If this is Rullan, you're in good hands. Only thing I might add is that you should defer the filler until the swelling goes down, which can take up to 2 weeks. So go with subcision + microneedling + cross. Then get filler 2 weeks later. In fact, you can get the filler doneelsewhere if you choose.

@Sirius LeeIhave readit mentioned he may not be the best for filler ? Im sorry I dont know who said that or even if its a case by case basis. But are there filler experts we know of ? I think many of them arent the best - my friend has really been a filler queen. She gets under eye filler. Cheekbone filer etc and sometimes its natural and sometimes not. She has been to many diff docs.
second question I was worried micro with sub and filler may be a lot for my skin which takes forever to heal. Is there a down side to getting the micro later or its best to do it all and possibly wait on the filler for a few weeks ? Im so confused. Im not in a rush to be aggressive. Slow and steady works best for me but NOT if it makes it less favorable in the final result. Thank you !

@Sirius Leesorry one more Question hit send too fast !! Is there research to support ( I feel like I read it here but cant find it now ) that doing filler at the same time HELPS to keep the scar from re - tethering ? Thank you.
also I dont want to do any Perm filler. One poster said that bellafill is not being recommended during covid anyway.

1 hour ago, SharonBarnes said:

@Sirius Leesorry one more Question hit send too fast !! Is there research to support ( I feel like I read it here but cant find it now ) that doing filler at the same time HELPS to keep the scar from re - tethering ? Thank you.
also I dont want to do any Perm filler. One poster said that bellafill is not being recommended during covid anyway.

Fillers, when used as a spacer or barrier, will help prevent scar from reattaching. They normally use hyaluronic fillers not a permanent fillers like Bellafill, so you shouldn't need to worry.

1 hour ago, SharonBarnes said:

second question I was worried micro with sub and filler may be a lot for my skin which takes forever to heal. Is there a down side to getting the micro later or its best to do it all and possibly wait on the filler for a few weeks ? Im so confused. Im not in a rush to be aggressive. Slow and steady works best for me but NOT if it makes it less favorable in the final result. Thank you !

You're right, slow and steady is the way to go and there is no downside to receiving treatments separately. In fact, I recommend you to get them on different dates. One major reason for this is swelling. Another reason is complication from nodules. After subcision, your face will be very swollen. How could you correctly inject fillers? It would be almost impossible. Also, with such swelling and possibly bruising, filler could potentially mask a buildup of nodule/infection. As such, I suggest you get the subcision first. Then wait 2 weeks before getting the filler. Micro can be done after 3 months. Since Rullan only uses the standard microneedling as opposed to RF micro, it shouldn't matter too much.

1 hour ago, SharonBarnes said:

@Sirius LeeIhave readit mentioned he may not be the best for filler ? Im sorry I dont know who said that or even if its a case by case basis. But are there filler experts we know of ? I think many of them arent the best - my friend has really been a filler queen. She gets under eye filler. Cheekbone filer etc and sometimes its natural and sometimes not. She has been to many diff docs.

Filler is more of an art than science. Frankly, it's very hard to find a skilled injector. If you're lucky enough to find one, you should stick with that person as long as possible.

@Sirius Leethank you for your input Im thinking of

sub with cross

two weeks later if its not swollen filler

all healed micro in two to three months unless that could mess up the filler ?

is there a reason for not doing micro + sub +cross in one session ? Thank you !

Hey Sirius ,

I called one doctor in my home town , they provide infini RF for 100 $ a session .

Subscion is 100 $

And filler is 200 $.

No success for TCA cross . Even TCA is not available online here in India max one is 35%

But phenolic acid is availible online. I think it's widely popular snack replant.

I have following questions :

1.Why no body try phenol cross even with lower percentage ?

2. What is best way to treat edges of scar ?? Co2 laser at angled light ?

Regards.

Ravi

7 hours ago, Ravi.kumar.engineer said:

Hey Sirius ,

I called one doctor in my home town , they provide infini RF for 100 $ a session .

Subscion is 100 $

And filler is 200 $.

No success for TCA cross . Even TCA is not available online here in India max one is 35%

But phenolic acid is availible online. I think it's widely popular snack replant.

I have following questions :

1.Why no body try phenol cross even with lower percentage ?

2. What is best way to treat edges of scar ?? Co2 laser at angled light ?

Regards.

Parth

USD $100 For Infini? Tell me the name of your home town now!!!

35 minutes ago, wombatstaywoke said:

USD $100 For Infini? Tell me the name of your home town now!!!

You need to search sakhiya clinic , Surat .

17 hours ago, SharonBarnes said:

@Sirius Leethank you for your input Im thinking of

sub with cross

two weeks later if its not swollen filler

all healed micro in two to three months unless that could mess up the filler ?

is there a reason for not doing micro + sub +cross in one session ? Thank you !

As far as I know, Rullan doesn't use RF microneedling, so your filler should be fine.

More is not necessarily better when it comes to acne revision. With each treatment, which is pretty invasive, you're inflicting trauma to your skin. This will only add undue stress to your immune system, which is critical in your ability to heal. Moreover, when you have multiple treatments, how would you know which modality works and which doesn't? You might as well throw darts on the wall.

10 hours ago, Ravi.kumar.engineer said:

Hey Sirius , 

I called one doctor in my home town , they provide infini RF for 100 $ a session .

Subscion is 100 $ 

And filler is 200 $.

No success for TCA cross . Even TCA is not available online here in India max one is 35%

But phenolic acid is availible online. I think it's widely popular snack replant.

I have following questions :

1.Why no body try phenol cross even with lower percentage ?

2. What is best way to treat edges of scar ?? Co2 laser at angled light ?

Regards.

Ravi

Awesome. However, keep in mind the the skill of the operator/doctor is critical for subcision, infini and filler. Just because it's cheap doesn't mean it's good or better. Why nobody tried phenol DIY, I don't know. Maybe I will give it a try in the future. For treating the boxcar edges, I still think TCA is the best. Laser should be left to treat rough texture

With regards to 100% TCA in India, I found this. ( https://www.biomall.in/product/trichloroacetic-acid-99100gm-ast2704100gm )

Is there anything we can do to make our derm appts safer for covid ?

I recommend reading Mr. Matt's thread on subcision, which I recently brought to the top of the thread list. He used no filler. I don't recommend filler. Any retethering and the filler, will get squeezed, making your face lumpy. Retethering can occur. The filler is supposed to prevent it but . . .

Mr. Matt used suction instead to prevent retethering.

Thank you @Urbanitebut Im having trouble finding the link. Top of which thread list ?

Question as I await @Urbaniteto respond do you @Sirius Leehappen to know where this thread below is thank you ( I really need to make a decision on the filler at the time of sub Vs later )

recommendreading Mr. Matt's thread on subcision,which I recently brought to the top of the thread list. He used no filler. I don't recommend filler. Any retethering and the filler, will get squeezed, making your face lumpy. Retetheringcanoccur. The filler is supposed to prevent it but . . .

Mr. Matt used suction instead to prevent retethering.

56 minutes ago, SharonBarnes said:

@Sirius Leehappen to know where this thread below is thank you ( I really need to make a decision on the filler at the time of sub Vs later )

https://www.acne.org/forums/topic/232731-man-in-the-mirror-pre-and-post-subcision-photos/

Note that scars don't retether overnight. It takes up to 8 weeks, or about as long as it takes the new scar tissue to form under the skin. Now the reason for using the filler after subcision is to prevent retethering from happening. Filler can take up to 4 weeks to integrate with the tissue. After this time, there is almost zero chance for retethering, provided the filler was correctly placed where it should be. This is why I suggested you wait 2 weeks for the swelling to come down before injecting filler.

Ok @Sirius LeeI will do that then. Thank you so much

Ireally, really discourage fillers. Let your face do most of the work in building natural collagen after subcision.Mr. Matt got three subcisions spaced 2 months apart -- March, May and July -- with no fillers.Then about a year or so later he got a fourth and started suctioning.

Something to consider. Have you ever seen a road full of potholes that are patched? Some look mostly flat with the surrounding area but still perceptible. Some get depressed over time but the asphalt filler extends higher at the edges like a donut, some sink. The result is a very lumpy road.

This is what can happenwith filler at rolling acne scars. Itmight look fine for the first year or so then after that time mayendup looking worse than when you started and there is NO turning back. Like that road, over time you mayget some slight mounds, donuts and sunken areas all the while your natural collagen is diminishing with age.

How long do dermafillers really last?

Thank u @UrbaniteI have the option to return to the office after the swelling goes down. I do tend to bruise easily but got the little Chinese cups and also the black head pore extractor if I just suction.
i did have a bad experience with filler once so Im afraid even though I trust the doctor. PTSD I guess.
can you give me your honest answers pls after reading this. I just want the least risk.

the dr said the result would be better better with filler but its up to me. He saiddoing fillerat the same time of the procedure because it helps the scars from reattaching and it helps mold the tissue below after the subcision. You would not need the suctioning if you did it this way. He said hecould always do a minimal amount to help the scars from reattaching and see how Ido, he does not think iwill react the bad way as when I had filler before as he thinks it was how it was injected that gave methe complication. He has a method that would reduce that risk. The small amount could be enough to prevent reattachment and fill a bit, but not fill to full efficacy.

thoughts ? @Sirius Lee@beautifulambition@Urbanite

First, thanks to@Urbanitefor the interesting video. The main takeaway for me isn't so much with the longevity of the filler but with the migration. It would actually be a great thing if the filler can last longer than the usual 12 months--as long as you're happy with the result. That means no more routine top-ups. So I guess it can be both a blessing and a curse, depending on how you look at it.

@SharonBarnesAs I stated elsewhere, scars do not reattach overnight. It can take up to 8 weeks. There will also be a lot of swelling after subcision. It just would not be feasible to cover every scar with so much swelling. Moreover, doctors usually only inject a small amount and you end up with a lot of unused filler. Why would you pay for a whole syringe when you won't be using it?

When I started the journey, my face didn't look like a padded quilt. If the filler "magically disappears" then why did it leave such a mess?

Just so you know I did not have subcision. My plastic surgeon injected the acne depressions. For a few, he had to use the injection needle to break some of the tethering.

@Sirius Leewhat is your feeling on the idea to do just enough to space the area after sub but not enough to attempt to fill the scar ? It seems like a decent compromise ? That way I dont have to worry about suctioning and can still let the filler do its job without worrying about over filling swollen scars ?

1 hour ago, SharonBarnes said:

@Sirius Leewhat is your feeling on the idea to do just enough to space the area after sub but not enough to attempt to fill the scar ? It seems like a decent compromise ? That way I dont have to worry about suctioning and can still let the filler do its job without worrying about over filling swollen scars ?

I'm sorry but I've already answered you many times across different threads regarding your treatment and yet you want more assurance. I don't know what else to say.

Im sorry @Sirius LeeIve read them and Still confused ( maybe pandemic brain - Ive been under a lot of stress lately with stuff other than the scarring )am I correct in that you are 100 against doing even a minimal amount of filler at the time and then topping off ? Again sorry Im just still confused.

6 minutes ago, SharonBarnes said:

Im sorry @Sirius LeeIve read them and Still confused ( maybe pandemic brain - Ive been under a lot of stress lately with stuff other than the scarring )am I correct in that you are 100 against doing even a minimal amount of filler at the time and then topping off ? Again sorry Im just still confused.

Okay. All I'm saying is that you should get the filler when the swelling goes down enough for the injector to see the scars. That's the only way to ensure accuracy that allthe subcised scars will be covered. When there is still swelling, eg. immediately after subcision, you can bet the filler will beplaced haphazardly and, as a result, a lot of the scars will be missed.