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swen

Carbolic/phenol cross & subcision with Dr. Rullan journey: with FINAL RESULTS!

Update 03/22/2020:

I made a quick and to-the-point video omg this process. Might be easier to watch :)


________

 

3 months post procedure follow up:

 

https://imgur.com/a/hvZ8viY
 

I’m really happy with my skin now :) it is miraculous how one procedure can change everything so much. I can safely say my skin went from moderate to mild scarring. I don’t think about my skin as much anymore. It was so worth it.

________

ONE MONTH POST-PROCEDURE UPDATE WITH BEFORE PICS:

Skin is looking good. It obviously doesn’t look like smooth skin esp compared to my arm or something but there’s a huge improvement on my temple which was my biggest concern. I’d say there’s like a 50-80% improvement in harshest lighting. Very impressed with the one treatment!

https://imgur.com/a/nOAsBbE 

________

UPDATE: final results (6 weeks post procedure)

 

Here are my 6 week results with before and after side by side :)

the most dramatic improvement is my left temple, which had the worst scarring. Improvement of 50%+.

in the areas of milder scarring, improvement is 20-50%. 
 

https://imgur.com/a/oxTP9J2
 

_________________
(original post)

I had the honor of seeing Dr. P. Rullan today and documented my journey for anyone interested. I'll post updates as I heal. I had to book the appointment 2 months in advance and pay a $500 deposit 1 month prior.

before pics: https://imgur.com/a/jGczkbX

I have moderate boxcar, icepick and rolling scars on my temples and cheeks.

11/21

Arrived for my procedure and filled out a bunch of paperwork. I was so nervous, I had the runs. Then I was taken to a room in the back by a medical assistant named Yesenia. She cleaned my face with acetone. Then I met Dr. Rullan, who made a lot of comments about my ethnic background (I'm Asian) in an attempt to be relatable, but he was kind and caring so I really appreciated that. He started off with carbolic cross and I could feel a bit of a sting, but the pain was only a 3-4/10. No numbing yet. He answered all my questions as he was doing the procedure. Then came subcision. He injected my cheeks and temples with anesthetic, and my face ballooned up to twice the size. I could see my cheek out of my side vision, which was a bit concerning. However, I knew that was normal. He started aggressively subcising and I could hear dull bands snap. He spent about 10 minutes on each side of my face, including temples and cheeks on both sides. It was a bit painful at one point but he injected more anesthesia and I felt okay. He told me that he knows when to stop subcising when he doesn’t hear any more snapping. By the end, I was swollen as fuck and declined to look at myself in the mirror. I have four days off so I’ll just keep the room dark and avoid mirrors as long as possible, lol. After he left, the medical assistant gave me an optional kenalog injection into my ass cheek. The kenalog decreases the healing time for my puffy face from 1 week to 3-4 days, so I went for it. Yes, I had to pull my pants and underwear down. I bought a dark face visor at the front desk as I checked out.

One unexpected thing was slight eyelid swelling/numbness, which I felt as he injected the anesthetic near my temples. He told me that's normal and will go down as my face recovers from the swelling in the next 3-4 days.

 

He answered all my questions and they are listed:

-can shower the next day, just don’t knock off scabs

-improvements timeline: swelling for 3 days, back to normal in 2 weeks. Scabbing for first 2 weeks. Will see maximal improvement in 2-3 months as collagen forms.

-avoid sunscreen and makeup like dermablend for 1 week, 2 if possible

-can use the cetaphil lotion I bought as early as the next day if I want

-only possible complication is infection, which shows up as red and hot. Has never happened to his patients

______________

Suctioning: started on day 9 after all the scabs fell off. Suctioned every day from days 9-14, then backed off and did it every other day or every 3 days. Used a silicone cup and just went over each area for 4 seconds 2-3 times. I didn't want it to be too bruised because then I would need makeup for work. This has worked well for me. 

Edited by swen

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Awesome congratulations on your visit to Dr Rullan! Hope your recovery goes well. The Kenalog shot does wonders for swelling, and I did it the last couple of times I did subcision with him.

Today, I'm recovering my CROSS session yesterday, and decided I need to go out for a walk to get some air, so ended up putting on some light sunscreen (I use LaRoche Posay's fluid imported from Europe) and went to get brunch with scabs all over my face. No one said anything, and much easier than I expected. I didn't do subcision this time around, so no embarrassing swelling to deal with.

I'm also using Dr Sam's moisturizer as well. I put on Aquaphor last night, and don't plan on using it as much this time around. I used loads of Aquaphor each time prior though, and it's quite greasy and hard to wash off.

 

 

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5 hours ago, superburrito said:

Awesome congratulations on your visit to Dr Rullan! Hope your recovery goes well. The Kenalog shot does wonders for swelling, and I did it the last couple of times I did subcision with him.

Today, I'm recovering my CROSS session yesterday, and decided I need to go out for a walk to get some air, so ended up putting on some light sunscreen (I use LaRoche Posay's fluid imported from Europe) and went to get brunch with scabs all over my face. No one said anything, and much easier than I expected. I didn't do subcision this time around, so no embarrassing swelling to deal with.

I'm also using Dr Sam's moisturizer as well. I put on Aquaphor last night, and don't plan on using it as much this time around. I used loads of Aquaphor each time prior though, and it's quite greasy and hard to wash off.

 

 

Oh wow, that's awesome! Thanks, and I hope your treatments are going well too. I saw your thread and it was helpful! How much of an improvement do you think you saw after your first treatment with him, and how much improvement do you have right now compared to before any of these treatments? I tried to find a healed picture near the end of the thread but got confused with all the posts from others lol

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@swen If I recall, I saw about a 10% improvement after the first treatment, I did subcision and microneedling at the same time. And prior I had done Infini in Florida with Dr Weiner, so it might have been all cumulative.

I feel like overall it’s been a 50+% improvement after several treatments.

I’ve done a bunch of various treatments before like microdermabrasion and Sublative RF, but they really didn’t do anything.

I’ll try to take some photos after I heal from this round to show the improvements!

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Just now, superburrito said:

@swen If I recall, I saw about a 10% improvement after the first treatment, I did subcision and microneedling at the same time. And prior I had done Infini in Florida with Dr Weiner, so it might have been all cumulative.

I feel like overall it’s been a 50+% improvement after several treatments.

I’ve done a bunch of various treatments before like microdermabrasion and Sublative RF, but they really didn’t do anything.

I’ll try to take some photos after I heal from this round to show the improvements!

I see, that's still something. And 50% is insanely good!! That's like 1-2 grades improvement. Congrats! I will save up when I start working and hope to see similar results!

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Healing update: day 3

The swelling has gone down by 75% but I still look puffy around the cheekbone, temple and cheek area.

I've developed early scabs on all the CROSS sites, they are reddish pink. I must have about 200 of them in total. I've showered last night, careful not to splash any water on my face, but probably got a few drops by accident. Today, I gently washed my face using 10:1 dilated white vinegar with clean hands, and followed up with Cetaphil moisturizing lotion with hyaluronic acid. Feeling 2/10 pain when moving my face at the sites of CROSS and subcision, which is barely noticeable but definitely there. 

Feeling a little nervous about returning to work on Monday, but it is what it is. 

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@swen Good luck on your continued healing! You'll likely have a few more scabs fall off by Monday when you return to work, so hopefully it won't be look too bad. If you try makeup, please let us know how it turns out and what technique you used. I have not had a lot of luck with it!

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Swen,

I went to see Rullan on Thursday as well for the same treatment! We probably just missed crossing paths.

I had a similar experience to you..the only difference I think is that I got fewer than the 200 CROSS scabs that you mentioned (maybe 100), and I ended up getting Erbium laser as well. I wasn’t planning for that, but he suggested it for my scar type during the treatment and I just decided to go with it, although I did ask him to do it conservatively as I’m nervous about side effects.

My healing is going similar to yours...the swelling is mostly gone and now just have the scabs/dark spots (plus light grid marks from the Erbium).

My before pictures are in my previous post if you want to see. It would be interesting to compare notes as we heal since we both did it the same day!

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Guest

@Firsttimelongtime I gather Dr Rullan did the cross first and then the laser? How is your recovery time after the laser? 

All the best with your procedures :-)

Edited by Guest

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@JenSteli Yes, he did CROSS, then subcision, then laser.

The recovery is going well, thanks! Today will be 4 days from the day of treatment, and right now I have a little bit of bruising from subcision, scabs from CROSS, and very light grid marks and basically redness/bronzing from the laser. I actually think the laser side effects are the most minor, and if I had just had laser I would be almost fine to go out in public. Especially for girls (which I am not) it could be pretty easily covered up with makeup. That being said I luckily have the week off :)

I think the scabs from CROSS are the most embarrassing if I were gonna go out.

 

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Sounds super. Apart from the scabs part. I wish I could do phenol cross too. Now that I've read that it is actually safer that tca cross, more than ever!! You are in luck you can get treatment with Rullan. Speedy recovery :-)

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On 11/23/2019 at 4:10 PM, blueberrylove said:

Did he do your forehead and chin or just temples?

 

Just forehead, temples and cheeks! That's where all my scarring is.

On 11/23/2019 at 9:06 PM, Firsttimelongtime said:

Swen,

I went to see Rullan on Thursday as well for the same treatment! We probably just missed crossing paths.

I had a similar experience to you..the only difference I think is that I got fewer than the 200 CROSS scabs that you mentioned (maybe 100), and I ended up getting Erbium laser as well. I wasn’t planning for that, but he suggested it for my scar type during the treatment and I just decided to go with it, although I did ask him to do it conservatively as I’m nervous about side effects.

My healing is going similar to yours...the swelling is mostly gone and now just have the scabs/dark spots (plus light grid marks from the Erbium).

My before pictures are in my previous post if you want to see. It would be interesting to compare notes as we heal since we both did it the same day!

Hi there,

I totally did not see your post reply! Wow, what a small world haha. I hope your healing is going well! Not much has changed for me since day 3, except slightly less swelling now. I'm just wondering why I don't have any scabs falling off even though others tend to have them fall off by day 5 already.

 

Since I already posted my day 5 pics elsewhere, here they are again for completeness:

https://imgur.com/a/TMxMISv

I'll check out your before pics too! Hope to hear about your updates in the future as well. :)

Edited by swen

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Day 6

things haven’t changed much since day 5 but here’s some pictures with better lighting. Bruising around eyes is getting a bit better but I still look like a raccoon. I just recalled that Dr. Rullan said scabbing is normal for the first 2 weeks so I’m not so worried that I still have them.

https://imgur.com/a/E1RTsV5

Edited by swen

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1 hour ago, Firsttimelongtime said:

Hi Swen, my scabs started peeling today in the shower. How about you?

Hey there! I actually just started having some scabs fall off, which was unexpected since most of my scabs are rather light colored and not the deep purple ones I've seen in other people's pictures. It was a relief because I felt like nothing was happening. Thanks for checking in!

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Day 8 update:

scabs have fallen off, about 1/3-1/2 of them are gone. The scabs on my temples are particularly stubborn. The skin underneath is mostly not red (few are) but definitely indented more than when I started, which is expected. Still have some bruising but everything is improving. Feeling optimistic :) will start cupping once 90% of the scabs are off.

https://imgur.com/a/9KFme17

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Day 9

The scabs are almost all off. Only a couple left deep indentations. Most scars actually look more shallow than before :) 

My “scabs” were actually super thin laters of hard skin, I was expecting them to be thicker. I plan on suctioning tonight with the cups.


https://imgur.com/a/7YqikG1

 

Edit: It's only day 9 and maybe it's due to residual swelling, but some of the deepest boxcars, located on my left temple, have become 80% less deep! I hope it stays like this/gets better :)

Edited by swen

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@swen Glad the healing is going well for you! And I agree that "scabs" is a bit of a misnomer, because it's more like hard dark skin, rather than like a scab that you'd get from a regular wound. Great that you're seeing the scars look more shallow already!

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Day 10:

I used a manual rubber/silicone cup last night over all the areas that were subcised. It caused some bruising on my left temple, which has the deepest boxcar scarring. I'm really happy with my temples because they used to be the deepest/most troublesome, and they have really become less tethered and more filled in. When I smile, my left temple doesn't show the prominent scars anymore. I know some of it is swelling or bruising but I am seriously really happy with how my scars are filling in so far. 

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On 11/29/2019 at 8:14 AM, swen said:

Day 9

The scabs are almost all off. Only a couple left deep indentations. Most scars actually look more shallow than before :) 

My “scabs” were actually super thin laters of hard skin, I was expecting them to be thicker. I plan on suctioning tonight with the cups.


https://imgur.com/a/7YqikG1

 

Edit: It's only day 9 and maybe it's due to residual swelling, but some of the deepest boxcars, located on my left temple, have become 80% less deep! I hope it stays like this/gets better :)

I went to see Rullan on the same day as you I believe and was unsure of when to start suctioning. I will probably start tonight as well. 

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28 minutes ago, shei514 said:

I went to see Rullan on the same day as you I believe and was unsure of when to start suctioning. I will probably start tonight as well. 

Such a small world! I was there at 9am so depending on your time we might have crossed paths.

I saw your thread and that you had laser too, I'm not sure the downtime before suctioning but I would keep that in mind as well. I only had cross and subcision.

By the way, your results are really impressive! Happy for you and your progress on your skin.

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It’s only 10 days out but I wanted to share my progress. I took the pic at the end of the day to minimize morning swelling, so that’s why it’s so dark lol. My left temple has filled in quite a bit. I’d say at least 50% improvement. Will keep suctioning and eating lots of collagen, hopefully this lasts ;D

 

https://imgur.com/a/2PnekoO

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On 11/30/2019 at 9:38 AM, swen said:

Such a small world! I was there at 9am so depending on your time we might have crossed paths.

I saw your thread and that you had laser too, I'm not sure the downtime before suctioning but I would keep that in mind as well. I only had cross and subcision.

By the way, your results are really impressive! Happy for you and your progress on your skin.

I had my appointment at 11 am so I probably just missed you! Dr Rullan is definitely popular in southern california and around the states a lot of us are seeing him. 

I did have laser too but I heal pretty quickly from that, the phenol cross and the redness from that takes me a little longer. 

Thank you! Your results so far seem great too, it's amazing what a skilful dermatologist can do tbh! 

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