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Uhghatethis

Need more than needling and tret, any recs?

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I'm so sick of my skin. I've been microneedling every few months for a couple of years. Using tret for over 2 years. Doing lil peels here and there. 

I was close to doing infini but then decided not to because of the possibility of little improvement and facial fat loss. I was thinking subcision, but I don't know if I have the right scars for it. Does anyone have advice? How bad is it really? I'm thinking about seeing dr. Rullan. 

 

20200930_035941.jpg

Edited by Uhghatethis
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Need more pictures in different light angles to really see but from that single picture they look fairly superficial. Maybe 2-3 subcision with filler and infini after for texture.  I personally tried needing at home and used tret for almost 3 years thinking I could save money and unfortunately saw no real major difference.  If I could go back and start professional treatments sooner even just 1 per year I would.  I finally got my first subcision two months ago and while the difference isn't drastic there is certainly some softening.  I would also use this time to your advantage if possible.  Traveling for treatments and downtime will probably never be easier with facemasks being socially accepted.  

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My scars were your depth and I had improvement with Genius RF. No fat loss. You need an experienced operator and there isn't much concern with Genius. RF lifts but if you feel discontent with your texture you'll still need resurfacing. 

Resurfacing is a valid option. Rullan would be your go to. He would be able to assess if anything needs subcision prior.  

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12 hours ago, Uhghatethis said:

I was close to doing infini but then decided not to because of the possibility of little improvement and facial fat loss. I was thinking subcision, but I don't know if I have the right scars for it. Does anyone have advice? How bad is it really? I'm thinking about seeing dr. Rullan. 

 

The photo is too blurry/dark to see the pits. I have a feeling it's a lot worse in proper lighting. Can you take another snap using the instruction as follows? 

Angle-lighting approach is shown in the picture below. This will create a heavy shadow that will accentuate the scar for better evaluation. This can be done by pointing a bright light perpendicular to the angle of the lens. So if you're shooting the side of the face, you would point the light from either the front or the back of the face.

image.png.e235ad914ccddcb765af7612633aeacc.png

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2 hours ago, Sirius Lee said:

The photo is too blurry/dark to see the pits. I have a feeling it's a lot worse in proper lighting. Can you take another snap using the instruction as follows? 

Angle-lighting approach is shown in the picture below. This will create a heavy shadow that will accentuate the scar for better evaluation. This can be done by pointing a bright light perpendicular to the angle of the lens. So if you're shooting the side of the face, you would point the light from either the front or the back of the face.

image.png.e235ad914ccddcb765af7612633aeacc.png

Tried to get better lighting. Any thoughts? 

20200930_193202.jpg

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48 minutes ago, Uhghatethis said:

Tried to get better lighting. Any thoughts?

The photo isn't as clear as I like it to be, but you display a combination of rolling (atrophic) scars and icepick scars (and/or enlarged pores). From what I can tell, they' appear mild. Rolling scars, especially if they're tethered, are best treated with subcision. Icepicks are dealt with TCA Cross. One way to see if the scar is tethered, although not very accurate, is by pulling the skin back and see if the scar shape changes. If the scar is still visible, then it's highly likely the scar is tethered. But to really know if the scar is tethered, one would need to feel the skin. Also moderate rolling scar isn't usually tethered. In such a case, you will be better off with an energy device like Infini or the like. TCA Cross is done by applying 80%-100% TCA to the icepick/enlarged pores. You will require multiple treatments to see much improvement.

 

On a concluding note, it's always important to consider previous treatments you've had, so tell me in your reply if you've underwent any treatment.

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4 hours ago, Kay24 said:

My scars were your depth and I had improvement with Genius RF. No fat loss. You need an experienced operator and there isn't much concern with Genius. RF lifts but if you feel discontent with your texture you'll still need resurfacing. 

Resurfacing is a valid option. Rullan would be your go to. He would be able to assess if anything needs subcision prior.  

How much improvement do you got from infini?

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19 minutes ago, Sirius Lee said:

The photo isn't as clear as I like it to be, but you display a combination of rolling (atrophic) scars and icepick scars (and/or enlarged pores). From what I can tell, they' appear mild. Rolling scars, especially if they're tethered, are best treated with subcision. Icepicks are dealt with TCA Cross. One way to see if the scar is tethered, although not very accurate, is by pulling the skin back and see if the scar shape changes. If the scar is still visible, then it's highly likely the scar is tethered. But to really know if the scar is tethered, one would need to feel the skin. Also moderate rolling scar isn't usually tethered. In such a case, you will be better off with an energy device like Infini or the like. TCA Cross is done by applying 80%-100% TCA to the icepick/enlarged pores. You will require multiple treatments to see much improvement.

 

On a concluding note, it's always important to consider previous treatments you've had, so tell me in your reply if you've underwent any treatment.

Thanks for willingness to help, I really appreciate it.

So far I've done diy microneedling... for a few years. I felt like there was improvement up until last year, now it's kind of stagnated. I've used a roller, switched to a stamp, and now have an electric microneedling device. 

I've done some minor at home chemical peels from mua choice. Lactic & salicylic. I don't remember the percentages. 

I think for the most part they're rolling scars... and massive pores. 

Do you have recommendations for types of fillers that might work that wouldn't be permanent? 

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17 minutes ago, Uhghatethis said:

 

Thanks for willingness to help, I really appreciate it.

So far I've done diy microneedling... for a few years. I felt like there was improvement up until last year, now it's kind of stagnated. I've used a roller, switched to a stamp, and now have an electric microneedling device. 

I've done some minor at home chemical peels from mua choice. Lactic & salicylic. I don't remember the percentages. 

I think for the most part they're rolling scars... and massive pores. 

Do you have recommendations for types of fillers that might work that wouldn't be permanent? 

I hate fillers they dissolve and gives you false hope. 

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4 minutes ago, can i get a new life please said:

I hate fillers they dissolve and gives you false hope. 

It would be nice to have good skin, even if its temporary. I would continuously pay money to fix this. 

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31 minutes ago, Uhghatethis said:

Do you have recommendations for types of fillers that might work that wouldn't be permanent? 

Unfortunately, your scars are too extensive and fillers would not be of any help. Actually, it will only make it look more lumpy. The best thing to do at this time is to even out the scars as much as possible. 

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11 minutes ago, Sirius Lee said:

Unfortunately, your scars are too extensive and fillers would not be of any help. Actually, it will only make it look more lumpy. The best thing to do at this time is to even out the scars as much as possible. 

Bummer, do you think my skin will ever look normal? 

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1 hour ago, can i get a new life please said:

How much improvement do you got from infini?

50% after 3 treatments. I have the same exact scars as this individual, extensive but mild in depth. I have a handful of boxcars that are deeper and it was not as effective for those. I still desire a resurfacing. Not perfect but improved. 

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1 hour ago, Uhghatethis said:

Bummer, do you think my skin will ever look normal? 

100% improvement? No. But I'm willing to say over 50% or more. It won't be easy though. It will take many years of treatment. It will take a toll on your psyche and emotion. It will also drain your finance. However, if you stick around long enough, you'll see the end of the long dark tunnel, where once you thought none existed.

I suggest you start with subcision and TCA Cross. It's also worth remembering that it takes roughly 3 months for full collagen synthesis, so all your treatments should be scheduled 3 months apart. 

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22 minutes ago, Sirius Lee said:

100% improvement? No. But I'm willing to say over 50% or more. It won't be easy though. It will take many years of treatment. It will take a toll on your psyche and emotion. It will also drain your finance. However, if you stick around long enough, you'll see the end of the long dark tunnel, where once you thought none existed.

I suggest you start with subcision and TCA Cross. It's also worth remembering that it takes roughly 3 months for full collagen synthesis, so all your treatments should be scheduled 3 months apart. 

Thanks, Sirius.

Jw- Has anyone made a list of all of the providers who offer subcision in the US? I've looked for one on here and can't find anything like that. I have previously called around and even when it says someone does subcision on their website, they frequently dont. :( I'm thinking about Dr. Rullan, but if there are cheaper options with similar proficiency that would be ideal. 

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1 hour ago, Kay24 said:

50% after 3 treatments. I have the same exact scars as this individual, extensive but mild in depth. I have a handful of boxcars that are deeper and it was not as effective for those. I still desire a resurfacing. Not perfect but improved. 

Hi! Do you happen to have before and after pics you want to share? I would love to see!

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19 hours ago, Sirius Lee said:

100% improvement? No. But I'm willing to say over 50% or more. It won't be easy though. It will take many years of treatment. It will take a toll on your psyche and emotion. It will also drain your finance. However, if you stick around long enough, you'll see the end of the long dark tunnel, where once you thought none existed.

I suggest you start with subcision and TCA Cross. It's also worth remembering that it takes roughly 3 months for full collagen synthesis, so all your treatments should be scheduled 3 months apart. 

So when I pull my skin taught, or puff out my cheeks, most of them go away. Most of them are really shallow, the photo looks a lot worse than it actually looks irl. Do you think subcision would be the first route to go? If there are minimal bands to break up, do you think I could go in with genius or infini at the same time? Or should I still wait the 3 months? 

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3 hours ago, Uhghatethis said:

So when I pull my skin taught, or puff out my cheeks, most of them go away. Most of them are really shallow, the photo looks a lot worse than it actually looks irl. Do you think subcision would be the first route to go? If there are minimal bands to break up, do you think I could go in with genius or infini at the same time? Or should I still wait the 3 months? 

Well, like I said above, stretching the skin isn't all that accurate. But you do have a point. Shallow scars usually aren't tethered. So I don't think there's anything wrong with either skipping subcision altogether or getting it with another treatment like Infini concurrently. But here's the rub. You will never know for certain where the improvement came from. It could be from subcision or it could be from infini--or both. So bear that in mind going forward. I personally don't like mixing treatment, but whatever works for you.

 

 

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2 hours ago, Sirius Lee said:

Well, like I said above, stretching the skin isn't all that accurate. But you do have a point. Shallow scars usually aren't tethered. So I don't think there's anything wrong with either skipping subcision altogether or getting it with another treatment like Infini concurrently. But here's the rub. You will never know for certain where the improvement came from. It could be from subcision or it could be from infini--or both. So bear that in mind going forward. I personally don't like mixing treatment, but whatever works for you.

 

 

Thank you for all of your insight @Sirius Lee , I will update how it goes in a few weeks. 

Do you have before/after progress pics of yourself anywhere? How is everything going for you? 

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Okay, subcision is done. What the fuck. That was so uncomfortable. So much snapping and popping and pushing. It felt like 100 snaps. Ahhh. Some were somewhat painful, or just super uncomfortable.

She also did Lase MD afterwords to help with healing and try to minimize my pores. Hopefully it does, that would be so wonderful. 

Right now I look just like a younger chubbier version of myself. The swelling makes me look 15. I'm also bright red. My face stings, but it's not unbearable. 

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