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JYSLA

Seeking advice for treatment and doctor rec!

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Hi all!

 

I stumbled across this forum few days ago searching for acne scar treatments and blown from all the info, experiences, and resources shared in this forum. You guys are amazing!

 

I was hoping to get advice and input on treatment options and doctor recommendation.

 

I received my first TCA cross procedure by Dr. Ben Behnam last week, and he recommended that I do a round of TCA+Subcission+PRK next session.

However upon reading the forum I see that Dr. Russell seems to be another very experienced doctor in this field and many of you have experience with Dr. Russell.

I have attached pictures for reference and I was wondering if Phenol Cross would be a better treatment option vs TCA Cross for my type of scar.

Also, I see that Dr. Russell like to include microneedling for his “Trio” procedure. Is this a set procedure or does he personalize for each patient?

I have gotten numerous microneedling previously with no improvement as the needles don’t reach deep enough for my scars.

I am leaning towards Dr. Russell as he is most mentioned here in this forum with good results, and would appreciate your thoughts/input.

Thanks in advance!

 

20210715_130006.jpg

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The only thing I have to add is that your scars look more boxcar than icepick to me, at least some of them. So a combination of TCA CROSS (for the icepick scars) and other procedures for the boxcar ones seems to make sense. 

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Where is Dr. Russell based?

I agree with Dan. TCA Cross is the treatment that would best smooth out the harsh borders of your scars. 

Dr. Rullan is in San Diego which is not too far from Dr. Benham. He also performs Phenol Cross which he says is better and safer than TCA Cross although that is hard to prove. Benham charges a high amount for Cross which I don't appreciate. His technique isn't unique.

I'm not sure microneedling will do anything except drain your wallet. 

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On 7/25/2021 at 6:56 AM, JYSLA said:

Hi all!

 

I stumbled across this forum few days ago searching for acne scar treatments and blown from all the info, experiences, and resources shared in this forum. You guys are amazing!

 

I was hoping to get advice and input on treatment options and doctor recommendation.

 

I received my first TCA cross procedure by Dr. Ben Behnam last week, and he recommended that I do a round of TCA+Subcission+PRK next session.

However upon reading the forum I see that Dr. Russell seems to be another very experienced doctor in this field and many of you have experience with Dr. Russell.

I have attached pictures for reference and I was wondering if Phenol Cross would be a better treatment option vs TCA Cross for my type of scar.

Also, I see that Dr. Russell like to include microneedling for his “Trio” procedure. Is this a set procedure or does he personalize for each patient?

I have gotten numerous microneedling previously with no improvement as the needles don’t reach deep enough for my scars.

I am leaning towards Dr. Russell as he is most mentioned here in this forum with good results, and would appreciate your thoughts/input.

Thanks in advance!

 

20210715_130006.jpg

Here is my 2 cents you have few bad ones, but since you have few that also created the perfect opportunity for excision. Tca cross will take some time to get there but excision and laser can get you there faster. The biggest risk with excision is opening up, there is also the case of slight indented line but that can be resolved with laser. So we’re left with opening up, in your case if it opens up it will be worse like it is now and temporary pigmentation. But if you are succeeded you can instantly boost confidence. It is a risky bet but remember excision will look worse in the start . The only thing you need to focus on is if it opened up as long as it is closed we are good.

but again if you want to be conservative I would say is attack the edges and smooth it out and Blend the scars.

Edited by getsmart121
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On 7/26/2021 at 11:27 AM, Dan said:

The only thing I have to add is that your scars look more boxcar than icepick to me, at least some of them. So a combination of TCA CROSS (for the icepick scars) and other procedures for the boxcar ones seems to make sense. 

I had an online consultation with Dr. Rullan and he suggested the same. Thank you for your reply!

On 7/26/2021 at 2:45 PM, Amanda Hall said:

Where is Dr. Russell based?

I agree with Dan. TCA Cross is the treatment that would best smooth out the harsh borders of your scars. 

Dr. Rullan is in San Diego which is not too far from Dr. Benham. He also performs Phenol Cross which he says is better and safer than TCA Cross although that is hard to prove. Benham charges a high amount for Cross which I don't appreciate. His technique isn't unique.

I'm not sure microneedling will do anything except drain your wallet. 

Thank you for your reply. I was refering to Mr. Rullan sorry for the confusion. Haha.

I have made an appointment to see Dr. Rullan in late August! 

On 7/26/2021 at 4:46 PM, getsmart121 said:

Here is my 2 cents you have few bad ones, but since you have few that also created the perfect opportunity for excision. Tca cross will take some time to get there but excision and laser can get you there faster. The biggest risk with excision is opening up, there is also the case of slight indented line but that can be resolved with laser. So we’re left with opening up, in your case if it opens up it will be worse like it is now and temporary pigmentation. But if you are succeeded you can instantly boost confidence. It is a risky bet but remember excision will look worse in the start . The only thing you need to focus on is if it opened up as long as it is closed we are good.

but again if you want to be conservative I would say is attack the edges and smooth it out and Blend the scars.

I am hoping to see some improvements on my boxcar scars after I see Dr. Rullan. I know there wont be much from one session but my scars are way deeper than it appears in the photo and I feel like excision might be the best solution for my scars.. but then again my scars are mainly on my cheecks and are very close to eachother so Im not sure how that would work out.

Edited by JYSLA
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Btw just to add I did not like Dr. Behnams toothpick application of the TCA. Photos attached. $850.

20210715_132314.jpg

20210715_132317.jpg

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1 hour ago, JYSLA said:

Btw just to add I did not like Dr. Behnams toothpick application of the TCA. Photos attached. $850.

I think Benham is a little too casual with his Cross application. It's just a quick dib and dab. He missed some of your scars. The cost is also too high for me.

Good luck with Dr. Rullan! He's more thorough than Benham and charges less. Phenol Cross is not a miracle. It didn't help with some of my scars. But for one that I did with him several weeks ago.... looks better!

It will be a series of treatments and the costs will add up, unfortunately. He might offer you the triple threat so be prepared for this. I don't know if Erbium and microneedling will help as much as Cross so consider all of this.

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1 hour ago, JYSLA said:

Btw just to add I did not like Dr. Behnams toothpick application of the TCA. Photos attached. $850.

20210715_132314.jpg

20210715_132317.jpg

$850 is steep. When I saw him back in 2019 I was charged $600. Prices are definitely rising. 

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2 hours ago, JYSLA said:

Btw just to add I did not like Dr. Behnams toothpick application of the TCA. Photos attached. $850.

20210715_132314.jpg

20210715_132317.jpg

You don’t need to excise all scars in the same sessions so you can gap the scars being excised in such that would not interfere with the healing of the scars. Here is a strategy I would propose, for the big scars excise the middle portion( split the boxcar) and for small scars you can excise it anyhow since they are small. The criteria being that they should be deep. Remember if they are are already deep , if the excision opens up it will be deep like before, worst case scenario.

got to a plastic surgeon and get atleast two scars excised. That will tell you atleast what to expect from excision. Suppose you need a total of 30 excisions, you can spread out monthly doing 10 excisions. Also make sure not to excise one scar next to another one, leave two scar gap, just to play it safe. And finally smooth out with laser after all excision. Make sure the doctor who performs the laser perform laser and excision as he would know how to make the excision lines or indents heal properly with the right settings. Dr mark taylor is good with lasers.

Edited by getsmart121
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On 8/2/2021 at 10:37 PM, Amanda Hall said:

I think Benham is a little too casual with his Cross application. It's just a quick dib and dab. He missed some of your scars. The cost is also too high for me.

Good luck with Dr. Rullan! He's more thorough than Benham and charges less. Phenol Cross is not a miracle. It didn't help with some of my scars. But for one that I did with him several weeks ago.... looks better!

It will be a series of treatments and the costs will add up, unfortunately. He might offer you the triple threat so be prepared for this. I don't know if Erbium and microneedling will help as much as Cross so consider all of this.

I agree. And considering the risks associated with scar widening with the TCA Im not willing to take any more risks with it. Not to mention I feel like I couldve done a better job applying the TCA :(

I am seeing Dr. Rullan for his "Quatro" including Erbium in late August.

 

On 8/2/2021 at 11:04 PM, shei514 said:

$850 is steep. When I saw him back in 2019 I was charged $600. Prices are definitely rising. 

Hi Shei!

Been stalking your posts! I think your scars definitely improved alot. I remember reading you were considering excision for your boxcar scars, have you decided yet?

I was quoted ~$3600, IRRC for Behnams "Trifecta" of TCA+Sub+PRP :0

On 8/2/2021 at 11:19 PM, getsmart121 said:

You don’t need to excise all scars in the same sessions so you can gap the scars being excised in such that would not interfere with the healing of the scars. Here is a strategy I would propose, for the big scars excise the middle portion( split the boxcar) and for small scars you can excise it anyhow since they are small. The criteria being that they should be deep. Remember if they are are already deep , if the excision opens up it will be deep like before, worst case scenario.

got to a plastic surgeon and get atleast two scars excised. That will tell you atleast what to expect from excision. Suppose you need a total of 30 excisions, you can spread out monthly doing 10 excisions. Also make sure not to excise one scar next to another one, leave two scar gap, just to play it safe. And finally smooth out with laser after all excision. Make sure the doctor who performs the laser perform laser and excision as he would know how to make the excision lines or indents heal properly with the right settings. Dr mark taylor is good with lasers.

Thank you!

Guess I will see how my scars respond to Dr. Rullans treatments as I have so many different type and sizes and excise the ones that dont respond. Thank you for the doctor recommendation and advice!

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4 minutes ago, JYSLA said:

I agree. And considering the risks associated with scar widening with the TCA Im not willing to take any more risks with it. Not to mention I feel like I couldve done a better job applying the TCA :(

I am seeing Dr. Rullan for his "Quatro" including Erbium in late August.

 

Hi Shei!

Been stalking your posts! I think your scars definitely improved alot. I remember reading you were considering excision for your boxcar scars, have you decided yet?

I was quoted ~$3600, IRRC for Behnams "Trifecta" of TCA+Sub+PRP :0

Thank you!

Guess I will see how my scars respond to Dr. Rullans treatments as I have so many different type and sizes and excise the ones that dont respond. Thank you for the doctor recommendation and advice!

I debated with a member here about applying TCA yourself. That member thought it's best to leave it to a professional but I think that people who stare at their face all of the time know where their scars are better than most doctors. But you need to know which percentage to apply - you can always work your way up. Anyway, Rullan is someone a trust with acid. Some doctors are too quick to apply TCA and they charge too much.

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On 8/3/2021 at 6:05 AM, JYSLA said:

Btw just to add I did not like Dr. Behnams toothpick application of the TCA. Photos attached. $850.

20210715_132314.jpg

20210715_132317.jpg

This is sloppy application of tca. Go see Rullan he will do a better job at phenol cross minimizing the risk of widening.

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I just read a patient review on Dr. Benham:

"Don't be impressed with the reviews. They are inflated. They offer gift cards for 5 star ratings."

 

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10 hours ago, Amanda Hall said:

I just read a patient review on Dr. Benham:

"Don't be impressed with the reviews. They are inflated. They offer gift cards for 5 star ratings."

 

Wow. Im just so glad I stumbled upon this site and found out about Dr. Rullan!

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1 hour ago, JYSLA said:

Wow. Im just so glad I stumbled upon this site and found out about Dr. Rullan!

I found him through this site as well and am a current patient of his. Besides being a good doctor, he's a really good person if you talk to him. 

Please post back after your treatment! Your feedback will help other people on this forum. Let us know what you liked and didn't like about Dr. Rullan and the treatment. 

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2 hours ago, Amanda Hall said:

I found him through this site as well and am a current patient of his. Besides being a good doctor, he's a really good person if you talk to him. 

Please post back after your treatment! Your feedback will help other people on this forum. Let us know what you liked and didn't like about Dr. Rullan and the treatment. 

Yes definetely! Would love to contribute back to the forum and will report back with updates!

Attached are current pictures of my acne scar.

20210806_171036.jpg

20210806_171010.jpg

20210806_171333.jpg

Edited by JYSLA
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I believe you are really a good candidate for excision you have few scars but they are deep. Let’s see how much does tca helps. Don’t dishearten if tca doesn’t helps, excision should be able to take care of it. Also if you have oily skin it could cause problems when healing with excision, this is as per dr Taylor.he usually like to prescribe accutane 14 days prior to excision.

by the way do you ever remember what caused these scars. Was it cystic acne or like deep blackheads. I believe deep blackheads can also cause these scars?

what do you think?

Edited by getsmart121
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16 minutes ago, getsmart121 said:

I believe you are really a good candidate for excision you have few scars but they are deep. Let’s see how much does tca helps. Don’t dishearten if tca doesn’t helps, excision should be able to take care of it. Also if you have oily skin it could cause problems when healing with excision, this is as per dr Taylor.he usually like to prescribe accutane 14 days prior to excision.

by the way do you ever remember what caused these scars. Was it cystic acne or like deep blackheads. I believe deep blackheads can also cause these scars?

what do you think?

The pictures you just uploaded better show the depth of your scars. Cross is a lengthy process but I think you will see at least decent results if you stick with it. As you know, it takes a while for collagen to do its thing.

Excising the scars is another possibility but it may get expensive unless the doctor does a number of them at a time. If you consider it, maybe do or two to see how you heal. Due to the depth of some of your scars, there's a good chance than the new and revised scar will be better. 

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1 hour ago, getsmart121 said:

I believe you are really a good candidate for excision you have few scars but they are deep. Let’s see how much does tca helps. Don’t dishearten if tca doesn’t helps, excision should be able to take care of it. Also if you have oily skin it could cause problems when healing with excision, this is as per dr Taylor.he usually like to prescribe accutane 14 days prior to excision.

by the way do you ever remember what caused these scars. Was it cystic acne or like deep blackheads. I believe deep blackheads can also cause these scars?

what do you think?

I used to pop my acne and then pick at the scabs because I couldnt hide it with make up. Makes me cringe just even thinking about it now lol.

1 hour ago, Amanda Hall said:

The pictures you just uploaded better show the depth of your scars. Cross is a lengthy process but I think you will see at least decent results if you stick with it. As you know, it takes a while for collagen to do its thing.

Excising the scars is another possibility but it may get expensive unless the doctor does a number of them at a time. If you consider it, maybe do or two to see how you heal. Due to the depth of some of your scars, there's a good chance than the new and revised scar will be better. 

Yes. Seen people talk about the importance of lighting and here we are lol

Honestly as getsmart and you have mentioned my scars are really deep. I been lurking this site and havent seen a post yet with similar case as me, that has seen results from treatments such as TCA+Sub etc. I dont know if tca+sub would be sufficient to raise deep scars like mine. Honestly think that excision would be the best option for me. But I am just starting treatment and think it would be a good idea to see Dr. Rullan before I jump on the wagon. Another thing that I am worried about is that my scars are concentrated in a small area and I am not sure if it would be enough skin to excise and stitch together if you know what I mean? 

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35 minutes ago, JYSLA said:

I used to pop my acne and then pick at the scabs because I couldnt hide it with make up. Makes me cringe just even thinking about it now lol.

Yes. Seen people talk about the importance of lighting and here we are lol

Honestly as getsmart and you have mentioned my scars are really deep. I been lurking this site and havent seen a post yet with similar case as me, that has seen results from treatments such as TCA+Sub etc. I dont know if tca+sub would be sufficient to raise deep scars like mine. Honestly think that excision would be the best option for me. But I am just starting treatment and think it would be a good idea to see Dr. Rullan before I jump on the wagon. Another thing that I am worried about is that my scars are concentrated in a small area and I am not sure if it would be enough skin to excise and stitch together if you know what I mean? 

Jus don’t do all the scars at the same time. If you divide the cheek into 3 vertical lines, you can target 1 and 3 area scars. The plastic surgeon would know to keep gap. Which would mean not all scars will be excised. Some surgeon might also do at the Same time.

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37 minutes ago, JYSLA said:

I used to pop my acne and then pick at the scabs because I couldnt hide it with make up. Makes me cringe just even thinking about it now lol.

Yes. Seen people talk about the importance of lighting and here we are lol

Honestly as getsmart and you have mentioned my scars are really deep. I been lurking this site and havent seen a post yet with similar case as me, that has seen results from treatments such as TCA+Sub etc. I dont know if tca+sub would be sufficient to raise deep scars like mine. Honestly think that excision would be the best option for me. But I am just starting treatment and think it would be a good idea to see Dr. Rullan before I jump on the wagon. Another thing that I am worried about is that my scars are concentrated in a small area and I am not sure if it would be enough skin to excise and stitch together if you know what I mean? 

I know what you mean. This is why you need to talk to a qualified doctor, not just a regular one who does 50 punch excisions at the same time. Does skin stretch after it heals? I don't know. I'm not that experienced with excisions. All I can tell you, from my own experience having several excisions, is that they heal differently. Several of my excisions resulted in visible linear scars and one is almost invisible. One of the linear scars got smoothed by laser treatment and the other just won't. It really depends on the area and how much tension there is.

If you have patience, like years as some veterans here have said, I think you'll get improvement. 

Another option that came up is punch elevation. I don't know how effective this is but Google it and read up on it as much as you can. Don't trust just one doctor. Maybe consult with multiple ones. As much as I like Dr. Rullan, I wouldn't take just his opinion. 

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Also try combining with laser in the same session. There will be an increased chance that you will not have excision lines post laser. But again it’s still possible to have excision lines.

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17 hours ago, Amanda Hall said:

I know what you mean. This is why you need to talk to a qualified doctor, not just a regular one who does 50 punch excisions at the same time. Does skin stretch after it heals? I don't know. I'm not that experienced with excisions. All I can tell you, from my own experience having several excisions, is that they heal differently. Several of my excisions resulted in visible linear scars and one is almost invisible. One of the linear scars got smoothed by laser treatment and the other just won't. It really depends on the area and how much tension there is.

If you have patience, like years as some veterans here have said, I think you'll get improvement. 

Another option that came up is punch elevation. I don't know how effective this is but Google it and read up on it as much as you can. Don't trust just one doctor. Maybe consult with multiple ones. As much as I like Dr. Rullan, I wouldn't take just his opinion. 

If we do excision on tension line what if we dont move a muscle on our face? Will it heal like non tension line excision?

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17 hours ago, Amanda Hall said:

I know what you mean. This is why you need to talk to a qualified doctor, not just a regular one who does 50 punch excisions at the same time. Does skin stretch after it heals? I don't know. I'm not that experienced with excisions. All I can tell you, from my own experience having several excisions, is that they heal differently. Several of my excisions resulted in visible linear scars and one is almost invisible. One of the linear scars got smoothed by laser treatment and the other just won't. It really depends on the area and how much tension there is.

If you have patience, like years as some veterans here have said, I think you'll get improvement. 

Another option that came up is punch elevation. I don't know how effective this is but Google it and read up on it as much as you can. Don't trust just one doctor. Maybe consult with multiple ones. As much as I like Dr. Rullan, I wouldn't take just his opinion. 

Amanda for those excision lines you need to  ablate the area with fully ablative laser. Go to dr Taylor in Salt Lake City Utah. After excision I had an indented excision line where two scars were excised side by side. Very wired looking . After 6 months it’s got finer but still didn’t heal well. You could still see it clearly. Did. Tca cross on the that indented line helped a bit. Then went for fully ablative on that spot, it is complete invisible now two months later.

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

If we do excision on tension line what if we dont move a muscle on our face? Will it heal like non tension line excision?

What she means is about the facial anatomy on how the skin pressure is on that area. The higher the pressure the greater chance of excision line or opening up. One way is to use absorbable sutures and keep sutures longer to provide it adequate support.With this method you can keep the sutures longer.

Edited by getsmart121
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