Notifications
Clear all

[ONGOING POST] Scar revision treatment diary - Asian / 20s / USA

MemberMember
3
(@ashley-pomelogmail-com)

Posted : 06/21/2021 10:30 pm

Hi everyone - I thought I should document the progress on my acne scars on this forum as I continue to get treatments. Compared to a lot of you, I feel like a relative noob to all of this. However, I have gone to half a dozen Drs and tried tens of thousands of dollars of treatments by this point, so hopefully I have something of value to share here. My goal for these posts is so that none of you make the same mistakes that I have made.

 

My acne history

  • Age 12 - mid-20s: cystic acne, concentrated on cheeks and temples. When I was younger, I had large cystic pustules that resulted in scarring. As I aged, the acne became tamer, but began appearing around my jawline and upper neck.
    • Treatments (various): Everything under the sun, including Chinese traditional medicine (herbs), acupuncture, acupressure, Chinese traditional medicine facials, topical antibiotics, oral antibiotics, aesthetic LED & oxygen facials, topical tretinoin (OTC), benzoyl peroxide (prescribed)
    • Outcomes: Everything I tried helped a little, but never *fixed* my acne. My mom was against Accutane, so that was never in question when she brought me to the ONE derm we saw when growing up (that ONE derm took a 10-sec look at me, prescribed benzoyl peroxide, and called it a day). She believed that we should go the traditional Chinese medicine route, since she thought something was *wrong* with my diet/lifestyle - this is the reason why we never sought out reputable dermatologists to help me.
  • Mid-20s: occasional acne around my jaw and upper neck. By this point, I was working and in a big metropolitan city, so I took it upon myself to seek out treatment (finally!)
    • Treatment #1: Spironolactone (oral)
      • Outcome: Helped with my acne by 30~%. However, I still had pimples around my jaw and upper neck that still were not clearing
    • Treatment #2: Accutane (oral - 9 months)
      • Outcome: It completely cleared my acne. I was also on the Spiro during my Accutane treatment. It made me very dry - I would be using chapstick 24 hours a day, and woke up with dry eyes every morning. However, it did work.
      • Dr recommended that I wait 6 months after stopping Accutane to start scar revision treatments
  • Now: I have rollingboxcar, and a lot of icepick scars. They are most heavily concentrated in the middle of my cheeks. I have depressed scars on my temples as well. What bothers me most about my scars are the icepick and boxcar scars - they are the most visible on my face and look like enlarged pores. I have Asian skin, which is thicker and more prone to pigmentation.

 

My acne scar revision history (a work in progress!)

The way I'm going to structure this section is by DOCTOR, and in CHRONOLOGICAL order.

Pre-1st Doctor - Dr Iforgothername (2017)

  • Treatment plan: Picosure laser
  • Treatments done: 1x Picosure laser to cheeks + temples
  • because I wanted another opinion; also the Dr did not treat patients with my skin tone much

2nd Doctor - Dr Gr (2019 - 2020)

  • Treatment plan: E-matrix for scar texture; Dermal fillers for lost facial volume; Vbeam for redness
  • Treatments done:
    • E-matrix - 5 sessions spaced 1month apart - WOULD NOT RECOMMEND. The Dr basically had me on a never-ending treatment plan with E-matrix. I noticed that she heavily advertises the Ematrix laser on her Realself, which makes me question whether she really does believe in it as a technology or if she'd been bought. After 5 sessions, each of which had a 3-5 day downtime, I saw almost no improvement from baseline. Maybe this technology works for other skin types, but it was just a huge waste of money for me. Other doctors I consulted with shat on E-matrix as a treatment option, saying they didn't find it helpful for patients themselves.
    • V-beam - 4 sessions spaced 1month apart - JUST OKAY NOT SUPER NOTICEABLE. Vbeam is supposed to help with red pigmentation from acne scars; I found these treatments to have helped a little, but not noticeable enough to really justify the price.
    • Dermal fillers (Voluma) - 2 sessions spaced 6 months apart - OKAY COSMETIC TREATMENT FOR SUNKEN CHEEKS. I did like the look of the dermal filler in my cheeks, but it was really expensive doing filler so I ended up doing a fat graft to my cheeks with a plastic surgeon later on for a more permanent solution
  •  Because subcision on the temples is a delicate procedure with potential complications involving blindness, I didn't want to risk it with a doc who isn't forthcoming on his training.
  • Cost: $350 for consult

4th Doctor - Dr G (2021)

  • Treatment plan: Infini RF, "as many as I want"
  • Treatments done: 1x Infini RF session
  • TO BE CONTINUED

 

PROGRESSION PICTURES - right cheek

Apologies angles & lighting not consistent. I'm trying to get better at that!

AO_1508.jpg.1a7aa6e541b995d177a2fe91e9f25f97.jpg

ABOVE - 2015: acne in my early 20s (2015); unfortunately don't have earlier photos of my really bad cystic acne because I didn't feel comfortable with my skin in my teens

AO_1907.jpg.fe9eaf4629c5d30df2891a5560ed4fda.jpg

ABOVE - 2020: scarring in my mid-20s (2020), after finishing Accutane. Not visible is the shallow rolling scars. Still on Spiro

AO_2105a.jpg.415d4788538c12127d67aebf1d50f261.jpg

ABOVE - 2021 May: skin texture after 5 e-matrix treatments (7 months post), 4 v-beam treatments, 2 dermal fillers

AO_2106.jpg.7eb36cb9dd14d23698ce4c03e1d10e31.jpg

ABOVE - 2021 June: LEFT cheek after 1 Infini RF treatment, 5 days post-op. The doctor did not cleanse my face before starting the procedure, leading to a bacterial breakout.

Quote
MemberMember
410
(@catharsis2018)

Posted : 06/21/2021 10:47 pm

Thanks for sharing your treatment progress. Can you share a bit more about the fat graft you had? mainly did you find the fat transfer to the cheeks worth it, how much improvement you saw + how much fat remains after the transfer?

Quote
MemberMember
657
(@miro)

Posted : 06/22/2021 3:35 am

5 hours ago, brused_banana said:

Hi everyone - I thought I should document the progress on my acne scars on this forum as I continue to get treatments. Compared to a lot of you, I feel like a relative noob to all of this. However, I have gone to half a dozen Drs and tried tens of thousands of dollars of treatments by this point, so hopefully I have something of value to share here. My goal for these posts is so that none of you make the same mistakes that I have made.

 

My acne history

  • Age 12 - mid-20s: cystic acne, concentrated on cheeks and temples. When I was younger, I had large cystic pustules that resulted in scarring. As I aged, the acne became tamer, but began appearing around my jawline and upper neck.
    • Treatments (various): Everything under the sun, including Chinese traditional medicine (herbs), acupuncture, acupressure, Chinese traditional medicine facials, topical antibiotics, oral antibiotics, aesthetic LED & oxygen facials, topical tretinoin (OTC), benzoyl peroxide (prescribed)
    • Outcomes: Everything I tried helped a little, but never *fixed* my acne. My mom was against Accutane, so that was never in question when she brought me to the ONE derm we saw when growing up (that ONE derm took a 10-sec look at me, prescribed benzoyl peroxide, and called it a day). She believed that we should go the traditional Chinese medicine route, since she thought something was *wrong* with my diet/lifestyle - this is the reason why we never sought out reputable dermatologists to help me.
  • Mid-20s: occasional acne around my jaw and upper neck. By this point, I was working and in a big metropolitan city, so I took it upon myself to seek out treatment (finally!)
    • Treatment #1: Spironolactone (oral)
      • Outcome: Helped with my acne by 30~%. However, I still had pimples around my jaw and upper neck that still were not clearing
    • Treatment #2: Accutane (oral - 9 months)
      • Outcome: It completely cleared my acne. I was also on the Spiro during my Accutane treatment. It made me very dry - I would be using chapstick 24 hours a day, and woke up with dry eyes every morning. However, it did work.
      • Dr recommended that I wait 6 months after stopping Accutane to start scar revision treatments
  • Now: I have rollingboxcar, and a lot of icepick scars. They are most heavily concentrated in the middle of my cheeks. I have depressed scars on my temples as well. What bothers me most about my scars are the icepick and boxcar scars - they are the most visible on my face and look like enlarged pores. I have Asian skin, which is thicker and more prone to pigmentation.

 

My acne scar revision history (a work in progress!)

The way I'm going to structure this section is by DOCTOR, and in CHRONOLOGICAL order.

Pre-1st Doctor - Dr Iforgothername (2017)

  • Treatment plan: Picosure laser
  • Treatments done: 1x Picosure laser to cheeks + temples
  • because I wanted another opinion; also the Dr did not treat patients with my skin tone much

2nd Doctor - Dr Gr (2019 - 2020)

  • Treatment plan: E-matrix for scar texture; Dermal fillers for lost facial volume; Vbeam for redness
  • Treatments done:
    • E-matrix - 5 sessions spaced 1month apart - WOULD NOT RECOMMEND. The Dr basically had me on a never-ending treatment plan with E-matrix. I noticed that she heavily advertises the Ematrix laser on her Realself, which makes me question whether she really does believe in it as a technology or if she'd been bought. After 5 sessions, each of which had a 3-5 day downtime, I saw almost no improvement from baseline. Maybe this technology works for other skin types, but it was just a huge waste of money for me. Other doctors I consulted with shat on E-matrix as a treatment option, saying they didn't find it helpful for patients themselves.
    • V-beam - 4 sessions spaced 1month apart - JUST OKAY NOT SUPER NOTICEABLE. Vbeam is supposed to help with red pigmentation from acne scars; I found these treatments to have helped a little, but not noticeable enough to really justify the price.
    • Dermal fillers (Voluma) - 2 sessions spaced 6 months apart - OKAY COSMETIC TREATMENT FOR SUNKEN CHEEKS. I did like the look of the dermal filler in my cheeks, but it was really expensive doing filler so I ended up doing a fat graft to my cheeks with a plastic surgeon later on for a more permanent solution
  •  Because subcision on the temples is a delicate procedure with potential complications involving blindness, I didn't want to risk it with a doc who isn't forthcoming on his training.
  • Cost: $350 for consult

4th Doctor - Dr G (2021)

  • Treatment plan: Infini RF, "as many as I want"
  • Treatments done: 1x Infini RF session
  • TO BE CONTINUED

 

PROGRESSION PICTURES - right cheek

Apologies angles & lighting not consistent. I'm trying to get better at that!

AO_1508.jpg.1a7aa6e541b995d177a2fe91e9f25f97.jpg

ABOVE - 2015: acne in my early 20s (2015); unfortunately don't have earlier photos of my really bad cystic acne because I didn't feel comfortable with my skin in my teens

AO_1907.jpg.fe9eaf4629c5d30df2891a5560ed4fda.jpg

ABOVE - 2020: scarring in my mid-20s (2020), after finishing Accutane. Not visible is the shallow rolling scars. Still on Spiro

AO_2105a.jpg.415d4788538c12127d67aebf1d50f261.jpg

ABOVE - 2021 May: skin texture after 5 e-matrix treatments (7 months post), 4 v-beam treatments, 2 dermal fillers

AO_2106.jpg.7eb36cb9dd14d23698ce4c03e1d10e31.jpg

ABOVE - 2021 June: LEFT cheek after 1 Infini RF treatment, 5 days post-op. The doctor did not cleanse my face before starting the procedure, leading to a bacterial breakout.

U could have bought house instead lol , Thats a lot of money , are from USA ?

Quote
MemberMember
3
(@ashley-pomelogmail-com)

Posted : 06/22/2021 10:04 am

6 hours ago, Miro said:

U could have bought house instead lol , Thats a lotof money , are from USA ?

Yup! In New York City - probably the most expensive city (not proud of it ha) in North America for these treatments. I'd much rather be near SoCal for this, since there seems to be way more Drs who specialize in scar treatments / Asian skin.

11 hours ago, Catharsis2018 said:

Thanks for sharing your treatment progress. Can you share a bit more about the fat graft you had? mainly did you find the fat transfer to the cheeks worth it, how much improvement you saw + how much fat remains after the transfer?

I chose fat graft since I was tired of spending so much $ on temporary facial fillers, which I did like. Honestly I feel like the facial filler recommendation by Dr Gr was a ploy to get a continuous income stream out of me. If she hadn't recommended the facial fillers with HA fillers, I'd never in a million years thought I'd try fillers.

Anyway, the fat graft was great. It does what the HA fillers do but on a more permanent basis.

Procedure for fat grafting to the cheeks:

  • Liposuction from stomach - I had some other cosmetic things done with the plastic surgeon as well, so I was fully anesthetized
  • Insertion of fat to cheek - after Dr purified the fat, she used a small gauge needle and injected fat to the apples of my cheeks via an insertion point near the base of my 2 nostrils
  • Scarring - none on face. There are 2 small 5mm (.25") scars on my hip, where the Dr inserted the needle to lipo the fat. They are very subtle and can be easily lasered away.

Cost:

  • $2000 for the procedure, not including operating room fees and anesthesia
  • I believe this procedure can be done in-office; I went under because I had other things done at the same time

I'm very happy with the fat graft to the cheeks. It's very subtle, but I know that compared to pics of my face from years ago (when I had active acne), my cheeks look a lot fuller. I also like how the procedure is marginally more expensive than 1-2 vials of filler.

Quote
MemberMember
46
(@flooressence)

Posted : 06/22/2021 10:26 am

This is a beautifully formatted post and its nice to read a unique journey with interesting treatments. Be sure to keep updating it!

I have to say though, your skin looks really smooth and the scarring now seemingly very minor. What are your current goals? I don't want to downplay any negative affect from your scars, and perhaps your skin looks worse IRL than in the pics, but it doesn't seem worth it to pay such prices for treatments with how good your skin is. Again, maybe the photos don't tell the whole picture, or money isn't an issue for you, but I just want you to know your skin looks good! In case you were struggling with any self conscious concerns or even issues with vanity.

I've been paying about $30 USD for subcision and $50 for vbeam, but this is Australia and the government health care subsidises a large chunk of it / dermatologists don't seem to be as profit-oriented here. The idea of paying $3200 for 4 V-Beams is nuts.

Quote
MemberMember
657
(@miro)

Posted : 06/22/2021 12:20 pm

Have u also visited dr Emer ?

Quote
MemberMember
108
(@de-rerum-natura)

Posted : 06/22/2021 5:13 pm

Your topic is very well done and summarized. Im sorry youve been through so many shit inyour journey, probably we all can relate how unethical and unprepared most of the dermatologists or surgeons can be regards acne scar treatments.

Your skin does not look bad and your scars are not severe, u should find your way to improve it eventually. Iwould suggest TCA cross on the boxscars/ice pick ones.

I will follow your journey now on, good luck.

Quote
MemberMember
195
(@gynoscar)

Posted : 06/22/2021 8:02 pm

Agreed with everyone that your scars aren't severe or even bad at all. You are your worst critic. If you can work on the redness, most people probably won't even notice them to be honest.

 

Quote
MemberMember
3
(@ashley-pomelogmail-com)

Posted : 06/24/2021 3:54 pm

On 6/22/2021 at 11:26 AM, Flooressence said:

This is a beautifully formatted post and its nice to read a unique journey with interesting treatments. Be sure to keep updating it!

I have to say though, your skin looks really smooth and the scarring now seemingly very minor. What are your current goals? I don't want to downplay any negative affect from your scars, and perhaps your skin looks worse IRL than in the pics, but it doesn't seem worth it to pay such prices for treatments with how good your skin is. Again, maybe the photos don't tell the whole picture, or money isn't an issue for you, but I just want you to know your skin looks good! In case you were struggling with any self conscious concerns or even issues with vanity.

I've been paying about $30 USD for subcision and $50 for vbeam, but this is Australia and the government health care subsidises a large chunk of it / dermatologists don't seem to be as profit-oriented here. The idea of paying $3200 for 4 V-Beams is nuts.

@Flooressencethank you for this info!! Yes, it's absolutely crazy the amount derms charge here in the NYC area. Acne scarring is not considered 'medical' in the USA,so there are no insurance benefits for these treatments (unlike the treatment of acne, which was reimbursable with insurance). I can't believe you are paying $30-50 for your skin treatments!!

And yes, I realize too that my skin isn't as bad as I think it looks. My boyfriend tells me every time he doesn't even notice scarring. My current goal is to try to ameliorate the boxcar and ice pick scars as much as I can - my personal timeline is that I'll continue with acne scar treatments until I'm 30, at which point I'll switch over to anti-aging treatments. I agree with you this is a lot of $$ to be spending on 85% 'good' skin, but my mindset is if I can continue to improve at all, I'll continue trying!

On 6/22/2021 at 1:20 PM, Miro said:

Have u also visited dr Emer ?

Nope I have not! I've only looked at east coast Drs. Have you any experience with him?

On 6/22/2021 at 6:13 PM, De Rerum Natura said:

Your topic is very well done and summarized. Im sorry youve been through so many shit inyour journey, probably we all can relate how unethical and unprepared most of the dermatologists or surgeons can be regards acne scar treatments.

Your skin does not look bad and your scars are not severe, u should find your way to improve it eventually. Iwould suggest TCA cross on the boxscars/ice pick ones.

I will follow your journey now on, good luck.

Thanks! Yes - soooo much pain, wasted time, and social downtime. I believe the Dr who did my subcision also does TCA cross - I'll ask her next time if she would recommend doing it for me.

On 6/22/2021 at 9:02 PM, gynoscar said:

Agreed with everyone that your scars aren't severe or even bad at all. You are your worst critic. If you can work on the redness, most people probably won't even notice them to be honest.

 

Thanks for the feedback! In this lighting it def look like there's a lot of redness. After my subcision swelling goes down I'll re-evaluate whether I'll keep working on that redness!

Quote