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melinder08

Acne Scar Treatment - Subcision, Sculptra, Cross Carbon, & Microneedling w/ Dr. Rullan

I just wanted to share my journey to treat my acne scars, with before and after pictures, in case this will help anyone else.

PLAN:
- Subcision, Sculptra, cross carbolic and microneedling with Dr. Rullan in CA done 4/18/19 (I live out of state).  He also did some sort of acid on my face to treat some white spots and something to the raised scar on my chin but I'm not sure what.
- RF needling in 3 months (not sure with who yet, but locally).  Derminator at home in between.
- Subcison, Sculptra (still need to figure out if this needs to be done sooner), cross carbolic and microneedling again with Dr. Rullan End of Oct or Nov. 
- More RF needling 
- Re-evaluate where I'm at and what makes sense for me.  Will probably have more subcision, maybe filler, peels and/or lasers
 
BACKGROUND:  I had cystic acne as a teen treated with Accutane twice, leaving lots of scars.  About 15 years ago I did ablative CO2 erbium treatment and after that I've not wanted to do anything else until now.  My skin is always dry and flakey looking.  I've tried a bazillion different products and nothing really helps.  I also live in a very dry climate so that's not helping my cause.  I have redness issues and white spots on my face as well.  On a side note, I have an auto-immune disease called Ankylosing Spondalytis (inflammatory disease) and am on Humira which increases my risk of infection but it hasn't been a problem.  I also have a swollen knee at the moment from the disease.  I am a wife and stay at home Mom to 2 kids, age 9 and 5.  
 
Thank you Beautiful Ambition for the all the advice.  It makes sense to me to first untether the scars, work on the fat loss and build collagen, then work on peels and or/lasers for surface texture stuff.  I plan to go in with realistic expectations that this is a process over the next few years.  I will take it slow, to let my skin heal between procedures and hopefully maximize results.  
 
Wish me luck on this journey.  I will follow up to this thread with before and after pictures and will not disappear.  Posting pics of myself in the worst light possible is not something I'm excited to do but hopefully it helps others.  Please keep it positive, thank you!
 
** The pictures I'm posting after the procedure are to show healing.  Obviously they are not in bad lighting or meant to comment on scarring because it's too early for that.  
 
FIRST TREATMENT: 4/18/19 with Dr. Rullan went really well.  I was very nervous but the only thing that hurt, and barely at that, was the acid he put on my white spots and then the shot to numb me but seriously it was not bad at all.  I also was scared of the noise everyone talks about from the subcision but it was no big deal.  I did take a valium ahead of time to keep me calm that Dr. Rullan provided.  No pain after, just tight feeling.  To the touch it feels like a bruise.  I bought product from Dr. Rullan's office that was supposed to be for after microneedling but I think it was drying my skin out too much and making it produce too much oil (which happens to me a lot) so I stopped it and as of day 7 it's better.  Procedure was on Thurs and we drove 11 hours home on Sat.  I had to drive my son to school on day 4 and put on zinc sunscreen and makeup which looked awful, I wouldn't be comfortable in a room full of people.  At day 7 I felt comfortable in public and can wear makeup.  As of day 9 my face looks fuller and when I went into public bathroom lighting it looked great, which most of us know is the worst.  I know that a lot is swelling and temporary from the sculptra but a girl can dream, I'm enjoying it while I got it!  I'll take more pictures at a later time.

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Thanks for sharing! Hope you recover well I slathed my face on with emu oil this last time and found they helped with recovery and texture afterwards. 

Haha the visor is a great idea - why didn’t I think of that. I just bought those stick on shades for the windows

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They sold the visor at the office, I didn't know what else to do.  And I was surprised there was no after care recommendations from the doctor, I will definitely try emu oil next time, thanks for the tip!

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@melinder08 Thanks for sharing your journey, this can help others.

Aftercare: Sun Visor was great. We don't want to be putting oil on a fresh wound until it's sealed up a few days after as I don't know the purity of that oil. Like any cut or wound you want to use sensitive facial soap - a good way to wash the face and speed up the scabs falling off is vinegar soaks 50 percent white vinegar and the rest water splash on the face or pat to kill bacteria - never let the shower go directly on the face - instead splash the water, minimal products, no exfoliates, rubbing, or acids, or things that are irritating. Sunscreen is a must if you go out in the sun. A collagen pill, vitamin c internally are good but not necessary, jello/ bone broth/ collagen foods. Ice with a clean towel as needed for swelling, some take a antihistamine for this. You can use a occlusive like Vaseline on the wound areas (only the healing entry points not all over) until they seal up or triple antibiotic ointment, or for many a light moisturizer with sensitive ingredients is fine a few times a day... some prefer the dry method of wound healing as they feel the wet makes it longer. The wet does help and prevent cracking or bleeding in severe cases.  When the swelling is down a and your scabs have fallen off you can start your skin care routine again including retinoid if your using one. No Alcohol, excess sugars, or refined foods. You don't want anything the makes you flair like wine, the gym, excess movement and strain, etc. Avoid anti coagulants like asprin, warfin, cayenne, etc that thin the blood.

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Thank you, that is all good to know.  I feel like it's healed aside from a small bruise near the eyes, at what point can you work out, drink wine, etc?

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@melinder08 thank you for sharing your story and pics. I had some questions, was it the subcision and Sculptra that caused the redness and marks, or the other treatment you had? 

I am considering just subcision and Sculptra with Rullan as well, but didn't know if I should expect a lot of downtime.

How much Sculptra was injected and where? 

I wish you lots of luck in your journey! 

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@melinder08 A week after to be safe, some heal quickly and it's a few days. 

@edie9598 No it's subcision, she had aggressive subcision, this is what happens, part of the healing process. There is swelling for about a week for many, sometimes more for some slow healers, you can put makeup over it. 

She cannot show you where sculptra is injected, it's not spot injected but injected throughout the area of scarring deeply as a foundation, ... it is not a HA filler for instant volume you do with latter subcisions. Sculptra is approriate if you have widespread scarring, atrophy / fat loss (big areas), or aging related concerns women/men often use it throughout the cheeks.

 

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@melinder08 @beautifulambition  Thank you for replies. Makes sense. I didn't realize the subcision could cause so much bruising. Good to know! I suspect some of what I see in the pics is skin healing from the acid he put on the white spots? I was told I would get 2 vials of Sculptra, I imagine it will be placed under the scar area where there is fat loss and then other areas for age related volume loss. I am very nervous about the Sculptra for some reason. But excited to try to get some improvement too! 

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I wasn’t sure either which part of the treatment caused the scabs and which caused the peeling, which were the worst parts. I still have a slight bruise near my eye but I think he was pretty aggressive with my treatment. At day 7 for me a felt totally comfortable being out.

He didn’t say how much sculptra he put in. I felt like it was more of an art with what he did, saw what it needed and did it if that makes sense. I was really nervous going in but honestly now that I’ve been through it I didn’t need to be.

I initially was just thinking sculptra and subcision too but when it came down to the price, i didn’t think it was that much more money and I figured while I’m numb and don’t feel it I might as well.

Sorry I’m not sure I’m being very helpful. 

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You go girl! Excited to watch your journey, im doing similar with dr. Rullan in future. It’s going to look amazing at the end! Good luck 

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Sorry I have my account Set for notifications when someone responds but that didn’t happen.

Yes it Definitely helped for fat loss but I don’t Know if that’s temporary or not. I’m going in for my next treatment in Nov and I’ll post updated pics soon. 

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Here are some before and after a little over 6 months since my first treatment with Rullan. I’m way more comfortable in bad lighting. And I can see a big difference! I did have Sculptra done so now I’m questioning how it’ll look long term, if this is only temporary.  Anyone know? The only other treatment I did since Rullan is one microneedling at home with the derminator. Life has been busy lol.

 

I’ll be seeing Dr. Rullan next month for my second treatment.  

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Honestly, that is amazing improvement. Like I cannot believe how you were able to obtain that over 6 months. Congrats and you are definitely in good hands with rullan 

Edit: This also proves that not rushing treatment can truly be a benefit since you see what works and what doesn’t. Great job 

Edited by SaraTheGerman

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@melinder08 Hi! Your progress is amazing, I hope you are happy :) I have similar scarring to yours, and I'm also thinking of going to Dr. Rullan. I already emailed his office and I'm waiting to hear back from them about possible treatments and pricing. Would you mind sharing how much it was for your treatment? I want to get a general idea before I plan any travel since I don't live in the US. Thanks!

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Hi!  I am really excited and it's made me way more comfortable in my skin!  I am a little worried that the results are temporary because of the sculptra.  I really don't know what to expect long term. I definitely feel like it was worth it though!  It was $2,000 total.  The sculptra was the expensive part, $750 alone.  I was thinking of doing Sculptra again on my visit in November and then not again after that, which will make the next one more affordable.  I was thinking 3 treatments total.  I'm not sure I can handle a phenol peel so I'll figure out next steps after that.  Good luck on your decision!

Sorry, I don't know how to reply to your actual post without replying to everyone.    

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But i would like to say you get in real bad or harsh lighting noones skin is flawless esp older u get so i wouldnt worry too much....when im in normal lighting and normal day time noone notices my scars...and they are severe

in harsh lighting which is very rare ligthing people see the real u 99 % of the time...who agrees?

 

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3 hours ago, tryinghard123 said:

But i would like to say you get in real bad or harsh lighting noones skin is flawless esp older u get so i wouldnt worry too much....when im in normal lighting and normal day time noone notices my scars...and they are severe

in harsh lighting which is very rare ligthing people see the real u 99 % of the time...who agrees?

 

what you want to say  in ur 2nd para ...

yes our skin look good in normal lighting and look bad in bad ighting

so in which lighting people mostly see us....????

i think people see us in both lights but they dont notice our scars...remember when we were scarless we never noticed anyone scar....and now we notice every person scar

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On 10/17/2019 at 11:25 PM, melinder08 said:

Hi!  I am really excited and it's made me way more comfortable in my skin!  I am a little worried that the results are temporary because of the sculptra.  I really don't know what to expect long term. I definitely feel like it was worth it though!  It was $2,000 total.  The sculptra was the expensive part, $750 alone.  I was thinking of doing Sculptra again on my visit in November and then not again after that, which will make the next one more affordable.  I was thinking 3 treatments total.  I'm not sure I can handle a phenol peel so I'll figure out next steps after that.  Good luck on your decision!

Sorry, I don't know how to reply to your actual post without replying to everyone.    

How many vial of Sculptra did you have?

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Your improvement looks great. Honestly with how far you’ve come I wonder if more treatments are even needed - maybe just more sculptra if it dissipates?

I had the same treatment a little over a week ago with Rullan. Waiting for my face to fully heal before I post any before / after photos. One question - how long did it take before you noticed sculptra making a difference? 

Once again, your results are amazing, you should feel great how far you’ve come already

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Hi! I’m 3 days out of another treatment with Dr. Rullan. I did the same procedure subcision, TCA cross, microneedling and sculptra. My first visit he didn’t do the forehead or chin and I think I was so nervous I didn’t address it. This time he did them at my request.  Also I would definitely recommend the Valium. I was supposed to have my procedure Wednesday but I got a call Tuesday on the shuttle going into Disneyland (with my family). Dr. Rullan had a family emergency so if I was going to do it, I needed to go that day. So we drove to Chula Vista and by the time I got there I spaced the Valium. Last time it just made the process feel easier. 
 

I honestly don’t think I’ll do another treatment. The treatments really aren’t that bad but I’ve had a lot of health problems in the last 15 years and am just not up for anything else. Maybe I’ll do some aesthetician peels or more microneedling but nothing drastic. Probably lol. 

I don’t really remember when I felt the fullness.  I feel like after that first week I could see a difference in terms of scarring and I paid more attention to that than the fat loss. I’m 39 and had noticed the fat loss near my smile lines and into the cheeks. I feel like i can really see a difference there. I just look a little less old. 

Good luck with your healing! I hope you get some good results, can wait to see pics!

 

And thanks for all the kind words! I’ll post some more pictures in a few days.

Also, they kind of honored my pricing from last time and raised it only $100, so I paid $2,100. Moving for they said the treatment would be $2,450 ($1,750 for subcision, cross and microneedling and $700 for sculptra). 
 

Just thought I’d share. 

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