If your scars aren't that deep and have they show no noticeable borders, you could get away with just fillers. However, these pics are very blurry and I can't really comment until I see better pics.

So consider taking another picture using the angle-lighting approach as 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 (90-degree) 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.

Also don't shoot so close that it only shows the cheek. Try to include other parts of the face (eg. nose, mouth and/or ear). This will give better perspective of the scar size.

10 hours ago, Sirius Lee said:

If your scars aren't that deep and have they show no noticeable borders, you could get away with just fillers. However, these pics are very blurry and I can't really comment until I see better pics.

So consider taking another picture using the angle-lighting approach as 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 (90-degree) 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.

Also don't shoot so close that it only shows the cheek. Try to include other parts of the face (eg. nose, mouth and/or ear). This will give better perspective of the scar size.

 

 

Yeah these scars show noticeable border... Pics from different lighting how to treat this ( Mark one with orange color) scar? 

11 hours ago, Adroit dexter said:

Yeah these scars show noticeable border... Pics from different lighting how to treat this ( Mark one with orange color) scar?

You have a combination of boxcar and rolling scars coupled with fat loss.

My treatment protocol for scar treatment is pretty straightforward. Whatever scar type you might have, get rid of the scar edge first. No edge, no reflection. No reflection, less visibility. Try to smooth the edges as much as you can, then fill any remaining depressed area (eg. scar pit) with collagen boosters like RF microneedling, laser, or dermal filler, etc.

I would suggest you get subcision to release any tethers, followed by TCA cross to smooth out the edges. Rinse and repeat TCA cross every 3 months. Once the edges have been flattened enough, get fillers to lift up the pits.

BTW Don't get fillers while the edges are still visible.

7 hours ago, Sirius Lee said:

You have a combination of boxcar and rolling scars coupled with fat loss.

My treatment protocol for scar treatment is pretty straightforward. Whatever scar type you might have, get rid of the scar edge first. No edge, no reflection. No reflection, less visibility. Try to smooth the edges as much as you can, then fill any remaining depressed area (eg. scar pit) with collagen boosters like RF microneedling, laser, or dermal filler, etc.

I would suggest you get subcision to release any tethers, followed by TCA cross to smooth out the edges. Rinse and repeat TCA cross every 3 months. Once the edges have been flattened enough, get fillers to lift up the pits.

BTW Don't get fillers while the edges are still visible.

Thanks for advice but what kind of subcision should be done nokor, cannula or taylor laberator ? And which one is better fat grafting or filler ?

1 hour ago, Adroit dexter said:

Thanks for advice but what kind of subcision should be done nokor, cannula or taylor laberator ? And which one is better fat grafting or filler ?

Cannula should suffice. There are times when the scar bands are so thick that you must use nokor. However, these are usually very deep scars and your scars don't qualify for nokor IMO.

As for fillers, I would suggest temporary fillersat first, which you can reverse if you do not like the result. This is primarily to test the water to find the injector you can trust for the long haul. If you like what you see, you can move up to more permanent ones.

On a final note, I strongly suggest you look into TCA to smooth out those edges as mentioned in my earlier reply.

2 hours ago, Sirius Lee said:

Cannula should suffice. There are times when the scar bands are so thick that you must use nokor. However, these are usually very deep scars and your scars don't qualify for nokor IMO.

As for fillers, I would suggest temporary fillersat first, which you can reverse if you do not like the result. This is primarily to test the water to find the injector you can trust for the long haul. If you like what you see, you can move up to more permanent ones.

On a final note, I strongly suggest you look into TCA to smooth out those edges as mentioned in my earlier reply.

Yeah I will surely do tca cross but it should be done alone or combine with other treatments?

12 hours ago, Adroit dexter said:

Yeah I will surely do tca cross but it should be done alone or combine with other treatments?

You can get them together or separately, it's your call. It's probably more economical to get both though.

On 12/24/2020 at 1:41 AM, Sirius Lee said:

You can get them together or separately, it's your call. It's probably more economical to get both though.

Should I take treatment of punch excision, punch elevation and punch grafting before tca cross ( for tethered rolling scars)?

2 hours ago, Adroit dexter said:

Should I take treatment of punch excision, punch elevation and punch grafting before tca cross ( for tethered rolling scars)?

If you are really, really, really desperate and impatient, then punch excision/elevation/grafting can be an option (for your boxcars, not the rolling scars).

But, man, you need to reply in a timely manner. Otherwise, I would forget everything and have to re-read the whole thing, which ain't fun. Just saying.

I went to a number of plastic surgeons and dermatologists for my scars. Only one of them recommended fat transfer. Based on this, it's hard for me to recommend that. Subcision is definitely cheaper and more predictable, and there are way more cases of that than fat transfers on this forum.

Because of your dark skin, I would be cautious about do excisions because you may be left with visible linear scars. The purpose of this procedure is to go from one scar (not so good looking) to another (better looking). It's not as simple as excising and lasering. This works for some people but not others. In darker skin, you may have more issues including PIH.

Bellafill is the best bang for the buck but it's semi-permanent. Some doctors suggest that you get fillers that will eventually all dissolve to see if you like the result first.

5 hours ago, Sirius Lee said:

If you are really, really, really desperate and impatient, then punch excision/elevation/grafting can be an option (for your boxcars, not the rolling scars).

But, man, you need to reply in a timely manner. Otherwise, I would forget everything and have to re-read the whole thing, which ain't fun. Just saying.

Really really sorry for delaying replay... As u said I have to take treatment of tca cross but how many sessions of tca cross should be done? And what should be duration between two settings of tca cross?... And last one which one is better phenol cross or tca cross for my scars.... My aim is to reduce rolling scars first then look after other one's....

10 hours ago, Adroit dexter said:

As u said I have to take treatment of tca cross but how many sessions of tca cross should be done?

Before I answer your question, do you know why I'm suggesting TCA? It's to soften the scar edges, especially for the boxcars. When the light bounces off the scar borders, it makes the scars really stand out. This is why in certain angles, the scars are more visible.

Per your question, it depends on how well your skin reacts to the treatment. It can be as low as 3 or 4, or much higher.

10 hours ago, Adroit dexter said:

And what should be duration between two settings of tca cross?

Get treatment every 3 months.

10 hours ago, Adroit dexter said:

And last one which one is better phenol cross or tca cross for my scars

I'm not qualified to comment about Phenol since I've only used TCA.

One of the supposed benefites of phenol, according to Dr Rullan, is that it won't widen scars. However, some board members here claim otherwise. They say it does widen scars. So go figure.

That said, TCA can also widen scars. Not always, but sometimes.

But that's the whole point of scar remodeling. If you think scars will magically disappear without a hiccup, you're too naive. On that note, any treatment (laser, microneedling, chemical peels, etc) can possibly widen your scar.That is howthescar remodelingsupposed to work. During the scar remodeling phase, the scars will literally change shape. As the scar pit gets filled over time, the floor will get pushed up. This will further add tension and pressure to the scar edge, pushing it outward, and likely making the scar widen.

10 hours ago, Adroit dexter said:

My aim is to reduce rolling scars first then look after other one's....

I beg to differ.

Rolling scars are pretty easy to treat in comparison to other scars.Boxcars with their prominent edges are the real killers.

Here's the game plan. Get rid of any hard boxcar edges first. Once these edges have flattened enough, the boxcar will look more like a rolling scar. At that time, even out the skin texture with dermal filler. This will effectively elevate any undulation from rolling scars.

Good luck.

4 hours ago, Sirius Lee said:

Before I answer your question, do you know why I'm suggesting TCA? It's to soften the scar edges, especially for the boxcars. When the light bounces off the scar borders, it makes the scars really stand out. This is why in certain angles, the scars are more visible.

Per your question, it depends on how well your skin reacts to the treatment. It can be as low as 3 or 4, or much higher.

Get treatment every 3 months.

I'm not qualified to comment about Phenol since I've only used TCA.

One of the supposed benefites of phenol, according to Dr Rullan, is that it won't widen scars. However, some board members here claim otherwise. They say it does widen scars. So go figure.

That said, TCA can also widen scars. Not always, but sometimes.

But that's the whole point of scar remodeling. If you think scars will magically disappear without a hiccup, you're too naive. On that note, any treatment (laser, microneedling, chemical peels, etc) can possibly widen your scar.That is howthescar remodelingsupposed to work. During the scar remodeling phase, the scars will literally change shape. As the scar pit gets filled over time, the floor will get pushed up. This will further add tension and pressure to the scar edge, pushing it outward, and likely making the scar widen.

I beg to differ.

Rolling scars are pretty easy to treat in comparison to other scars.Boxcars with their prominent edges are the real killers.

Here's the game plan. Get rid of any hard boxcar edges first. Once these edges have flattened enough, the boxcar will look more like a rolling scar. At that time, even out the skin texture with dermal filler. This will effectively elevate any undulation from rolling scars.

Good luck.

Can i combine tca cross treatment with subcision and fractional co2 laser or any other treatment?

2 hours ago, Adroit dexter said:

Can i combine tca cross treatment with subcision and fractional co2 laser or any other treatment?

Yes, you can combine with other treatments, but I personally don't believe multi-modality is any more effective than single-modality. It just costs significantly more.