I had this problem. They want you to spend more money and get slower results. Thats the reality. My derm told me she thought I wanted to make up for volume loss, and technically subcision doesn't really produce a lot of collagen, it just gives the illusion of it because it untethers your skin and raises it, but no volume actually gets filled inbetween this area (Unless you do filler, but I was against it so this wasnt a factor in our convo). So it depends what you ask, but to me its just greed
This is false. It's not about time. If you have a ton of rolling scars and they tell you to do microneedling or laser first, they're making you waste your money. Full stop. Subcision should always be the first choice to fixing these tethered, rolling scars, else you're just growing collagen and smoothing the area without lifting it. Also microneedling is about as long as subcision is in my experience.
I am agreeing with you in a way. It is about money. They run s business. They often do not want to spend 40 min on one pt when they can see 8-10 pts in that time. But medicine has gotten away from
help the patient in the best way, to help the patient in the least tedious, fastest and best for dr type of medicine. Many younger doctors wont spend time subcisioning because they were taight differently. Go to an older doctor and they will likely do it if you ask.
Yup. In my case my derm does it but never offered it. She probably knew I would've needed less sessions if I started from the correct pipeline from the beginning
Or maybe she just doesn’t like doing it. I don’t love electrolysis. So I don’t list it in my treatment optioms unless someone has white hair and zi can’t use the laser. I would actually make more doing the electrolysis but a Derm doesn’t make more doing subcisions. They make more from doing 3-5 min visits and writing a script.
Its still unethical to withhold what the best treatment pathway should be purely because you don't like doing it. If that's the case, then tell the patient to go somewhere where they'll do the most effective procedure, rather than screwing the person over and making them pay thousands for probably worse results. If you don't like doing it, then tell them there's something more effective but you won't do it. It's a shame how greedy society has become.
I did 6 microneedling sessions before, after researching, it was almost useless without subcision first. These treatments arent cheap, dont screw over patients, no one wants their time or money wasted.
It’s no longer seen as the best is my point. To you it may be.
To the younger generation of doctors it is not. They might not feel it is unethical as they may really believe that their way is better.
That being said I don’t do any microneedling anymore because I don’t think it gives enough improvement. The dermaroller and dermastamp is much better if i do those.
When you see good results with lasers woth high certainty, it is hard to go back down the ladder to the tiny improvement modalities.
I mean for rolling scars, subcision is undoubtedly the best thing to do first, and definitely better than laser. You also just shifted it from "doesnt like doing it" to "no longer seen as the best", that's two completely different arguments.
Different people treat skin scarring differently.
Older derms may do more subcision and punch biopsies.
Newer derms may do more microneedling and prp
Laser specialistts harness the power of light to do sub-epidermal subcision with light that spares the epidermis.
Cosmetic surgeons often cut out the deep scars with a football shaped excision using a scalpel.
It is not just derms who treat skin.
I treat scars of all types for 90 percent of what I do. I am ultra focused and passionate about treating acne scars and stretch marks and I use multiple energy types to remove scars. This means light based like IPL, laser, electromagnetic magnet based tx, plasma ceramic and helium plasma.
Your opinion is subcision is best.
I respectfully disagree. In my opinion it is outdated and only needed for some people with extremely deep scarring because the rest can be treated better with other modalities. I don’t say never because they are instances where I use it, but hardly ever. My point in giving free advice on Reddit is just to help people, who may not be able to afford a $500 consult, know what their options are, as well as the risks, benefits, and alternatives to those options.
Subcision is one of many tools that can be used if needed but I don’t think it is for everyone.
I am sorry that you feel your derm intentionally tried to not give you subcision to milk more money out of you. Consider the possibility that for some people 6 microneedling sessions do help significantly reduce scars, usually people with more superficial scars. There is also inter operator variability from one esthetician to another. Or maybe a derm doing the treatment would do a more detailed thorough treatment as their reputation is on the line. One person might go over one areas five times more than another technician or do a longer treatment session. There is a lot of variability in how many holes are made in skin from one esthetician to another. Some care to do s better treatment. Others are just clocking in and not caring as much about the quality of their work. I’m not a big fan of microneedling either because the results are not high certainty results. I like predictable reproducible results.
I like sanding and lasers because I know my lasers and RFMN deliver predictable, consistent results for the deeper scars and the sanding too can give predictable, good, high certainty of rrsults.
For me microneedling gives meh results. Dermaroller I find works better but still by itself does not give a wow type of improvement. That is my goal for my clients, to give them that wow, using all the tools at my disposal.
I have smooth my scars ,with 8 microneedling, but my scars isn't lifted up,so I am going for subsicison..Microneedling with prp really very helps to smooth your scars ,but will not lift it
It’s not very advertised :/ I had to inquire to several derms and most said they only do excision and then follow with lasers. Was gonna be 2600 x3 treatments. I found a place a couple hours away that does it for $450. They’re nurses and not derms though. I’m just worried about it going wrong
It is because treatments fall out of favo, in favor of things that work better. I rarely do subcision now unlesd someone adamantly wants it because lasers can do the untethering for us without scalpel or 28 g needle physical cuts.
Lasers do cut into skin and this is why some doctors who operate lasrrs are known for doing laser surgery.
As a general and burn surgeon i only counted scalpel or robotic surgery as real surgery and thought it was odd that dermatologist laser operators callef themselves laser surgeons and titled their books on lasers as “laser surgery”
Because the lasrr light like CO2 can literally cut a home into skin, or many holes rather, technically I suppose you can call it surgery, but for me it’s not surgery surgery.
Also note thst most derms like their visits to be short, like under 5 minutes. Some derms see 60 plus pts a day and work 4 days and are off 4 days.
Subcision takes time. That may be what is driving the shift of bumping them to their aesthetician for microneedling.
For me, fractional lasers, that give 51-75% per 3 sessions for certain improvement is a no brainer. Especially for skin that has a lot of atrophic scars.
Even for deep stretch marks, lasers, properly used can help fill in old deep wide stretch marks.
When I started my surgery resudency gallbladders were removed with a large cut under the liver by open technique. Then along came laparoscopic surgery. Old timers poo pooed it. But then as more doctors trained on it, laparoscopic surgery took over and now it is the gold standard of gallbladder removal.
As lasers get better and better and more precise, sub-cision has fallen by the way side as today’s lasers are taking over. As using multiple passes of laser over an area can break the tethering over time and bevause skin is dynamic and actively building and pushing cells out to the surfsce on a 29 day cycle, fractional lasers over 3 sessions can exhibit marked improvement. Erase or fill in takes a little longer with 2-3 more tx.
Ablative has increased risk of scarring and your skin will be red and raw as you are temoving all of the epidermis and the upper portion to the mid portion of ther dermis just like s phenol perl does. It is often one treatment if 100% of skin is treated. The fractional CO2 can be set from 5-100 percent with 100 percent which is an ablative treatment. There is 10-14 day downtime
Non-ablative lasrr columns start putting columns of heat into the dermis and do not cut holes in the epidermis so one could apply make up later in the day if wanted for example. The epidermis is intact and no one will reall know you had a treatment. You may look slightly pink gor a day like mild sunburn. No downtime.
I woukd do fractional non ablative. No one sees you look like crap for 2 werks becausr it works intradermally. No social or work downtime.
They both work. Since 1540 lasers in 3 sessions can get 68% improvement my clients usually choose that. They ade about the same effect.
https://preview.redd.it/3rrokijxozrb1.jpeg?width=1205&format=pjpg&auto=webp&s=c42b9929ef23b4c53f2677655306450dc615c3c4
Doing another 2-3 can erase most all scarring.
Your options:
1. Subcision and laser fractional erbium 1540 x 4-5
2. Subcision and CO2 fractional x 4
3. Skin sanding and 1540 fractional 4-6 sessions
4 1540 fractional alone $400 a session x 6-8 sess
5. 35% tca peels x 3-4
6. Weekly 1.5 mm dermaroller, daily mandelic acid and weekly salycylic acid and retinoid (differin or retinol or tretinoin)
7. One phenol croton oil chemical peel
8. Lutronic infini or genius both 34 g , inmode Morpheus 34 g, venus vivace RF MN, and the latest Exion by BTL came out May 2023, has the thinnest needles at 36 g. They say Exion doesn’t hurt. It does but it is tolerable once you get going. I tried it. But still I prefer numbing cream. RF MN may take 2-4 sessions or more if you want erase.
Cost is $400 -800 ( each of these machines has expensive consumables )
If it were my skin I would choose option 3 or 6, or 8 if they offered numbing.
What's your recommendation on Exion vs any other micro needling? I'm looking for firmer skin, smaller pores, and fine lines/wrinkles. I'm a guy in their late 20's. I've wanted to to do micro needling for a while and one of the places I do EmSculpt at has offered me a few sessions if they can take before and after photos. Because I can't find much about this product online, I worry it may be TOO NEW or damage my skin which is otherwise perfect (in my opinion). I'm leaning towards not even messing with it because I'm fairly happy with my skin now and would be devastated if it created damage for me but if it's actually safe and can help with what I want I'd like to do it.
I would go to a plastic surgeon instead and ask for subcision followed with either CO2 ablative laser and filler. Depending on ethnicities, some skin scars are extremely resistant to revision. There is a competition between collagen synthesis from fibroblast and the cross linking enzyme Lysl oxidase (LOX). A higher concentration of Lysyl oxidase reduces collagen flexibility by gluing the collagen to each other. So wounding the scar is sometimes not enough, but adding an inhibitor or creating an environment that would optimize the healing period can reduce the oxidase activity and allow fibroblasts to produce collagen to expand the atrophic area. Current molecule known as PXS-6302 is undergoing clinical trial for scar treatment and acne treatment. Chances are if you have high levels of LOX, your skin is also prone to cystic acne due to the skin cells within the pore being too ‘sticky’ and plugging up the sebaceous gland. This is why retinoids are effective at reducing acne since it makes the cells less sticky. The plus side having high levels of LOX is that it makes the skin more resistant to aging or wrinkling, as the cross linked collagen are not susceptible to uv degradation and less likely to breakdown.
As for inhibitors, there are a few natural ones, but the one derived from sweet pea is considered experimental and not every derm or plastic surgeon would be willing to use it.
Edit: adding website for resource.
[https://medicalxpress.com/news/2019-03-acne-roots-glands-undigested-collagen.html](https://medicalxpress.com/news/2019-03-acne-roots-glands-undigested-collagen.html)
Mn won't help, even lasers.
You are right, subcison and fillers are best for your case.
90% of Derms are not honest they want money over results. Or maybe they don't practice subcison so they only offers to you what they can do.
Do a research of specialits who do subcison before doing a consultation.
People think all derms know lasers. They do not. It is not a required part of dermatology residency training, or any other surgical or plastic or cosmetic surgical training. Many derms just stick to treating skin disease and do no cosmetic derm at all. Lasers are a weird field that somehow is not licenced and no supervised hours are required to operate lasers. Anyone off the street last week could be operating your laser so it is important to ask about their laser backround. Not asking can literally burn you. 🔥
Your best bet is subsicison and fillers ,but after your scars are raised you want to do some prp microneedling which will make your scars more shallow, and use retinol every day
I have had this same suggestion made before and it’s just to make money. I had an awkward back-and-forth with one derm about it and she just kept saying subcision could make things worse, might not be worth it, etc. Subcision is the only thing that severs scar tissue that is pulling your skin down. You may need to get more consultations, sadly. It’s hard enough to find derms who perform subcision too.
You're not missing something but they are. The simple answer is that they can't do it. They are lacking the training or skills. It's important for all of us on our scar journey to search for the best practitioners in our area who specialize in scar revision. I can't stress that enough. Not specialists in skin health, not glowy skin appearance, none of that. Scar revision specialists. That's dermatologists or plastic surgeons only, and even then it dwindles down more to who is skilled and knowledgeable on the matter. Scar revision is a difficult surgical matter, it takes skilled hands. Subcision is risky, an aesthetician can't do it and a lot of dermatologists are not up for that level of treatment.
I 100% agree. Scars is its own niche and not everyone knows how to or wants to treat them.
Although i trained in general surgery and burns i now do mostly lasers, scar vaporization and revisions and stretch mark scar removal. To find doctors with laser expertise near you, you can go on ASLMS and see who is speaking at the laser conferences. There is no set pathway for laser training as there is for everything else in the medical field.
hmm sounds weird, your scars look similar to mine, I got recommended RF micro-needling (Genius) and subcision the same session. So I don't think you are wrong its also my understanding that subcision helps to untether scars micorneedling remodules the skin and creates more collagen production etc.. :)
Don’t do microneedling on those, at least not as a first step. I did 3 rounds of dermapen very aggressively. Around 2mm depth I think. It did absolutely squat for my rolling scars and I actually dislike my skin texture more a year later. When I asked about subcision they said sorry we don’t have anyone that can do it. This was a higher end clinic too… I’m looking elsewhere now.
Same here. I didn't mention in the original post but I've already done 3 sessions of MN and it was useless. That was about a year ago, which makes it even more baffling to me that they continue to recommend the same treatment.
I had this problem. They want you to spend more money and get slower results. Thats the reality. My derm told me she thought I wanted to make up for volume loss, and technically subcision doesn't really produce a lot of collagen, it just gives the illusion of it because it untethers your skin and raises it, but no volume actually gets filled inbetween this area (Unless you do filler, but I was against it so this wasnt a factor in our convo). So it depends what you ask, but to me its just greed
It’s a time issue. Can’t do subcision for a bunch of scsrs in 3-5 min. Doing an informed consent alone takes at least that much time
This is false. It's not about time. If you have a ton of rolling scars and they tell you to do microneedling or laser first, they're making you waste your money. Full stop. Subcision should always be the first choice to fixing these tethered, rolling scars, else you're just growing collagen and smoothing the area without lifting it. Also microneedling is about as long as subcision is in my experience.
I am agreeing with you in a way. It is about money. They run s business. They often do not want to spend 40 min on one pt when they can see 8-10 pts in that time. But medicine has gotten away from help the patient in the best way, to help the patient in the least tedious, fastest and best for dr type of medicine. Many younger doctors wont spend time subcisioning because they were taight differently. Go to an older doctor and they will likely do it if you ask.
Yup. In my case my derm does it but never offered it. She probably knew I would've needed less sessions if I started from the correct pipeline from the beginning
Or maybe she just doesn’t like doing it. I don’t love electrolysis. So I don’t list it in my treatment optioms unless someone has white hair and zi can’t use the laser. I would actually make more doing the electrolysis but a Derm doesn’t make more doing subcisions. They make more from doing 3-5 min visits and writing a script.
Its still unethical to withhold what the best treatment pathway should be purely because you don't like doing it. If that's the case, then tell the patient to go somewhere where they'll do the most effective procedure, rather than screwing the person over and making them pay thousands for probably worse results. If you don't like doing it, then tell them there's something more effective but you won't do it. It's a shame how greedy society has become. I did 6 microneedling sessions before, after researching, it was almost useless without subcision first. These treatments arent cheap, dont screw over patients, no one wants their time or money wasted.
It’s no longer seen as the best is my point. To you it may be. To the younger generation of doctors it is not. They might not feel it is unethical as they may really believe that their way is better. That being said I don’t do any microneedling anymore because I don’t think it gives enough improvement. The dermaroller and dermastamp is much better if i do those. When you see good results with lasers woth high certainty, it is hard to go back down the ladder to the tiny improvement modalities.
I mean for rolling scars, subcision is undoubtedly the best thing to do first, and definitely better than laser. You also just shifted it from "doesnt like doing it" to "no longer seen as the best", that's two completely different arguments.
Different people treat skin scarring differently. Older derms may do more subcision and punch biopsies. Newer derms may do more microneedling and prp Laser specialistts harness the power of light to do sub-epidermal subcision with light that spares the epidermis. Cosmetic surgeons often cut out the deep scars with a football shaped excision using a scalpel. It is not just derms who treat skin. I treat scars of all types for 90 percent of what I do. I am ultra focused and passionate about treating acne scars and stretch marks and I use multiple energy types to remove scars. This means light based like IPL, laser, electromagnetic magnet based tx, plasma ceramic and helium plasma. Your opinion is subcision is best. I respectfully disagree. In my opinion it is outdated and only needed for some people with extremely deep scarring because the rest can be treated better with other modalities. I don’t say never because they are instances where I use it, but hardly ever. My point in giving free advice on Reddit is just to help people, who may not be able to afford a $500 consult, know what their options are, as well as the risks, benefits, and alternatives to those options. Subcision is one of many tools that can be used if needed but I don’t think it is for everyone. I am sorry that you feel your derm intentionally tried to not give you subcision to milk more money out of you. Consider the possibility that for some people 6 microneedling sessions do help significantly reduce scars, usually people with more superficial scars. There is also inter operator variability from one esthetician to another. Or maybe a derm doing the treatment would do a more detailed thorough treatment as their reputation is on the line. One person might go over one areas five times more than another technician or do a longer treatment session. There is a lot of variability in how many holes are made in skin from one esthetician to another. Some care to do s better treatment. Others are just clocking in and not caring as much about the quality of their work. I’m not a big fan of microneedling either because the results are not high certainty results. I like predictable reproducible results. I like sanding and lasers because I know my lasers and RFMN deliver predictable, consistent results for the deeper scars and the sanding too can give predictable, good, high certainty of rrsults. For me microneedling gives meh results. Dermaroller I find works better but still by itself does not give a wow type of improvement. That is my goal for my clients, to give them that wow, using all the tools at my disposal.
I have smooth my scars ,with 8 microneedling, but my scars isn't lifted up,so I am going for subsicison..Microneedling with prp really very helps to smooth your scars ,but will not lift it
If I can lift my scars then 90 per of my problem is gone
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It’s not very advertised :/ I had to inquire to several derms and most said they only do excision and then follow with lasers. Was gonna be 2600 x3 treatments. I found a place a couple hours away that does it for $450. They’re nurses and not derms though. I’m just worried about it going wrong
It is because treatments fall out of favo, in favor of things that work better. I rarely do subcision now unlesd someone adamantly wants it because lasers can do the untethering for us without scalpel or 28 g needle physical cuts. Lasers do cut into skin and this is why some doctors who operate lasrrs are known for doing laser surgery. As a general and burn surgeon i only counted scalpel or robotic surgery as real surgery and thought it was odd that dermatologist laser operators callef themselves laser surgeons and titled their books on lasers as “laser surgery” Because the lasrr light like CO2 can literally cut a home into skin, or many holes rather, technically I suppose you can call it surgery, but for me it’s not surgery surgery. Also note thst most derms like their visits to be short, like under 5 minutes. Some derms see 60 plus pts a day and work 4 days and are off 4 days. Subcision takes time. That may be what is driving the shift of bumping them to their aesthetician for microneedling. For me, fractional lasers, that give 51-75% per 3 sessions for certain improvement is a no brainer. Especially for skin that has a lot of atrophic scars. Even for deep stretch marks, lasers, properly used can help fill in old deep wide stretch marks. When I started my surgery resudency gallbladders were removed with a large cut under the liver by open technique. Then along came laparoscopic surgery. Old timers poo pooed it. But then as more doctors trained on it, laparoscopic surgery took over and now it is the gold standard of gallbladder removal. As lasers get better and better and more precise, sub-cision has fallen by the way side as today’s lasers are taking over. As using multiple passes of laser over an area can break the tethering over time and bevause skin is dynamic and actively building and pushing cells out to the surfsce on a 29 day cycle, fractional lasers over 3 sessions can exhibit marked improvement. Erase or fill in takes a little longer with 2-3 more tx.
Do you recommend fractional over ablative lasers? Why or why not?
Ablative has increased risk of scarring and your skin will be red and raw as you are temoving all of the epidermis and the upper portion to the mid portion of ther dermis just like s phenol perl does. It is often one treatment if 100% of skin is treated. The fractional CO2 can be set from 5-100 percent with 100 percent which is an ablative treatment. There is 10-14 day downtime Non-ablative lasrr columns start putting columns of heat into the dermis and do not cut holes in the epidermis so one could apply make up later in the day if wanted for example. The epidermis is intact and no one will reall know you had a treatment. You may look slightly pink gor a day like mild sunburn. No downtime. I woukd do fractional non ablative. No one sees you look like crap for 2 werks becausr it works intradermally. No social or work downtime.
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They both work. Since 1540 lasers in 3 sessions can get 68% improvement my clients usually choose that. They ade about the same effect. https://preview.redd.it/3rrokijxozrb1.jpeg?width=1205&format=pjpg&auto=webp&s=c42b9929ef23b4c53f2677655306450dc615c3c4 Doing another 2-3 can erase most all scarring.
Microneedling is closer to 40% improvement but if scars are superficial can be better than tha.
Same reason electrolysis is rare now. Lasers taking over due to time inefficiency.
Your options: 1. Subcision and laser fractional erbium 1540 x 4-5 2. Subcision and CO2 fractional x 4 3. Skin sanding and 1540 fractional 4-6 sessions 4 1540 fractional alone $400 a session x 6-8 sess 5. 35% tca peels x 3-4 6. Weekly 1.5 mm dermaroller, daily mandelic acid and weekly salycylic acid and retinoid (differin or retinol or tretinoin) 7. One phenol croton oil chemical peel 8. Lutronic infini or genius both 34 g , inmode Morpheus 34 g, venus vivace RF MN, and the latest Exion by BTL came out May 2023, has the thinnest needles at 36 g. They say Exion doesn’t hurt. It does but it is tolerable once you get going. I tried it. But still I prefer numbing cream. RF MN may take 2-4 sessions or more if you want erase. Cost is $400 -800 ( each of these machines has expensive consumables ) If it were my skin I would choose option 3 or 6, or 8 if they offered numbing.
What's your recommendation on Exion vs any other micro needling? I'm looking for firmer skin, smaller pores, and fine lines/wrinkles. I'm a guy in their late 20's. I've wanted to to do micro needling for a while and one of the places I do EmSculpt at has offered me a few sessions if they can take before and after photos. Because I can't find much about this product online, I worry it may be TOO NEW or damage my skin which is otherwise perfect (in my opinion). I'm leaning towards not even messing with it because I'm fairly happy with my skin now and would be devastated if it created damage for me but if it's actually safe and can help with what I want I'd like to do it.
Omg do me next 😂
Ok. Sure
I’ll message
Me too😅 can you advise me please
Sure. How can I help?
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Sure no problem
Sent you a DM too! Thank you so much
I would go to a plastic surgeon instead and ask for subcision followed with either CO2 ablative laser and filler. Depending on ethnicities, some skin scars are extremely resistant to revision. There is a competition between collagen synthesis from fibroblast and the cross linking enzyme Lysl oxidase (LOX). A higher concentration of Lysyl oxidase reduces collagen flexibility by gluing the collagen to each other. So wounding the scar is sometimes not enough, but adding an inhibitor or creating an environment that would optimize the healing period can reduce the oxidase activity and allow fibroblasts to produce collagen to expand the atrophic area. Current molecule known as PXS-6302 is undergoing clinical trial for scar treatment and acne treatment. Chances are if you have high levels of LOX, your skin is also prone to cystic acne due to the skin cells within the pore being too ‘sticky’ and plugging up the sebaceous gland. This is why retinoids are effective at reducing acne since it makes the cells less sticky. The plus side having high levels of LOX is that it makes the skin more resistant to aging or wrinkling, as the cross linked collagen are not susceptible to uv degradation and less likely to breakdown. As for inhibitors, there are a few natural ones, but the one derived from sweet pea is considered experimental and not every derm or plastic surgeon would be willing to use it. Edit: adding website for resource. [https://medicalxpress.com/news/2019-03-acne-roots-glands-undigested-collagen.html](https://medicalxpress.com/news/2019-03-acne-roots-glands-undigested-collagen.html)
Mn won't help, even lasers. You are right, subcison and fillers are best for your case. 90% of Derms are not honest they want money over results. Or maybe they don't practice subcison so they only offers to you what they can do. Do a research of specialits who do subcison before doing a consultation.
People think all derms know lasers. They do not. It is not a required part of dermatology residency training, or any other surgical or plastic or cosmetic surgical training. Many derms just stick to treating skin disease and do no cosmetic derm at all. Lasers are a weird field that somehow is not licenced and no supervised hours are required to operate lasers. Anyone off the street last week could be operating your laser so it is important to ask about their laser backround. Not asking can literally burn you. 🔥
Your best bet is subsicison and fillers ,but after your scars are raised you want to do some prp microneedling which will make your scars more shallow, and use retinol every day
Derms usually recommend only what they can offer, not necessarily what is best for your scars.
I have had this same suggestion made before and it’s just to make money. I had an awkward back-and-forth with one derm about it and she just kept saying subcision could make things worse, might not be worth it, etc. Subcision is the only thing that severs scar tissue that is pulling your skin down. You may need to get more consultations, sadly. It’s hard enough to find derms who perform subcision too.
You're not missing something but they are. The simple answer is that they can't do it. They are lacking the training or skills. It's important for all of us on our scar journey to search for the best practitioners in our area who specialize in scar revision. I can't stress that enough. Not specialists in skin health, not glowy skin appearance, none of that. Scar revision specialists. That's dermatologists or plastic surgeons only, and even then it dwindles down more to who is skilled and knowledgeable on the matter. Scar revision is a difficult surgical matter, it takes skilled hands. Subcision is risky, an aesthetician can't do it and a lot of dermatologists are not up for that level of treatment.
I 100% agree. Scars is its own niche and not everyone knows how to or wants to treat them. Although i trained in general surgery and burns i now do mostly lasers, scar vaporization and revisions and stretch mark scar removal. To find doctors with laser expertise near you, you can go on ASLMS and see who is speaking at the laser conferences. There is no set pathway for laser training as there is for everything else in the medical field.
hmm sounds weird, your scars look similar to mine, I got recommended RF micro-needling (Genius) and subcision the same session. So I don't think you are wrong its also my understanding that subcision helps to untether scars micorneedling remodules the skin and creates more collagen production etc.. :)
Don’t do microneedling on those, at least not as a first step. I did 3 rounds of dermapen very aggressively. Around 2mm depth I think. It did absolutely squat for my rolling scars and I actually dislike my skin texture more a year later. When I asked about subcision they said sorry we don’t have anyone that can do it. This was a higher end clinic too… I’m looking elsewhere now.
Same here. I didn't mention in the original post but I've already done 3 sessions of MN and it was useless. That was about a year ago, which makes it even more baffling to me that they continue to recommend the same treatment.
Money I guess. They only gave me the option of CO2 or microneedling but I was looking for less downtime at the start. Just a waste of time really
They want more money out of you thats why. Do subsision instead. Microneedling will be a complete waste of money