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dirigo39

What should I do next? Nothing works.

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I've done 3 subs, 3 rf micro, 1 erbium pixel, 2 sculptra, tca. . That big one the middle has lunch excised but the doc didn't make the hole big enough. I will definitely get a few more punch excisions. Asian but don't really have a problem with pigmentation. 

PXL_20220118_145956674._exported_0_1643474498071~2.jpg

Edited by dirigo39
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Why aren’t you considering subcision plus fillers it seems huge volume loss in spots. I don’t think body can create that much of collagen. I would suggest Subcison and filler in the same session. Fillers are injected using two methods one is a spot method and throughout method. Spot method is used for scar level depression and overall is used for large area. I don’t think punch excision is going to make a big difference, I don’t see any scars compatible with punch excision

https://www.reddit.com/r/SkincareAddiction/comments/kk779z/ba_one_month_post_acne_scar_subcision/

Also have you looked into subcision plus co2 gas it seems like the gas is injected into skin.

Edited by getsmart121
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I agree with getsmart. And that's a great link/example of a success story, whatever they did. That's one example of when TCA cross appears to have worked well on those tiny boxcars unless they did other stuff. The filler might be temporary for that person in the link though, can't tell. But 7 days in it's near 90% "improved" visually and she confirmed 4 months after it was "holding up" and while not perfect, I do believe the trauma likely does stimulate some collagen.

You might want to try to mimic that with sculptra or something else and subscision.

Edited by harmlessboy1441
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5 hours ago, getsmart121 said:

https://www.reddit.com/r/SkincareAddiction/comments/kk779z/ba_one_month_post_acne_scar_subcision/

Also have you looked into subcision plus co2 gas it seems like the gas is injected into skin.

Unlike the Reddit girl, who only had about 5 rolling scars (without any visible scar borders), OP has more numerous scars and additional issues with the scar edges. When you have "smooth" rolling scars like hers, you only need to inject fillers and it will look perfect. Moreover, Reddit girl had nearly flawless skin surrounding the scars, which helps immensely in the aftermath. OP displays uneven texture and the depth of her scars are also uneven, thereby making it more challenging.

I would first suggest eliminating the scar borders as much as possible. Then work on making more collagen to fill the indents. For treatments, I would suggest low density CO2 laser or TCA Cross (along with TCA peel) for minimizing scar borders, and Sculptra for collagen production. If you plan to get laser and sculptra, I highly recommend getting them together. Scultra needs to be injected first, then laser 2 weeks after.

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3 hours ago, Sirius Lee said:

Unlike the Reddit girl, who only had about 5 rolling scars (without any visible scar borders), OP has more numerous scars and additional issues with the scar edges. When you have "smooth" rolling scars like hers, you only need to inject fillers and it will look perfect. Moreover, Reddit girl had nearly flawless skin surrounding the scars, which helps immensely in the aftermath. OP displays uneven texture and the depth of her scars are also uneven, thereby making it more challenging.

I would first suggest eliminating the scar borders as much as possible. Then work on making more collagen to fill the indents. For treatments, I would suggest low density CO2 laser or TCA Cross (along with TCA peel) for minimizing scar borders, and Sculptra for collagen production. If you plan to get laser and sculptra, I highly recommend getting them together. Scultra needs to be injected first, then laser 2 weeks after.

True she still has some border but some scar bordrs are soft hence fillers. So all in all she would see good amount of improvement. At any given point of time there will always be few scars left that still would need to be treated. For treating scar borders high power co2 on edges.

@dirigo this is what angling of co2 laser look like

https://www.instagram.com/tv/B0jPnCVA5Lx/?utm_medium=copy_link

Edited by getsmart121
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I forgot to add I had 2 sculptra and tca cross :/

I read that reddit post, yes her scars were way fewer but theyre similar to mine. hazany was her doc. Werent there a few negative post by him? 

10 hours ago, getsmart121 said:

True she still has some border but some scar bordrs are soft hence fillers. So all in all she would see good amount of improvement. At any given point of time there will always be few scars left that still would need to be treated. For treating scar borders high power co2 on edges.

@dirigo this is what angling of co2 laser look like

https://www.instagram.com/tv/B0jPnCVA5Lx/?utm_medium=copy_link

Who in the US would know that technique? I don't mind traveling to Tehran to get this done. 

!!!

1Hazany

2 iran doc

3 Taylor libertator

 

Which should I do first? 

Edited by dirigo39
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13 hours ago, Sirius Lee said:

Unlike the Reddit girl, who only had about 5 rolling scars (without any visible scar borders), OP has more numerous scars and additional issues with the scar edges. When you have "smooth" rolling scars like hers, you only need to inject fillers and it will look perfect. Moreover, Reddit girl had nearly flawless skin surrounding the scars, which helps immensely in the aftermath. OP displays uneven texture and the depth of her scars are also uneven, thereby making it more challenging.

I would first suggest eliminating the scar borders as much as possible. Then work on making more collagen to fill the indents. For treatments, I would suggest low density CO2 laser or TCA Cross (along with TCA peel) for minimizing scar borders, and Sculptra for collagen production. If you plan to get laser and sculptra, I highly recommend getting them together. Scultra needs to be injected first, then laser 2 weeks after.

Yeah now that you point that out, that's a fair point but she looks like she'd benefit from similar things. She says above she tried sculptra twice and TCA cross. Is sculptra that hit or miss with people or are here differences to the reddit girl significant enough to not show progress with sculptra? 

Edited by harmlessboy1441
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12 hours ago, dirigo39 said:

Who in the US knows how to do angle CO2? Can a nurse at a medpsa do this? 

Well it’s just a mode on a laser not sure if it is available in all laser devices if some medspa has a good laser ask them about full ablative mode for co2. And tell them can you use it to target the edges , also another factor is settings. Doesn’t make sense to travel to Iran. Sculptra is semi permanent I am not sure if that can lift scars it more like absorbs by skin tissues and it is done for collagen production but doesn’t add volume as far as I know. You need to do fillers like HYalaronic acid or bellafil.

dr Taylor  does the technique for scar edges with erbium not sure if he does with a co2 laser though. Ask him.

 

Edited by getsmart121
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On 1/31/2022 at 12:27 AM, getsmart121 said:

Well it’s just a mode on a laser not sure if it is available in all laser devices if some medspa has a good laser ask them about full ablative mode for co2. And tell them can you use it to target the edges , also another factor is settings. Doesn’t make sense to travel to Iran. Sculptra is semi permanent I am not sure if that can lift scars it more like absorbs by skin tissues and it is done for collagen production but doesn’t add volume as far as I know. You need to do fillers like HYalaronic acid or bellafil.

dr Taylor  does the technique for scar edges with erbium not sure if he does with a co2 laser though. Ask him.

 

Bellafil is bad for scars I heard. Is there a technique I should tell my local doc to do for HA filler? 

 

Sculptra gave me a slight overall fullness. Didn't help scars. 

Edited by dirigo39
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This is what I know from dr rullan. He told he uses overall technique and then he also uses a spot technique for fillers.

Edited by getsmart121
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If this local doc doesn't know how to do angle CO2, is it risky to do normal CO2 over the entire cheek?

Is juvederm or restylene ok then?

Edited by dirigo39
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On 1/29/2022 at 10:39 PM, Sirius Lee said:

Unlike the Reddit girl, who only had about 5 rolling scars (without any visible scar borders), OP has more numerous scars and additional issues with the scar edges. When you have "smooth" rolling scars like hers, you only need to inject fillers and it will look perfect. Moreover, Reddit girl had nearly flawless skin surrounding the scars, which helps immensely in the aftermath. OP displays uneven texture and the depth of her scars are also uneven, thereby making it more challenging.

I would first suggest eliminating the scar borders as much as possible. Then work on making more collagen to fill the indents. For treatments, I would suggest low density CO2 laser or TCA Cross (along with TCA peel) for minimizing scar borders, and Sculptra for collagen production. If you plan to get laser and sculptra, I highly recommend getting them together. Scultra needs to be injected first, then laser 2 weeks after.

What kind of HA filler should I get?

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7 hours ago, dirigo39 said:

If this local doc doesn't know how to do angle CO2, is it risky to do normal CO2 over the entire cheek?

Is juvederm or restylene ok then?

You can do overall as well but you might not see much improvement. The reason why we target the edges is because that is what is making the scar visible. If you are driving on a road which pots are more visible from far. Obviously pots which has sharp borders not the rolling pots. The lesser the angle of the edge compared to 90 degrees the less it will be visible to other people. And the lesser the angle of scar edge, the more likely it will respond to filler.

Edited by getsmart121
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9 hours ago, getsmart121 said:

You can do overall as well but you might not see much improvement. The reason why we target the edges is because that is what is making the scar visible. If you are driving on a road which pots are more visible from far. Obviously pots which has sharp borders not the rolling pots. The lesser the angle of the edge compared to 90 degrees the less it will be visible to other people. And the lesser the angle of scar edge, the more likely it will respond to filler.

Even if HA filler work, wouldn't I have to repeat of every year?

This website said CO2 is better for acne scars than erbium.

 

 

Edited by dirigo39
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Yes co2 produces better results. They say co2 fractional is safer even in darker skin types but erbium has better safety profile. Co2 produces heat plus evaporation of skin tissue whereas erbium just evaporates. And as you have darker skin types are sensitive to heat due to pigmentation side effects. But if the doctor has experience he can dial the right settings and you,can do fractional co2 if you canT find doctor that do angled co2. I haven’t seen any method that can give huge improvement in shaving off boxcar edges as lasers I’m single session.

Edited by getsmart121
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On 2/1/2022 at 6:29 PM, dirigo39 said:

What kind of HA filler should I get?

Without first getting rid of the scar edges, HA filler wouldn't help. Like I stated in my previous post, I think you will benefit more by getting a combination of Sculptra and CO2 laser (low-density). Be sure to get Sculptra first, then laser 2 weeks later.

Good luck!

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1 hour ago, Sirius Lee said:

Without first getting rid of the scar edges, HA filler wouldn't help. Like I stated in my previous post, I think you will benefit more by getting a combination of Sculptra and CO2 laser (low-density). Be sure to get Sculptra first, then laser 2 weeks later.

Good luck!

I got sculptra and then rf micro, twice. 

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11 minutes ago, dirigo39 said:

I got sculptra and then rf micro, twice. 

Micro needling rf is not the same as co2 laser. That won’t help you smooth out edges, what serious lee is saying is to target the edge with co2. Low density means less area of coverage aka hitting scar edge.

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4 hours ago, getsmart121 said:

Micro needling rf is not the same as co2 laser. That won’t help you smooth out edges, what serious lee is saying is to target the edge with co2. Low density means less area of coverage aka hitting scar edge.

 

Do you think I should do the Taylor libertator first or CO2 the edges first? 

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9 hours ago, dirigo39 said:

 

Do you think I should do the Taylor libertator first or CO2 the edges first? 

Dr Taylor does full abaltive erbium laser on the edges and subcision in the same session. 
https://youtu.be/770n-Dh0iSY

Edited by getsmart121
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28 minutes ago, getsmart121 said:

Dr Taylor does full abaltive erbium laser on the edges and subcision in the same session. 
https://youtu.be/770n-Dh0iSY

I'm gonna ask a local medpsa if they can do my edges. It's going to be a nurse practitioner. Is this a dumb idea? 

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It’s settings and technique that is key. Maybe u can the medspa to do a small area and see of course with safe settings. See if they would do 

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Why do you think the 3 docs that did my subs didn't give me filler? Weiner, rullan, and Blake

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