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Maya

Any questions for Dr Chu? Subcision,N-lite,Isolagen,Excision

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I am seeing Dr Chu tomorrow for subcision, N-Lite and excision.

If you have any specific questions that you would like answered, please post here before 8.30AM London time - and I will try and get some answers for you.

Wish me luck :)/

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well my GP referred me to him TODAY, so could u ask him if he would kindly hurry up with my appointment? i dont wanna wait 6 months lol

oh, and could u ask him what treatments he would recommend for surface redness? ask him what he thinks of the pulse diode laser PLEASE thank u

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Ask him about creating a blood clot in the area and what the true effect of this is.

Also if you remember Mark's post. Ask about the top layers of the scarred skin already being tensioned and damaged so regardless if you get collagen growth it will still not be able to force this tensioned skin to rise.

Good luck. I will say a prayer for you.

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Hey maya

Would you ask him if Isolagen helps skkin discolorations (red/purple/brown marks)from acne. On their website there is a picture of a burn victim and the "after treatment" picture is just amazing. I didnt quite understand how isolagen would help burn victims though.

2. What is it he recommends for these red/brown marks?

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Good luck Maya!

It would be interesting to hear which punch method (excision, graft and elevation) he thinks is best and why. I will have an excision myself in two weeks (can't wait :))

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Hello Maya! I hope all goes a lot of good! i'm sure you'll get the best of the improvements!

My question: What is the best energy of the laser for acne scars?? My doctor uses in my 3,7 j/cm2, and she tell me that is so high, but it is better. But i have readed in pages that usually the values are from 1,5 to 3 j/cm2. Can you ask him what level he uses in your face, and if 3,7 is better than low?? (another derm tells me that 3,7 is high, but is very good for the scars, because there is more stimulation of the collagen).

Good luck!

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Ask him about creating a blood clot in the area and what the true effect of this is.  

Also if you remember Mark's post. Ask about the top layers of the scarred skin already being tensioned and damaged so regardless if you get collagen growth it will still not be able to force this tensioned skin to rise.

A little confused about your question Will - please could you explain what you mean exactly, I don't recall much about Mark's post. Thanks.

Thanks everyone - I have noted your Qs and will check again before I go.

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Hello Maya,

Good luck tomorrow Maya. I wish I were going with you to see Dr. Chu!

Thanks for your offer to take our questions to Dr. Chu. I would like to know if he could see me for Isolagen (or to determine if I am a candidate for it) or if he could recommend someone that could help me. I am in the US, near Philadelphia, PA, and I really think he and Isolagen could help me.

I have hypertrophic scars on my right cheek from a chemical burn. Some areas of my cheek look like rolling scars and I have some hyper and hypopigmentation as well.

I'm highly motivated to do whatever I can to help my skin regenerate. I am using many of the suggestions on this board and they are helping.

Many thanks Maya,

Mimi2468 :):D

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Mimi - I think that Isolagen will be approved by the FDA early next year - it's better to wait for that to happen.

Surely, it would be difficult to make 5 trips to the UK every 2 weeks just to get the top up Isolagen injections?

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Why are your scars limited to this level of improvement? First think about how rolling scars are formed. Some of you will relate to this. First you get a cyst. The cyst fills. The irritated skin turns red. The cyst is drained or goes away. The red irritated area turns hard with dead skin. The dead skin sloughs away to leave a red mark which subsides over the next few weeks. The cyst has done damage to both the lower levels of the skin and the upper levels of skin as seen through your newly formed valley. Now you lack the collagen below (which can be corrected through the above mentioned procedures) but the outer layers of skin are also damaged which has also lowered the surface level of the skin. When the fibroblasts in your body produce new collagen, they are limited by the surface tension of the skin. They will stop producing when the tension has reached a predetermined amount. Therefore, they can only correct so much.  

This what he wrote. I just think it makes sense, but Dr Chu might agree or disagree. I will ask my doc but he probably wouldn't know.

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Yes, Maya,

You are right, it would not be easy to travel to the UK for the ongoing injections...you know, I just don't have certainty that the FDA approval for Isolagen will happen soon and I just don't want to wait another whole year. If I knew that Isolagen would be available in the US in early 2004, I would definitely wait till then. Maya, do you really think it will be approved soon?

I do think it would be of value to get Dr. Chu's opinion about whether Isolagen would be suitable for me so I would know if I should pursue it or not.

I can't help but think that Dr. Chu must have some patients who travel from the US to see him and I wonder how they manage it....

Thinking about you today Maya and wishing you well...

Mimi

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Mimi

I had a PM from a poster who has spoken with the inventor of Isolagen - Dr.William Boss. He said that Isolagen should be approved in January 2004 by the FDA. The doc also told him that other NEW lasers will be coming on the market that will be even better than the ones out now.

So... hold tight, it's not too long to wait.

From Dr Chu's point of view - Isolagen will NOT fill in deep pits - Isolagen fibroblasts go where they will (randomly) so improve your skin overall, so is good for uneveness all over.

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Why are your scars limited to this level of improvement? First think about how rolling scars are formed. Some of you will relate to this. First you get a cyst. The cyst fills. The irritated skin turns red. The cyst is drained or goes away. The red irritated area turns hard with dead skin. The dead skin sloughs away to leave a red mark which subsides over the next few weeks. The cyst has done damage to both the lower levels of the skin and the upper levels of skin as seen through your newly formed valley. Now you lack the collagen below (which can be corrected through the above mentioned procedures) but the outer layers of skin are also damaged which has also lowered the surface level of the skin. When the fibroblasts in your body produce new collagen, they are limited by the surface tension of the skin. They will stop producing when the tension has reached a predetermined amount. Therefore, they can only correct so much.  

This what he wrote. I just think it makes sense, but Dr Chu might agree or disagree. I will ask my doc but he probably wouldn't know.

Actually Will - I agree to a certain extent with what Mark wrote - that's why pits need to be treated from the inside (needling/subcision) to push the scars up and then combined with some sort of resurfacing.

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OK - I'm about to leave - will try and get all your Qs answered.

Thanks as always for all your support and encouragement. Really, it's a pleasure to know you all. :)

I'm looking at my bare face in the mirror - I would say that in the last 12 months, I have had around 50% improvement on my pits - 2 lots of needling, the subcision and N-lite with Dr Chu, regular lactic peels, copper peptides and emu oil... In another 12 months, I think I will be able to say goodbye to all this and be happy with the results (I am not looking for total perfection).

Laters!!

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Isolagen should be approved in January 2004 by the FDA

YAY!!!! :)/

Depending how much more improvement I get from the smoothbeam (and how permanenet the improvement is) I may be doing that next!

Good luck Maya! Can't wait to hear what the good dr. has to say!

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I'm back! I only got subcision and N-lite - Dr Chu thought that it was best to try the subcision again on the deeper pits because they have shown some improvement since my last subcision 6 weeks ago. He's going to see me again in 4 weeks and will do the punch excision then if necessary.

Isolagen:

Dr Chu confirmed that Isolagen is likely to be approved by the FDA early next year. I asked him how accurate the photos were of the burn victim on the www.isolagen.com website - he said that they had definately been touched up and that it was a marketing thing - that it wasn't possible to get the kind of results seen on that site. One of the nurses also said the same thing.

Isolagen does NOT help with pigmentation/red marks etc..

N-Lite

Dr Chu said that it is the same protocol whether it was used to treat acne. scarring or wrinkles.

N-Lite does not help with pigmentation either and he said that he thought the Yag Laser was best for that. (The only laser they have at Dr Chu's clinic is N-Lite)

At his clinic, he does not offer any treatments for pigmentation/red marks and says that he just tells people to let their skin heal naturally (in it's own time)

About settings - I asked Dr Chu what he recommends as a setting. He said that he has done clinical tests and that it didn't make any difference whether it was a high or medium setting, that there were some risks of burning on the high setting, that's why they stick to medium settings.

I pass has the same effect as several passes.

He also said that darker skins need lower settings as they burn easily - my setting was 2.5 - and I have pale/medium brown skin. The paler the skin, the higher the setting used.

Also, the N-lite does hurt when used on active acne, but does not hurt when used on scar tissue.

Punch methods

I asked Dr Chu which is the most effective - graft, elevation or excision - he said that excision is best as the others often leave a raised scar/keloid.

Will - he was vague with your Q.

OK - so I am off again to Dr Chu's in early Se[tember. If you think of more Qs, just post here.

And please - only ask about the treatments he uses, he mainly does N-lite, subcision, punch excision and Isolagen.

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Hello maya! thank you very much for your help.

Now, i'm in the 3 week after the new n-lite session, and 4 september i will have another. My doctor tells me that she will increase one level the energy (3,9 J/cm2). At my 3 week, i definitivily don't see improvement, but the other times it happens to me the same. Until 3-4 months i couldn't see any improvement.

But at this moment, for me the N-Lite laser is the best option. I'm trying to find two things: a) smoothbeam in Spain, to can prove it (i heared is very good, but a "little" ablative) and B) i`m sending mails to the program of TV in what i see the supposed "best" treatment for scars, they tell me that on 15 of september they will begin again the transmissions, and that i could ask then.

Good luck with the treatment, and thanks again for the information!

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Oops sorry - forgot to add something about N-Lite

This is more to do with acne, than scarring.

Whilst in the waiting room, I spoke with a guy who has been using N-Lite for 2 years. He is part of one of the clinical trials that Dr Chu has been conducting.

He said the following: He gets N-Lite every 3 months (for 2 years already) and after the N-Lite.. weeks 2 to 6 are amazing, real softening of the face (he didn't have any scarring) and all acne goes.. after week 6/7, acne starts to return again. So, it doesn't sound like it's a long term solution but is more effective when combined with something more invasive.

BTW - it was funny asking Dr Chu all these Questions.. I felt like a reporter with my little notepad firing questions at him - he had an amused look on his face!

One of his nurses said that I was his LEAST nervous patient.. but the MOST chattiest!!

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Guest Cubsfan

hey maya,

you know how you get a line scar after punch excision, do you know if Isolagen can fill that line scar in after excision? oh and whats the diff. between punch graft and elevation.

ta.

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I have had excision so iknow a few things about it and the different types. I am not a Dr so understand that before you read.

"standard" punch excision: A round instrument called a biposy punch is used to make a circular hole around your scar. The instrument is essentially a round razor and it cuts out the scar and leaves a perfectly round hole. This hole is then stitched closed and "should" leave a fine line scar in it's place.

OPINION: I HAVE NEVER MET A SATISFIED PUNCH GRAFT PATIENT AND 95% OF THE ONES I HAVE MET FEEL THAT THE SCAR WAS MADE WORSE, INCLUDING ME.

"elavation" punch excision: Same as above except the skin that is punched out is actually left in the hole but is left higher than level with the surrounding skin. The desired effect is to remove the actual depressed scar tissue and re-insert it into the hole level with the skin or slightly higher than the skin level so the tissue is no longer depressed like a crater and is returned to skin level.

OPINION: THE SKIN WILL ALMOST ALWAYS SINK BACK TO IT'S ORIGINAL DEPTH. SINCE IT IS REMOVED ALL THE WAY DOWN ABOVE THE MUSCLE, THERE IS NOTHING KEEPING THE ELEVATED PUNCH FROM SINKING BACK DOWN.

Punch skin grafting: Same principle as elevation whereby a piece of skin is put back into the hole as opposed to stitiching it closed. However, this time the skin is taken from another part of the body that isn't depressed, (healthy tissue). The good skin hole will be stitiched and then that tissue is placed into the scarred area hole. Both holes are identical in size and the same size punch is used to remove both. Skin is usually taken from behind the ear where a scar is less visible.

OPINION: FIRST OF ALL YOU WILL NOW HAVE AN ADDITIONAL NEW SCAR BEHIND YOUR EAR THAT YOU HOPE WILL LOOK GOOD. SECOND, THE SKIN FROM ANY OTHER PLACE ON YOUR BODY WILL NOT PERFECTLY MATCH THAT OF YOUR FACE SO YOU MAY HAVE A DISCERNABLE DIFFERENCE IN SKIN APPEARANCE. FINALLY, THE SKIN THAT IS REINSERT IGNOREED MAY HEAL AS A KELOID OR RAISED RED SCAR, MAY PUCKER OR LOOK ODD, MAY HEAL AS A ROUND SCAR, MAY NOT GROW HAIR (IF YOU HAVE BEARD HAIR) AND MAY NEED TO BE RE-TREATED IN THE FUTURE TO MINIMIZE THE ABOVE PROBLEMS.

Hope that helps.

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nottoobad: that is the reason of why i just only use N-Lite. I think subscision, etc... are bad for the skin. And i think that the only way to remove acne scars is just only to have repeated sessions of non ablative lasers, like smoothbeam or n-lite. Just this, repeated sessions every month. In two years, you'll have a different face.

Of course, lemon&vinegar method will help.

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"standard" punch excision: A round instrument called a biposy punch is used to make a circular hole around your scar. The instrument is essentially a round razor and it cuts out the scar and leaves a perfectly round hole. This hole is then stitched closed and "should" leave a fine line scar in it's place.  

OPINION: I HAVE NEVER MET A SATISFIED PUNCH GRAFT PATIENT AND 95% OF THE ONES I HAVE MET FEEL THAT THE SCAR WAS MADE WORSE, INCLUDING ME

I'm confused...did you have a punch excision or a punch graft? What kind of scar did you have and how come the scar looked worse? Did it reopen?

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Guest Cubsfan

thanks for the informative post nottoobad!

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I had a standard punch excision, not a graft. The scar was punched out with a 2mm punch, very small. It was stitched and even after the stitch was removed the scar was worse. I knew the minute I saw the stitch it was going to look worse but at that point it was too late.

For the record, Dr Rappaport told me he would never do excsion on anybody unless the case was very extreme.

As far as multiple Nlite sessions, I am not certain that the do anything. And at $650 a pop every six weeks you will be broke well before you are healed.

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