Prioritise subcision. You appear to have a lot of tethering, this will give you a big improvement. Tca cross any shallow ice picks or boxcars, punch any deep ice picks and dont let him touch your face with tixel its a waste of money go for something a bit stronger but wait untill youve lifted the scars first with subcision and tca. Then go for in one treatment deep erbium full ablation 400 microns in areas of scarring 200 in others to blend and over that straight after c02 fractional deep low density this will promote deep collagen regeneration filling your cheeks out. Once this has all healed use a ha filler to fill in any remaining volume loss

Thank you very much for this. It's great to be able to go to the appointment with an idea of the best approach is. I'll be sure to avoid tixel;it's also very expensive. I haven't heard about erbium but I will look into this as a follow on treatment as you recommend. I notice that fillers are sometimes used alongside subcision, is this something I should avoid? Also do you know how many sessions I can expect to have to do?

49 minutes ago, InstinctiveBaritone said:

Thank you very much for this. It's great to be able to go to the appointment with an idea of the best approach is. I'll be sure to avoid tixel;it's also very expensive. I haven't heard about erbium but I will look into this as a follow on treatment as you recommend. I notice that fillers are sometimes used alongside subcision, is this something I should avoid? Also do you know how many sessions I can expect to have to do?

There are varying levels of subcision, some more aggressive than other I would recommended a more aggressive version like Taylor liberator. Filler with subcision can be misused by doctors as they sometimes do a poor job of the subcision and then just stuff it with filler to make it appear better in the short term. So if you can try and avoid it. For amount of Tca treatments it just depends on how shallow the scars are, you want to get them to a depth where you can lasers under them then you will basically eliminate the scar.

Ok, I will check if the doctor uses the Taylor Liberator. If not, will the standard subcision needle be ok? I will make sure to discuss not using filler right away so I can see the actual filler result.

As for the larger and wider scars, would they need to be treated with punch excision?

8 minutes ago, InstinctiveBaritone said:

Ok, I will check if the doctor uses the Taylor Liberator. If not, will the standard subcision needle be ok? I will make sure to discuss not using filler right away so I can see the actual filler result.

As for the larger and wider scars, would they need to be treated with punch excision?

The needle one is still viable, it will just take more treatments and potentially less effective. So in the long run it might be worth while seeing a different doctor as it might be cheaper. The larger/deep scars can be excised if its just one or two but I wouldnt do mass large excisions. I would probably just lasers the edges and lift it up with filler and subcision.

Thanks so much for walking me through this. I looked further into the Taylor Liberator method and saw some polarising opinions. Some dermatologists think it's too much whereas others swear by its efficacy, and this opinion seems to be shared on this forum also. Do you think it's a much riskier option, or am I overthinking it?

As for the excisions, I'll be sure not to go for too many. There are definitely a few large scars that may be worth doing (largely some of those in the upper left region where it'sreallybad)as those ones sometimes show up even in regular lighting!

My appointment is on Friday so I'll share the outcome of the discussion with you. Are there any questions you think I should ask when I'm there?

29 minutes ago, InstinctiveBaritone said:

Thanks so much for walking me through this. I looked further into the Taylor Liberator method and saw some polarising opinions. Some dermatologists think it's too much whereas others swear by its efficacy, and this opinion seems to be shared on this forum also. Do you think it's a much riskier option, or am I overthinking it?

As for the excisions, I'll be sure not to go for too many. There are definitely a few large scars that may be worth doing (largely some of those in the upper left region where it'sreallybad)as those ones sometimes show up even in regular lighting!

My appointment is on Friday so I'll share the outcome of the discussion with you. Are there any questions you think I should ask when I'm there?

I think due to the fact you have quite widespread tethered scars, it would make sense to go with Taylor liberator otherwise it would take a very long time using other methods. Also I would only excise if there is extreme textural damage if its just a volume loss avoid it

Its hard to determine subjectively what is the best treatment/procedure for scars like these, as I also have them too. Ive done plenty of treatments and am nowresorting to excisions, which are risky in terms trading a scar for another scar which could be worse or better. With that said, I cannot for sure determine what would be the best course of action for you because its all based on individual factors that are all hard to control.

You may response well to treatments that I didnt respond to and vise versa. The majority view here is that scar treatment is doctor specific, meaning that the doctor you choose in treating your scars is the most important variable. I have used the opposite approach for some time and its hard todiscern whether my progress is hindered by it or whether it doesnt matter. However, when it comes to actual surgery, thats where I go to doctors that have excellent experience and can back it up.

I think my point is that we all have our own approaches but we are all still trying to figure out what is producing long term results and those that arent, which is individually based in my opinion.

I like toread studies or trials on scar revision to educate myself but the task is never fully done. Education is a constant. I think this is the most important aspect of trying to resolve scars, to know that somethings procedures are ineffective for you individually and vise versa and in order to try to mitigate these things, try to research standards and people in studies with your similar scarring and try to understand a doctors specific technique or the manner the equipment is used to better understand what may occur for you.

So far, Im doing excisions, lasers and Im looking into this new technology called micro-coring (approved for facelift alternativebut I am predictingpotential use in scarring) where it takes micro-punches of the skin without any scarring.

I could be very wrong in my plan for my specific scars so I wouldnt ever advise anyone to do what I do or say but I document my journey here to help people and guide them in what may be the best approach for themselves. Only you must determine this through due diligence.

So, idk, I hope this was helpful in some way to you because when I started this journey I wish someone told that to me. It would of better prepared me emotionally and financially to take on the burdens of scar revision. But ah! life is still precious and beautiful no matter what sits on the surface of your skin, just keep that in mind. your worth is not fixed on the texture of your skin. I try to remind myself of this when I look at my reflection and feel the creeping sensation of dissatisfaction. dissatisfactiona poison in large doses, especially with this new age of taking photos and videos in every span of time and posting it for others to assess.Be mindful and be kind to yourself.

Thats all I want to say.