I went for a consultation with Dr Rullan in San Diego a few days ago and want to share my experience, as well as welcome any advice for my acne scar treatment journey.
The majority of the consultation was with a young woman of hisstaff. She talked about Dr Rullans experience and the types of treatment he usually provides for acne scars. Dr Rullan then came in for a couple minutes tolook at my scars. He mentioned that most of my scars were boxcar. His recommendation was to do subcision,phenol cross, erbium laser andfiller. He recommended onesubcision to see if any of the scars were tethered but it seemed like the focus would be onmultiple phenol cross and laser treatments. He said that the Juvederm fillerwould be a small amount (.3 ml or cc).
This is what I was quoted:
subcision-1250
phenol cross- 300
juvederm filler- 550
erbium laser-500
Since all 4 treatments would be $2600 and I cant really afford that currently, Im thinking of doing just the subcision and phenol cross to start.And then after a few months doing the cross again with the erbium laser. Or would it be better to do multiple cross before startingthe laser? Im hesitant to do filler but probably will towards the end.Any advice?
I actually like everything you're saying. I always try to do less invasive things first. So, yeah, subcision and cross is what I would personally jump into first.
I don't like the idea of filler myself. I think of some celebrities faces who have overdone it on filler and I'm like no thanks. I'm not saying it's never a good idea, but I don't personally like it. It creeps me out. I'd do it if it was my own fat, but I don't like artificial fillers.
19 hours ago, dirigo39 said:I'm not impressed by erbium so far.
He offers microneedling as well which I dont believe is better than erbium. If you can ask the doctor please do on full ablative setting forthe spot. Microneedling pokes the skin, erbium evaporates skin or columns of skin. That is why u need to do on full ablative mode if you have hard boxcar edges. Here is an example.
3 hours ago, getsmart121 said:He offers microneedling as well which I dont believe is better than erbium. If you can ask the doctor please do on full ablative setting forthe spot. Microneedling pokes the skin, erbium evaporates skin or columns of skin. That is why u need to do on full ablative mode if you have hard boxcar edges. Here is an example.
Is that doc I'm the video reputable?
Do you have a dermabrasion recc?
16 hours ago, getsmart121 said:Yes even is. I would recommend not to go fractional as it could give more texture issues.
What?
Maybe I'm confused about lasers.
"Thatis why u need to do on full ablative mode if you have hard boxcar edges. Here is an example."
"I would recommend not to go fractional as it could give more texture issues."6
4 hours ago, dirigo39 said:What?
Maybe I'm confused about lasers.
"Thatis why u need to do on full ablative mode if you have hard boxcar edges. Here is an example."
"I would recommend not to go fractional as it could give more texture issues."6
Yes the doctor is reputable he invented the Taylor liberator for acne scars.
here is a video of dermabrasion
On 11/15/2021 at 11:55 AM, CuddlyKoala said:I went for a consultation with Dr Rullan in San Diego a few days ago and want to share my experience, as well as welcome any advice for my acne scar treatment journey.
The majority of the consultation was with a young woman of hisstaff. She talked about Dr Rullans experience and the types of treatment he usually provides for acne scars. Dr Rullan then came in for a couple minutes tolook at my scars. He mentioned that most of my scars were boxcar. His recommendation was to do subcision,phenol cross, erbium laser andfiller. He recommended onesubcision to see if any of the scars were tethered but it seemed like the focus would be onmultiple phenol cross and laser treatments. He said that the Juvederm fillerwould be a small amount (.3 ml or cc).
This is what I was quoted:
subcision-1250
phenol cross- 300
juvederm filler- 550
erbium laser-500
Since all 4 treatments would be $2600 and I cant really afford that currently, Im thinking of doing just the subcision and phenol cross to start.And then after a few months doing the cross again with the erbium laser. Or would it be better to do multiple cross before startingthe laser? Im hesitant to do filler but probably will towards the end.Any advice?
Subcision and Cross are Rullan's specialties. Erbium may help but, if you have deep scars, I'm not sure if you will see noticeable results - even after multiple treatments. Erbium seems to be for shallow scars and ofter subtle improvement. Filler will offer immediate improvement but it goes away and the long-term cost is something to consider.
Cross may take many treatments for you to see results so keep that in mind. I had it done several times and didn't see any changes in my scars. It wasn't until my last appointment unless I saw improvement, and this was due to him painting the Carbolic acid around my scar, not on my scar. Weird concept because he never touched the actual scar, but the point was to lower the surrounding edges to soften the appearance of the borders. I got Erbium zapped as well. Seeing improvement but who knows if this is still swelling or not. Last time, I saw improvement but it ended up being swelling.
2 hours ago, dirigo39 said:
Would the sciton profractional be OK, or will it give me texture issues?
I think it depends from person to person but I had like 5 passes of erbium fractional laser and had more textured skin like dotted appearance. But I dont think I would experience that with a full ablative laser. I have a proven article on this by a derm in realself
please see responses by dr below:
https://www.realself.com/question/manchester-gb-correct-damage-caused-fractional-laser
https://www.realself.com/question/people-worse-skin-after-laser-threatment
sure full ablative laser has more risk but the trade off is huge in term of results from boxcars edges and overall texture.dr believe if going full ablative we need to go with erbium instead of co2 full ablative laser as that is safer but gives the same effect.
6 hours ago, getsmart121 said:I think it depends from person to person but I had like 5 passes of erbium fractional laser and had more textured skin like dotted appearance. But I dont think I would experience that with a full ablative laser. I have a proven article on this by a derm in realself
please see responses by dr below:
https://www.realself.com/question/manchester-gb-correct-damage-caused-fractional-laser
https://www.realself.com/question/people-worse-skin-after-laser-threatment
sure full ablative laser has more risk but the trade off is huge in term of results from boxcars edges and overall texture.dr believe if going full ablative we need to go with erbium instead of co2 full ablative laser as that is safer but gives the same effect.
Will sciton profractional fully ablative be ok for me then? That laser can be either fully ablative or not. Since my scars are wide, do I need to do each scar or can I do the whole cheek?
Do full cheek fully ablative erbium laserat the endwhen u dont see much depth in scars. Now focus on boxcar and deep rolling scar edges to smooth out using fully ablative erbium laser. See the video posted above where dr mark taylor is going around the scars edges. All this is going to make the scars edges smoother hence less noticeable so that u can later go for fillers. Make sure dr is skilled enough to smooth the scars.
I'd just do the subcision but make sure Dr Rullan cuts the tethers in the superficial dermis opposed to the deep dermis. and also suction follow this thread and do the same suctioning this person did:
You need to start suctioning once the subcision needle marks are healed AFAIK it takes a day or two. But you ideally want to start suctioning by day 3 after subcision. again make sure your subcision needle marks (wounds) are healed so blood doesn't weep out when you suction.
You need to suction by day 2-3 because your skin starts retethering25 days after subcision and rapid retethering happens day 5 to day 10.