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Seriously considering undergoing Facial fat transfer OR Phenol with Dr.Rullan in Aug 2021 (end of journey?)

 
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410
(@catharsis2018)

Posted : 06/17/2021 2:44 pm

Hi everyone. 

I have undergone a plethora of treatments at this point and my once atrophic scars are much near level now. Background: 27F in Canada, atrophic acne scarring on cheeks mainly. Skin type 3.4/4 (middle eastern descent)

I am stuck with lots of texture issues though and overall damaged skin. Trying to figure out the next treatment I should do. Considering both facial fat transfer or phenol. 

 

TREATMENT HISTORY: 

- blunt cannula subcision with dilute sculptra in September 2019, December 2019, February 2020
- infini RF (3 sessions) in summer 2020
- blunt cannula subcision with dilute Radiesse (3 sessions) in July 2020, October 2020, December 2020
- combination treatment in late December 2020 with tca cross, dilute Radiesse, CO2, v cannula subcision 
- profractional in early December 2020
- juvederm volite and cannula subcision in mid January 2021
- punch excision of at least 12 atrophic scars on each cheek on April 27 2021
- fully ablative erbium laser and 90% tca cross on May 5 2021
- restylane skinboosters vital light 
(2 syringes) on June 9 2021

Key Points: Infini RF and Profractional did zilch for me. I am looking to do Phenol because I™ve been reading people get most improvement in the cheek area and I™m at the end of my treatment journey (hopefully). Probably going to have some fillers after the phenol. But I am also thinking maybe I should consider a facial fat transfer to make up for The volume loss. 

Looking for others that have/are planning on getting phenol done soon/have some input on phenol with Rullan OR have had a facial fat graft / are considering it.

 

prior to subcision #1 in 2018:1CFE430D-D512-4BD6-89CD-12B3AAF16001.jpeg.f975c46cf944b565ec3c2ffa3b251f8f.jpegB7927DF3-5C13-4B30-9B3D-F4134ECE2C27.jpeg.5a7aa38ccc486e0379cff3cefdec57b0.jpeg

current face in 2021:E92F1C66-EDB0-4DE5-8785-CE0C52CEDE8F.jpeg.f64ae2dd161b28b612f143c216eadfd5.jpeg785E0F45-E854-44BF-95FE-896FF8DF4020.jpeg.c1f008115c02db64f66ee248627db735.jpeg

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(@catharsis2018)

Posted : 06/17/2021 4:50 pm

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

You need to level up the scars more, or phenol cant give you what you want

Really? What would you suggest

im not sure what else to do at this point. My derm has been talking a lot to me about being at the point of diminishing returns so Im thinking phenol is the best way to combat the texture issues. I have 13 excision PIH spots on each side of the cheek.

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(@getsmart121)

Posted : 06/17/2021 11:24 pm

6 hours ago, Catharsis2018 said:

Really? What would you suggest

im not sure what else to do at this point. My derm has been talking a lot to me about being at the point of diminishing returns so Im thinking phenol is the best way to combat the texture issues. I have 13 excision PIH spots on each side of the cheek.

Go with one more fully ablative erbium laser and maybe combine subcision in the same session. Sometimes the second time does the trick. Curettes used by dr rullan is similar to fully ablative laser as it removes the whole area wherever the laser hits. The laser can be adjusted as to how many microns you want to fully remove the skin.

Are you sure you had fully ablative laser treatment or fractional ablative treatment.

checkout dr Taylor from sale lake city Utah he combines subcision and erbium laser fractional and fully ablative in the same session. Or if you can find someone do it locally then great you could save some money.

 

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(@ikermourinho99gmail-com)

Posted : 06/18/2021 12:34 am

1 hour ago, getsmart121 said:

Go with one more fully ablative erbium laser and maybe combine subcision in the same session. Sometimes the second time does the trick. Curettes used by dr rullan is similar to fully ablative laser as it removes the whole area wherever the laser hits. The laser can be adjusted as to how many microns you want to fully remove the skin.

Are you sure you had fully ablative laser treatment or fractional ablative treatment.

checkout dr Taylor from sale lake city Utah he combines subcision and erbium laser fractional and fully ablative in the same session. Or if you can find someone do it locally then great you could save some money.

 

Why these doctors post this types of videos ? I dont care what are they doing , i wanna see before after - the results, who cares what he says. If he want to post such a video, why to post it online without results ?

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(@getsmart121)

Posted : 06/18/2021 1:21 am

44 minutes ago, Iker99 said:

Why these doctors post this types of videos ? I dont care what are they doing , i wanna see before after - the results, who cares what he says. If he want to post such a video, why to post it online without results ?

I agree on this there are some other video of him where he is posted before and after but the the thing is before and after are selected of the best patients. Anyways here is the video

 

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(@ikermourinho99gmail-com)

Posted : 06/18/2021 11:04 am

9 hours ago, getsmart121 said:

I agree on this there are some other video of him where he is posted before and after but the the thing is before and after are selected of the best patients. Anyways here is the video

 

Thanks man

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(@tantan42)

Posted : 06/18/2021 10:09 pm

I had phenol with rullan many years ago and was legit useless. I still have similiar scars to urs and tried so many approaches without noticeable results. My last option is subcision with cupping then doing fillers. You should do the same

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(@getsmart121)

Posted : 06/19/2021 11:07 am

12 hours ago, Tantan42 said:

I had phenol with rullan many years ago and was legit useless. I still have similiar scars to urs and tried so many approaches without noticeable results. My last option is subcision with cupping then doing fillers. You should do the same

Did you had phenol chemobrasion or phenol peel?

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657
(@miro)

Posted : 06/19/2021 12:32 pm

14 hours ago, Tantan42 said:

I had phenol with rullan many years ago and was legit useless. I still have similiar scars to urs and tried so many approaches without noticeable results. My last option is subcision with cupping then doing fillers. You should do the same

If scar is suitable for subc+ filler this is just best u can do , Its not permanent but while filler lasts it makes some scars almost disappear , u need to refill from time to time and find dr that is goodwith filling technique

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410
(@catharsis2018)

Posted : 06/20/2021 5:09 pm

On 6/19/2021 at 3:49 PM, can i get a new life please said:

Try at home microneedling i have a similar scars to yours it gives me good results. If you wanna get best results from phenol peel you need to make your scars looks like textural issues phenol cant penetrate the pitted scars it can work only surface scars.

I used to do a lot of Microneedling at home with the Derminator. But then I got worried that I made my overall texture worse and that I created more scarring

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(@catharsis2018)

Posted : 06/22/2021 10:30 pm

On 6/18/2021 at 11:09 PM, Tantan42 said:

I had phenol with rullan many years ago and was legit useless. I still have similiar scars to urs and tried so many approaches without noticeable results. My last option is subcision with cupping then doing fillers. You should do the same

Did you have a full 2-daychemabrasion?? and what is your skin type. Dr.Rullan's staff member (Amy) emailed me back to say i'm a great candidate for phenol....not sure what to think....

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(@Anonymous)

Posted : 06/23/2021 4:13 pm

17 hours ago, Catharsis2018 said:

Did you have a full 2-daychemabrasion?? and what is your skin type. Dr.Rullan's staff member (Amy) emailed me back to say i'm a great candidate for phenol....not sure what to think....

Did she say how much improvement you can get?

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(@Anonymous)

Posted : 06/23/2021 4:48 pm

I'm not trying to be mean but can you upload pictures with more similar light and angle? Maybe I'll see the improvement more clearly.

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(@catharsis2018)

Posted : 06/23/2021 11:11 pm

6 hours ago, versefifty said:

I'm not trying to be mean but can you upload pictures with more similar light and angle? Maybe I'll see the improvement more clearly. 

Here are some more of me last year, prior to punch excision and CO2 and Erbium. Most of my scars are much more shallow and filled in now C7C5BC1E-7875-4F87-A8E8-35D1ABCC7151.jpeg.d875eea343b0fab6719e2e60ffb8efe8.jpeg54F1A9BC-4633-4D4B-8FD2-FA73B683F951.jpeg.5c35a163e98fac84addcef0c4eea2b9f.jpegD12BDD7D-BA89-4826-A2DC-068347AB96C4.jpeg.fbf19c8c54e16c1f38891e5626e9c7ad.jpeg60BB1A71-238A-4290-B49A-B487238088BA.jpeg.f9898da9a229b34940774ab7c984d084.jpeg8F0F0DD9-5C4A-4949-917D-F800D5CAD0D7.jpeg.d0cca7f25ce295f5482fc48c958425a1.jpeg 

Versus now 0583AFB1-A321-4955-8BB0-7FBAFEF43D9F.jpeg.c7e37bb51412283ec29ec9ea4f540bb0.jpegA946A98D-CC54-416B-B455-A5942EC1EE5C.jpeg.8a0f4c9ef56a4b9b67cfbee341fcf967.jpegD5C93942-36D5-4927-BA60-99C34D2B6B98.jpeg.4f5b1c85faf1d9762cb2fff0f5063888.jpeg

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1353
(@getsmart121)

Posted : 06/24/2021 3:10 am

3 hours ago, Catharsis2018 said:

Here are some more of me last year, prior to punch excision and CO2 and Erbium. Most of my scars are much more shallow and filled in now C7C5BC1E-7875-4F87-A8E8-35D1ABCC7151.jpeg.d875eea343b0fab6719e2e60ffb8efe8.jpeg54F1A9BC-4633-4D4B-8FD2-FA73B683F951.jpeg.5c35a163e98fac84addcef0c4eea2b9f.jpegD12BDD7D-BA89-4826-A2DC-068347AB96C4.jpeg.fbf19c8c54e16c1f38891e5626e9c7ad.jpeg60BB1A71-238A-4290-B49A-B487238088BA.jpeg.f9898da9a229b34940774ab7c984d084.jpeg8F0F0DD9-5C4A-4949-917D-F800D5CAD0D7.jpeg.d0cca7f25ce295f5482fc48c958425a1.jpeg 

Versus now 0583AFB1-A321-4955-8BB0-7FBAFEF43D9F.jpeg.c7e37bb51412283ec29ec9ea4f540bb0.jpegA946A98D-CC54-416B-B455-A5942EC1EE5C.jpeg.8a0f4c9ef56a4b9b67cfbee341fcf967.jpegD5C93942-36D5-4927-BA60-99C34D2B6B98.jpeg.4f5b1c85faf1d9762cb2fff0f5063888.jpeg

You seem to be a good candidate for your phenol chemobrasion, if this is not ready then why get a phenol chemobrasion in the first place if it can™t even fix these hard to see scarring. My understanding of scarring if it is hard to see but needs bad lighting to show means you are ready for phenol chemobrasion. Others can correct me on this

@Sirius Lee. Is she ready for phenol chemobrasion?

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(@Anonymous)

Posted : 06/24/2021 3:32 am

Can you tell me more about your punch excision please? Are you happy with excision results? For what scars did you get improvement and how did you heal after, any linear scars left? ? Great improvement, btw.

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(@catharsis2018)

Posted : 06/24/2021 6:48 am

3 hours ago, JPK said:

Can you tell me more about your punch excision please? Are you happy with excision results? For what scars did you get improvement and how did you heal after, any linear scars left? ? Great improvement, btw. 

had punch excision of 12-13 atrophic scars on each cheek and I would do it again in a heartbeat. My texture has improved a lot and I definitely don™t have to deal with the horror of overhead lighting as much. Most scars look a lot better than they did before. Mind you, my dermatologist injected baby botox to each punch excision suture to minimize the chances of a hypertrophic scar forming. Unfortunately, it gave me a smile complication - where I have been unable to fully smile (my punch excision was on April 27 so it should be wearing off soon).but overall, I don™t think I regret the micro botox to each suture. Maybe a hypertrophic scar would have formed if I didn™t do that.
 

 I may even want to do more punch excisions in the future on some remaining atrophic scars. But I am not sure, last time my derm said he didn™t see anything worth excising. I may have gotten a bit obsessive about my acne scar treatments and seeking improvement lol. 

I will admit, having 12-13 sutures in each cheek for a week was obviously awkward lol had to avoid the public and keep mask on at all times xD .. also polysporin daily. 

interestingly, a lot of the scars filled in over time, like several weeks. I have all linear scars left, flat and pink/reddish but they have been fading over time and blending with the surrounding skin. Something I hated was the top lighting effect and how they made my scars look horrific. I don™t deal with that worry as much anymore / rarely. 

 

added some photos for reference - immediately after the procedure.5B9EE571-8558-4B04-8302-ED84045F0F14.jpeg.ed735bbfae8dc4ec42927a9d8e291ee1.jpeg15E0B81C-8FD4-43EC-968E-8FD98B266F6B.jpeg.f9e895587bd937dacfed1e2bb9136da6.jpeg

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(@Anonymous)

Posted : 06/24/2021 7:10 am

1 hour ago, Catharsis2018 said:

had punch excision of 12-13 atrophic scars on each cheek and I would do it again in a heartbeat. My texture has improved a lot and I definitely don™t have to deal with the horror of overhead lighting as much. Most scars look a lot better than they did before. Mind you, my dermatologist injected baby botox to each punch excision suture to minimize the chances of a hypertrophic scar forming. Unfortunately, it gave me a smile complication - where I have been unable to fully smile (my punch excision was on April 27 so it should be wearing off soon).but overall, I don™t think I regret the micro botox to each suture. Maybe a hypertrophic scar would have formed if I didn™t do that.
 

 I may even want to do more punch excisions in the future on some remaining atrophic scars. But I am not sure, last time my derm said he didn™t see anything worth excising. I may have gotten a bit obsessive about my acne scar treatments and seeking improvement lol. 

I will admit, having 12-13 sutures in each cheek for a week was obviously awkward lol had to avoid the public and keep mask on at all times xD .. also polysporin daily. 

interestingly, a lot of the scars filled in over time, like several weeks. I have all linear scars left, flat and pink/reddish but they have been fading over time and blending with the surrounding skin. Something I hated was the top lighting effect and how they made my scars look horrific. I don™t deal with that worry as much anymore / rarely. 

 

added some photos for reference - immediately after the procedure.5B9EE571-8558-4B04-8302-ED84045F0F14.jpeg.ed735bbfae8dc4ec42927a9d8e291ee1.jpeg15E0B81C-8FD4-43EC-968E-8FD98B266F6B.jpeg.f9e895587bd937dacfed1e2bb9136da6.jpeg

That's great Catharsis. So positive outcomes to hear gives me hope that I can improve my scars too. Excision also gives an immediate improvement after you heal unlike tca cross where you need at least 3-4 over time to see some difference. From what I've researched it's recommended for ice-picks and boxcar scars. Sorry I didn't quite understand what yours were that responded best. Did you get only ice picks excised? Or also boxcars? And how big in diameter or how deep were they? Do the scars need to be more or less surface level in order to be excised? Interesting idea with the botox microdroplets and hope that everything resolves quickly. Sorry for the many questions but I have some ice picks and a few small boxcars, as well as some bigger boxcars which might be good for excision I hope. I was thinking about getting tca cross repeatedly for those but it would mean waiting for a year for results and might go for excision. I've seen results on the internet here and there and people seem happy. 

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(@getsmart121)

Posted : 06/24/2021 11:34 am

4 hours ago, JPK said:

That's great Catharsis. So positive outcomes to hear gives me hope that I can improve my scars too. Excision also gives an immediate improvement after you heal unlike tca cross where you need at least 3-4 over time to see some difference. From what I've researched it's recommended for ice-picks and boxcar scars. Sorry I didn't quite understand what yours were that responded best. Did you get only ice picks excised? Or also boxcars? And how big in diameter or how deep were they? Do the scars need to be more or less surface level in order to be excised?Interesting idea with the botox microdroplets and hope that everything resolves quickly. Sorry for the many questions but I have some ice picks and a few small boxcars, as well as some bigger boxcars which might be good for excision I hope. I was thinking about getting tca cross repeatedly for those but it would mean waiting for a year for results andmight go for excision. I've seen results on the internet here and there and people seem happy.

I strongly believe any acne scar treatment should have excision as part of plan since every acne scar patient has a collection of bad scars that they look at when they look in mirror. Improving these gives a huge boost of confidence. But yeah not every scar need to be excised. Another strategycould be using absorbable sutures so that you can keep that in longer so that excision dont open prematurely

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(@Anonymous)

Posted : 06/24/2021 11:50 am

21 minutes ago, getsmart121 said:

I strongly believe any acne scar treatment should have excision as part of plan since every acne scar patient has a collection of bad scars that they look at when they look in mirror. Improving these gives a huge boost of confidence. But yeah not every scar need to be excised. Another strategycould be using absorbable sutures so that you can keep that in longer so that excision dont open prematurely

Did you have good experience with excision as well? A pro of excision would be the 100% improvement (minus the linear scar immediately after but it can be lasered eventually). You remove the ice pick scar en bloc. With tca cross or phenol cross you get incremental improvement, 15% with each treatments as people describe it, and you might end up with 80%, not a complete removal of the scar. Not to mention the risk of widening or hyperpigmentation.

I could really use the confidence boost of a successful scar treatment. It's been terrible on the psyche to get treatments which make your skin worse.

Here's a link I found on excision. The improvement is substantial. The photos seem ok as far as lighting and angle go..thoughts?

https://www.instagram.com/p/CEqzvvtAtQb/?utm_medium=copy_link

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(@getsmart121)

Posted : 06/24/2021 12:01 pm

4 minutes ago, JPK said:

Did you have good experience with excision as well? A pro of excision would be the 100% improvement (minus the linear scar immediately after but it can be lasered eventually). You remove the ice pick scar en bloc. With tca cross or phenol cross you get incremental improvement, 15% with each treatments as people describe it, and you might end up with 80%, not a complete removal of the scar. Not to mention the risk of widening or hyperpigmentation.

I could really use the confidence boost of a successful scar treatment. It's been terrible on the psyche to get treatments which make your skin worse.

Here's a link I found on excision. The improvement is substantial. The photos seem ok as far as lighting and angle go..

https://www.instagram.com/p/CEqzvvtAtQb/?utm_medium=copy_link

I personally had good experience with it but sometimes excision can open up as well and not close correctly so that is the risk but the good thing is you can excise it again if needed.only get thee deep ones excised icepick or boxcar scars. And sometimes you dont even need to excise the complete scar you for instance if a large boxcar you can break it into two excisions. Its not like we have a flawless skin anyways we modify the large boxcar into two thin lines and one shallow scar instead of a big excision line. Shallow scars no point in doing excisions. You would not any how notice it...

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(@amanda-hall)

Posted : 06/24/2021 12:01 pm

How many sessions of TCA Cross have you had? You've got some harsh borders on some scars and Cross seems like the best treatment to tackle that issue.

I've had TCA and Phenol Cross but haven't seen the results I wanted. But I'm also keeping in mind that it takes many treatments and ice pick scars are best.

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(@Anonymous)

Posted : 06/24/2021 12:19 pm

18 minutes ago, getsmart121 said:

I personally had good experience with it but sometimes excision can open up as well and not close correctly so that is the risk but the good thing is you can excise it again if needed.only get thee deep ones excised icepick or boxcar scars. And sometimes you dont even need to excise the complete scar you for instance if a large boxcar you can break it into two excisions. Its not like we have a flawless skin anyways we modify the large boxcar into two thin lines and one shallow scar instead of a big excision line. Shallow scars no point in doing excisions. You would not any how notice it...

I see

 

18 minutes ago, getsmart121 said:

I personally had good experience with it but sometimes excision can open up as well and not close correctly so that is the risk but the good thing is you can excise it again if needed.only get thee deep ones excised icepick or boxcar scars. And sometimes you dont even need to excise the complete scar you for instance if a large boxcar you can break it into two excisions. Its not like we have a flawless skin anyways we modify the large boxcar into two thin lines and one shallow scar instead of a big excision line. Shallow scars no point in doing excisions. You would not any how notice it...

I see. So another favourable outcome of excision! Do you feel comfortable sharing photos? Here or in a pm.

I am mostly considering excision for a few ice picks and small deeper boxcar scars. I think they are "the rate limiting" scars to get substantial improvement of my skin as Dr Lim coined the expression. On the rest of the ice picks and scarred pores I can get 3x tca cross with Dr Davide as planned.

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(@Anonymous)

Posted : 06/24/2021 1:05 pm

13 hours ago, Catharsis2018 said:

Here are some more of me last year, prior to punch excision and CO2 and Erbium. Most of my scars are much more shallow and filled in now C7C5BC1E-7875-4F87-A8E8-35D1ABCC7151.jpeg.d875eea343b0fab6719e2e60ffb8efe8.jpeg54F1A9BC-4633-4D4B-8FD2-FA73B683F951.jpeg.5c35a163e98fac84addcef0c4eea2b9f.jpegD12BDD7D-BA89-4826-A2DC-068347AB96C4.jpeg.fbf19c8c54e16c1f38891e5626e9c7ad.jpeg60BB1A71-238A-4290-B49A-B487238088BA.jpeg.f9898da9a229b34940774ab7c984d084.jpeg8F0F0DD9-5C4A-4949-917D-F800D5CAD0D7.jpeg.d0cca7f25ce295f5482fc48c958425a1.jpeg 

Versus now 0583AFB1-A321-4955-8BB0-7FBAFEF43D9F.jpeg.c7e37bb51412283ec29ec9ea4f540bb0.jpegA946A98D-CC54-416B-B455-A5942EC1EE5C.jpeg.8a0f4c9ef56a4b9b67cfbee341fcf967.jpegD5C93942-36D5-4927-BA60-99C34D2B6B98.jpeg.4f5b1c85faf1d9762cb2fff0f5063888.jpeg

Thanks a lot. Your skin has improved a great deal, especially the right side. I'll be following your phenol treatment should you decide to go for it. 

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(@keving100)

Posted : 06/24/2021 1:31 pm

14 hours ago, Catharsis2018 said:

Here are some more of me last year, prior to punch excision and CO2 and Erbium. Most of my scars are much more shallow and filled in now C7C5BC1E-7875-4F87-A8E8-35D1ABCC7151.jpeg.d875eea343b0fab6719e2e60ffb8efe8.jpeg54F1A9BC-4633-4D4B-8FD2-FA73B683F951.jpeg.5c35a163e98fac84addcef0c4eea2b9f.jpegD12BDD7D-BA89-4826-A2DC-068347AB96C4.jpeg.fbf19c8c54e16c1f38891e5626e9c7ad.jpeg60BB1A71-238A-4290-B49A-B487238088BA.jpeg.f9898da9a229b34940774ab7c984d084.jpeg8F0F0DD9-5C4A-4949-917D-F800D5CAD0D7.jpeg.d0cca7f25ce295f5482fc48c958425a1.jpeg 

Versus now 0583AFB1-A321-4955-8BB0-7FBAFEF43D9F.jpeg.c7e37bb51412283ec29ec9ea4f540bb0.jpegA946A98D-CC54-416B-B455-A5942EC1EE5C.jpeg.8a0f4c9ef56a4b9b67cfbee341fcf967.jpegD5C93942-36D5-4927-BA60-99C34D2B6B98.jpeg.4f5b1c85faf1d9762cb2fff0f5063888.jpeg

I would go with fully ablative erbium laser (Sciton Contour TRL) with 500-600 micron ablation with an expert doctor, rather then 2 day phenol chemabrasion

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