1. Atrophic scars is there a hope

    Forums Scar treatments 1 reply

    @Olqa9229 Thank you for your patience, because of our recent endorsement by Dr Lim we have high traffic to answer questions. Please be patient. I will try to respond to you in 24-hrs. Your main issue is PIE or wounding post acne (redness), you need a few sessions of V-beam to blend the skin color. - I see your causing this with TCA Cross. Regarding scars You mainly have surface rolling scars with some boxcars. I do not see fat loss. Filler would be hard to use for these type of scars. Consult with Emil when you see him on this. The second pic looks like there might be deeper depressions but I am not sure, .. .If so filler will help. 3 rf treatments alone would not help your scars (you don't want to start wit this). You need Cannular Subcision (3-4 sessions) throughout the cheeks. Good you are seeing Dr Emil. Yes you need subcision. I would do tca peels instead of tca cross after your subcisions. Emil will also uses laser. He could do fractional laser. If he angles the laser to the border of some of your boxcars it will smooth them out. After a few subicsions I would have him do a deeper peel with his erbium to do a resurfacing of the cheeks. Start with subcision. Are you using retin-a/tretinorin/differin nightly. I think we have to get your acne and oily skin under control as well is important to avoid scars. Have you considered Spiro for Hormonal acne, speak to Emil about this or a local derm. BA
  2. @Lalelu12345 Hi there the pictures did not attach. There is another step, choose files, insert into post, draft and submit. I cannot give relevant information until I see the pictures to customize your solution. This is concerning your going on Amazon and just buying random TCA that is 100%. TCA quality varies and the average user should not be using 100%, they can seriously hurt them self. Even MUAC does not sell 100% because it's considered illegal. People have burnt their face badly with high tca % acid. Many companies give you auto part cleaner or other mixed ingredients. Please read the TCA guide,... first post in the scar treatment sub is the FAQ - goto the TCA section, click the mega link for peels and read. You can really hurt yourself again. Try ebay and Amazon. I cannot help you get a illegal item besides giving this info. It is illegal to purchase TCA in Germany, this is why people buy it online. Read the guide it clearly says what TCA cross and a peel is. I cannot answer this question as there are no pictures included regarding the stamping. Because of our recent endorsement by Dr Lim it is taking us longer to answer posts. Please be patient it may be 24 hrs. BA
  3. @seattlegal90 I would say "at least" one month between. Peels can take 6 weeks to heal from depending on the %. It really depends on how you heal and respond. More healing time is always best.
  4. Chicken Pox scar

    Forums Scar treatments 16 replies

    I personally would not cut on my midline in this high movement and vascular area Glabella. Why not try the non- surgical methods first. Botox, subcision with a standard needle and saline. Angled co2 just to the walls of the box car. But a dermastamp and start stamping it at home. When they cut, ...it's always bigger than your existing scar. IF you do a few times of all the above then go the surgical route, I have seen things not turn out nice in this area as well as there is so many muscles and vascularity. Simple first.
  5. Derminator holes

    Forums Scar treatments 6 replies

    @AghhNe Yes "red" dots are normal. Healing can be slow in some people. After laser or rf needling some heal for a few months. You probably have sensitive skin. Do not go so deep next time and to the point of bleeding. I have had some do microneedling and be red for a few weeks. All of this is very much about how you heal. If you cannot use microneedling, ... then there is clear and brilliant which is expensive but gentler . Do a test spot on your face at a low mm depth without bleeding or pushing down to hard. Try to glide with HA serum and see how you do on a small test spot that was not treated. BA
  6. IF you could include some pictures of your scars I can help with a customized plan. I do not recommend excisions normally unless you have very few scars. Any time we cut and stitch that can lead to more scars. IT's sort of a outdated treatment if not used for a specific purpose. Treatment recommendations will be based off your pictures. Scars make shadows. Please use a flashlight or directional light for the pictures as this helps. BA
  7. Your picture is zoomed in, his is farther away. You have shadows, and he has bright light which hides things. Try the TCA cross locally. Remember they can get bigger and you need to repeat treatment several times. Then we laser w/ angled co2 or faxel and erbium resurfacing. If all else fails goto Korea.
  8. This is a Friendly Reminder, From: Beautiful Ambition (BA) - Thanks Everyone For Your Patience, Due to High Traffic From Dr Lim's Endorsement to our Forums I Will Respond ASAP (As Soon As Possible) - 24-hrs to your Private Messages and Forum Posts. Will get to everyone. Do me a favor to best help: Please include pictures of your scars making shadows with a flashlight or directional light so we can provide custimized help. Some people are having issues posting pictures. There is a extra step, we: "choose file" > "Insert Into Post" > Draft the message > and "Submit." New members might be throttled to one picture and approval of the first post. You can always try to PM me. I am often asked where is the FAQ (Lots of Info on Scars) or List of Dr's as a Courtesy: It's the very first post in the "Scar Treatments" Sub-Forum (see the location your are in at the top of the post). Dr's List are on the very bottom. Thank You For Your Patience and Understanding. To Your Scar(s) Improvement, BA
  9. Please Take a look at this post: That New Zealand article is flat out wrong. The white papers agree that TCA Cross is very effective to icepicks. How can you subcise something that goes to the bone and is not attached but devoid of tissue. Subcision is for skin depressions (atrophy) held by tethers. Icepicks and scarred pores are not tethers. TCA Cross is to raise the scar floor so we can resurface the skin. The nose is not again a cheek or temple. What would we be subcising with large scarred pores or icepicks, we would stab the sub instrument through one side of the scar and out to the other side of the scar (not releasing anything). Yes I think that's smart try tca cross at home several sessions, ... then laser the texture or peel. Co2 fractional / Fraxel is used to vaporize columns or in your case pores and shrink sebaceous units. You may dermastamp it at home if you wish to try. If you don't get results off this, travel to Korea, I linked a clinic in the FAQ (top post). Ba
  10. The Derminator Thread

    Forums Scar treatments 312 replies

    @Gookishe75 There are no general recommendations for needle length because were all different. Some have thin skin and some thick. Start with .5mm and build up to 1mm if thick enough. IF you hit bone, back off the depth.
  11. Hi Negga, ... your scars are severe and will take many treatments. You have extensive boxcars, fat loss in the cheeks and icepicks. I would never start with lasers first. Why, because you have lots of manual work to do on the scars before starting laser. You need extensive TCA cross and tca paint on or tca spot peels. This is where to the boxcars acid is painted on the floor of the scar only 3X in a session. TCA cross at a higher % is used on the smaller icepiclcks. Several sessions will be needed. I would do 4 sessions of subcision with filler for the fat loss in the cheeks. Treat again when you need a top up. I would then do co2 3-7% density with full power angled only to the borders of those boxcars. This will soften them. You can also do rf microneedling. A few sessions are needed. Lastly you will do multiple TCA pees for texture. Scars are not one and done. Many treat over 3 years as they have time and money. Separate out your treatments and space them a minimum of 3 months apart. Everything is optional. Because of your skin type start on nightly retin-a/tretinorin/differin and a konjac arbutin cream for cell turn over and to avoid skin discoloration. I think your scars are much more extensive than his plan and treatments should be spread out, the body is slow to heal. Thanks, Ba
  12. Hi @Hope828, I will try to help. Please attach the pictures, didn't work ... Posters often don't realize you have to find file, insert into post, draft, and submit,it. I have to see your scars to customize a solution. Subcision is very dependent (technique) on the one doing it. So while the kind RN might have done something, I have to see the pic to confirm. Microneedling while helpful will not fix scars alone. You need a multi-step plan. Please be patient, due to Dr Lim's recent endorsement of the boards I will get back to you as soon as I am able 24-hrs typically. Thanks! Ba
  13. @cali_scars Sure I would get the demrinator, ... it's cheaper than these places doing the treatment. I think you will benefit most from tca cross, and fraxel or co2 3-7% low density and the highest power . IT will take many sessions of tca cross. Allow proper healing time. Before delving into a home tca, perhaps have her do it ocne to see how you react, etc... We have a full guide in the FAQ - top post of the acne treatments sub, first post, goto the tca section, the mega link for peels. TCA work is based on skill, hopefully she is good as there are many methods of application. Dr Rullan is excellent and in SD if you can fly down for a few hrs, ... as a option if needed. Worry about laser once you try cheaper at home treatments or your tca cross with the doc. BA
  14. The Derminator Thread

    Forums Scar treatments 312 replies

    @ AghhNe "Any" needle can leave a mark on the skin, until it heals. Especially if you stimulate the tissue to bleed. I don't know of any procedure that is invisible or sensitive except maybe a cream for scars that is not highly effective. I am sorry you are having this issue. Many don't. Perhaps the setting was too aggressive for you or you do not handle this treatment or others because,... treatments again are personalized. The only reason I mention derminator is it's priced fairly for what it does. Many do these treatments at Dr's offices and could buy their own unit for the cost. If something better comes out for DIY purposes I will recommend that. Micro-needling has been heavily studied as effective in White paper case studies.IF you want try a manual dermastamp and see if it does the same thing,... that is the manual method. We only apply this to scars. Are you using the fastest setting. There is no need to bleed for the treatment to work. We are stimulating healing. If your referring to needle mars, ... those can heal in a few days for many people. When you get a shot from the Dr when does your injection site heal?Are you on any medications or blood thinners, ... some products when used with micorneedling can cause a allergic reaction as well, or bacteria can also cause infection if the site is not cleaned. Do you have any other issues when using topical, getting treatments done, healing from cuts, bruises, etc... Do you have sensitive or thin skin (dealing with any sort of sickness or auto-immune disease), ? These are the people who have issues with treatments weather at home or by Dr's. You are going to see red dots for a few days... the same as you would see if you had a shot at the Dr and bled.We all have different healing times, ... some of us our extremely slow healers and they do a peel and take months to heal from it. So maybe try a lower depth, ... not to the point of bleeding. Many people's cheeks are red for 3 days post microneedling, so that is not shocking. It's not a one day treatment. Have had many do it on a Friday and goto work Monday.IF it's not for you it's not for you. Laser can cause similar issues for weeks or months, ... peels, etc. It's all about how we heal. Perhaps put some makeup over it while you heal if it bothers you.Are you using a retin-a/tretinorin/differin nightly for cell turnover?
  15. Looks like you have a cross between scarred pores and icepicks. The nose is not a standard area, ... it's cartilage not traditional skin. Your scars do not look giant, so a bit confused by this. Was this Lim's analysis on Realself of you individual case or your thinking yours are giant. Yes TCA Cross can be done on the nose, and it does take a few sessions. Scars can look worse though before better so be aware they can become bigger. The point is to raise the scar floor and then Fraxel is highly effective for this or Co2 the nose and resurface it with ERbium or TCA peels. The scars are designed to get larger with TCA Cross, ... we are raising the scar floor in order to then laser the surface texture. Laser is a tool to deal with scars along with other treatments when necessary, ... no one thing will fix your scars alone. You can see Lim in AUS or Rulland in SD. I would not see Novick for this. Dr's in Korea could also treat this at one of the major dermatology clinic's for visitors as that is closer to you.
  16. Rolling/Boxcar scars, 31yo female

    Forums Scar treatments 2 replies

    Thank you for posting / sharing. You have Surface Rolling scars and some box cars. Subcision will help alot. Do 3-4 sessions of cannular subcison with filler. As they are surface scars you want something softer like Volbella, or Beletero. Other Juvederm products can work as well. You don't have to repeat subicsion till you need a top up and can space the below between these treatments. Spot peel or paint on to some of the pits, they put 3 coats of acid on the floor of the scar. IT takes a few sessions. Some Drs still call this TCA Cross. I would also do a few sessions of rf microneedling or co2 laser 3-7% low density and the highest power angled just to the borders of the scars. You can do a few tca peels for surface texture to end with or a erbium laser resurfacing to smooth out the texture. Treat as you have time and money, scar treatment is a marathon not a sprint. Space treatments at least 3 months apart, ... many treat over 3 years. All of this is optional. Subicsion will help you most. Picosure is not for scarring per say... It is good for Melasma and Discoloration issues.
  17. @spasticated Without a recent pic hard to determine. I can say your last pic looked good like you would heal. Obi was saying to do V-beam to deal with persistent redness in weeks 3-6. If the area was already atrophied aka the scar that was filled, ... the filler is gone, and it will need to be filled again. Your practitioner seems attentive and will fix the problem including filling it when things heal up. Those with scars have extra veins in strange places as the tissues are damaged, so things like this can happen. I would not worry about this too much right now unless you see serious concerns, please share and tell your practitioner. Healing is slow.
  18. Derminator holes

    Forums Scar treatments 6 replies

    @AghhNe I am sorry you are having this issue. Many don't. Perhaps the setting was too aggressive for you or you do not handle this treatment or others because,... treatments again are personalized. The only reason I mention derminator is it's priced fairly for what it does. Many do these treatments at Dr's offices and could buy their own unit for the cost. If something better comes out for DIY purposes I will recommend that. Micro-needling has been heavily studied as effective in White paper case studies. IF you want try a manual dermastamp and see if it does the same thing,... that is the manual method. We only apply this to scars. Are you using the fastest setting. There is no need to bleed for the treatment to work. We are stimulating healing. If your referring to needle mars, ... those can heal in a few days for many people. When you get a shot from the Dr when does your injection site heal? Are you on any medications or blood thinners, ... some products when used with micorneedling can cause a allergic reaction as well, or bacteria can also cause infection if the site is not cleaned. Do you have any other issues when using topical, getting treatments done, healing from cuts, bruises, etc... Do you have sensitive or thin skin (dealing with any sort of sickness or auto-immune disease), ? These are the people who have issues with treatments weather at home or by Dr's. You are going to see red dots for a few days... the same as you would see if you had a shot at the Dr and bled. We all have different healing times, ... some of us our extremely slow healers and they do a peel and take months to heal from it. So maybe try faster speed, a lower depth, ... not to the point of bleeding. Many people's cheeks are red for 3 days post microneedling, so that is not shocking. It's not a one day treatment. Have had many do it on a Friday and goto work Monday. IF it's not for you it's not for you. Laser can cause similar issues for weeks or months, ... peels, etc. It's all about how we heal. Perhaps put some makeup over it while you heal if it bothers you. Are you using a retin-a/tretinorin/differin nightly for cell turnover?
  19. Please help with this scar

    Forums Scar treatments 4 replies

    @djfumon According to the circle it's a rolling scar. People often get these, or smokers lines, or ... from using straws. subcision and filler is highly effective. Might need a few sessions. Laser for this area (CO2 also tightens things up for surface texture). Ba
  20. @Sibel Botox is fine, ... thousands/ millions of patients have had it for all sorts of conditions. No one has ever gone blind from it. Just get less units to start if your afraid. You don't have to treat around the eye,... just the upper forehead Frontalis. Botox really does not spread that far with a few units. Maybe you need to ease into it when doing some filler with someone you trust. Give it a try, ... a few units. The forhead scars would improve a bit. OF course you can try the manual things first. Ie. subcision, or rf needling. I would consider your issues 2 areas: forehead and cheeks/ lower. Different plans of action.
  21. Hi @cali_scars I would just do microneedling with her, ... that price is crazy but it is the bay area. Shop around for prices. Socal is cheaper if you fly down there. Med spa's are also a option. Good stay with TCA cross first, ... will take several sessions. CA - skin institute is price fixing the bay area, hence the high prices. They get a cut as well and boost the price. Shop around even Modesto. BA
  22. Please help with this scar

    Forums Scar treatments 4 replies

    Please post a pic so I can give you a customized treatment plan. Scars make shadows, ... use a flashlight or directional light. The very first post is called FAQ of the scar treatments sub, If you wish to read about scars. To post a pic people are having issues, ... insert, ... insert into post, attach, and submit. Thanks, BA
  23. Hi There, As we are growing and getting new member's thanks to Dr Lim's endorsement ;-). Can you do me a favor.... Please post here any international practitioner(s) you have "seen" or heard of that is not in the FAQ - list. They must do manual acne scar work like Subcision, TCA Cross, etc. Even if you have seen them in another post while browsing. Recommended Top 1% Acne Scar Specialists Dr. Davin Lim *** Highly Recommended, Famous Specialty Acne Scars Dr, YouTube Channel : Lasers and Lifts Brisbane, Australia Specialty: **Lasers for Acne Scars, Subcision, TCA Cross, Filler, PRP, Vbeam / Picosure, multiple treatments at the same time. http://www.lasersandlifts.com.au Dr. Rullan *** Highly Recommended as a Top Scar Dr For the West Coast by Many Forum Members Chula Vista, California Specialty: Subcision, Fillers, Sedated Acid Peels for ALL SKIN TYPES (teaches Drs how to do peels for resurfacing) Even Dark Skin, TCA Cross, Vbeam, Lasers http://www.drrullan.com/ Professor and Department Head Tony Chu Chiswick, London Specialty: Dermatologist Expert - Teaches Other Derms, Economical, PRP, Subcision, TCA Cross, Microneedle http://www.westlondondermatology.co.uk Dr. Emil Henningsen Denmark / Nyborg, Sweden Specialty: Subcision, TCA Cross, Microneedle, Lasers http://www.emilhenningsen.dk/behandling_ar/ Dr. Nelson Lee Novick *** Highly Recommended Acne Scar NYC Favorite Dr. NYC, New York & Israel - Prices 1/2 Off, perfect for Europeans / Middle Eastern Region Specialty: Expensive Famous Dr, Aggressive Subcision, Filler Master Injector, Can do Peels like Laser Resurfacing, TCA Cross, General Derm http://www.doctornovick.com Dr. Adrian Lim Sydney, Australia Dr. Davin Lim's Mentor While in Med School and Famous Derm Specialty: Fillers, Microneedle, Subcision, TCA Cross, Vbeam, Lasers http://urepublic.com.au/our-expertise/ Prof C.L. Goh Singapore, Malaysia Specialty: Lasers for Asian Skin http://www.nsc.com.sg/Patient-Guide/Our-Doctors/Pages/Dermatologists.aspx Dr. Mark Taylor Salt Lake City, Utah Specialty: Inventor of Full Face subcision w/ Taylor Liberator Tool (See Video Below) https://www.youtube.com/watch?v=sqoy5D6ilss Dr. Richard Sadove *** Highly Recommended Acne Scar Fat Grafting Facial Plastic Surgeon Gainesville, FL Specialty: Fat Grafting For Acne Scars, Subcision, Excision http://acnescarflorida.com/about-dr-sadove/ Dr. Jill Waibel Laser Burn and Traumatic Scar Specialist Miami, Florida Specialty: Jill specializes in major burn and body scars with lasers and steroids laser drip, grafting, surgeries, General Derm http://www.miamidermlaser.com/jill-waibel/ Dr. Weiner Youtube Channel: Dr Weiner Panama City, Florida Specialty: Expert Injector/ Plastic Surgeon /Famous trainer, pioneer Infini RF spokesman, Fillers, Laser, Aesthetics, Good friend of Dr Limhttp://www.theclinique.net _______________________________________________________________ "General" Recommended Dermatologist's and Plastic Surgeon's Who Treat Acne Scars Dr. Naomi Sydney, Australia Specialty: All Things Filler (Expert Injector), Skin Boosters, Lasers, Subcision http://drnaomi.com.au/ Renewme Various, Korea Specialty: Acne Scars, Subcision, Lasers, Plastic Surgery, Micro Fat Grafting http://rnmeskin.net/ Dr. Shivananjappa Boston, Massachusetts Specialty: PRP, Subcision, Rf Microneedling, HA & Bellafill Fillers, Laser Resurfacing https://shanthalamd.com/ Professor and Department Head UC Irvine Dr. Chris Zachary Irvine, California Dr. Davin Lim's Mentor While in Med School Specialty: All Things Dermatology - Main Focus is Laser Wrote books on the subject, TCA Cross, Subcision http://www.drzachary.net/ Dr. Sandra Lee AKA Dr. Pimple Popper YouTube Channel Upland, California Specialty: General Derm, Popping Pimples and Cysts, Extractions, Acne Scars, TCA Cross, Microneedle, Subcision http://www.skinps.com/ Dr. Kim Hollywood, California Dream Clinic - Plastic Surgeon in LA Also Has Clinic in Korea Specialty: Fat Grafting, Korean Face Lifts, Subcision http://www.drkennethkim.com/meet-dr-kim/dream-medical-group/ Dr. Suzanne Kilmer Sacramento, California Specialty: Lecturer and Trains Drs on anything about Lasers http://www.skinlasers.com/ Dr. Evan Ransom San Francisco, California Specialty: Facial Plastic Surgeon, Infini RF, Lasers, Aesthetics, Dermabrasion, Subcision http://www.sanfranciscofacialplasticsurgery.com Dr. Seven Swengel Los Gatos, California Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.RefinedMD.com Dr. E Victor Ross San Diego, California http://www.scripps.org Dr. Joe Niamtu YouTube Channel: Joe Niamtu Midlothian, Virginia Specialty: plastic surgeon and trainer laser expert, fillers, subcision, chemical peels, excision, dermabrasion, and scar revision Now does Taylor Liberator Subcision from DR. Taylor below in Salt Lake, Full Face aggressive Sub done by a plastic surgeon. http://www.lovethatface.com/ https://www.youtube.com/watch?v=sqoy5D6ilss Dr. Yang NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.GeorgeYangMD.com Dr. Ron Shelton NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.thenyac.com Dr. Roy Gerononus in NYC, New York Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.laserskinsurgery.com/Dermatologists/Roy-G-Geronemus-MD Dr. Berry Dibernardo Montclair, New Jersey Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.newjerseyplasticsurgery.com o2Clinic Antwerp, Belgium Specialty: Micro Fat Grafting / Injections, Lasers, Plastic Surgery http://www.o2clinic.be/en/ Dr. Philip Bekhor Box Hill, Melbourne, Australia Specialty: Lasers, TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.drphilipbekhor.com.au/ Richard Ort Lone Tree, Colorado Specialty: Subcision http://www.myskincaredoctor.com/ Dr. John Burns Dallas, Texas Specialty: Aggressive Subcision http://drjohnburns.com/ Dr. Sam Lam Plano, Texas Specialty: Fat Grafting, Plastic Surgery, Microneedle, Fillers, General Derm http://www.lamfacialplastics.com/ Dr. Michael Gold Nashville, Tennessee Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.goldskincare.com Dr. Tina B. West Chevy Chase, Maryland Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.westskinlaser.com Dr. Noelle S. Sherber Washington, District of Columbia Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://sherberandrad.com/ Dr. Moon Choi Vancouver, Canada Specialty: Subcision, TCA Cross, infini Dr. Benjamin Barankin Toronto, Canada Specialty: Energy Devices, Subcision (?), TCA Cross, infini Dr. Sheldon Pollack Toronto, Canada Specialty: Energy Devices, Subcision (?), TCA Cross, infini Dr. Payman Kosari Toronto, Canada Specialty: Plastic Surgeon, Fully Ablative Erbium Resurfacing, Subcision, Energy Devices, TCA Cross, infini Dr. Jeffrey Orringer Ann Arbor, Michigan Specialty: Subcision, TCA Cross Dr. Murad Alam Chicago, Illinois Specialty: Subcision Dr. Steven Mandrea Chicago, Illinois Specialty: Subcision with sculptra
  24. Acne Scars 10 years after Isotretinoin

    Forums Scar treatments 1 reply

    Hi there you mainly have box cars and icepicks all over the face. You will need 3-4 sessions of cannular subicision. You can do a bit of filler if you want. As you have box cars you need paint on / also called spot peels / or some even call it tca cross. Acid is placed on the scar bed only, 3x. You can see the application steps in the FAQ- top post of the acne scar sub, tca section, mega post link to peels, and paint on. Several sessions of this may be needed. TCA cross is done to the smaller ice picks. You will need angled co2 at 3-7% density with full power only to the scar borders to soften them. RF microneedling is also very effective for boxcars. The forehead is harder to treat (Very thin, does not respond as well, and many use botox, normal needle subcision, rf needling and angled laser. Once you raise the scars several tca peels can be done, or erbium resurfacing. You have ethic skin so please apply tretinorin/differin nightly and a arbutin cream with konjac for sell turnover and to avoid hyperpigmentation. Treat as you have time and money, everything is optional, I suggest waiting 3 months between treatments as this is how the body heals, ... many treat over 3 years. BA