin differently look more even! Without a doubt I see a big improvement. Now I know this is a combination of the moisturizer, sunscreen and C02 Laser. Although, I am sure the subcision has helped my indentations that difference would not show up on my license photo. But all in all, I'm kind of astonished how much younger my skin looks in comparison to all the other photos I had taken over the last 15 years. The only problem is my face looks a bit bigger! LOL! I don't know if it's because the photo was taken closer up like the lady said, or because I gained weight, or because I am still a big swollen from the laser procedures back in early February. But all in call, I am astonished how much better the tone of my skin looks.

Great to hear!

Is it safe to use moisturizer AND sunscreen all in one after subcision and laser? Or is it smarter to use them separately? 

Sorry I just created a new thread asking the best kind to get. But I remembered I should have asked this too so I am posting it in this thread.

I use a separate moisturizer and a sunscreen on top. I think I put in my routine with suggested products earlier in the thread.