1. Today
  2. On 4/11/2018 at 6:28 PM, Candy Says said:

    do you think this is fake?

    silicone_micro_injections2.jpg

    scar-revision-before-after-drgallo-624x4

    How?


    Well, pictures are pictures. I, for one, want to know about the missing details like what were the treatment protocols? How far were treatments spaced out, especially from the first to the last? Considering that not every patient will get the same result out of these treatments, what aftercare was utilized by the patient? Blah, blah, blah...

    Without any details, it's all noise. Sorry to say.
  3. What type of scars do I have?

    Forums Scar treatments 5 replies

    18 minutes ago, Byebyescars said:

    1) Can you please tell me what type of scars I have?

    2) I just bought the derminator - will this help with improving them? Should I also do TCA peels? And if so, how should I space these things apart?

    3) Or do you folks feel like I need professional treatment - and if yes, what would that be? Any suggestions are greatly appreciated. Thanks :) 


    1) You have a combination of rolling and boxcar scars. 

    2) Unfortunately, your scars are too deep to be fixed by Derminator or TCA peels. However, they will help down the road once the pits have been raised. 

    3a) You need various treatment modalities. However, I think it will be more easier if I grade your scar at the outset and reference the treatments based on that. From 1 to 10, I would grade your scar at 7 (roughly speaking). Scars above 5 requires more aggressive treatment like subcision. Severe scars are usually anchored to the bottom, hence the deeper indentation, and subcision is about cutting those bands. Scars below 5, on the other hand, would require RF treatments. From my own observation, subcision works very well for severe scars but not for mild to medium scars, and vice versa for RF. So you should consider getting a series of subcision (and filler) until your scars have improved from 7 to, say, 4. Then you can switch to RF like Infini.

    3b) If you can afford it, I would strongly suggest you add hyaluronic filler with subcision. You don't need to fill every pit, only the deepest ones that you suspect are tethered. Later, when you move up to RF, I highly recommend Sculptra (different type of filler).
  4. Yesterday
  5. 1 hour ago, aspirin said:

    1. Do most people usually do all their procedures at one clinic? There are places in my city that do RF microneedling and other places that do TCA cross, but not both.
    2. Is there an order that's generally accepted for scar treatment? Like subcision first, then microneedling, then fraxel, or something like that?
    3. Are there only limited amounts of times a procedure can be done? Like can I only do subcision X amount of times before it becomes a bad idea?
    4. I saw in another thread that 3 months is the recommended time between procedures. Do people get other procedures done during those 3 months (e.g. home TCA) or is it just sit-and-wait?


    1) It shouldn't matter as long as the operator/practitioner is qualified.

    2) Yes. You want to fill the pits as much as possible first before sanding the top, much like a road construction. Before you can repave the road, you need to fill the potholes first. 
    • For rolling and boxcar scars: 1) Subcision for deep atrophic scars; 2) RF microneedling for medium indentations. So subcision should be continued for deep scars until they're "medium grade", then move to RF like Infini.
    • For icepick scars: TCA cross.
    • Resurfacing: Once the scar beds have risen enough, you can sand any surface irregularity like the boxcar edges with either ablative erbium or TCA peel.

    3-4) No. You can get as many as you wish as long as it's working*. However, it's a good idea to give at least 3 months (ideally 6 months) to allow collagen remodeling to take place. A lot of doctors will push you to repeat treatments at 6 week interval. That is too soon, and will only disrupt the process. From my own experience, there was a huge difference in improvement when I got treated after 6 weeks vs after 6 months. I saw nearly no improvement after 6 weeks. I would also advise against doing DIY treatments during the 3 month period.

    * How much improvement you will get from any treatment largely hinges on your body's healing ability. While that depends on a lot of limiting factors like diet, environmental toxins, and genetics (well, no shit sherlock >_<), taking good supplements at least 3 months prior to the treatment helps IMO. Some of the supplements I suggest are vitamins C and E, zinc, and fish oil.
  6. Last Week
  7. what treatment works

    Forums Scar treatments 13 replies

    Well, OP's atrophic scars will definitely benefit from RF, regardless of which he uses. It's also worth noting that his icepicks are very shallow, more like enlarged pores than outright icepicks. In that regard, the non-insulated tip would be better suited for surface treatment from the coagulative damage to the epidermis.


    BTW the claim that Infini is more colorblind to ethnic skin, leaving less erythema than other treatments, is completely overblown. Don't fall for that crap. Even Lim says repeatedly that Infini is notorious for its carbon buildup. Personally, I've had a series of several Infini already and I've always been left with grid/red marks for extended period of time, up to 2 months at times. I too am ethnic in every sense of the word.


     

  8. 7 hours ago, aspirin said:

    1) Has there been much improvement in Fraxel technology since 2010?
    2) Is it worth it if I'm not able to get the strongest treatment?
    3) For Asians here, would you suggest another treatment that works well for Asian skin? The only treatment I'm not interested in is fillers.


    1) No
    2) No
    3) Yes. Depending on the type of scars you have, you can elect to get subcision, RF microneedling like Infini. as well as TCA peel or cross.
  9. Acne Scar Consultation w/ Dr. Rapaport

    Forums Scar treatments 10 replies

    2 hours ago, dazzed said:

    Uh okay.   That was..... Interesting.   The difference between a $125 in person consult vs the phone is that they can actually see you in real life.  The difference is more than obvious.   You're telling it's acceptable to charge $50 for a phone call and then $200 for an in person consultation?

    Honest question, what is your relationship to some of these doctors?  Why do you defend certain doctors so vociferously?


    Did you read the ENTIRE post, from the top to the bottom? That was NOT what he meant. 

    I've already stated that I was personally against paying for consultations. But, needless to say, you kinda get what you pay for. So if you walk into a FREE consultation and then come out feeling neglected because the doc was a douchebag, you really have no reason to gripe. That was your choice, just as it's your choice to go elsewhere.

     
  10. what treatment works

    Forums Scar treatments 13 replies

    58 minutes ago, thepwhisp said:
    @Sirius Lee  Thank you 60% sounds great.  I will definitely prep my body for the treatments.  I have a lady near me who does endymed intensif and shes about 40 minutes away give or take.  Do you think this is comparable to Infini?  There is also a doctor who is one of the best with infini about 3 hours away.  Do you think it's worth getting the infini over the intensif?

    The easy answer you hear all the time is that Infini is insulated and Intensif is not...so Infini must be better. Well, not really. In your case, however, I would think Intensif will be more helpful for those shallow icepick scars.

    However, I'll also add as a reference what Dr Lim has to say about the two.

    5b08714d07158_Screenshot(1).thumb.png.6f45a723167be06a808806bd729b1695.png



  11. Is the “ghost surgery” the subject of legal punishment in Korea?

    Recently a controversy has arisen about so-called “ghost surgery” practices, and people have voiced their opinions for legal sanction against such practices, which clearly undermine the foundation of medical ethics. However, there has been a lack of legal basis for punishing those actions. The present study aims to examine which pre-existing legal provisions could be applied to regulate ghost surgery.

    In other words, even if other medical professionals are present in the operating room, the operating surgeon who received consent must take overall responsibility for the whole process of the surgery. A surgeon should bear in mind that a violation of such duty can constitute a criminal offense.
  12. 7 hours ago, ScarsWillBeHistory said:

    In Korea, dermatology hospital includes "dermatology" in the name.(FYI, dermatology = 피부과) So the dermatology hospital's name will be something like "XX피부과." You can also find out if the doctor or clinic is the real dermatologist or dermatology on this website. (Written in Korean. So, you have to search it in Korean)
    http://www.akd.or.kr/test/test.html
    The first option : Search by address
    The second option : Search by the name of the hospital
    The third option : Search by the name of the doctor


    Just use the Chrome browser and have it automatically translate the webpage into english (or whatever your mother tongue is).
    7 hours ago, ScarsWillBeHistory said:

    As a Korean, I agree to these words 100%. Non-dermatologist doctors are also allowed to do the treatments. I am one of the victims. My life has been completely ruined since I got treatments from a non-dermatologist doctor I'd rather call a swindler.


    S. Korea to crack down on unregistered plastic surgery clinics after medical tourist complaints



    Check the above article to catch up on how things are panning out in Korea's lucrative industry with phonies clamoring to take their piece of pie. In the last few years, there has been a steady flow of news about how plastic surgeons (and these were doctors from reputable clinics) were allowing nurses and other non-trained (visiting) doctors to do their surgeries. 
     
  13. 6 hours ago, user54321 said:

    I'm not so sure what they mean by "23G needle", and whether that's nokor?  


    Edit by MOD: We do not allow medical information that can performed by posters here. As such Google for more information.  "NOKOR.".

    BTW have you done any background check on the clinic? Even though Korea is well known for its cosmetic procedures, there are still seedy clinics that you should avoid. This is especially true for those who charge much less than their competitors.
  14. Boxcar scars edges

    Forums Scar treatments 1 reply

    3 hours ago, Lorzz said:

    Unfortunately, I am Asian and live in SE Asia, where these procedures are non-existent.


    I don't mean to sound negative but I thought you got your previous treatment from Rullan, who I know doesn't operate in SE Asia. Why can't you travel out of country to get the proper treatment this time as well?

    Anyway, in order for you to correct the boxcar edges, you really need the fully ablative erbium. 
  15. Scar advice?

    Forums Scar treatments 6 replies

    1 hour ago, NicoletteCB said:

    I bit the bullet though and bought a derminator. I’m wondering if I also invest in a 15%-20% tca peel to be done at home, if I can get away with seeing improvments. 


    Read the FAQ for DIY instructions. You can also find video tutorials on Youtube. For TCA, I suggest you get 50% and dilute it to suit your needs. That way, you can gradually work up to 35%, which is usually the recommended strength.
  16. Acne Scar Consultation w/ Dr. Rapaport

    Forums Scar treatments 10 replies

    It appears that everyone love him on RealSelf and, equally, everyone hates him on Yelp. Go figure!

    I would usually write off anyone who charges a consultation fee. That tells me he or she places a higher value on money than the patient's concerns. Anyway, send him a detailed email with a few pictures and see if he replies in a timely manner.

  17. Scar advice?

    Forums Scar treatments 6 replies

    55 minutes ago, Johnjoeman said:

    what do you mean Full abaltive erbium for only 10-20% ?? 

    You mean if patient only does erbium (no TCA) improvement may only be 10-20% ? 

    Where as CO2 and TCA much more effective ? 

    What about multiple TCA Cross followed by one Erbium ablative laser at the end ?

    Is that as effective as Low CO2 and TCA in each setting combined ? 


    I can't answer for Obiwan but, considering that the OP's scars are mostly very shallow icepick, there's no need for fully ablative erbium, which is more suitable for smoothing out jagged boxcar edges. In her case, TCA cross will effectively raise the scar bed while the low density CO2 will close up the enlarged pores. 


     
  18. Remedies

    Forums General acne discussion 6 replies

    On 5/21/2018 at 8:51 PM, GracieP said:
    I use sulfur as a spot treatment...its awesome.

    I am just super prone to picking...

    What sulfur are you using? Have you ever heard of DMSO? It's also sulfur-based and works like a charm for bringing cysts under control. 

    When it comes to self-image, do you consider yourself as above-average? Then be content in knowing that 1 or 2 zits ain't going to matter. On the other hand, if you're below-average, then also be content in knowing that 1 or 2 zits ain't going to matter. You see, it's how you internalize how you see yourself that matters.
  19. On 5/21/2018 at 4:33 PM, Bell33 said:

    I applied Tea Tree Oil to it every night but it dried my skin out so I stopped using it and my acne just came back way worse as soon as I stopped, so I tried to go back to it but now my skin just rejects it and nothing has changed. 

    Ive heard the amazing reviews on the Indian healing clay mask so I got some and have been using it for the past two weeks, mixed with applie cider vinegar and tea tree oil...


    Are we talking about 100% undiluted Tea Tree Oil and Apple Cider Vinegar?

    If so, you're absolutely crazy. Where are you reading these crazy success stories? They're supposed to be diluted before using topically on the skin. For example, TTO is to be mixed with a carrier oil like olive oil or coconut oil. ACV is to be mixed with water.

    Your skin has probably developed dermitits (eg. allergic reaction). You need to back off of these products until your skin is healed. Give enough time for the skin to breathe.

    In the meantime, apply honey for 30 minutes at bedtime and rinse off with tepid water.

     
  20. What can be done about my scarring

    Forums General acne discussion 6 replies

    12 hours ago, Its_nic said:

    Well here's the scars from my right and left side. I don't have that many on my left side but on my right side i have a lot of scars. It looks a bit better currently because my acne has cleared and I had the infini rf but its only been since Saturday so I'm assuming the scars will return to normal soon 


    First, you're posting in the wrong forum. Head over to the Scar Treatments section for more in-depth help.

    At any rate, you have a mixture of boxcar and icepick scars. Each of these scars require different treatment modality. Your boxcars are fairly deep and would need treatments like subcision and Infini that would help produce new collagen. Icepick can be treated with TCA Cross method. Again, I suggest you make a new post in the Scar Treatment.



     

    12 hours ago, Its_nic said:

    I had the infini rf but its only been since Saturday so I'm assuming the scars will return to normal soon


    Okay, so you've already had Infini like 3 days ago. Yet I don't see much swelling, if any. Usually both microswelling and redness would last more than a week. Do you know what setting (eg. depth and power) were used? For your type of scars, a skilled operator would have gone pretty aggressively, which would have left a good amount of inflammation.
  21. Please help..!!!

    Forums General acne discussion 8 replies

    8 hours ago, blahblahblah12 said:

    well it kinda looks like the first picture, but not as manny bald spots. i have 2-3.. but as i read what are those, it seems to me like they are pimples not fungial infection.. it is the hormons i guess.. i try and change my diet and see what happens


    No, those are fungal infection. If you still see those bald patches, go get tested. Once the test comes back as positive, you will be given an anti-fungal medication for treatment. It's very easy to treat.
  22. Scars type and advice

    Forums Scar treatments 13 replies

    @One_day123 I think you should concentrate first on fixing the biggest pits. Just elevating these scars alone would give you a huge leg up IMO. You can do that by getting SUBCISION + FILLER. 

    Laser, whether CO2 or Erbium, should be reserved for last to smooth the surface once the pits have been filled. You priority, however, should be on filling (elevating) the holes. Advice given by @beautifulambition is a sound plan. Get a few more subcision with filler, then move up to RF + Sculptra. By then, you should see a noticeable improvement.

    Hope that helps.
  23. Please help..!!!

    Forums General acne discussion 8 replies

    17 hours ago, blahblahblah12 said:

    and after 2-3  months i started getting pimples like crazy.. especally in my head. when the pop the leave bald spots on my head and it takes months to grow back hair.


    Did it look like the below pictures? What you are looking at are the symptom of ringworm (tinea capitis), which is caused by fungal infection. They usually look like small pimples at first, but eventually get bigger in size, leaving scaly bald patches. Fortunately, hair will grow back in time.


    Image result for ringworm infection

    Image result for scalp ringworm infection
  24. what treatment works

    Forums Scar treatments 13 replies

    3 hours ago, thisistroublesome said:
    You grid marks last longer for infini as compared to co2 ? the marks from co2 only lasted for about a week in my case.

    how many infini did you have to go through ? 

    I had 3 Inifini. Maybe it's just me. Or maybe you have a thicker skin than me (no pun intended). It's probably different for everyone. Anyway, the bigger pressing question shouldn't be about whether there will be holes in your face but how much collagen can be stimulated so that your scar pits will be filled. Right?

    Okay, enough said. It's your call. I wish you good luck.
  25. years of acne scar

    Forums Scar treatments 26 replies

    2 hours ago, garyly said:
    • home microneedling ( not doing as much now)
    • intracel x3 
    • subcision with cannula x1 
    • cO2 fractionated laser x1 

    Good improvement but, damn, you did all that in the course of 1 year? That sounds a lot.
     
    2 hours ago, garyly said:

    can anybody tell me what concealer is best for my skin type i am thinking of dermablend 
    and what shade is for me? would be helpful as i am a guy really don't want to go into any cosmetic shops  


    Honestly, I have no idea but there are tons of Youtube makeup tutorial just for men. This is one of the better ones I think.
     
  26. what treatment works

    Forums Scar treatments 13 replies

    12 hours ago, thisistroublesome said:

    The red grid marks (both lines and holes) will last for a month or longer ? will my skin be permanently sensitive or only during the period of recovery 


    Since you've already received so many lasers, you should be just fine. It's usually those with virgin skin that reacts the worst. Anyway, redness and grid marks are expected up to 4 weeks. Sensitivity wise, well, any invasive treatment will make your skin sensitive for a while. But again, you'll be good in a few weeks.
     
    2 hours ago, thepwhisp said:

    @sirius lee Did you end up getting good improvement from your Infini treatments?  IIRC it was ages ago but did you end up maintaining those results or did they go back to normal to a certain extent?


    Overall, I see about 60% improvement. Scars are still visible but much better than before (much softer). Even the most visible ones have responded pretty well. What was a boxcar is now a shallow rolling scar.

    Here's what I would like to point out for those who are thinking about getting Infini or similar invasive treatment. Prep your body by taking supplements at least 3 months ahead of the treatment. This would be like collagen producing vitamins like A, C, E, as well as amino acids like Lysine and Proline. All of these will help you heal better. I also strongly suggest Serrapeptase, which I believe played the biggest factor in the outcome.
  27. what treatment works

    Forums Scar treatments 13 replies

    5 hours ago, thisistroublesome said:

    I thought fractional co2 laser treatments help with collagen growth. How does it thins the skin ? Does that means i shouldnt do anymore of fractional co2 laser. Will the skin grow back to the original thickness over time?


    Yes, CO2 does stimulate collagen--just enough to fill wrinkles. Unless you have superficial scars, that's not be enough. Wouldn't you agree after 6 treatments? Anyway, it's been documented that too many laser treatments will lead to the overall thinning of the dermis (eg. enlarged pores is one of its major symptoms). Only way to thicken the already thinned skin is through skin tightening and collagen stimulation.

     
    5 hours ago, thisistroublesome said:

    I did a little research on infini. Some reviews i read says infini treatments leaves some holes on the face due to the needles piercing the surface of the skin. Have you tried infini before ? Does it leaves marks ? Or thins the skin 

    How many tca peels will Be necessary?


    I've gotten several Infini in the past. For about a month, give or take, you will be left with red grid marks (both lines and holes). But they will disappear over time. Your skin will be more sensitive after the treatment.

    The number of TCA peels required depends on the % concentration used.
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