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update 2 (06/20/2022): Yesterday, I was visiting my mom and her new kittens and one of them invariably scratched my nose and below my right eye - leaving a long laceration on my nose and a puncture below my left eye. I began to bawl. My mom questioned why I was bawling, and I spoke aloud the thoughts racing in my head: I can’t deal with potentially having another two scars to treat when I have such difficult treatable acne scars in the first place. To my annoyance, she went on some rant about how “no one notices my scars and I am delusioned”. Extremely irritating to hear, especially when your mother has porcelain skin (seriously - porcelain. My whole life, she has had perfect porcelain skin. Sometimes people do a double fake when I introduce her as my mom and my worst self-critic says it’s because of the difference in our skin). Anyways.. long story short, I took a few facial photos last night in my teary state in her living room… and despite the overhead lighting at my moms, my scars are looking more shallow (no where near where I’d like them to be. But I have been doing monthly Secret PRO RFM + light co2 peel in the same session and will continue this regimen until my phenol in December. So far I have done two sessions - third session is booked for this afternoon. The other part of me says my scars look better because of the lighting.. though in the past I’ve taken photos in this lighting before at her place and thought my scars looked worse). As for the mental, I am trying to find a therapist… not sure why I didn’t do this sooner, maybe denial.. but at this point, I think it’s needed. Photos from June 19 2022 after that ….. scratched my face):
AB94CC4B-730A-43F5-8BBF-371F158B137C.jpeg.a1ac61c0f1b661b93e1f86a6474c9b0e.jpeg4B1A1ABA-C6A3-46BE-8F9E-DB36CFC1A330.jpeg.c951761dc6ab83df3f4dd9eb2ac7714a.jpeg4C6AC7CE-2720-449D-B788-F96F5CB643A1.jpeg.12a98dad58246a75b91e3019b51990ed.jpeg

I truly believe boxcar scars need to be excised, that nothing is going to improve them the way excision can. Prior to my MASS punch excision, I had spent valuable dollars on the following (that did NOTHING for my Boxcar scars) :

  • 3 Infini RF Microneedling Treatments with Dermatology at Bloor (Toronto, ON)
  • 3 blunt cannula subcision with tumescent anesthesia and diluted sculptra with Dr.Lemckert at Cutis Clinic (Hamilton, ON)
  • 4 blunt cannula subcision with tumescent anesthesia and diluted Radiesse with Dr.Sajic at DermaSKIN (Guelph, ON)
  • 1 cannula subcision without the tumescent anesthesia and Juvederm Volite filler (HA filler) with Dr.Barankin at Toronto Dermatology Centre (Toronto, ON)
  • 1 v-shape cannula subcision and tumescent anesthesia with diluted Radiesse, 70% TCA Cross & Fractional CO2  with Dr.Sajic at DermaSKIN (Guelph, ON)
  • 1 profractional session at Toronto Dermatology Centre (Toronto, ON)

if you suffer from deep boxcars and your dermatologist isn’t recommending excision treatments for you, then you should consider finding a new dermatologist. Unfortunately most dermatologists love to squeeze all of the money out of you and giving you lacklustre results is the best way to get you coming back for more.  If it’s one thing I’ve learned in my acne scar journey, it’s that you have to be your own advocate. I pushed for this mass punch excision. My dermatologist relented by excising only 2/3 scars in March. I healed well, and then he obliged by doing this for me in late April. A linear scar over an atrophic one that gives you a scary appearance over overhead lighting? I’ll take that any day of the week and if you have boxcars, I think you should to. Also.. be meticulous with your acne scar journey. Do your research. Take all of the precautions plus some. 

Background:  Gender: Female skin type: IV  Location: Ontario, Canada   skin condition: mostly divots & atrophic boxcars, with overall bad texture

Skincare: Includes daily SPF (Elta MD), UPF wear, daily moisturizer, retinol in the PM, Vitamin C in the AM.


December 6th 2018: Prior to ANY treatments such as subcision, Infini, TCA Cross, erbium, etc. Up to this point, I had done a few Sublative eMatrix Laser treatments but let's be honest, that only gives you some micro-swelling (I.e ZERO permanent results). Two photos below are from December 6th 2018. Wish I had some better photos but this is all I could find in my camera roll. 
235807E3-B788-4832-B763-AEA5F25F78D6.jpeg.54d6cd4cfba5304b3f644af59953e6c2.jpeg811AFCE6-056E-485D-9F3F-C0E61193CE4D.jpeg.3c33729137d6d9ffe5bbafa275b3f963.jpeg

September 29th 2019: blunt cannula subcision #1 with tumescent anesthesia and diluted sculptra  Practitioner: Dr.Lemckert in Hamilton, Ontario. Improvement Gauged: 5-10%

Personal Thoughts: This was my first subcision EVER and I was so fascinated by hearing the tethers snapping. It was like the sweetest music to my ears. I was a bit weary by the fact that this physician (Dr.Lemckert) did NOT mark my scars prior to the subcision and that NO special lighting was used to properly gauge each scar's depth. However, I decided to look past this since he was ERRONEOUSLY listed as one of the best acne scar physicians in Canada in BA’s recommended practitioners list. 

November 2019: Picture Below
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December  2019: blunt cannula subcision #2 with tumescent anesthesia and diluted sculptra  Practitioner: Dr.Lemckert in Hamilton, Ontario. Improvement Gauged: 2-5%

Personal Thoughts: I was a bit miffed by the fact the subcision only took 15-20 minutes in total, it felt quite rushed to me and that Dr.Lemckert was NOT thorough. 

February 2020: blunt cannula subcision #3 with tumescent anesthesia and diluted sculptra  Practitioner: Dr.Lemckert in Hamilton, Ontario. Improvement Gauged: 2-5%

Personal Thoughts: This was my last and final subcision with Dr.Lemckert, he took even less time (15 minutes maximum) on my subcision procedure. I was left feeling a bit too uncertain if all of the sculptra I purchased was in fact  injected. unfortunately I felt like the trust I previously had for this physician was no longer there.

April 14th 2020: at this point I have had 3 blunt cannula subcision with diluted sculptra each time (Sept 29 2019, Dec 22 2019, Feb 2020)   Practitioner: Dr.Lemckert in Hamilton, Ontario. Total improvement Gauged: 5-8% - the two photos below are taken on April 14th 2020 under harsh lighting. 

954A4E2D-6C9F-4017-B303-219D2EB592E8.jpeg.ea2b0ed296c393f633604fc51951cc1a.jpeg4A4180AC-D41A-4D47-A9D2-7376AE559C5E.jpeg.ea661b54365aa27b131585330de8ae5c.jpeg

 

July 2020: blunt cannula subcision #4 with tumescent anesthesia and diluted Radiesse Practitioner: Dr.Sajic in Guelph, Ontario. Improvement Gauged:5-10%

Personal thoughts: This was my first treatment with Dr.Sajic. I felt Dr.Sajic was much more knowledgable about acne scar treatment than Dr.Lemckert and appreciated the fact that he marked each scar with a makeup pencil prior to conducting the subcision. However, no special lighting was used to identify each scar precisely

IMG_4396.jpg.b5942cb7e603609b846f2ad3f051b7bd.jpgIMG_4393.jpg.cb445f54980e2fe02d0b5105c63d2d39.jpg

July, August, September 2020: 3 Infini RF treatments Practitioner: Dr.Abdullah at Dermatology at Bloor oversaw the treatment plan (I.e the laser settings for all three treatments) but a laser technician (Amy) actually performed the laser procedure. Improvement gauged: 2-5%. Personal thoughts: the Infini did nothing for my boxcars. I did feel like it did shrink some of my pores, but that’s not why I’m doing acne scar treatment… so that was the end of Infini for me. Felt like it was all hype with very little substance.

October 2020:  blunt cannula subcision #5 with tumescent anesthesia and diluted Radiesse Practitioner: Dr.Sajic in Guelph, Ontario. Improvement Gauged:5-10%. Personal Thoughts: Again, I appreciated the fact that Dr.Sajic marked most of my scars prior to treatment but did feel he could have been a bit more thorough with the subcision this time around. 

November 2020: Profractional - Settings used: 400 joules at 11% single pass, 150 joules at 11% double pass on pigmented areas. Practitioner: Toronto Dermatology Centre Improvement Gauged: 0-2% Personal Thoughts: Waste of money for the most part. Did appreciate the microswelling.

December 2020: Radiesse & V-Shape Cannula Subcision  & TCA Cross70% & eCO2. Practitioner: Dr.Sajic in Guelph, Ontario. Improvement Gauged:5-10%. Personal Thoughts: I really wanted this mass treatment to do more for me and it didn't. I also got paranoid that the eCO2 created more scarring for me (though I can’t say for certain). that or maybe like some of my facial fat got depleted, because my scarring became more obvious to me a week after the procedure. 

January 2021:  Cannula Subcision & Juvederm Volite. Practitioner: Dr.Barankin in Toronto, ON. Improvement Gauged: 0-5%. Personal Thoughts: Dr.Barankin is NOT an expert on acne scarring. He doesn't believe in "tumescent anesthesia" for subcision etc, a bunch of things that should have made me leave the office right away…but he is highly praised as a great general dermatologist and I was desperate at the time. Unfortunately the Juvederm Volite did also leave a bump that I had to deal with for several weeks. 

March 24th 2021: Two scars excised, Test erbium patch, TCA Cross 70/80% (can't remember exact percentage).  Practitioner: Dr.Sajic in Guelph, Ontario. Improvement Gauged: 5-7%. Personal Thoughts: I was very pleased with how I healed from the two excisions as well as the fully ablative erbium test patch. Regretted not excising more scars that day.

IMG_3322.jpg.9b85831bf99a1c838b5e116e6cce1e53.jpgIMG_3325.jpg.705431b29490ca8e2165d69808ebb336.jpg

 

APRIL 27th 2021: Punch excision of 12-14 atrophic scars on each cheek with micro-botox injected directly on top of each suture to minimize hypertrophic scar formation / the suture opening pre-maturely etc. Practitioner: Dr.Sajic in Guelph, Ontario. Improvement Gauged: 30-40%

F9D8891D-668E-4AB3-9C43-8392C0D9CF9A.jpeg.f56788af3ce304ee20d5ba74d074f7f4.jpeg98D0D717-2129-404D-BBDB-CA86512DCEA4.jpeg.9bfd470660eb0fa1ce1377e8a30d733d.jpeg

Personal Thoughts: My texture has improved a lot and I definitely don’t have to deal with the horror of overhead lighting as much as before. Most scars look a lot better than they did before. Mind you, my dermatologist injected baby botox (about 1 unit) directly on top of each punch excision suture on the day of the procedure. This was to minimize the chances of a hypertrophic scar forming. Unfortunately, it gave me a smile complication - where I was been unable to fully smile because my smile muscles became frozen  (my punch excision was on April 27 2021 and it has mostly worn off). 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 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 mostly  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. 
May 4th 2021: Photos below are immediately after the sutures were taken out

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May 11th: immediately before fully ablative Erbium
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June 16 2021: Personal thoughts: All healed up from the erbium. I definitely liked how the erbium helped with any sort of PIH I was experiencing from the previous excisions / TCA cross procedures. Biggest issue for me at this point was the overall texture of my skin. 

97856620-841C-4127-9F8B-42A236CB4868.jpeg.04681dcd2397fce2092ee13b9172c655.jpeg0A137F88-2E15-4FFB-92DA-038CD4BB8AF1.jpeg.78b1b0f3a29afa7143edb719f7394e86.jpeg

June 25 2021:  90% TCA cross and two syringes of restylane skinboosters. Practitioner:
 

Unfortunately there was malpractice, causing the TCA to spread on one of my cheeks and give me a TCA Line. Unfortunately this is the same dermatologist that has done all my procedures cited in this post so naturally I was a bit devastated. photos below are from June 28 2021: 

EB82AA16-54BC-47F1-BA51-671C99D994EF.jpeg.fd0e329f5c37dea3d1ef817a5ee2c624.jpegDE5A25EC-FEFB-489E-A507-71B8719D52D3.jpeg.8c0c8467d42cfd5e3c0999337196d590.jpeg

 

July 20 2021: TCA Line is still there. It is likely to be permanent. Just goes to show you that you can never be too careful. The derm I have been going to is considered one of the best in the province (I live in Ontario, Canada). 
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August 23rd 2021: Pictures below are from August 23rd 2021. It's pretty hard to get my scars fully captured on camera at this point - and I know the multiple TCA cross i've done + mass excision helped in that, mainly by smoothing the scar edges out to the point that they are quite near to the surface,

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UPDATE: August 25th 2021: Phenol (Carbolic) Cross, VBeam Laser, Blunt Cannula Subcision with Tumescent Anesthesia & Erbium Yag Laser. Practitioner: Dr. Peter Rullan (Chula Vista, CA). Improvement Gauged: Too early to tell. 
Personal thoughts: Finally meeting Dr. Rullan was truly awespiring for me. The whole visit was smooth - which can be expected when you're receiving treatment from an expert in the field. First, he did some carbolic/phenol cross (took less than 5 minutes), then he did VBeam for my pigmented spots from my previous TCA cross, followed by blunt-cannula subcision. During the subcision, I heard a lot of tethers getting cut through, he said this was fibrosis from my previous TCA Cross peels. Finally, he did Erbium - as a final polish. I almost cried during the VBeam, mainly because of the pure glee I was feeling from FINALLY being treated by this physician (lame I know). It is way way way too early to tell what the results will look like, I currently look like a chipmunk from the tumescent anesthesia. I asked him about undergoing the full face 2-day phenol sometime in the future and he did comment that I can potentially go ahead with the phenol in the future if I like, but that he was going for a “home run” with this one treatment and hoped I would be happy with the final results from today. So fingers crossed that I am. As the laser resurfacing inflammation slowly subsides, I do see that the TCA line left from my previous derm is still quite apparent, which is a bit disheartening. But I’m still too hyped up from all of the dopamine release from meeting Rullan to really care about it right now.

august 25 2021: pictures below are taken at Rullan’s office prior to treatment.  
AFF70275-F3E9-49B4-A1BE-DE374BECD564.jpeg.a06ee295a4a1a9cedf8c606c34a102c3.jpeg783EF79B-6949-4CDB-9D09-5659FD07A45C.jpeg.1abe4a03c060dd9c7bf7ef187a26834a.jpeg3494C525-A99F-4AC0-BC5C-D7A0B4A7F4D9.jpeg.3be30e9b729a4d41cb4f901305170832.jpeg

august 25 2021: picture below is immediately after treatment 
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Edited by Catharsis2018
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Absolutely agree! If they are deep then excise it. If it fails it’s the same deep scar you had. If successful you will be happy and if not you can go for excision again. And doing 1 month post laser. Super must.

how did the line come there from tca ? Was he painting tca. Hoping it would heal!

why did you go for tca cross again for very shallow scars and at high percentage. The risk was not worth it IMO. Phenol chemobrasion would have been wise. Also why is dr rullan hesitant on using phenol peel he already uses for darker skin.strange?

Edited by getsmart121
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1 hour ago, getsmart121 said:

Absolutely agree! If they are deep then excise it. If it fails it’s the same deep scar you had. If successful you will be happy and if not you can go for excision again. And doing 1 month post laser. Super must.

how did the line come there from tca ? Was he painting tca. Hoping it would heal!

why did you go for tca cross again for very shallow scars and at high percentage. The risk was not worth it IMO. Phenol chemobrasion would have been wise. Also why is dr rullan hesitant on using phenol peel he already uses for darker skin.strange?

His assistant was holding the zimmer (a cooling device) and she held it too close to my face, and it made the TCA spread. This is what I believe caused it. The TCA itself was injected with a baby botox needle. 

yes, in hindsight I agree haha. 
 

im thinking it’s because of the unhappy dark skinned customer that got hypopigmentation and left him a bunch of 1 star reviews. Also it is a very intense procedure so I guess it’s fair that he wants to see my skin in person first. But I really don’t think subcision can do much for me at this point so we will see. 

Edited by Catharsis2018
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35 minutes ago, Catharsis2018 said:

His assistant was holding the zimmer (a cooling devices) and she held it too close to my face, and it made the TCA spread. This is what I believe caused it. The TCA itself was injected with a baby botox needle. 

yes, in hindsight I agree haha. 
 

im thinking it’s because of the unhappy dark skinned customer that got hypopigmentation and left him a bunch of 1 star reviews. Also it is a very intense procedure so I guess it’s fair that he wants to see my skin in person first. But I really don’t think subcision can do much for me at this point so we will see. 

Since you earlier had tca from him, did he change the application method? Like previously toothpick and now with injection needle.

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8 minutes ago, getsmart121 said:

Since you earlier had tca from him, did he change the application method? Like previously toothpick and now with injection needle.

He did do the toothpick method back in December from what I remember. And the baby botox needle was supposed to be more precise. But the zimmer kind of messed that up 

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1 minute ago, Catharsis2018 said:

He did do the toothpick method back in December from what I remember. And the baby botox needle was supposed to be more precise. But the zimmer kind of messed that up 

If a person starts doing recently then it is best to avoid as they don’t have enough experiences of what could go wrong. And also doctors should share best practices for each procedure. If I was the derm I would have been thinking what else could go wrong. I personally don’t think injection is the right method. If you really want precision then better to use paintbrush. That way you get liquid on the scar much more controllable rather than injection.

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44 minutes ago, getsmart121 said:

If a person starts doing recently then it is best to avoid as they don’t have enough experiences of what could go wrong. And also doctors should share best practices for each procedure. If I was the derm I would have been thinking what else could go wrong. I personally don’t think injection is the right method. If you really want precision then better to use paintbrush. That way you get liquid on the scar much more controllable rather than injection.

Yeah I think you’re right, in using a micro paintbrush. Rullan has confirmed that he will be using a paintbrush for the carbolic cross on the 31st. 
yes it was just negligence on their part

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Hey, can you tell me after subcision when your scars healed, the boxcars disappeared fully? Are they became suture lines or they became smaller indented scar? 

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On 7/30/2021 at 6:17 PM, can i get a new life please said:

Hey, can you tell me after subcision when your scars healed, the boxcars disappeared fully? Are they became suture lines or they became smaller indented scar? 

They’ve mostly disappeared yes, I can’t  really see them anymore. I mostly deal with minor texture issues these days and the redness from the TCA I.e PIH. 

pictures taken outside on July 20 2021

i did have 1 or 2 box scars that weren’t excised, but those are also hard to see in most lighting

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Edited by Catharsis2018
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UPDATE AUGUST 22nd 2021: I am

Flying out of Canada tomorrow to see Dr. Rullan for my August 24 appointment.
What’s on the agenda: Phenol cross, blunt cannula subcision, Erbium laser. 
What I might ask to be added: punch excision to anything that can be excised. 
photo below is taken yesterday. Going to get some overhead lighting ones taken to update this log. Cheers!

370895B9-9659-4C35-A198-27C7968AA3BA.jpeg.a185f53f61971c8c27288457954efdfd.jpeg

Edited by Catharsis2018
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Hi thanks for being brave and your wonderful post and I truly hope things get better for you and your scars.  I am 45 and it is a terrible disease that has destroyed me both mentally and physically

 

I did punch punch excision once and it made no difference for my scars as circled the big ones circled.  do you think i try again?

 

I have done all the tradtional acne scar treatments over 20 years laser fillers subcision tca cross excisions grafts prp needling and lucky if i gotten 5 percent imrovement and am short 30 000 dollars plsu all those years

Inkedthumbnail_20210625_173944 (3)_LI.jpg

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1 hour ago, pleasehelp321 said:

Hi thanks for being brave and your wonderful post and I truly hope things get better for you and your scars.  I am 45 and it is a terrible disease that has destroyed me both mentally and physically

 

I did punch punch excision once and it made no difference for my scars as circled the big ones circled.  do you think i try again?

 

I have done all the tradtional acne scar treatments over 20 years laser fillers subcision tca cross excisions grafts prp needling and lucky if i gotten 5 percent imrovement and am short 30 000 dollars plsu all those years

Inkedthumbnail_20210625_173944 (3)_LI.jpg

I think if you do punch excision again, you should specifically ask the physician to inject a micro amount of botox (about a unit) directly on top of each excised scar (on the same day, right after the excised scars have been sutured up) to ensure that the scar does not reopen.  Plus make sure you go to someone who knows acne scars and has a credible background in the field. It doesn’t necessarily have to be one of the golden physicians everyone is trying to see, there are acne scar specialists around, you just have to be meticulous with your research


The micro botox may give you a smile complication, like it did to me (I wasn’t able to fully smile for 2/3 months), but all of my excised scars have remained closed 

Edited by Catharsis2018
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Thanks Cartharsis do you think adding filler to those scars would help?  

 

You are a legend and that is the problem I cannot find a acne scar surgeon derm doctor who is capable and absolutely 110 percent love and agree with your comment i am meticulous but hard to find one who understands my concerns.  I only beg to have the ones circled improved as they bother me so much on my LHS.  As much as I hate my RHS I can live with them as they are many small ones and not big ones circled

 

Many thanks Cartharsis

Oh as i do not intend to have probably punch excision again can I just goto a physician and tell them 'micro botox' please to the scars circled?

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wished to post this here as my surgeon pointed this out for me so I thought some of you might want to express your opinions but I am looking forward to what they will say later in the year once my subcision settles in which has really provided no results as well as many other treatments I have done...aka the mid face zygoma - I mean when I pull upwards the scars do look better will anxiously wait to see what they say...

 

I use Restylane Cheek Fillers $480 for 1 ml, you may need more than 1 ml
 
 
I think let's wait and reassess later. 
My thoughts were to lift the mid face zygoma, so the light falls on the cheek and scars reflect the light at a different angle. 
 
That's just 1 suggestion.  I am sure you will have a think about it and see if it makes sense to you.
 
Would like some thoughts?
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On 8/23/2021 at 3:17 PM, Catharsis2018 said:

UPDATE AUGUST 22nd 2021: I am

Flying out of Canada tomorrow to see Dr. Rullan for my August 24 appointment.
What’s on the agenda: Phenol cross, blunt cannula subcision, Erbium laser. 
What I might ask to be added: punch excision to anything that can be excised. 
photo below is taken yesterday. Going to get some overhead lighting ones taken to update this log. Cheers!

370895B9-9659-4C35-A198-27C7968AA3BA.jpeg.a185f53f61971c8c27288457954efdfd.jpeg

All the best to you! Hope you see the results you want. Can I just say you are really lucky to have access to and receive treatments from Dr Rullan? He's really the best with scar treatments. Maybe not everyone gets the desired results with him, but I honestly think he is our best bet to improve acne scars. All of you who have access to him geographically and financially just know you are extremely lucky. 

I was at a consult with a new derm today about one final treatment and it was so pointess and frustrating when you know more about the scars than the doctor and when the dr plays dumb and denies possible side effects. Honestly, these regular derms don't have a clue. Thank God for this community and all the info. 

Edited by Guest
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I would safely know I know more about acne scars than 99 percent of doctors who claim they are acne scar experts too....agreed jasonC

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9 hours ago, pleasehelp321 said:

I would safely know I know more about acne scars than 99 percent of doctors who claim they are acne scar experts too....agreed jasonC

I am more inclined to travel to the US to Rullan despite the ban, or when the ban for entering the US falls. I swear regular derms suck big time. 

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JaysonC couldnt agree with you more almost 99 percent of Derms are useless...I am thinking of seeing him but this COVID travel ban...what treatment(s) are you planning to get?  do you have pictures of your scars?

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D11CD65A-9D6D-4C08-B2E1-F02D548D7B69.jpeg.f8648af65602153c41d7173198a8cad2.jpeg32D4D51F-CF00-4FC5-BAA8-04E40098332D.jpeg.a88d321102d275b86df2532e84ee6704.jpegUPDATE: august 25th 2021: Phenol (Carbolic) Cross, VBeam Laser, Blunt Cannula Subcision with Tumescent Anesthesia & Erbium Yag Laser. Practitioner: Dr. Peter Rullan (Chula Vista, CA). Improvement Gauged: Too early to tell. 
Personal thoughts: meeting Dr. Rullan was truly awespiring for me. The whole visit was smooth. First, he did some carbolic cross (took less than 5 minutes), then he did VBeam for my pigmented spots from my previous TCA cross, followed by blunt-cannula subcision. During the subcision, I heard a lot of tethers getting cut through, he said this was fibrosis from my previous TCA Cross peels. Finally, he did Erbium. I almost cried during the VBeam, mainly because of pure glee at finally being treated by this physician (lame I know). Way too early to tell what the results will be, I currently look like a chipmunk from the tumescent anesthesia. He did say I can go ahead with the phenol in the future if I like, but that he was going for a “home run” with this one treatment and hoped I would be happy with the final results. So fingers crossed. 

On 8/25/2021 at 2:41 AM, JaysonC said:

I am more inclined to travel to the US to Rullan despite the ban, or when the ban for entering the US falls. I swear regular derms suck big time. 

 

On 8/25/2021 at 7:15 AM, pleasehelp321 said:

JaysonC couldnt agree with you more almost 99 percent of Derms are useless...I am thinking of seeing him but this COVID travel ban...what treatment(s) are you planning to get?  do you have pictures of your scars?

I’d say go and see him. I have no regrets from seeing him. It’s truly something else to receive treatment from someone who has decades of experience in the topic of acne scarring. Though I do wish I had more time with him, but I guess that is also to be expected with someone so highly renowned. 

On 8/24/2021 at 9:47 PM, dirigo39 said:

Wow your results are great. can you msg me how much your Dr charged for the excisions? 

I definitely can when I’m back in canada. I have all of my previous invoices tucked away somewhere. Do note that I was seeing this derm for a while and he may have given me a more fair price than market price 

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On 8/24/2021 at 1:01 PM, JaysonC said:

All the best to you! Hope you see the results you want. Can I just say you are really lucky to have access to and receive treatments from Dr Rullan? He's really the best with scar treatments. Maybe not everyone gets the desired results with him, but I honestly think he is our best bet to improve acne scars. All of you who have access to him geographically and financially just know you are extremely lucky. 

I was at a consult with a new derm today about one final treatment and it was so pointess and frustrating when you know more about the scars than the doctor and when the dr plays dumb and denies possible side effects. Honestly, these regular derms don't have a clue. Thank God for this community and all the info. 

Thank you so much. I do feel extremely lucky and greatful to finally have met Rullan earlier today. Honestly a dream come true for me because I never thought it’d be possible. But if there’s a will, then there is a way. 
it’s true — the vast majority of dermatologists don’t know anything about acne scarring. So frustrating and it can be such a waste of time to research a derm, schedule a consult with them, set aside the time and financial resources to commute / to see them, only to hear some bogus advice related to a laser pitch etc… lol it’s maddening. 

sorry to hear you went through that today. I’ve been in your shoes (more than a couple of times), and it truly sucks. 
 

thank goodness people like Rullan do exist. Even my derm in my area, the one who did the mass excision for me, I think he’s a great derm. But the TCA Line, it was unfortunately my dealbreaker. He is a younger derm too, so I suppose still has a lot to learn… 

On 8/24/2021 at 5:51 AM, pleasehelp321 said:

wished to post this here as my surgeon pointed this out for me so I thought some of you might want to express your opinions but I am looking forward to what they will say later in the year once my subcision settles in which has really provided no results as well as many other treatments I have done...aka the mid face zygoma - I mean when I pull upwards the scars do look better will anxiously wait to see what they say...

 

I use Restylane Cheek Fillers $480 for 1 ml, you may need more than 1 ml
 
 
I think let's wait and reassess later. 
My thoughts were to lift the mid face zygoma, so the light falls on the cheek and scars reflect the light at a different angle. 
 
That's just 1 suggestion.  I am sure you will have a think about it and see if it makes sense to you.
 
Would like some thoughts?

In theory, it sounds good. But to be safe when translating it into practice (and being strategic with your spending), I think you should ask him to do one cheek first to see if it has the desired effect you’re looking for.

is he lifting the mid face zygoma with filler or a thread lift ?

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On 8/23/2021 at 6:27 AM, pleasehelp321 said:

I have done all the tradtional acne scar treatments over 20 years laser fillers subcision tca cross excisions grafts prp needling and lucky if i gotten 5 percent imrovement and am short 30 000 dollars plsu all those years

 

Yeah, but just exactly how many times did you repeat each procedure? Most people tend to quit only after one procedure when they see little to no improvement. The sad fact is that you need many procedures to see any meaningful improvement. For instance, with TCA, you won't likely see much for the first 4-5 treatments. But persistence will pay off in the end.

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yes you are well versed and smart in this field cartharsis they said they lift the mid face zygoma with filler so that it drapes over or something and the scars are not as obvious with 1ml on each side...what does this mean?

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8 hours ago, Catharsis2018 said:

Thank you so much. I do feel extremely lucky and greatful to finally have met Rullan earlier today. Honestly a dream come true for me because I never thought it’d be possible. But if there’s a will, then there is a way. 
it’s true — the vast majority of dermatologists don’t know anything about acne scarring. So frustrating and it can be such a waste of time to research a derm, schedule a consult with them, set aside the time and financial resources to commute / to see them, only to hear some bogus advice related to a laser pitch etc… lol it’s maddening. 

sorry to hear you went through that today. I’ve been in your shoes (more than a couple of times), and it truly sucks. 
 

thank goodness people like Rullan do exist. Even my derm in my area, the one who did the mass excision for me, I think he’s a great derm. But the TCA Line, it was unfortunately my dealbreaker. He is a younger derm too, so I suppose still has a lot to learn… 

In theory, it sounds good. But to be safe when translating it into practice (and being strategic with your spending), I think you should ask him to do one cheek first to see if it has the desired effect you’re looking for.

is he lifting the mid face zygoma with filler or a thread lift ?

Oh yes, it was the perfect laser pitch - the doctor didn't even ask me what treatments I have had before!!

I hope you see really nice improvement from the treatment. Dr Rullan is truly the most genuine and capable physician for acne scars. I am seriously thinking about putting some money to the side and going to see him. I am considering the deep phenol peel for acne scars but I am still not 100% sold on that. my concern is that all who have had it say it improved mostly the texture and the most superficial scars and if it is true I amnot sure If I want to spend 6k and go through this brutal procedure, but it's just me. Don't let yourself be influenced by me. Did you get filler with the subcision as well?

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Happy you were able to see him. He is truly a great dermatologist and his bedside manner too. Did you get to discuss punch excision with him? 

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