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npbm

Genius RF Treatment Progress

Hi everyone, after thinking about it for a long time I made the decision to start doing RF microneedling treatments. I wanted to start a thread to track and share my progress. When I first had my consult with the dermatologist, he actually recommended doing Fraxel Dual instead, but I resisted due to my concerns about hyperpigmentation since I have ethnic skin. So far I've had two treatments, both of them Genius which is basically the newer version of Infini. My first treatment was in February and I did the second treatment 6 weeks after the first. I will do at least two more treatments (third one is scheduled in May, 8 weeks after the second treatment). This is the minimum # of treatments the doctor recommended. After the fourth treatment, I'm probably going to take a break until the end of the year at which point I'll decide whether or not to continue with the Genius, switch to Fraxel Dual, or to stop altogether. Downtime is an issue for me so I'm not sure about pursuing subcisions.

Before/After Pics -- I think I've seen *some* improvement but it's honestly quite difficult to tell. My skin looks better 5 weeks post 1st treatment, than 2 weeks post 2nd treatment, and I am not sure it's because my skin is still healing or because the weather's been warming up so my skin is less 'tight'. I will upload an updated photo right before my third treatment.

 

before-2.jpg.0c4ea8833a7eb197ab7d9c53c92b329a.jpg1596732439_AFTER3-18_2.jpg.b12153a41064c483a7020fc3d877739f.jpg28584899_AFTER4-09_2.jpg.4ac80b3830a36bddf0dd57fb3b280e39.jpg

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Your skin is definitely improving! I think it's too early to tell what the results truly are since your skin is still healing. If you post pictures 6 months after your third session I think it'll be more indicative of permanent results. Did you do PRP too?

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In the second picture I do see improvement but it is too early still. IMO skin texture looks amazing.

Did you think about going in for subcision and getting Sculptra injected. BA recommends it prior to RF needling as the RF needling stimulates the Sculptra and helps to produce more collagen. Subcision is beneficial if there is tethering of the scars. Just an advice as it is often recommended on here and that's what I plan to do as well.

Can I ask where you got the procedure done and what type of settings were used ?

I wish you the best of luck with your journey!

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@npbm As I have helped thousands ... I often run into those who will only do certain treatments or just want low down time treatments. The truth is, you don't have down time, and you don't get results, ... the Dr keeps bringing in the cash for these machines with minimal % of improvement. This to me goes back  to the basics. On any road do they resurface it with a fresh layer to drive on before filling in the potholes. No. They fill the pot holes. Without doing the work to raise your scars and stimulate collagen naturally, we are going backwards and putting energy into atrophy, this is when I see fat loss often, ... they put the needles in and hit the fat as no prior work has been done. I also see this often with laser Dr's blast and blast a severely atrophied face, it's absolutely pointless, ... you cannot build up your own fat again, you can have substances injected. 

Regarding down time. There is very little down time for cannula subcision, ... a week is the common length of time. IT's just some swelling, many guys go directly back to work and make up a excuse. You can always use a concealer and there are very few needle entry points. You need 8 sessions of  subcision. 

But I respect your desire, if you wish to do laser and that is it. But what are they stimulating with rf needles, .... the fat layer is not stimulated by energy it atrophies. You see how we treat from the lowest level back up to the surface. When I do rf needling I am stimulating Sculptra often as SaraTheGerman said to get you more collagen formation. I am not just putting energy into the thinned skin.  Some only have time or money to do subcision once or twice a year and that's fine, ... find a week when you have some down time or work from home on a sick week, ... treatment will be longer but fit your schedule. 

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@poi_boi_23 Yes, definitely going to wait 6 months before judging/posting the permanent results. Unfortunately the doctor I went to does not offer PRP.

@SaraTheGerman Thanks! I went to Dr. Ibrahami in Stamford, CT. Unfortunately I don't know the settings but I believe the deepest needle was 2.0mm and went down to 0.5mm with 4 passes on each cheek.  

@beautifulambition Thank you, I really do appreciate the feedback. Tbh, I haven't been following these forums for some time so I wasn't aware of cannula subcision, I thought there was just the Nokor which had 7-14 days of downtime. I will reconsider my treatment plan and may postpone my May treatment to July so I can do a subcision. I have a couple of questions:

1. Other than Dr. Rullan in SD and Dr. Weiner in FL, are there other recommended doctors who do cannula in the Northeast? We seem to have a shortage of affordable cosmetic dermatologists up here....for instance I travel 2.5h to Dr. Ibrahimi because there are no dermatologists in my home city (and I live in a large city) where the doctor actually performs the Infini. It's always a medical assistant/aesthetician which I will not do.

2. Is the Sculptra necessary at the time of the subcision? I saw that f93d did his subcisions and waited to do the Sculptra until after. Are results comparable without it? Also, just so I'm understanding correctly, it is NOT a filler but a collagen stimulator? How long does it stay in the body before being absorbed?

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5 hours ago, npbm said:

@poi_boi_23 Yes, definitely going to wait 6 months before judging/posting the permanent results. Unfortunately the doctor I went to does not offer PRP.

@SaraTheGerman Thanks! I went to Dr. Ibrahami in Stamford, CT. Unfortunately I don't know the settings but I believe the deepest needle was 2.0mm and went down to 0.5mm with 4 passes on each cheek.  

@beautifulambition Thank you, I really do appreciate the feedback. Tbh, I haven't been following these forums for some time so I wasn't aware of cannula subcision, I thought there was just the Nokor which had 7-14 days of downtime. I will reconsider my treatment plan and may postpone my May treatment to July so I can do a subcision. I have a couple of questions:

1. Other than Dr. Rullan in SD and Dr. Weiner in FL, are there other recommended doctors who do cannula in the Northeast? We seem to have a shortage of affordable cosmetic dermatologists up here....for instance I travel 2.5h to Dr. Ibrahimi because there are no dermatologists in my home city (and I live in a large city) where the doctor actually performs the Infini. It's always a medical assistant/aesthetician which I will not do.

2. Is the Sculptra necessary at the time of the subcision? I saw that f93d did his subcisions and waited to do the Sculptra until after. Are results comparable without it? Also, just so I'm understanding correctly, it is NOT a filler but a collagen stimulator? How long does it stay in the body before being absorbed?

Dr. Khrom in Brooklyn does Cannula Subcision with sculptra/prp

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@npbm 

Sculptra is longer lasting than other HA fillers I believe. It is a filler but not used in acne scar patients for volumizing but to act as a spacer to prevent retethering and act as a collagen stimulator in conjunction with RF needling. Other HA fillers would be used to raise individual pits rather than being used on a widespread area.

I dont know how comparable the results would be without Sculptra  but think about it we use the Subcision to untether the tethered scars so we are basically laying groundwork for other treatments like the RF needling to work better since there are no tethers anymore so the scars are more lifted and we don’t have to fight against the tethering anymore.

With tethering still being there you can only have limited improvement with other treatments since your scars are still being held down. I think Dr. Weiner once said that it is possible for the RF energy to travel down those tethers and deliver the energy too deep into the skin, which can cause further damage. I believe he said that in video and he said that he always performs subcision prior to RF needling.(Not completely sure about the Energy travelling down but still good info to have)

@beautifulambition please correct me if I’m wrong.

 

Edited by SaraTheGerman

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@SaraTheGerman You got it, ... Dr Weiner Just validated everything I have advised for many years including my e-book on how to treat acne scars (see it pinned to the top of scar treatments called "faq"), and helping thousands. Checkout the post in the "proof" (pinned at the top - bottom of that) are of the main scar treatment sub. That is the game changer, without subcision and filler, treatment is pointless. 

@npbm There are many practitioners in the FAQ, pinned to the top of the scar treatments main sub, goto the bottom of that. I don't have if they do cannula subcision or not on all of them. You would have to call and ask. Binga gave you one of them that is in NYC. Remember you can goto a few Dr's and choose the ones who will do the services you need. Maybe Ibrahimi for your Infini,.... another Dr first for you subcisions, and you might need another expert injector for filler if they will not use the Sculptra you want. They don't all specialize in everything.

Yes in your case I would 100% get Sculptra, you have fat loss, atrophic scarring, ... this is the game changer as @SaraTheGerman said above. If you have seen f93d's post this is proof that it works, ... he is in the sucess stories linked in the faq. Many Dr's will tell you they won't inject it, that only means they are not experienced with the filler and coming up with excuses, it takes more skill than a standard filler. But expert injectors are in every city that can do it, even if they don't inject acne scars, ... they just need to inject deeply under the area of the scars as a foundation - spacer. Results in your scar type are not comparable without it. If all you can afford is one vial a year, tell the Dr that is all you will do. IT will take longer to treat but I understand financial issues. Do Chinese Cupping (amazon) your other sessions, if you can afford a full course of sculptra that's cool too. HA filler do your lasts few subcisions (remember you need up to 8 subcisions). I have seen some do HA filler for everything with deeeeeeeep atrophy, but can you imagine the cost, so expensive. Sculptra lasts (See the proof post I said to Sarah above). 

 

 

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Subscision is something that I have also been interested in doing as I, myself have seen some improvement from the modalities   (CO2 laser/ RF microneedling) that you mention however, they were unsuccessful in treating my stubborn scars.. I believe Dr Weiner stated that he is against using fillers for scars because of the risk of hematoma and that is why he uses the Genius RF device because the machine automatically measures how much energy it has to deliver into the skin, in order to be safe and successful his device was also cleared by the FDA in February 2019..It’s just a souped up version of the infini device that delivers better results.. I myself have had secret RF (5 sessions+ PRP) to no avail! I would be 100% down to try Subcision assisted RF microneedling with the genius if I could find a doctor in my area to perform it!  

Edited by Emilypark
Additional info

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Hi All - Just want to give a long overdue update. I had a third Genius treatment in June of 2019. I have a picture from November 2019 of my final "result" from these treatments (I was moving and wanted to make sure I had the same lighting to compare pre-treatment.) I would say that I had some level of improvement in texture and improvement in the most superficial scars. Though, as might already be obvious, there is no way to get better results without going the manual technique. I have a consultation for a cannula subcision this coming Friday. I will be doing chinese cupping afterwards (I guess working from home its perks - don't have to worry about corowkers seeing my bruising!) I see that BA has removed all the guides so I guess I'll need to do a little digging in the forum.

 

For now, I don't intend on doing any Sculptra or fillers. For this, I'd really want to go to an expert which will require flying. Not an option for me right now. In any case, I plan on doing 4 treatments before deciding whether to go the filler route. 

 

 

before.jpg

 

20191107_183044- small.jpg

Edited by npbm
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5 hours ago, npbm said:

Though, as might already be obvious, there is no way to get better results without going the manual technique. I have a consultation for a cannula subcision this coming Friday. I will be doing chinese cupping afterwards (I guess working from home its perks - don't have to worry about corowkers seeing my bruising!) I see that BA has removed all the guides so I guess I'll need to do a little digging in the forum.

I notice the second picture is from 11 months ago. If your scars are still relatively in the same ballpark as they were then, I would say your scar is too shallow for subcision. You might see a minor improvement but not a whole lot IMO. Well, I'm not here to dissuade you from getting whatever you want, but keep that in the back of your mind.

 

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8 hours ago, npbm said:

Hi All - Just want to give a long overdue update. I had a third Genius treatment in June of 2019. I have a picture from November 2019 of my final "result" from these treatments (I was moving and wanted to make sure I had the same lighting to compare pre-treatment.) I would say that I had some level of improvement in texture and improvement in the most superficial scars. Though, as might already be obvious, there is no way to get better results without going the manual technique. I have a consultation for a cannula subcision this coming Friday. I will be doing chinese cupping afterwards (I guess working from home its perks - don't have to worry about corowkers seeing my bruising!) I see that BA has removed all the guides so I guess I'll need to do a little digging in the forum.

 

For now, I don't intend on doing any Sculptra or fillers. For this, I'd really want to go to an expert which will require flying. Not an option for me right now. In any case, I plan on doing 4 treatments before deciding whether to go the filler route. 

 

 

before.jpg

 

20191107_183044- small.jpg

Your scars are so much better. Who is your doctor offering Genius? 

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@Sirius Lee I always appreciate feedback. The improvement I've seen is still there from last November. Can I ask what you would recommend looking into?

@BlueMaloney Dr. Ibrahimi in Stamford, CT. I am a Fitzpatrick IV and would highly recommend him if you're interested in RF but have a darker skin complexion. 

Edited by npbm

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1 hour ago, npbm said:

@Sirius Lee I always appreciate feedback. The improvement I've seen is still there from last November. Can I ask what you would recommend looking into?

@BlueMaloney Dr. Ibrahimi in Stamford, CT. I am a Fitzpatrick IV and would highly recommend him if you're interested in RF but have a darker skin complexion. 

Thanks for the information. I'm a Fitzpatrick II and I'm interested in RF indeed! It's wonderful to read treatment success stories! 

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4 hours ago, npbm said:

@Sirius Lee I always appreciate feedback. The improvement I've seen is still there from last November. Can I ask what you would recommend looking into?

 

As I wrote above, your scars aren't not very deep. What makes your scars stand out is the prominent scar edge. You can blur the edge with TCA or ablative laser. However, I recommend 50% TCA. You likely won't see a big improvement after the first treatment, but after 3-4 you'll find the edges smoother, making the overall scars appear less pronounced

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On 10/13/2020 at 10:35 AM, BlueMaloney said:

Your scars are so much better. Who is your doctor offering Genius? 

Well I am sorry for being negative, maybe its just me, or pics dont show true progress, but i dont see any results , 3 times Genius RF and this ? 

Is anyone seeing any progress ? 

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2 hours ago, Miro said:

Well I am sorry for being negative, maybe its just me, or pics dont show true progress, but i dont see any results , 3 times Genius RF and this ? 

Is anyone seeing any progress ? 

In my opinion the scars are smoother on the post pic, no sharp edges. I'm being realistic. I know that whatever I do I will still have my scars. They cannot be gone. But they can get smaller, shallower and smoother. That's my aim. I know no current treatment can give me baby smooth skin. 

Weren't you doing Genius yourself and having improvement? I'm curious. 

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10 hours ago, Miro said:

Well I am sorry for being negative, maybe its just me, or pics dont show true progress, but i dont see any results , 3 times Genius RF and this ? 

Is anyone seeing any progress ? 

That's ok. I would say I see improvement, but it's small. I don't think any scars are eliminated, but the edges are smoother. Improvement is in the eye of the beholder though - is the expense of the treatments worth the amount of money that I've spent? Maybe not.

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1 hour ago, npbm said:

is the expense of the treatments worth the amount of money that I've spent? Maybe not.

This warrants some serious discussion IMO. Is certain treatment or doctor worth the money for meager improvement? What's worse is that these doctors and manufacturers are predatory. Just as those who peddle snakeoil, they prey on the vulnerable. And with the rise of the number of acne scar sufferers seeking treatment, this is only getting worse by the day. 

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4 hours ago, Sirius Lee said:

This warrants some serious discussion IMO. Is certain treatment or doctor worth the money for meager improvement? What's worse is that these doctors and manufacturers are predatory. Just as those who peddle snakeoil, they prey on the vulnerable. And with the rise of the number of acne scar sufferers seeking treatment, this is only getting worse by the day. 

You raise an excellent point. I think part of that conversation would need to include expectations. Unfortunately, I do think many doctors give patients seeking acne scar suffers overly optimistic and unrealistic expectations for improvement. Which is why many people start expensive treatments expecting that they will have 70% improvement after 2 or 3 treatments. Before I started any scar treatments (Genius was the first type I ever tried), I told myself that it would likely not yield ANY improvement, that the process would be expensive, long, and that I would likely have to try other treatment types of treatments. So for me, the expense has been worth it. That's not going to be the case for everyone. 

On a final note, I would say that the most important part that warrants serious discussion is the necessity IMO of CBT for people who suffer from acne scars. The way I view my scars and myself gradually shifted as I made therapy part of my treatment. I did this before ever starting my treatments, and I think this is a must before anyone decides to forge ahead. 

Edited by npbm

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Alright, so earlier today I had cannula subcision treatment #1, quick rundown:

  • Doctor recommended hyperdilute radiesse to prevent retethering, apparently they do not use sculptra anymore in combination with subcision. I declined since I want to try cupping to prevent retethering, but I will reconsider for the next depending on my results. 
  • Doctor recommended TCA spot treatments as well so confirmation on what @Sirius Lee already said. Also will consider, but I wasn't ready today since I'll prefer to pretreat with hydroquinone due to my skin type
  • There was A LOT of tethering on my left side (not shown in my photos) which I wasn't expecting since it's my good size lol. Right had less tethering but still a lot
  • The popping/grinding of the scar tissue is really, really strange

I'll start cupping on day #3 and do for 14 days - speaking of which, can anyone point me in the direction of a guide on how to do this? I'm having trouble...

Plan on posting a 12 week progress picture. 

Edited by npbm

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