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Consulting with first PS tomorrow...

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So it's my birthday gift to myself...I am seeing a plastic surgeon tomorrow to discuss my options. I am consulting with a second PS on Wednesday. I'm excited and nervous at the same time. I've pretty much come to the conclusion that I am going to need to have the scar on my cheek excised...

 It sticks out like a sore thumb. I only have one scar, but it's rather large (now 3mm, maybe a smidge more) and almost perfectly round. My skin is otherwise nearly flawless. It  pretty much looks like I got shot dead center in my cheek. Because of its near-perfect satellite dish shape, it catches the light at every fucking angle. There is no 'good lighting' for me. I have very fair skin, so the constant shadow cast over the hole is incredibly noticeable. Makeup makes it look even worse. It's like a sharpie mark dead center on a white sheet of paper. There is a loss of pigmentation in the center, but it's not obvious. My skin is so fair, that you have to look VERY closely to see it. 

I've been microneedling for a little over a year. I can't say it hasn't helped at all, the divot has filled-in slightly, but it's also made it appear wider. Turns out that this is pretty much how needling works--and lasers have the same effect, but exaggerated. Casting a longer and longer shadow on my pasty face is not the outcome I desire, so it's time to re-evaluate. I can tell the center has tissue that is just too fibrotic to respond favorably to anything non-surgical like microneedling, peels or lasers.

Fillers are not a good option for me. They are absolutely a last resort. I have a ton of allergies and fillers are made with bovine collagen and would require testing to see if it is even a viable option. Also, fibrotic tissue is tough, so fillers have a tendency to migrate into the pliable soft tissue around the scar, instead of staying under the scar, often making it look worse. Even if it did work, the results are temporary and I would have to go back and get it topped off regularly.

I really think a thinner, linear scar would be a huge improvement over what I have been living with. 

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The standard advice is subcision with fillers for rolling scars. Most fillers are actually made of Hylauronic acid which is a natural substance produced in the body. The bovine collagen you are referring to is bellafill which I myself have tested positve on the allergy test so I can never have it injected. Maybe they can allergy test injection in your wrist if your worried, although that's not a common concern with HA fillers. HA fillers can last up to 12 month depending on how fast i breaks down in your body and the type injected. I would reccomend getting subcision in that one scar and then getting less than 1 cc of filler. I don't know why you have an oposition to filler if you never even tried it . It can be lumpy at first but I heard most people don't notice it. IF your're opposed to that you can do subcision with suction which you can find on amazon as a chinese cupping device. Just use it a few days after subcision to induce your own blood from the scar reattaching. I found cupping helps but not as good as filler.   

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Hi Joey...thanks. Yes--the doctor had suggested using an HA filler instead. I am quite sure I would test positive on a skin test for Bellafill. Last year, an eye doctor tried putting temporary punctal plugs in my tear ducts (bovine collagen) and I was so glad when they fell out, I pretty sure I was having an allergic reaction. 

The PS I saw did suggest the HA fillers as an option. Yes--I am hesitant--I've done my research and side effects can be really bad. But I am beginning to think those adverse reactions were more commonly associated with the silicone and bovine collagen injections. Even still, anything foreign in the body is a potential risk. Not only that, but how long they last varies from person-to-person and you have to keep going back periodically for maintenance 'top-offs'. 

This PS said that I shouldn't touch it surgically. He said that it was really a 50/50 if the outcome of cutting and stitching would be better or worse. He also pointed out that--although it is there and he understands what I am seeing and feeling--my perception of it is likely exaggerated from what other people see. He said that looking at me--it's truly not that noticeable. 

He told me that lasers would not be very helpful with leveling it, but would instead most certainly increase the hypopigmentation, so it would be best to avoid lasers, at least directly on that spot. The potential for improvement just didn't outweigh the potential for more damage.

Since I was already seeing improvement with home microneedling (it's just such slow progress), the doctor was inclined to believe that I could see more improvement with an RF device. He also thought it to be a safer alternative--it certainly wouldn't make it any worse. 

Although it was disappointing not to hear "yeah, we can zap that right out and fix it," he truly was not trying to sell me on anything either. I really do think he was being very honest with me about all the options and expectations and I do really appreciate that. 

After sleeping on it...I think I am going to opt for doing the three rounds of RF microneedling and then after my skin has had a chance to heal a bit, see where it stands. At that point, if I feel like I still need something--I'll think I'll get the HA filler. 




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