1. Last Week
  2. I don't think that's a fair critique of Dr. Lim.   He's a professional using medical grade tools in an office environment. Someone doing TCA Cross at home can damage themselves with just a toothpick.  We've seen it many times on here.  Sure you can do a lot more damage with a syringe, but is that really the fault  of the doctor?  

    And honestly, your scar is so small and minor given what happened to it several months ago.  I would absolutely not risk excision on the nose, which can potentially stretch and look worse.  

    Remember, when they do an excision, the incision is going to be larger than the scar so that the edges align flat.   You potentially could have a much longer and deeper scar.   

  3. Noticeable improvement.  Just wanted to say that your skin is not bad at all.  You're looking great.

  4. Last Month

    Forums Scar treatments 2 replies

    My general advice is to not go overboard on your first TCA cross procedure.  You need to gauge how your skin will react.  Choose a few scars that are deep and bother you the most and treat those.   If you have numerous ice pick scars and treat all at once, you will look BAD.   They will look wider and deeper for a while.   Just be mentally prepared for that possibility. 

  6. Subcision(with pics)

    Forums Scar treatments 15 replies

    I think your doctor is doing the right thing.   You want to go slowly.  We've all seen people on here who are so desperate to get all their scars treated in one session end up with problems.   It's a long process, so be patient or risk making hasty decisions.    

    He also seems honest because he is not pushing lasers on you.  Lasers don't do jack for rolling scars.   They're useless except for softening sharp edged boxcar scars.  

  7. If you get a steroid injection, make sure it is VERY diluted at a strength of 2.5mg/ml to 5mg/ml.   Do not go any stronger than that or you might get atrophy.   Fortunately, fat atrophy following a steroid injection usually fills back out, but there is a risk it may be permanent.  Better to go slowly.

  8. Overkill.  Do not do a deep peel.  Why would you treat perfectly good skin?  Your scars are so minor, just focus on the few ice picks you do have.   Personally I would just focus on good skin care and not bother.  The risk / reward tradeoff is not worth it. 

  9. Three days is really being optimistic.  Depending on aggressiveness, you will be swollen and have purple / yellow bruising.   

  10. Your scars don't look too deep, but they're accentuated by the redness and hyperpigmentation.   It causes any shadowing to be magnified even more.   I would do several sessions of Vbeam to fade the redness and then reassess the true depth of your scars.    

    In general, I think subcision and fillers would help to elevate the wider rolling scars and revolumize your mid face.  There is some slight facial fat atrophy from the scarring.  That also worsens the look of scars because they cause shadowing. 

  11. More Than a Month
  12. What I got from this is that genetics plays a huge role in how you heal. If one has a family history of severe acne, this shows that it is imperative that you hit the acne hard and early.   Cases like these do not "clear up on their own."    For me, the worst triggers were stress and lack of sleep.   For people with a family history, we have to adhere strictly to a regimen to prevent it from getting out of control.  

    If you are starting to get cysts, and if they begin to scar, you need to get on Accutane immediately.   Prevention is the only way to not deal with severe scars.  

  13. Who did you go to?   Usually you buy the entire syringe because once it is used on you, it is not sterile anymore.   They can save the remaining filler for another visit, but you pay for the full syringe.   Why would she charge for only a fraction of a syringe?  

    That doesn't make sense at all.   Did you see her open the syringe in front of you?  This struck me as odd.

    I would agree with the doctors.  I have had hyaluronidase and it never left atrophy and it was at a very high concentration.  Even if it did, your body replenishes the hyaluronidase every day.   Hyaluronidase also only has an effect on hyaluronic acid, not collagen or any other tissues.  

  14. Scam city.   This is not an ethical doctor. Doctors who demand patients buy their skincare line, push for packages of treatments, or create a  false sense of urgency are scam artists trying to get more money out of you.  Imagine if something went wrong, they would discard you as a patient in a heartbeat.

  15. The  Sculptra had to have been reconstituted 24-48 hours BEFORE your appointment.  I don't think he would change the game plan without your consent.  

    From your description it is most likely because not enough was used.  Two temples and 2 cheeks is a large surface area to cover.  When you say he injected the cheekbones, do you mean he was trying to lift the cheeks?  If so, that means he didn't actually inject the individual scars.  It means he might have injected it deep in an attempt to lift the entire cheek area.  

    Your temple scars look thickened, dense, and so it is hard for filler to stay put.   They will extrude and migrate to surrounding areas because of dense scar tissue.   It may require more subcisions to truly release all the adhesions.   

    In your case you don't really have volume loss so if fillers are to be injected, they have to be used superficially.  I mentioned this before and suggested Belotero since it can be used more superficially.  

    I think what happened is simply too little filler was used on too large an area, and injected too deeply.

    I completely understand your frustration.  Acne scars are extremely tough to treat.   It is very technically challenging to inject scars.   

    This girl is a Rullan patient and she did at least 4 or 5 sessions of fillers (Silikon 1000) AND Juvederm several times.    That's alot of filler.    One syringe in comparison is not much.  


  16. Scarless Healing

    Forums Scar treatments 9,928 replies

    Is everyone here too naive to realize that these companies have planted fake accounts to talk up their businesses?   One word : Theranos


  17. Scarless Healing

    Forums Scar treatments 9,928 replies

    I don't follow this thread at all, but frankly a lot of these companies remind me exactly of Theranos.   This was a multibillion dollar valued company and it was exposed as a complete, utter fraud.   And they survived for 15 years before they were exposed! 

    They had deals with Walgreens and seemed by all accounts to be a "legit" company until it all came crashing down.   Some of these claims from these biotech companies seem outlandish by a cursory review.   

    Just don't hinge your hopes on things that may never materialize.  

  18. Seeing your past posts, I expected them to be on the severe end of the spectrum.  But honestly, they are quite mild.   You could get away with some minor procedures, but I wouldn't bother with anything invasive.

    I think you've mentioned your mental health issues coping with them, and I really do think that it's more of a psychological issue than physical.   Yes, there are some minor scars, but literally no on would ever notice.  

  19. Well you finally found the right place.  People here are often times more knowledgeable than most doctors because we've researched / experimented / been in the trenches.    You'll get legit advice here.   I agree, you'll need revolumization with fillers for the sunken cheeks, subcision for the rolling scars.    The volume to your cheeks will make an immediate visual impact (Sculptra will take a few sessions for the collagen to be stimulated, whereas HA fillers will give you an immediate effect).  

    What you have going for you is that you don't seem to have very jagged scars, which makes it ideal for sub / filling. 

  20. I would never do permanent filler right out of the gate.  If you get donuting around a scar, it is permanent, and you'll have to repeatedly inject it with kenalog.  

  21. years of acne scar

    Forums Scar treatments 30 replies

    This is one of the best improvements I can remember on this forum for "textural" type scars.   This is where there are no deep or big scars, but numerous ones so close together.   Pat yourself on the back, this is incredible work you've put into this.  

  22. You're a good candidate for subcision and fillers.  What you have working for you is that your skin texture is mostly smooth.   The skin overlying the scars is not rough or jagged, which make them ideal for filling / subcision.   There is some volume loss in the cheek area.   If you fill this out, it will look immediately better because the shadowing will be reduced.

  23. Acne scar help

    Forums Scar treatments 104 replies

    Just quickly read through this, but awesome progress.   I'm not sure what you are deciding with filler, but if they truly are very superficial now, I would probably do a finer filler than Sculptra.   Sculptra is more for revolumizing wide areas of volume loss  / sunken cheeks.  It might be too unpredictable if used superficially since who knows how aggressive of a immune response your body mounts to the sculptra.  You don't want lumps.   Btout perhaps Dr. Rullan knows how to fine tune it so you avoid those lumps.  

    Reading all the great stories about Rullan makes me wish I could go back in time and started my journey with him.  Top notch guy all around.

  24. I think what is important is that the bands are severed, and if he can do that more safely with a blunt instrument and minimize collateral damage, thats a GOOD thing.  I also like that he's only making one entry point now, which will minimize the potential for incision site scarring. 

    Also, I think the use of cannulas will allow for more superficial subcision, something you can't do with a sharp scalpel-like instrument.   This is good for people with more textural scarring and widespread, but not deep pits.  

     To be frank, I think the incidents we've seen documented on here about his subcisions in the past causing too much hematomas prompted him to switch things up.   I think it's a positive development.  

    Thanks for this info.

  25. He seems willing to work with patients.  Just tell him you want to do a test spot.  A test spot is always a good idea.  Give it a shot, the worst he can do is say no, but you have a legit and logical reason why you want to do one. 

    This is why you should be careful with permanent fillers..


  26. Since they're superficial you can try Belotero, Restylane Silk, Juvederm Vollure (apparently new).  Voluma is too thick and hard to be used that superficially.  

    If you eventually want to do permanent, I would try Bellafill.   It's permanent and has the same risks as Silikon 1000 but at least it's FDA approved specifically for scars.   Also, I have read studies that show that lumps from Bellafill respond well to cortisone injections to flatten them, whereas Silikon 1000 lumps are very hard to treat once they form.  

    Spend the money and be safe rather than sorry.  Money you can always make back  

  27. For your scarring, I would be VERY wary of permanent fillers.   Your scars are widespread, but not very deep.  In these borderline cases, you may end up overcorrected and get bumps.  If you decide to do it, do it only on your deepest scars and WAIT and OBSERVE.     

    Remember, the volumizing from Silikon 1000 is only partly from the material, the other part of it is the collagen that your body produces to encapsulate / wall off the foreign substance.  That is why you have to wait 1-2 months to ascertain your immune response.  Also, while Rullan is a top notch doctor, there have been reports of people who were overcorrected or got lumps from temporary filler from him.

    At least in those situations you can dissolve the filler.   Being overcorrected with permanent fillers will cause a life long headache.   

    Do not do permanent fillers for your first time.  You have to KNOW first if your scar type even responds to filler.  Rullan can do an amazing job of filling your scars, but the unknown variable is your body's immune response.  Better safe than sorry.

  28. Yeah, I specifically suggested this doctor to the OP because they have the right scars - discrete, deep, soft shoulders, normal texture overlying the scars...If you have sharp jagged, small, but widespread scars it would not be ideal.  First, you'll more than likely get permanent lumps which are just as bad as pits.   

    Personally I think rolling scars are one of the easier but certainly NOT cheap types of scars to fix.