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Urbanite

My scar treatment journey. A cautionary tale.

About two years ago I came upon this forum and decided that maybe I could try to better my appearance once again. I had started in 2007 with Restylane injections into individual scars, but stopped around 2012.  Little did I know that I had slowly but surely turned my face into a street of repaired pot holes -- smoothish but lumply -- certainly not like a freshly paved road.

Then in 2017 I had Skinpen my left temple.  The results weren't great.  Redness for several months and the tethered areas seemed to get deeper, while the surrounding healthy skin got puffier.  Still I persisted and in December I decided to visit Dr. Novick in NY.  He suggest laying a foundation of filler by starting at the same point below each eye and laying a line of filler at the upper and lower cheek. He called it "field subcision."  I wish I'd thought more about how the edges would blend and what would happen if the scar tethers re-tethered.  Immediately after the filling I noticed that on the left cheek the line of filler was visible like a peanut shape. I thought it would resolve  but it never the did. The right side was okay or so I thought.

I didn't think much about the whole process immediately after. I went back to see Dr. Novick in July 2018 to talk about the "peanut" but he said it looked great.  I've waited two full years -- the "official" time for Voluma to dissolve but as Dr. Gavin Chan said in one of his videos, filler seems to last A LOT longer than anyone realizes.

While the "peanut" can be seen by me primarily -- it looks so unnatural -- the right side is really bad, certainly worse than pretreatment in 2017. True, it's okay in many lighting conditions but then in others it's "Oh. My. God." and that's what you see in the attached images.

I think I can get the remaining filler reduced but the filler is over such a broad area it might just make matters even worse. :smileys_n_people_57:

Any thoughts?  I"m out of ideas. 

Before_After_2.jpg

Right_2_2020.jpg

Left_2020.jpg

Right_Far_1.jpg

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How many subcisions have you had? I experienced some light lumpiness from the doughnut effect when filler was injected without subcision first.

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8 minutes ago, hlp334 said:

How many subcisions have you had? I experienced some light lumpiness from the doughnut effect when filler was injected without subcision first.

I never had typical subcision. Dr. Novick described his process as "field" or "light" subcision, which was basically wriggling the long needle as it made its way under the skin.

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Oh I’m not sure the difference. I’ve had subcision with a cannula needle. They made two entry points and wiggle around breaking the bands. I’ve had 3 done and plan on getting 8 total. I have widespread scarring so sometimes some spots are missed if its not done aggressive/thoroughly enough or without filler. I feel like subcision would help your case since the filler could just be doughnutting around the scars but I’d pm beautifulambition on here to ask their opinion. 

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I would absolutely get it dissolved.   I have had hyaluronidase injected to correct badly done filler, and it has never resulted in dents or worse texture.   You really should't have to live with this.   You're lucky you used temporary filler.

I think the best thing is to dissolve the worst spots first, and avoid trying to get rid of everything at once.  This will certainly take a series of injections to dissolve the restylane in stages. 

Inject, let it settle, and then reassess.   

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Posted (edited)

Lol. "Beautifu tale?"  More like "Nightmare on My Street."

It's been a rough ride, which has socially isolated me. Gawd, how can I be friendly with strangers with a face like in that last image?

Right now I'm in "consultation mode." Voluma is supposed to last two years max and two years time is up so it appears this is more or less how my face will look going forward.

Dr. Rullan has already weighed in with subcision for the deeper scars and for the lighter areas Juviderm or saline (?). Yah, saline.  First time I hearing that it can be a filler (is it reabsorbed quickly?).

I meet with Dr. Ringpfeil's assistant tomorrow.

Here is another image of my right cheek to show how it changes depending upon the light.

 

Right_Far_2.jpg

Edited by Urbanite

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I’m really sorry to hear that, I can relate to that feeling and if it helps I feel like scars matter much less on guys. I really do think you’ll achieve good results. This forum is great because you get opinions and experiences from real people treating acne scars and see what’s helped and not helped. I recommend doing subcision until there’s no longer tethering. I received feedback from different doctors saying my scarring was superficial (it’s not it can just come off that way in some lighting) and said subcision isn’t needed. But the advice BA gave me was 3-8 subcisions. I’m glad I insisted because each time I’ve done subcision and filler I’m closer and closer to what I’d be comfortable to have as an end result. 

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Posted (edited)

Today I had my free consult with Ringpfeil's assistant. She was promoting radio frequency needling. That's fine, but we both agreed that I needed to see Dr. Ringpfeil so that's going to set me back $150.

From what I'm being advised from different parties, my dents need subcision so I think that is where I'm headed. Dr. Ringpfeil does it for $500 according to her website.

Edited by Urbanite

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I would stop seeing Novick, as it doesn't seem he's capable of helping you. Some of these derms love injecting filler all over when in reality it is only a temporary fix. I've never been a fan because I don't want a temporary fix, and also because filler can make scars look worse. Before you do another treatment, I'd have the filler dissolved. Next, you should do cannula subcision, as this will help you more than any other treatment. You can do a filler to keep from re-tethering, chinese cupping, or Sculptra. Since you've done a lot of fillers, I'd consider Sculptra. You can also do chinese cupping after the first cannula subcision, then sculptra with the second and third. 3-4 months a part. Then assess after subcision #3. You should assess after each sub, but I wouldn't think about doing anything like RF needling until you do at least three cannula subcisions. 

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Yeah I would have to agree.  You should get the excess filler dissolved.  I don't understand why all these doctors are advising all different treatments when what you need is to reduce the excessive filler.   It's a simple fix.   You need to restart with a black canvas, and having poorly done filler sitting in there will make it harder to know what is actual scarring and what is lumpy filler.  

The thing about temporary filler is that if it migrates to adjacent areas, donuting can happen making things look worse.  That said, it can't do any permanent damage because it's just HA filler.  

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Posted (edited)

I'm resistant to trying to dissolve the filler at this point.  I believe that Dr. Gavin Chan is right -- filler lasts a lot longer than anyone realizes.  No doubt my face has a lot of filler still in it some two years later. So trying to dissolve the filler might look like the air was let out of a balloon and give me uneven sagging.

My appointment with Dr. Ringpfeil is on the 19th. I'm looking forward to seeing what she says. Her office does offer subcision but I'm not sure if it's cannula, which sounds somewhat new. I know when I was looking into options a few years ago only Nokor was discussed here at the forum but not cannula.

Edited by Urbanite

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I'd stay clear of nokor because with cannula, less side effects. less down time, and at the most two insertion points per side. Cannula has been around for about 2 years or so and is the superior method to doing subcision. 

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I called Dr. Ringpfeil's office today. She does offer cannula subcision so that's good. As you all know, having treatments done in one's hometown or nearby is helpful.

I didn't want to fill my left cheek but when I told Dr. Novick, he gave me a hard time so I relented mainly because of the distance.  That was a big mistake.

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In my last post I mentioned the left cheek that I did not want to fill. Here is a before and after picture. As I noted, it's one thing to get treatment that doesn't do anything. It's quite another to get treatment that actually makes the skin WORSE and as you can see, it did. I kick myself everyday when i look in the mirror for not listening to the voice in my head. The Voluma spead to areas of least resistance and when it met tethered areas it bulged.

 

Before_After_3.jpg

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Just a quick update.  My consultation appointment has been cancelled like everything else these days. I will reschedule for May depending. 

Stay safe everyone!

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I know you are hesitant to dissolve the Voluma, but give it some consideration.  I think you've suffered long enough.  Go about it slowly with a series of injections instead of trying to get rid of everything at once.  

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Yes, get the fillers dissolved, before you do anything else.

As, @dazzed said, you can direct the clinician to do it over a series of injections.

Then do subcision to release the tethered scars.

I had complications with fillers six months later, where I developed very lumps all over my face and had to go on several courses of Prednisone for it to get resolved.

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Novick is an idiot and no one should be going to him IMO 

 

I have gone to him, Khrom, and weiner and would definitely stick to Weiner if youre on the east coast and willing to travel. He can also use ultrasound on you and see whats going on under the skin

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