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DjDoggpound

Going to treatment

I've finally decided that I'm having treatment for my acne scars.

I'm a 30 year old caucasian male, Type 2, thick skin. I have scarring on my cheeks, temples and forehead... Mostly rolling scars which are pretty big in diameter and connected, with volume/fat loss. But almost all of the scars have fairly soft edges.

I don't have many icepicks or box cars, at least not any distinct ones, but my skin texture is pretty messed up anyways from a decade of infected cysts.

In normal lightning none of my scars are super visible. I can look quite pleasant in soft lighting I think, maybe because my scars mostly have soft edges. I mean they are absolutely visible, but they are not totally off putting. But in the harshest of lights I come forth as a grisly beast. And dark pits and jagged valleys of horror take place where it once used to be a face.

My plan is to have subcission with Sculptra fillers. From what I have gathered from the internet, it seems like Sculptra is a better option than HA-fillers. Please correct me if I'm wrong.

And I was wondering if I should do some other treatments while I'm there, as I have to travel quite far and it would better for my wallet to do as much as possible in one go. 

So my question is: What other treatments would be good to do the same day as subcission and fillers? What will give me the most bang for the buck? Microneedling, RF Microneedling (Genius), CO2 laser, Erbium, TCA peel? Any inputs?

Edited by DjDoggpound

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just word of advice, ask how many procedures the doc has done etc; make sure you like vet the doctors... seriously.... do yourself a huge favor and vet them... seriously; 

session 1; don't do anything other than sculptra and subcision. you need to massage your face to ensure the sculptra is applied evenly. imagine rubbing a bloody face with scabs. yea, not good for your scabs. 

session 2; subcision + anything else? tca cross imo or you could go for more rf microneedling. I'd say do rf micro needling before any other resurfacing. 

repeat session 2 like 2 more times then you can resurface. 

expected runway; 1-2years just like braces. inbetween, do your face routine. retinol sunscreen etc.

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Another question: is it smart to do cupping after subcision if you also have Sculptra fillers? Or is this not needed or maybe harmful?

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Just a little update. Sorry for the lack of photos, might upload later. I had my subsicion with HA fillers on Friday the 23th of January (5 days ago). With Nokor needle. 

I’m lightly bruised now, and probably a bit swollen still. I have been lightly massaging three times a day  

It looks like it has been pretty effective on rolling scars with soft edges. Under very harsh overhead spotlight I can see that many valleys in the skin have been lifted which gives a much more smooth impression.

I am going back for more subcision in a few months. And I probably have to do it a few times more after that too. But the changes in my skin I see has given me faith in this method.

Just wanted to tell you guys my experience since there seems to be lacking a clear consensus in the community about subcision. You have some people that says it works wonders and others that says it doesn’t do much and even some that says it makes skin worse. It’s probably really dependent on the individual case, both the nature of the scarring, the skill of the doctor, skin type, how your body heals, after care, etc. But this is at least another first hand good experience. 

I have(had?) deep wide pits which made a jagged cast of shadows on my cheeks, which made my face look quite disfigured in my opinion. This has improved significantly. What it obviously hasn’t done anything for is ice pick scars and general skin texture. So if the latter is your main issue maybe subcision isn’t going to give you the same wow factor. Luckily I have not so much of these, but I do have enough to still make my skin look bad in harsh lighting, but I now have less of the heavy «sculptural disfigurement» if I can call it that, that some deep rolling scars creates. Now I just have to wait for a few weeks/months until I’m sure that there isn’t any swelling left and see if the results hold.

In any case I think I will keep on doing subcision and fillers, and I will try to do some microneedling at home in between. Perhaps some peels. And maybe later have some other procedures done at the dermatologist. RF Microneedling is another thing I’m interested in, but this procedure also seems to be getting very contrasting opinions... Based on reviews it’s either very effective or not effective at all, you can’t really tell which of them is the abnormal outcome. 

Edited by DjDoggpound

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On 1/28/2020 at 8:34 PM, DjDoggpound said:

Just a little update. Sorry for the lack of photos, might upload later. I had my subsicion with HA fillers on Friday the 23th of January (5 days ago). With Nokor needle. 

I’m lightly bruised now, and probably a bit swollen still. I have been lightly massaging three times a day  

It looks like it has been pretty effective on rolling scars with soft edges. Under very harsh overhead spotlight I can see that many valleys in the skin have been lifted which gives a much more smooth impression.

I am going back for more subcision in a few months. And I probably have to do it a few times more after that too. But the changes in my skin I see has given me faith in this method.

Just wanted to tell you guys my experience since there seems to be lacking a clear consensus in the community about subcision. You have some people that says it works wonders and others that says it doesn’t do much and even some that says it makes skin worse. It’s probably really dependent on the individual case, both the nature of the scarring, the skill of the doctor, skin type, how your body heals, after care, etc. But this is at least another first hand good experience. 

I have(had?) deep wide pits which made a jagged cast of shadows on my cheeks, which made my face look quite disfigured in my opinion. This has improved significantly. What it obviously hasn’t done anything for is ice pick scars and general skin texture. So if the latter is your main issue maybe subcision isn’t going to give you the same wow factor. Luckily I have not so much of these, but I do have enough to still make my skin look bad in harsh lighting, but I now have less of the heavy «sculptural disfigurement» if I can call it that, that some deep rolling scars creates. Now I just have to wait for a few weeks/months until I’m sure that there isn’t any swelling left and see if the results hold.

In any case I think I will keep on doing subcision and fillers, and I will try to do some microneedling at home in between. Perhaps some peels. And maybe later have some other procedures done at the dermatologist. RF Microneedling is another thing I’m interested in, but this procedure also seems to be getting very contrasting opinions... Based on reviews it’s either very effective or not effective at all, you can’t really tell which of them is the abnormal outcome. 

Good points raised.

You are spot on. Subcision is a great method, but like all methods, it has variables in results. That's why there are so many methods, and that's why asking 10 different dermatologists would give you 15 different answers, that's why this forum exists.

Dr Davin Lim mentioned something in one of his videos that I love, and I paraphrase - there must be a benchmark. There must be a point a derm would say "We have done 5 of this treatment, let's see whether there is that 50% improvement we aimed for. Let's look at the before and after pictures."

That's why I disagree with some derms who give packages that look like "5 sessions of Infini for X amount of dollars" or scar revision package including: 3 x Treatment A, 5 x Treatment B, 2 x Treatment C. It looks great on paper, but almost everyone who has done any form of scar revision procedure can tell you the results can defer person to person. 

 

 

 

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On 2/11/2020 at 5:37 AM, xander_33 said:

What made you decide on HA fillers instead of Sculptra?

The dermatologist recommended HA-fillers. And I’ve read that it is recommended to go for more temporary fillers first, in case you don’t like the result, so I didn’t want to push it. But I have quite severe volume loss atleast on one side, so I will probably ask for Sculptra on a later occasion. 

A little update, 4 weeks after subcision: all the bruising was gone after about two weeks. But I have noticed some lumps, massaging seems to help. Even after massaging for just two days they seem to have been reduced... Will continue. 
 

Swelling is also gone, I can see that some scars are more noticable than they were at the two week mark. Still it is an definite improvement from how it was before treatment. I have got a new depressed scar though from one incision point. 
 

I will have my next round of subcision and fillers in about two months. I think he will use cannula instead of Nokor this time. Looking forward to the appointment and hopefully it will give me even more improvement.

Tomorrow I will try microneedling with dermastamp 1,5 mm for the first time. 

Edited by DjDoggpound

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4 hours ago, DjDoggpound said:

The dermatologist recommended HA-fillers. And I’ve read that it is recommended to go for more temporary fillers first, in case you don’t like the result, so I didn’t want to push it. But I have quite severe volume loss atleast on one side, so I will probably ask for Sculptra on a later occasion. 

A little update, 4 weeks after subcision: all the bruising was gone after about two weeks. But I have noticed some lumps, massaging seems to help. Even after massaging for just two days they seem to have been reduced... Will continue. 
 

Swelling is also gone, I can see that some scars are more noticable than they were at the two week mark. Still it is an definite improvement from how it was before treatment. I have got a new depressed scar though from one incision point. 
 

I will have my next round of subcision and fillers in about two months. I think he will use cannula instead of Nokor this time. Looking forward to the appointment and hopefully it will give me even more improvement.

Tomorrow I will try microneedling with dermastamp 1,5 mm for the first time. 

Congrats for getting the procedure done and the improvement you're seeing. I am also interested in having sub plus filler for mild scarring cause peelings didn't do a *it.  Did your doctor okey the microneedling 4 weeks after the fillers? So it won't damage the filler? 

Edited by Sisi90

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7 hours ago, Sisi90 said:

Congrats for getting the procedure done and the improvement you're seeing. I am also interested in having sub plus filler for mild scarring cause peelings didn't do a *it.  Did your doctor okey the microneedling 4 weeks after the fillers? So it won't damage the filler? 

Thanks, yes I asked him about it and he said wait 4 weeks :)

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12 minutes ago, Sisi90 said:

Thank you. When dr emil said that I can trust him :)

Which peels have you tried?

I'm interested in trying TCA peels in combination with microneedling, have read some promising stuff about it

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I've tried glycolic peels 70% 3x at a derm's office so far. I didn't get much improvement even though my scarring is not severe. I've ordered TCA 12,5% from MUAC but I'm still conjuring up some courage to do the peel at home! 

I've heard that TCA and microneedling can be a good treatment too. Are you doing it at home too? 

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16 hours ago, DjDoggpound said:

Which peels have you tried?

I'm interested in trying TCA peels in combination with microneedling, have read some promising stuff about it

 

9 hours ago, Sisi90 said:

I've tried glycolic peels 70% 3x at a derm's office so far. I didn't get much improvement even though my scarring is not severe. I've ordered TCA 12,5% from MUAC but I'm still conjuring up some courage to do the peel at home! 

I've heard that TCA and microneedling can be a good treatment too. Are you doing it at home too? 

For TCA in combination with microneedling, is there a specific sequencing or time duration strategy that is known to be beneficial with the two?  

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8 hours ago, slide. said:

 

For TCA in combination with microneedling, is there a specific sequencing or time duration strategy that is known to be beneficial with the two?  

BA says alternating one month peel the next needling is a good way to do it.

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