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MP28

Subcision buffer for widespread scars?

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Hi,

So we use HA filler often as a buffer after subcision for isolated boxcars..How are we supposed to buffer   more widespread and rolling scars? Is suction the only option? I’ve recently had success with my boxcars with juvederm and liked how easy it was to not have to worry about suctioning and having a red face for the next month.

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11 hours ago, Sirius Lee said:

Just because you have rolling scars, it doesn't mean the entire area is tethered. You need only inject filler where it was subcised.

Well for example Rullan will subcise all the scars on my forehead so it’s hard to tell what is exactly tethered and not. You would put juvederm under a rolling scar? Thought it was just isolated boxcars and isolated atrophic?

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39 minutes ago, MP28 said:

Well for example Rullan will subcise all the scars on my forehead so it’s hard to tell what is exactly tethered and not. You would put juvederm under a rolling scar? Thought it was just isolated boxcars and isolated atrophic?

You can actually feel the scar band as you move the Nokor or cannula under the skin. As such, Rullan would know exactly where the tethering is, so he should have no problem injecting the filler at exact location.

Rolling scars have higher incidence of tethering than boxcar or icepick scars. The problem is not all rolling scars are tethered. In truth, it's very hard to know for certain if the scar is tethered before you actually insert a needle under the skin. 

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27 minutes ago, Sirius Lee said:

You can actually feel the scar band as you move the Nokor or cannula under the skin. As such, Rullan would know exactly where the tethering is, so he should have no problem injecting the filler at exact location.

Rolling scars have higher incidence of tethering than boxcar or icepick scars. The problem is not all rolling scars are tethered. In truth, it's very hard to know for certain if the scar is tethered before you actually insert a needle under the skin. 

Well, I have some weird microneedling damage that you can’t exactly pinpoint specific scars in that area, but it could use plumping up. Juvederm is used on rolling scars?

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11 hours ago, MP28 said:

Well, I have some weird microneedling damage that you can’t exactly pinpoint specific scars in that area, but it could use plumping up. Juvederm is used on rolling scars?

Juvederm and Restylane are both used for forehead. But I personally don't think it's ideal, or safe, to shoot filler all over the forehead to plump it up. However, it is not impossible in the hands of a qualified professional. Go discuss with your doctor. 

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On 9/30/2020 at 7:40 AM, MP28 said:

Well for example Rullan will subcise all the scars on my forehead so it’s hard to tell what is exactly tethered and not. You would put juvederm under a rolling scar? Thought it was just isolated boxcars and isolated atrophic?

Are all your scars tethered and why does Rullan subcise box car scars? Thought only tethered rolling scars could benefit 

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18 hours ago, BlueMaloney said:

Are all your scars tethered and why does Rullan subcise box car scars? Thought only tethered rolling scars could benefit 

I mean it’s pretty hard to tell what scars are tethered until you get under there it seems. Plus i hear scar bands breaking in different areas in forehead.

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On 10/2/2020 at 6:36 AM, MP28 said:

I mean it’s pretty hard to tell what scars are tethered until you get under there it seems. Plus i hear scar bands breaking in different areas in forehead.

I understand. I was wondering because I see some doctors (like Rullan) suggest subcision even for what seems to be box scars and I didn't quite understand why.

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On 9/30/2020 at 4:59 PM, Sirius Lee said:

Juvederm and Restylane are both used for forehead. But I personally don't think it's ideal, or safe, to shoot filler all over the forehead to plump it up. However, it is not impossible in the hands of a qualified professional. Go discuss with your doctor. 

Do you believe subcision is effective without cupping or filler in these more widespread areas? As mentioned i have some more widespread shallow rolling scars and am wondering if my only option is to suction.

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13 hours ago, MP28 said:

Do you believe subcision is effective without cupping or filler in these more widespread areas? As mentioned i have some more widespread shallow rolling scars and am wondering if my only option is to suction.

A lot of people mistakenly think that all scars are tethered, but that's not the case. Among the types that are most vulnerable to tethering are those with medium to deep scars. Those who display shallow scars, on the other hand, need not worry about this and don't need subcision. In fact, many people with shallow scars have reported (here and elsewhere) that they didn't see much benefit from subcision.

Now regarding the forehead. This area has the thinnest layer on the face. There's only about 1.5 mm of skin thickness. So if there should be any sign of tethering, there would be a deep indentation. In your case, you have "widespread shallow rolling scars", which means there's no tethering. It's more likely a textural issue.

Going back to your question about the effectiveness of using suction and filler, of course they're beneficial as long as there is a sign of tethering. If no tethering, no benefit.

If it were me, I would get a botox to relax the forehead muscle. That in itself can make a lot of difference.

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2 hours ago, Sirius Lee said:

A lot of people mistakenly think that all scars are tethered, but that's not the case. Among the types that are most vulnerable to tethering are those with medium to deep scars. Those who display shallow scars, on the other hand, need not worry about this and don't need subcision. In fact, many people with shallow scars have reported (here and elsewhere) that they didn't see much benefit from subcision.

Now regarding the forehead. This area has the thinnest layer on the face. There's only about 1.5 mm of skin thickness. So if there should be any sign of tethering, there would be a deep indentation. In your case, you have "widespread shallowrolling scars", which means there's no tethering. It's more likely a textural issue.

Going back to your question about the effectiveness of using suction and filler, of course they're beneficial as long as there is a sign of tethering. If no tethering, no benefit.

If it were me, I would get a botox to relax the forehead muscle. That in itself can make a lot of difference.

Thanks for the input..however i’m only 19 so don’t know if I will use botox yet. I suppose I will either do subcision once more on one deeper scar I have and then just do Genius RF until I’m satisfied with Dr. Weiner I suppose? Maybe finish with some sort of laser and use tretinoin nightly. Also what are your thoughts on microneedling at 1.5/2mm on the forehead? I was microneedled by a nurse a couple years ago when I first developed scars and supposedly 1.5/2mm was used. Lately I’ve been skeptical that this caused my skin to atrophy more, but i’m thinking I’m just more paranoid than anything. If anything would I of just gotten some textural issues or prolonged redness from microneedling damage? I am a guy so I’ve heard my skin is a little bit thicker for whatever that’s worth.

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40 minutes ago, MP28 said:

Thanks for the input..however i’m only 19 so don’t know if I will use botox yet. I suppose I will either do subcision once more on one deeper scar I have and then just do Genius RF until I’m satisfied with Dr. Weiner I suppose? Maybe finish with some sort of laser and use tretinoin nightly.

First, I hope you understand why botox was suggested. The muscle in the forehead creates tension that pushes and pulls on the scar, making it look more worse than otherwise. Like I said above, forehead has very little skin and it should not be treated the same way as other areas.

I don't see why you should get Genius RF. It will not show much improvement, if any, on the forehead. You'd be pouring money down the drain (well, fattening Weiner's pocket for nothing). Save it for other treatments.

I think exfoliating the skin is good in the long run. In that regard, keep using tretinoin. You could also benefit from ablative laser or TCA as well.

 

3 hours ago, MP28 said:

Also what are your thoughts on microneedling at 1.5/2mm on the forehead? I was microneedled by a nurse a couple years ago when I first developed scars and supposedly 1.5/2mm was used.

It's definitely possible. 2 mm is probably not ideal for forehead.

Anyway, I wouldn't linger on it for too much. What's happened is done. You can't turn back the clock. Look forward instead. I'm sure better future is in store for you. This will be just one useless chapter in your life that you won't even bother thinking back on.

 

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