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Upset Lady

Asian Lady with severe acne scars, need opinion for sutaible treatment (New Photo Included)

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i have severe acne scsrs due to my oily skin and i would like to get advice from my few wuestions below:

a) Major scars type? rolling or boxcar?

b) Doctor advice to go through

i) 3x Genius RF microneedling+ subsicion+ filler

ii) eCO2 + subcision

will the above treatment works for my scar type?Do i need to do i) or ii) treatment in 1 short? 

if i choose to insert filler, what would be recomended and any cons after injecting filler as i understand filler might move around

c) should i first raised the pitted scars using subcision and filler then only stsrt to level surface scars? another reason asking this is that doctor told me i might hv outbreak after treatment

d) what is the after care treatment/skincare to heel the skin faster/build collagen?

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Edited by Upset Lady
added new photos
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4 hours ago, Upset Lady said:

a) Major scars type? rolling or boxcar?

While you have all 3 scar types (icepick, boxcar and rolling scars), it's predominantly rolling scar. However, these pictures really don't show the depth very well so it could be quite different. I would ask you to take another set of photos using the angled lighting approach as outlined below.*

 

4 hours ago, Upset Lady said:

b) Doctor advice to go through

i) 3x Genius RF microneedling+ subsicion+ filler

ii) eCO2 + subcision

will the above treatment works for my scar type?Do i need to do i) or ii) treatment in 1 short? 

if i choose to insert filler, what would be recomended and any cons after injecting filler as i understand filler might move around

Subcision is indeed the treatment of choice for rolling scars, but only when they appear tethered. Tethered scars are, for the most part, severely indented scars. Yours, on the other hand, is considered shallow and does not appear tethered. So I don't believe you'd get much improvement.

RF micro and CO2 might be more beneficial for you since they help with volumization through collagen production. However, they might not be enough (your body can only make so much collagen), not to mention that they're expensive.

My preferred method to scar revision is not to make more collagen but to eliminate any source that could accentuate the scar. One thing that definitely accentuates the scar is the scar border. When the light hits the edge, the scar becomes glaringly noticeable. Hence by getting rid of the edge, no reflection. And no reflection means no scar.

The best way to do this is with TCA. Depending on how well you react, you will need multiple applications over multiple years. This is mainly because you will need to space out the treatments to every 3 months, which is the ideal length for collagen formation

Once the edges have been sufficiently flattened, then I suggest dermal fillers to elevate any remaining indents. (Per filler migration, it's not something that happens very often so no worries.)

BTW TCA will also help with your oily skin.

 

4 hours ago, Upset Lady said:

c) should i first raised the pitted scars using subcision and filler then only stsrt to level surface scars? another reason asking this is that doctor told me i might hv outbreak after treatment

See above.

 

4 hours ago, Upset Lady said:

d) what is the after care treatment/skincare to heel the skin faster/build collagen?

You can take Vitamin C and Zinc. Topically, I suggest Vaseline or Aquaphor. No, unlike what others say, these will not make you break out. Most importantly, drink a lot of water.

One last note: Your skin is super oily for a reason. It could be the diet or your lifestyle. But the biggest culprit is likely what you apply on the face. Every skin product we buy contains some traces of toxin (preservative, coloring, etc). The less you apply, the better.

Hope that helps.

 

____________________________

* I can see the scars, but I can't really tell how deep they are. Can you take another pic, this time considering the instruction outlined below?

Consider taking a 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.

 

image.png.e235ad914ccddcb765af7612633aeacc.png

 

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9 hours ago, Upset Lady said:

Hi Sirius, will this be better?

 

Thanks for those pics. You have a combination of boxcar and rolling scars. Everything I stated above is still applicable. Repeat TCA cross every 3 months to fade out the scar edges. When the scars begin to look more like shallow rolling scars (see the pic below), fill the divots with dermal filler.

 

image.png.5f7857a06f4e53cfa283f003dfc409f5.png

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7 hours ago, Sirius Lee said:

Thanks for those pics. You have a combination of boxcar and rolling scars. Everything I stated above is still applicable. Repeat TCA cross every 3 months to fade out the scar edges. When the scars begin to look more like shallow rolling scars (see the pic below), fill the divots with dermal filler.

 

image.png.5f7857a06f4e53cfa283f003dfc409f5.png

Thanks Sirius...based on the photos is my scars tethered abd indented or just shallow abd does not appear tethered?

so the advice is to go through

1) subcision alone to raise the scar first? might required few sessions?

2) TCA to lighted the edge of the scars?

3) after 1 & 2 is done where scars is lessen...spare 1-2 weeks before adding filler? the type of filler recommended by clinic is smthg called PDRN, is it safe? what are the better choice?

4) Heard that chinese cupping after subcision is not a bad choice also. is this workable? if i do chinese cupping it can be perform 3 days after subcision and does it act as a steps to avoid scars to reattach?

5)  If still not perfect can consider Genius RF Microneedling is still needed? or eCO2 laser will be a better choice? 

6) Lastly, those at home microneedling like Dr pen will it help like maintainence after i’m happy with the results of the treatment? i was thinking to get 1

sorry for the lengthy questions. Hope to hear from you soon. 

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14 hours ago, Upset Lady said:

Thanks Sirius...based on the photos is my scars tethered abd indented or just shallow abd does not appear tethered?

1) subcision alone to raise the scar first? might required few sessions?

2) TCA to lighted the edge of the scars?

Yes, some scars look tethered, but I suggest you start with TCA. Try to smooth the edge as much as possible. Then you can get subcision and filler.

 

14 hours ago, Upset Lady said:

3) after 1 & 2 is done where scars is lessen...spare 1-2 weeks before adding filler? the type of filler recommended by clinic is smthg called PDRN, is it safe? what are the better choice?

Sorry, I don't know this particular product.

14 hours ago, Upset Lady said:

5)  If still not perfect can consider Genius RF Microneedling is still needed? or eCO2 laser will be a better choice? 

6) Lastly, those at home microneedling like Dr pen will it help like maintainence after i’m happy with the results of the treatment? i was thinking to get 1

No, don't get RF micro or eCO2. Maybe after you flatten the edges but not now.

You can do dermapens every 4-6 weeks at 1.5 mm (cheeks) ,1.0 mm (temples). This is only to exfoliate skin faster. It won't do anything for the scar.

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