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Ravi.kumar.engineer

Is excision option for my ugly scar ?? What should I do ??

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Hi, 

Even though I have many other scar on my face , i am not bothered about others .

I had reaction to tretenoin cream, may be i applied more , it created this big black nasty commedon type thing , it had happened to me earlier also in same area earlier , but at that time I was not able to figure out , so I had two big black comedons in same area , both of time I didn't went to doctor and used dermaroller over it. And the result is in attached file.

 

Now after almost year i am afraid of using any cream .

It is very ugly scar, i am fair skin guy , but that part is black, i am so diprreesd , i don't want to treat my other scars , just tell me how can I fix this extrem right corner scar , can I go for surgery ??

So far I have done 6 dermaroller with prp , with local dermatologist , 1 subscison with prp , last one helped me to improve my pigmentation.

But I want to get rid of this scar.

Please help 

sketch-1556764046653.jpg

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I will leave this quote from the other post you made (See below). You mainly have boxcars, some rolling scars, many icepicks, and hyperpigmentation.

I would simply do subcision on your many times including the scar closest to your ear, combined with tca cross for your icepicks and tiny box cars. I would also do some low density co2 laser many passes over the scars and some rf microneedling. Perhaps some pulse dye laser for your hyperpigmentation issues or picosure / picoway is a great laser for your skintype. This just looks like hyperpigmetnation to me with a slow healing wound. It needs to be lasered and hydroquinone used. Treatment is over 3 years. It will take many treatments, do not do any more microneedling if that is not helping, rf needling is more like a laser than needling above, and protects the epidermis. See a good Dr. I have a feeling whoever is doing this is not experienced treating scars. Get 3 consultations and pick the best Dr.

Dermastamping alone even with prp will do nothing for these scars, .. it is used in conjunction with other treatments, you need laser. PRP does not help one improve pigmentation.

 

Quote

@Ravi.kumar.engineer Be very careful comparing your scar condition to others. There are many factors that come into play. (Scalpel free hand cutting out tissue)Surgical exicsion is the riskiest procedure one can have. Why do you think plastic surgeon's hide the scars in the hair for a facelift. Results can be terrible. It's very dependent on the surgeon and they should be a plastic surgeon who knows how to do multiple kinds of "stitches," geometric closures. It is high risk, Whenever we cut there are possibilities of infection, loss of pigment (especially in ethnic patients), healing poorly, deformed closure, unsuccessful closure that needs to be revised. IF someone has areas all over their face, that can be a nightmare The larger the area the more the risk. It also depends how you heal, sensitivity, and your health concerns. IF you have one spot sure it could do well, many areas could be a nightmare. Always test patch a small scar before doing several. They always take more tissue (Excision) than the scar so be prepared for a larger area of healing or a larger linear scar. Note below there will be possible pigmentation issues, a linear scar still, and the wound is not healing up fully. That linear scar if not undermined properly can diviot, dog ears, stitch hypro and hyperpigmentation, pulling with skin tension (deform), or never blend in. Some people are prone to hypertrophic scarring when they do this as they set the body up to over produce scar tissue. I normally say do this last if everything else fails (other treatments) and you are willing to take on the risk of side effects (See above about test scar). Any surgery makes new scars.

Quote

image.png.0013c29a1e772f40a4fc2ba0d1138b3d.png   image.png.1437ef9d5ddecc43c248b65435c9d5bc.png

 

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Thanks @beautifulambition  for your kind reply. I appreciate all the efforts you make for us scar people. Also please suggest some way if I can do thing in return.

Now let me accumulate all the things you suggested .

1) my right end scar have pigmentation agree . Actually I didn't included but I had one session of Medlite laser ( that's brand i guess ) , do you think I should continue that it is some 60$ in India ??  And my skin too sensitive , will hydroquinone irritate skin ?? Can you please tell me the name of any cream with only hydroquinone ??

2) do you think that my corner scar is still healing ?? This scar is deepest on my chick . It is 1 year old and I still get itching there. I can send you some other photo if you want , but some how I want to improve this scar .

3) just subscison is pretty cheap here in India , i can go for many times , how often should I do and how many times should I do ?? Please let me know. Also if I add any filler , can I see major improvement ?? Also subscison with cupping will be useful here ??

4) most of derms here in India offer erbium laser , can I go for it ?? Also I want to reduce that corner scar in size, will it help. 

I understood that my options are lasers, TCA and subscison, over 3 years ?? Will fillers benefit me ? Here in India some clinics also offer Korean derma fillers , will you recommend it ??

Also sir/ma'am can you please give me a plan that I can follow , again I would be most happy if I can improve that corner scar , other scars don't bother me much . 

Also , I was much excited about excision because I found this guy on Google , and people were calling him artist , magician in surgery , who is driven by passion. I checked on Google reviews :

https://www.google.com/search?q=the+taulins+clinic+bengaluru+karnataka&oq=the+taulins&aqs=chrome.1.69i57j0.3251j0j9&client=ms-android-motorola-rev2&sourceid=chrome-mobile&ie=UTF-8#trex=m_t:lcl_akp,rc_f:nav,rc_ludocids:4411662717524296868,rc_q:The%20Taulins%20Clinic,ru_q:The%20Taulins%20Clinic

 

 

Regards, 

Ravi

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@Ravi.kumar.engineer

Replying from the other person's head to your post....

That is life and how the body heals, there is no magic wand or quick treatment, incremental procedures, ... it's a long journey. It's sad your skipping over treatments that could help you in order to have surgery thinking this is a better solution. I have helped many who have had severe side effects from doing this by unscrupulous Drs or poor healing. This is a last ditch sort of thing, like your willing to take a risk. I don't see that you have done many treatments for scars first like manual methods, laser, etc. I did read in yor other post your found a plastic surgeon who does this sort of thing, why not hold off until your try some subcision first. I would not leave your job to do this, ... it's incredibly stressful and there is nothing perfect. There are thousands of scientists working on all sorts of anti-aging solutions that never really make it as they are pointless. Can you imagine, you heal scars and then that cascades into anti-aging and fountain of youth... Not there. Secondly Engineers make great money. Get your money - in demand there and be able to be treated by good Drs. Checkout the scarless healing thread, I do not discuss these things here as it's pointless. They have been talking about stem cells, creams, and potions for years and it never materials and they get depressed. They expect perfection or nothing else, lots of cases need mental support or are delusional. Stem cells have been used since the 90s in rejuvenation with little improvement over all to scars. 

Your welcome, you can Private message me if you need, I get over 100+ messages a day from the worst cases so please be patient. 

1) Medlight is for surface pigmentation. Perhaps it's not effective for your case. Not something we use often. If it's cheap you could use it. Check on the darkened hyperpigmentation, push on it, if it goes away you need pulse dye laser if not you can try more sessions of this. You also need the below prep for discoloration in your skintype for any sort of procedure, ... nightly you do this.

Hydroquinone does irritate some people's skin, I believe in India it's over the counter in pharmacy mixed with a retinoid. You can try it out. If not do something that is a hyroquinone free formula instead like konjac, arbutin, licorice, etc for whitening. Also a tretinorin/ retinoid nightly. I cannot give you the name of a cream as in India you guys have a ton of your own products in pharmacy. 

 2) do you think that my corner scar is still healing ?? -

Perhaps press on it and see as I said above. 1 year old is a very long time. Perhaps it's just hyperpimented and needs medlite and or another laser for hyperpigmentation you have available (different brands in India than elsewhere).

3) If subcision is cheap in India I want you to do it many times throughout your cheeks and have someone do it agressive. The only thing I have seen with Indian subcision, is some Dr's are clueless and have terrible skill. 3-8 times. 3 months apart for ALL dr's procedures except medlight. I cannot tell you if you will see improvement, ... if you heal well yes, and your provider is skilled. It's a slow process many treat over 3 years as they have time and money. Yes you can do Chinese Cupping, but be prepared since you already potentially hyperpigmented, this can also cause the same thing here, hence why you use the products above nightly before and after the procedure, start now. Do your laser for pigmentation after treatments that might make more of it. In your skin type this is common to happen. The harder the procedure the more the hyperpigmentation and need for laser to treat it.

4) Yes I know, erbium is fine for your skintype, But it's how they do it. Fully ablative erbium I have done at the end of treatment. To resurface texture, not with the small tip many Indian Dr's use. It's a laser peel. Some Indian Dr's do low density co2 as well I have been told, but don't remember which Dr.

most of derms here in India offer erbium laser , can I go for it ?? Also I want to reduce that corner scar in size, will it help. 

Filler's benefit you if you have atrophy - pitting.

A plan would be hard for me as your asking me all sorts of things and wanting someone to just do surgery on your scars.

There is no magician, ... that is a terrible thing to tell scar suffers. Either he is a good surgeon or he is cheating and tricking people. I cannot say. You would have to do a consultation and ask for photos of people with scars like yours. I looked at the photos and I did not see anyone like your scar case there. He is skilled it looks like from training in the UK. But I cannot say how good he really is. Perhaps try subcision first. 


Box cars, a few rolling scars, many ice picks, hyperpigmentation.

* Subcision (many sessions are needed), w/ filler offers the best results. Chinese Cupping(Amazon) is a cheap alternative, with some side effects, see the FAQ for instructions.  3-8 of them.
* TCA Cross for icepicks, do the same time as the subcisions.
* RF needling several sessions for your box cars, and low density CO2 laser if you need a boost, but you can do fractional erbium if that's all you have
* Several TCA peels to soften the texture, once you raised everything, or a fully ablative erbium laser resurfacing (Sciton)
* Any redness or hyperpigmentation discoloration: vascular laser medlite, or for ethnic skin picosure/picoway/picotech stimulates collagen as well.

** Everything depends on your bodies ability to heal / your surgeons skill, it's variable % of outcome, if you heal poorly or are overly sensitive (skin) please don't micro needle.

** All treatments - 3 months apart (drs often tell you to do them more often but the skin does not heal like this, it's verrrrry slow to heal. Always best to observe what works and what does not. Also It is advantageous for Drs to do quicker treatments as swelling hides scars and gives them quicker $$$$. Everything is optional.

** Use nightly: Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), The Ordinary Granactive Retinoid (if you can't get the above). Cureology(USA) & Yoderm(USA) provides online prescriptions with customized skin care creams for your concerns, those in UK Dermatica provides the same thing. Apply a moisturizer when your face is dripping wet. Wait 5 minutes for it to dry, and then apply the tretinoin. This cuts down on irritation, you can also skip days of application (one or two days a week) if it's irritating and you need to build up %. This provides skin turnover - new collagen. To prevent (reds & browns from all Dr-treatments to ethnic skin or to work on current skin discoloration), try PCA hydroquione free gel for Hyperpigmentaion (Amazon) or Cureology/Dermatica includes this in their products if ordered. Using this prevents hyperpigmentation from treatments. Hydroquinone has side effects for some people, natural options  are better with ingredients like: kojic acid/Konjac, Alpha Arbutin, Niacinamide by The Ordinary is great for large pores, discoloration, and inflamation. The Ordinary, Cerave, Eucerin, Dr Sam Bunting Flawless Cleanser, La Roche-Posay (sensitive), and Acne.org's products are all great options for moisturizers and cleaners without fragrance / dyes / allergens. The Three most important things one can use are: Vitamin A skin turnover (retinol, retinaldehyde, retinoid), Vitamin C Serum which makes collagen, and a sunscreen (zinc oxide physical for sensitive skin).

** At Home or budget friendly alternatives are monthly "Derminator" (Google It) also known as dermastamping your individual scars and you can alternate with Glycolic peels or TCA Peels. Please the see how to guide pinned at the top of the scar treatments sub called "FAQ", goto acids section and click the mega-link. Subcision W/ Chinese Cupping is also very affordable even if you do only one every year with your at home DIY plan.

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@beautifulambition thanks a lot for giving me plan . I will now work on that. 

1) can you please tell me if I go subscison with fillers will it give me some boost specially for my box car / rolling ??  Atleast for 6 months ??

2) after that can I countine mnrf and medlite/picosure lasers ?? Mnrf at 3 months interval and picosure may be 3 weeks ?? Does it sounds good ??

3) can I countinue doing subscison even if I have fillers once ?? At 3 months interval ??

Bacisally i am refering to this video of dr. Davin lim :

 

Is it possible to me follow this plan replacing laser with mnrf and adding picosure laser ??

Again thanks a lot. Thanks for making me aware of excision issues.

May be one day we will meet for cup of coffee / beer .

 

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@Ravi.kumar.engineer 

1) I don't know what this means, you need 3-8 subcisions, this isn't a quick thing. 3-8 of them spaced out 3 months apart. you choose if you want to do filler after or Chinese cupping for a month after. I don't know how you heal. Nothing is mono (single based) treatment in acne scars, it's variable. 

2) Sure, ... but again it depends on your Dr. IF they are crap, the results will be crap. It's not universal. You can't see something online and expect that with every Dr. The Dr's skill matters the most, and I hear that is hardest to find in India. Give it a try, then you can get surgical methods with your"" magic man dr"" if needed. 

3) OF course you continue doing subcision, see above #1. Do not refer to videos by Dr Lim, he is not treating you, ... if you want him to treat you fly to see him. He will not treat you like any other Dr would (people often try to replicate things they don't understand are complex, the master vs the apprentice "other Drs"). He does unconventional things. Sometimes good, sometimes bad. The principles are the same I am giving you. IF you fly to Lim and have only a weekend he "may" do 5 things at once, why because that's all the time you have and he can take that risk. Is it optimal, probably not. But then your gone. We heal extremely slowly. The biggest mistake I see is patients buying into Dr's Bull'Sh... that you can be treated with magical devices once and be done. Not how it works, would be nice though. 

4) The plan is fullly optional, ... this is your plan. Some things may not work for you, some may. Dr's may not listen to my advice and do their own thing. It's a roadmap. As such if you want to rf microneedling and picosure great, I offered the other laser(S) as you may need a boost or may not respond from _____. 

Your very welcome!

Keep your eye on the prize, you have options, use them. IF you need to do excision, you have that as a option, I am warning those who go start off there as I have had to deal with the outcome and it can be terrible for some, some accept the results. 

I want you to do derma stamping and glycolic peels as well between treatments. 

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