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My understanding is that dermal grafts are expected to be permanent, which is the primary advantage over fillers. Last time he used the soft dermal tissue from behind ear. This time he dissected the epidermis off the 5 punch excisions and used that as the grafting material. He feels this works better because the punch graft material is firmer.

Stitches are in for 7 days then redermabond for another 3 days or so, at which point I can start swimming again. Prior excisions failed because Surgeon cut out an area with a couple small scars and there was too much tnesion on incision, so it separated. He did not use dermabond or intradermal stitches. I now know it is best to use the smallest possible punch and excise each scar individually. Prior surgwon was incompetent.

There is no downside to fraxel other than cost and time. But, the upside is not huge based on my experience. (i.e., low risk, low return)

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Can fraxel help the look of white lumpy uneven rough scar tissue? as i have this type of scarring after a botched dermabrasion on my cheek and jawline, and i just don't know what to do, all i know is i can't live any longer with this disgusting scarring on my face, i wont leave the house AT ALL because of it, it has ruined my life, I just want to know if fraxel really is an otion and if i will more than likely help, anyone think it will? has it helped anyone else with raised tough white scarring?

Please, please answer, i am so utterly desperate.

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Hi all,

I just completed a series of 4 fraxel treatments for acne scarring four days ago. My scars could probably be labeled as mostly shallow to moderate rolling scars, with more boxcar scars on my temples. I've actually been around the forums for quite a while now, but haven't really posted anything before.

Anyways up until now, I have not seen any improvement on any of my scarring. I was very confused as to why this was the case, as the cosmetic dermatologist I go to is very famous and has been regarded as one of the best laser surgeons in the nation. He also charges quite a large price tag accordingly (I paid almost 7000 for 4 Fraxels). However, upon examining the majority of the forum posters' treatment data, I was pretty shocked. It appears that most people have been receiving about 6 more passes per treatment than I have. My treatment data is listed below as follows..

Fraxel SR1500 treatments

Fraxel #1 3/15/07

40 MJ 2 passes with 312 density

4.03 kj

20% coverage

Fraxel #2 5/3/07

70 MJ 1st pass with 224 density

40 MJ 2nd pass with 392 density

5.22 kj

20% coverage

Fraxel #3 6/7/07

70 MJ 1st pass

45 MJ 2nd pass

4.74 kj

20% coverage

Fraxel #4 6/28/07

70 MJ 1st and 2nd pass with 225 density

4.22 kj

20%

From my treatment data above, would it be reasonable to assume that the reason I am not getting any results is because I'm not getting enough passes per treatment? I'm not really sure what to make of this at the moment. Like I said, my cosmetic dermatologist is one of the top in the nation, and I do trust his experience. It's just that the discrepency between my treatment levels and the treatment levels of fellow posters here is just way too big to ignore, and I feel I must question whether my treatment levels were high enough to improve my scarring. Thanks for reading.

I think the number of passes probably makes a difference, and my dermatologist indicated the same when I asked her about it. That being said, I have only been able to tolerate 4 passes on the aggressive settings on my cheeks (my scarred area). After 4 treatments, I am seeing improvements, but it has not been quite the miracle I had hoped for, by any stretch of the imagination. I have 2 treatments, left, however, so the jury is still out on if the downtime/pain/$$ are worth it.

I certainly do appreciate you posting your results. Finally, my suspicion are confirmed. You are the ONLY one on here who ventured into the 70 mjs settings multiple times and didn't see good results who posted about it. That is so so heartbreaking for me, but in a sense helps to know. I think I will probably discontinue my treatments after this. I am so so depressed :(

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Hi all,

I just completed a series of 4 fraxel treatments for acne scarring four days ago. My scars could probably be labeled as mostly shallow to moderate rolling scars, with more boxcar scars on my temples. I've actually been around the forums for quite a while now, but haven't really posted anything before.

Anyways up until now, I have not seen any improvement on any of my scarring. I was very confused as to why this was the case, as the cosmetic dermatologist I go to is very famous and has been regarded as one of the best laser surgeons in the nation. He also charges quite a large price tag accordingly (I paid almost 7000 for 4 Fraxels). However, upon examining the majority of the forum posters' treatment data, I was pretty shocked. It appears that most people have been receiving about 6 more passes per treatment than I have. My treatment data is listed below as follows..

Fraxel SR1500 treatments

Fraxel #1 3/15/07

40 MJ 2 passes with 312 density

4.03 kj

20% coverage

Fraxel #2 5/3/07

70 MJ 1st pass with 224 density

40 MJ 2nd pass with 392 density

5.22 kj

20% coverage

Fraxel #3 6/7/07

70 MJ 1st pass

45 MJ 2nd pass

4.74 kj

20% coverage

Fraxel #4 6/28/07

70 MJ 1st and 2nd pass with 225 density

4.22 kj

20%

From my treatment data above, would it be reasonable to assume that the reason I am not getting any results is because I'm not getting enough passes per treatment? I'm not really sure what to make of this at the moment. Like I said, my cosmetic dermatologist is one of the top in the nation, and I do trust his experience. It's just that the discrepency between my treatment levels and the treatment levels of fellow posters here is just way too big to ignore, and I feel I must question whether my treatment levels were high enough to improve my scarring. Thanks for reading.

I think the number of passes probably makes a difference, and my dermatologist indicated the same when I asked her about it. That being said, I have only been able to tolerate 4 passes on the aggressive settings on my cheeks (my scarred area). After 4 treatments, I am seeing improvements, but it has not been quite the miracle I had hoped for, by any stretch of the imagination. I have 2 treatments, left, however, so the jury is still out on if the downtime/pain/$$ are worth it.

I certainly do appreciate you posting your results. Finally, my suspicion are confirmed. You are the ONLY one on here who ventured into the 70 mjs settings multiple times and didn't see good results who posted about it. That is so so heartbreaking for me, but in a sense helps to know. I think I will probably discontinue my treatments after this. I am so so depressed :(

From what I understand about Fraxel it takes TIME. To state that because someone has ventured into the 70 mjs setting a few times RECENTLY proves or disproves nothing. It is not like traditional laser resurfacing where results are more or less immediate because the top layer of skin has been burnt off. I had my first fraxel yesterday. I will have one a month for the next 5-6 months. My derm appears to be reasonably aggressive beginning with 40 mj and 8 passes plus a couple of extra on my cheeks where scarring mostly is. HOWEVER, I am not even going to begin to look for true long-lasting improvements until 5 or 6 months into this. I am not saying fraxel does work, what I am saying is that trying to assess its efficacy on the basis of a couple of recent treatments is not the way to do it.

I also just wanted to say that I am nearly forty. I have lived with acne scars for many years. My heart goes out to all those that are younger and feel that scarring is ruling their life. I just want you all to realise that scarring is not a death sentence, it needn't stop you from doing absolutely ANYTHING you want to in life (except maybe being a poster model for acne preparations!). Despite my acne scars I am extremely happily married with two beautiful children and am living my dreams of being a writer with my first book coming out next year.

I don't say any of these things to boast about them, I simply say them to give you hope. You are not defined by your acne scarring. Getting rid of them is good, but they will not stop you achieving what you want to - believe me! Is is very, very important that you do not let them depress you to the extent that they rule your life.

Caesar2

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Thanks Caesar2, but it is so much easier said than done. And its because it is my face, MY face I am talking about and having to deal with scarring on the face is very traumatizing.

I also called Roche and told them about my experience with Accutane and the depression I am going through with the scars. I am also trying to see a shrink, but I just can't seem to get over it. I'm trying to be more postive, but it is so hard when I put so much work into my face only to have it look like hell still.

Anyway, POLOHO when the doc did your 70 mjs settings, did you have a lot of residual rednes and rawness lasting for weeks. Because that is what I had. I really thought the best way to go at acne scars are HIGH DENSITIES and HIGH SETTINGS for MOST DEPTH. You might be missing out on the former if he isn't doing enough passes. This is what I am HOPING is true.

It is just so hard because I truly lose hope when I see someone like you who has had multiple treatments at 70 mjs and still complains of unsatisfactory imrpoevemnt. In fact it scares me alot, and I wanted to know about this for so long.

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Ylem, you really need to compare total energy, not just the intensity. In my opinion, Poloho was undertreated based on her low total KJs. Perhaps her doc feared pigment problems because she is Asian. I have read articles where docs state that full face for acne scarring should be close to 10 KJs in each session.

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Hi all,

I had quite a bit of residual redness with the 70 MJ settings that lasted about about two to three weeks on average. However, my skin was never really raw to speak of after it all peeled off around day 7 or so post fraxel. As it is right now, I still feel Fraxel can be effective, though I did not receive satisfactory results at the moment. Keep in mind like many other people say, you must wait a few months to see the full benefit of it. Also, I am not the typical 70 MJ treatment example you would want to look at, since I was likely undertreated. It appears the average fraxel patient on here receives roughly 6 passes more than me, and a whole lot more energy as well.

Also, like Caesar2 stated, just because we have acne scars does not mean that it stops us from having a good life. While acne scars are very depressing and are quite the pain to live with, it is not the end of the world. A lot of us here are still young, and I am confident that acne scarring procedures will only get more and more advanced in the future.

In my case, I have to say that I was/am deeply affected by my scarring. I'm 21 now, and I've had scarring for roughly 2 years. In these two years, I've transformed from pretty social guy into a little more than a recluse. You know, after I found out I had possibly been undertreated for Fraxel, I expected myself to feel really bad, since it felt like I had so much riding on the success of this Fraxel. However, this was not the case, and for some reason, whether it be good or bad, I feel like through this fraxel failure/unsatisfactory result I have learned to come to terms more with my scarring. My scarring is shallow to moderate, and I have quite a large amount of it. Maybe even with future treatments it'll never all go away, and I'll never have perfect skin again, maybe it will.

We only live once, so wouldn't it be a total shame to waste your whole life sitting indoors thinking of your scars, and how much better your life could be if you were scarless? I went out to a social event for the first time in a while yesterday, and I have to say that my scarring apparently did not detract anything from my social experience. I still had a really good time, and it was good talking to all those friends that I had neglected or stopped hanging out with due to my scarring. Basically what it comes down to is we can either live with scarring, and have a fulfilling life filled with friends, family, significant other, a good career and such, or we could live with scarring, and have none of those above. Which one would you rather pick? I believe I made my choice yesterday, as it still is very fun hanging out with my friends, even though I have acne scarring.

For now, I will probably just wait out a few months so I can get a good estimate of my fraxel results. I'm leaving the country soon to start a new job in Japan. As I am a recent college graduate, I'm going to try to focus on my career mostly for the next few years, and try not to let the scarring get to me too much. I still have treatments/procedures done when I can, but like I said, I'm going try not to think/concern myself with the treatments too much, and instead redirect my energy elsewhere. Whats the point in worrying about something you can't control? It's just unneeded extra stress. Good luck to everyone on the board with their treatments, and thanks Caesar2 for pointing out the painfully obvious but not always apparent fact that life does not end with acne scarring.

Oh, and Billyboy, I'm a guy.

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how many of you have noticed drier skin after fraxel (not just while healing but long term). im curious whether moderate to high levels can affect oil and sweat glands, either inhibiting or denaturing them.

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Sheryllynn - I noticed on another post that you had seen Dr. Sire for subcision... how were the results? I've seen Dr. Sire previously as well for a consultation, but he refused to do subscision on me without a filler such as restylne underneath it.. much to my disappointment. Did you have any temp filler injected under your scarring?

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well just completed my 5th fraxel with new tip but suprisengly they couldent go more then 40mj still so i did 40mj level r1, 10-12 passes

i might go for 1 more next month and thats it for awhile let my skin rest and i have noticed gradual improvements so far.

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i am set to get fraxel in a few weeks for my acne scarring. i just want updated feedback from anyone that has had negative results from the fraxel 1500 (the new version). also, any recommendations on supplements i should take before hand? any other recommendations? thanks so much!

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how many of you have noticed drier skin after fraxel (not just while healing but long term). im curious whether moderate to high levels can affect oil and sweat glands, either inhibiting or denaturing them.

Hi. After my 1st fraxel session, i noticed that my skin's oil prod'n has been greatly reduced. It has minimized the appearance of pores so this may have contributed to that effect. I'm hoping that this is something long-term, & not just a temporary side-effect of the treatment.

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Sheryllynn - I noticed on another post that you had seen Dr. Sire for subcision... how were the results? I've seen Dr. Sire previously as well for a consultation, but he refused to do subscision on me without a filler such as restylne underneath it.. much to my disappointment. Did you have any temp filler injected under your scarring?

Hi Poloho - Yes I did have restylne injected after the subcision. I had great results on some scars. I want to have it done again on other scars but I have to wait until after fraxel because of filler.

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well just completed my 5th fraxel with new tip but suprisengly they couldent go more then 40mj still so i did 40mj level r1, 10-12 passes

i might go for 1 more next month and thats it for awhile let my skin rest and i have noticed gradual improvements so far.

Hi Wildbb99 - what was the doctors reasoning for not going higher than 40mjs??

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how many of you have noticed drier skin after fraxel (not just while healing but long term). im curious whether moderate to high levels can affect oil and sweat glands, either inhibiting or denaturing them.

Hi. After my 1st Fraxel session, i noticed that my skin's oil prod'n has been greatly reduced. It has minimized the appearance of pores so this may have contributed to that effect. I'm hoping that this is something long-term, & not just a temporary side-effect of the treatment.

of course it's short term. Your sebaceous glands have been cooked a bit, so they won't be pumping out oil like they did until they've healed.

Retinoids and lasers that actually destroy or shrink the sebaceous gland are the only thing that reduces oil production permanently more or less. Fraxel doesn't even really specifically target your lower epidermal layer, it just burns little holes everywhere it's used, and of course bakes your skin a bit with heat energy.

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well just completed my 5th fraxel with new tip but suprisengly they couldent go more then 40mj still so i did 40mj level r1, 10-12 passes

i might go for 1 more next month and thats it for awhile let my skin rest and i have noticed gradual improvements so far.

Hi Wildbb99 - what was the doctors reasoning for not going higher than 40mjs??

there were none the machine couldent go more then 40mj even with the new tip

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Hi guys and gals. Just some quick info. Reliant just received FDA approval for its new Re:pair laser that uses co2 instead of erbium. They are currently conducting studies on acne and Re:pair. Here's a link to the news release:

http://www.reliant-tech.com/newsdetails.cfm?NEWSID=66

In a past study, new collagen replaced the entire ablated zone within 3 months of being treated with fractional co2. What's even more impressive is that the epidermis actually collapses/moves into the zone, thus, tightening in the skin and making the width of the scars smaller. Take a look at some of the biopsy slides:

https://www.imagestore.md/aslms/posters/241/#

It's weird: technology is advancing so rapidly right now. So for those of you haven't gotten the dream results that you want, don't despair. There are rapid advances right around the corner. Hopefully, the Re:pair will be available soon.

Best,

Robby

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Hi guys and gals. Just some quick info. Reliant just received FDA approval for its new Re:pair laser that uses co2 instead of erbium. They are currently conducting studies on acne and Re:pair. Here's a link to the news release:

http://www.reliant-tech.com/newsdetails.cfm?NEWSID=66

In a past study, new collagen replaced the entire ablated zone within 3 months of being treated with fractional co2. What's even more impressive is that the epidermis actually collapses/moves into the zone, thus, tightening in the skin and making the width of the scars smaller. Take a look at some of the biopsy slides:

https://www.imagestore.md/aslms/posters/241/#

It's weird: technology is advancing so rapidly right now. So for those of you haven't gotten the dream results that you want, don't despair. There are rapid advances right around the corner. Hopefully, the Re:pair will be available soon.

Best,

Robby

I posted my thoughts about this in Sanjoseskin's thread about the re:pair.

I will mention again: why are they not addressing the potential for acne scar improvement in the articles about this. They mention photodamage and occasionally mention surgical scars, but NO acne scars. None at all- it's the same song and dance as the last fraxel. And it reinforces the fact that they're not serious about acne scars, otherwise they'd be doing clinical trials on them with this new laser.

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Yelm,

The news release states that they are conducting trials on acne scarring in phase 2 and 3 of the study, only phase one has been completed, although I'm not sure who is conducting them. I know for sure that they are conducting studies on atrophic surgical scars and stretch marks. Suzanne Kilmer is currently conducting this study:

http://www.skinlasers.com/laser/clinical/closed.php

Although it doesn't pertain to acne scars directly, it does address atrophic scarring in general and, thus, acne (i.e. lost of collagen).

I posted my thoughts about this in Sanjoseskin's thread about the re:pair.

I will mention again: why are they not addressing the potential for acne scar improvement in the articles about this. They mention photodamage and occasionally mention surgical scars, but NO acne scars. None at all- it's the same song and dance as the last fraxel. And it reinforces the fact that they're not serious about acne scars, otherwise they'd be doing clinical trials on them with this new laser.

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Acne scars as a result of acne inflammation reach at a much deeper level than do surgical scars, of whatever kind, and stretch marks. Most on here would agree. I dunno still sounds fishy and I don't know if there will ever be anything for acne scars specifically.

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I have been to two dermatologists to see what I can do with the rolling scars I have. Both did recommend lasers, but one mentioned to use fraxel and then use fillers. I have been doing alot of reading up on this to see if this really would work or are they just trying to sell me on something that will not. I really got excited when I first heard about this as it is relatively new technology and the possibility that it could work. As the more I looked into this the more I think that there is no way that this could possibly work on rolling scars, how will any laser push up my indentations that I have. Sorry for being negative about this but I just don't see this working as a stand alone product for acne scars. I think it could work if it was added with say subcision, where you push up the indentation, set it in place, then use Fraxel to help build the new collagen. This is probably the route I will go, I just need to do more reading up on it and hopefully hear some positive results from people who have done it this way.

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I have been to two dermatologists to see what I can do with the rolling scars I have. Both did recommend lasers, but one mentioned to use fraxel and then use fillers. I have been doing alot of reading up on this to see if this really would work or are they just trying to sell me on something that will not. I really got excited when I first heard about this as it is relatively new technology and the possibility that it could work. As the more I looked into this the more I think that there is no way that this could possibly work on rolling scars, how will any laser push up my indentations that I have. Sorry for being negative about this but I just don't see this working as a stand alone product for acne scars. I think it could work if it was added with say subcision, where you push up the indentation, set it in place, then use Fraxel to help build the new collagen. This is probably the route I will go, I just need to do more reading up on it and hopefully hear some positive results from people who have done it this way.

Well, if you read this whole thread, fraxel has worked the best on rolling scars.

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Am visiting acne.org and fraxel thread after a long time. I am not doing / seeking to do any treatment and quite happy with my skin today. I was reading some latest posts in this thread.

Poloho, I did dermal grafts with Dr. Dhawan around 3.5 years back in four rounds ( first was test round ). They are still there and so permanent. As you guessed, some scars might be needed to be filled again and again until desired level is achieved. I guess, reason is it is difficult to estimate how much will get absorbed during healing and remodelling. Am wondering, when you had an overfill, did you go back to Dr Dhawan ? I had the same problem on 4 scars ( they were raised after 3 months ). He drained them with a syring to level it. In fact, I got one scar drained twice. He also injects cortizone if he doubts scar is raised due to inflammation. He had told me then that he can even replace the graft if required. What I liked about it is, it's low cost, local to the scar, minimal downtime and repeatable treatment.

I did 8 fraxel treatments, six months after the grafts. I think, that certainly helped grafts getting more togather with the rest of the skin. Before that, I did 2 erbium sessions with Dr. Dhawan but didn't think that was very effective as they were just like peels I had done before. Main purpose of fraxel also was to fill small and very shallow scars which couldn't be filled or cut or stitched and were disqualified by Dr. Dhawan for any scar revision treatment.

To all who keep emailing me about hyperpigmentation after Fraxel :

yes, I got significant hyperpigmentation from Fraxel though levels were not that high. Good news is, it is very treatable. I am female of asian Indian origin and have type 3 ( fair olive with yellow undertones ) skin. I also attribute it to the fact that after years of scar treatments ( especially blue peels ), my skin has become quite sensitive. But there are many non-white people on this forum having Fraxel and don't experience it. Texture wise, I got more than satisfactory results ( I was expecting Fraxel only as a finishing / minor resurfacing treatment ) s o I think, it was worth it.

I did these two things which were very effective in removing hyperpigmentation :

1. I started 3 months after last Fraxel treatment. This is important. I initially used Triluma but switched to combination of Obagi clear, Obagi blender and Tazorac ( 0.1 %) every other night. This is quite strong and peeled my skin every day. I did this for 3 months.

2. I did 3 IPL sessions after that. IPL works great for spot hyperpigmentation and is quite gentle.

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Coobreeze

Congrats on your success. After my disaster with floats by Dr. Y., I went to Dr. Dhawan based on your positive reference. So far, so good, but not fantastic on dermal grafts. Stitches come up tomorrow on 5 excisions, so I will know more tomorrow.

That said, when I think of the the money I spent with Dr. Y (many failed floats) and Dr. Chris Zachary (3 failed excisions) to end up with worse scars, I am really happy to have found Dr. Dhawan. Ironically, most of what he is fixing is the mistakes left by these 2 docs. I am confident he will get me back to a much better position than when I started with Zachary.

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