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

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.

Oh Im not sure the difference. Ive had subcision with a cannula needle. They made two entry points and wiggle around breaking the bands. Ive 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 couldjust be doughnutting around the scars but Id pm beautifulambition on here to ask their opinion.

Thank you. I did ask BA and I'm awaiting his suggestions.

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.

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.

Im 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 youll achieve good results. This forum is great because you get opinions and experiences from real people treating acne scars and see whats helped and not helped. I recommend doing subcision until theres no longer tethering. I received feedback from different doctors saying my scarring was superficial (its not it can just come off that way in some lighting) and said subcision isnt needed. But the advice BA gave mewas 3-8 subcisions. Im glad I insisted because each time Ive done subcision and filler Im closer and closer to what Id be comfortable to have as an end result.

hmm. sounds like you need a new doctor.

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.

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.

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.

I'm resistant to trying to dissolve the filler at this point. I believe that Dr. Gavin Chanis 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. Sotrying 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.

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.

I called Dr. Ringpfeil's office today. She doesoffer 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.

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.

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

Stay safe everyone!

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.

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

As,@dazzedsaid, 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.

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

Update: So I finally saw Ringpfeil in person today for my consultation. She was very thorough and agreed that any fillers I had SHOULD NOTbe dissolved with hyaluronidase because she said it was a powerful enzyme that could dissolvemy own tissue. My lumpy face would likely getlumpier.

She felt subcision was a good bet HOWEVER, she is not familiar with cannula based subcision and would instead rely on the old Nokor needles. I'm not sure how I feel about that. She said shecould use the cannulas but was wary about bending and how effective they'd be at cutting through the tethers. Also she mentioned that infection was a 5% possibility since bacteria likes to collect in spaces created by the cutting of the tethers. Yikes!!! That would be awful, just awful.

Postscript: Dr. Ringpfeil says she is familiar with the blunt cannula method, doing it as a precursor to the nokor type. For me she will just use the blunt cannula. So it looks like I'm on for September 17th!

On 8/13/2020 at 12:54 AM, Urbanite said:

Update: So I finally saw Ringpfeil in person today for my consultation. She was very thorough and agreed that any fillers I had SHOULD NOTbe dissolved with hyaluronidase because she said it was a powerful enzyme that could dissolvemy own tissue. My lumpy face would likely getlumpier.

She felt subcision was a good bet HOWEVER, she is not familiar with cannula based subcision and would instead rely on the old Nokor needles. I'm not sure how I feel about that. She said shecould use the cannulas but was wary about bending and how effective they'd be at cutting through the tethers. Also she mentioned that infection was a 5% possibility since bacteria likes to collect in spaces created by the cutting of the tethers. Yikes!!! That would be awful, just awful.

Postscript: Dr. Ringpfeil says she is familiar with the blunt cannula method, doing it as a precursor to the nokor type. For me she will just use the blunt cannula. So it looks like I'm on for September 17th!

 

Let me help you out here.

I went for subcision twice. The first time I had Nokor because I have very deep and tough scars. The second time I had cannula because my scars are not so thick but the doctor had a Nokor needle on standby.

So, if it is your first time, and your doc is experience using Nokor, please go with it. The fillers will probably realign themselves after the bonds are cut.

And I avoided fillers by using the suction device.

On 8/12/2020 at 9:54 AM, Urbanite said:

Update: So I finally saw Ringpfeil in person today for my consultation. She was very thorough and agreed that any fillers I had SHOULD NOTbe dissolved with hyaluronidase because she said it was a powerful enzyme that could dissolvemy own tissue. My lumpy face would likely getlumpier.

She felt subcision was a good bet HOWEVER, she is not familiar with cannula based subcision and would instead rely on the old Nokor needles. I'm not sure how I feel about that. She said shecould use the cannulas but was wary about bending and how effective they'd be at cutting through the tethers. Also she mentioned that infection was a 5% possibility since bacteria likes to collect in spaces created by the cutting of the tethers. Yikes!!! That would be awful, just awful.

Postscript: Dr. Ringpfeil says she is familiar with the blunt cannula method, doing it as a precursor to the nokor type. For me she will just use the blunt cannula. So it looks like I'm on for September 17th!

 

I still think you should test it by dissolving a small area of your face, preferably somewhere less inconspicuous. How would you know unless you try it out?

23 hours ago, Sirius Lee said:

I still think you should test it by dissolving a small area of your face, preferably somewhere less inconspicuous. How would you know unless you try it out?

No way will I try it. I have a very strong suspicion the appearance will worsen because the dissolving won't happen in an even plane. Dr. Ringpfeil also noted that old filler is much harder to dissolve than new filler.

A very important lesson to all of this face work is that one can make appearances worse. I didn't think about that until Dr. Novick so now I'm very careful.

Update:  Well, I was supposed to have subcision on my right cheek with Dr. Ringpfeil but I got cold feet. What if something goes wrong? What if I make things worse than they are now?