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I have scheduled to have laser resurfacing (Total...

I have scheduled to have laser resurfacing (Total FX) for moderate acne scarring, mostly on my cheeks. I am female, age 31 with pale skin that tans fairly easily but have not had any tan in several years. I decided to go with Dr. Duplechain in Lafayette,La after doing a little research. As of today, I have my initial consultation and my pre-op appointment. I am a little bit worried because he seemed quite adamant that I be put under general anesteshesia. I am terrified of anesthesia because I have sleep apnea. We decided that they would do it under local anesthesia, using lidocaine shots to the face and taking ativan before hand. He also prescribed some antiviral valtrex as a precautionary measure, as well as an anti-biotic. I also have an RX for some pain medicine, and the nurse said they could give me a shot of demerol. I am a little concerned with the amount of meds there- it seems like a lot. He said it is going to hurt a lot though and may even be unbearable. A lot of the reviews I have read have said the patient remained alert- I wonder if it is because my scars are worse than the other patients, therefore going deeper? I hope it isn't too painful, because this is my one and only shot to have this done and I am getting married in the Summer. I plan to just suck it up, with my skin numbed, demerol, plus lidocaine that should be sufficient,no? I don't have another $300 to be put nder anyway and I really don't want to. I don't want him to be less thorough because I am alert and in pain. I have had my tattoos removed with no numbing or pain meds, it hurt like heck but i tolerate it and power through. I am sure this is much more intense though. I can't control if my body starts shaking or my heart beating fast- I hope those things don't hinder the process. He said I can expect at least 45% improvement and at most 70%. I really hope it's closer to 70%. I also have been instructed not to take any blood thinners, anything with aspirin in it, only tylenol is approved. I have been instucted to wash my hair with baby shampoo the day of, and my body with hibiclens. I have to have a ride home and keep my face covered. I bought a really big sun hat to wear on the ride home, and my fiance is going to drive me. Afterward, I am going to be given a container of cutagenix (which i think Dr. D. invented, or created) to apply on my skin. It's an oxygenated skin cream that is supposed to speed recovery time, or something like that, I wonder how it's going to feel on raw skin. I hope I am not allergic or sensitive to it. That would be horrid. I chose to go with Dr. Duplechain because he has a lot of experience, and he was flexible on the price. He also did a free consultation. I was seriously considering two other providers- another doctor who did a similar laser and a laser tech at a dermatologists' office who would have been a lot cheaper. I ruled out the other doctor because he was too expensive- the price was just more money than I had, plain and simple. Dr D's price was much more but they offered a reduction and I was able to barely come up with the sum they asked for of $2500. The laser tech was much much cheaper, but there were red flags of why I should not go in that direction. One, he is not a doctor, just a technician. This is my face we are talking about. Two- he had no before and after pictures at all. That showed me that he really doesn't care about the results. Three- he is a travelling laser tech, not local. If I had any problems, I would not be able to get in touch with him. Four- and this was the biggest one- they would not even give me his name (so that I could look up his credentials.) They said it was for privacy/liability reasons. That's a big deal to me. I am not letting someone laser my face who won't even give me their name! so Dr. D was about $1000 more than the laser guy- but I figured it was worth the money to reduce the risk. i figure, if things went bad with the laser guy- it could go either way- he might go too deep and damage my skin. with the doctor the risk is more of will i see any results than will my skin be damaged. Obviously, I don't want things to be worse so I put the extra money together. I am on a very very tight budget so this is huge for me to spend this kind of money on something like this- bt I want to look and feel beautiful on my wedding day and for the rest if my life. After the procedure has been completed i will update this- during the healing process and up to 6 months after. I am praying this goes well and I see optimal results.

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Welcome, it's great you posted your review pre -op, what is the date of your treatment? It's great you did your research and multiple consultations and were careful with who you picked to do the procedure.  I look forward to hearing how your treatment goes.

Regarding the choice of anesthesia, I was thinking the same thing when I read that your Doctor wanted to put you to sleep for the procedure...I wonder if it is because they will need to do a deeper treatment. 

Good luck!!


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Thank you! i'm very nervous about this procedure!

tomorrow is the day.... wow... scary

Well tomorrow is my laser procedure and I am so nervous about having it done. I have filled my prescriptions. I also disinfected my entire house- never can be too safe. I cleaned out my fridge, lysol'd everything, swept and mopped with disinfectant and washed all my towels and blankets/sheets/pillowcases with bleach and hot water- I purchased some brand new washcloths for my face and i am washing them in bleach as well. I have wiped down every surface in my house with disinfectant wipes. This was not per my doctor's instructions- just a precautionary step for me to feel more relaxed while I recover. I spoke with the nurse on the phone today, she said they were not likely going to give me the demerol shot unless absolutely necessary because they don't want to over-sedate me. Yikes! First doctor says he doesn't think I can handle it without being put under and now the nurse says too much medication could be a problem. How will I ever sleep lol. This time tomorrow I am going to be in a lotta pain, and quite uncomfortable. I wonder how long I am going to look not fit to go out in public? Double Yikes! Wish me luck.

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How did your treatment go?
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I had the laser done today.

Alright, had my laser done today. My mother in law called at the last minute and lent the money for the anesthesia- an extra $300. I guess it was probably worth it for the anesthesia because i didn't feel a thing during the procedure. I was kinda bummed out that I didn't get to see or talk to the doctor before my procedure. I didn't see him until after it was all over- He came out, said a few words, shook my hand and then he was gone. I think doctors in general are pretty rushed. He did talk to my fiance a little. I was out at that time though. The reason i was bummed was because it doesn't look like he zapped under my eyes- i have some fine lines I wanted addressed. I told his nurse that i wanted my lines zapped but i guess she didn't tell him. Those weren't my main concern but would have been nice to have them taken care of while we were at it. They aren't bad though anyway. They did zap my upper eyelids- the top half near the brow to mid lid. So the actual procedure- I was very nervous leading up to it, more so about the anesthesia. The staff is super nice though, the nurses, and the anesthesia guy were so nice and very comforting. I hated wearing the hospital gown. My butt was out lol, I should have worn granny panties or boy shorts. So he gave me the anesthesia in light increments. At some point I was really relaxed and telling them how hot my fiance is. haha. Then I was out- next thing i'm waking up and my face is burning and i am shivering so much. I am not sure why I was shivering- it wasn't too cold in there. They had a bunch of blankets on me and like a hot air fan blowing on my legs which was lovely. I wish i had that here at home, it's so relaxing. They took the compresses off my face and the light was terrible. I had a pounding headache- i felt hungover. i think that was from the anesthesia. The nurse put the cutagenix on my face- which was still numb from lidocaine. It's kind of like a foam that turns into a lotion-"a biologically inert liquid capable of dissolving and exchanging oxygen with the environment. " (I copied that from the website lol) I like it. It's not greasy and won't make me break out like vaseline. My skin wasn't really hurting just burning at that point so much like fire ants on my face. I had a big floppy hat on and put a tshirt on top of that to make sure my skin wasn't exposed to the sun at all. I also put foil on my window yesterday to keep sun out. Maybe it's overkill- but i want to do this right. I was surprised when i got home and looked at myself because it looked so normal- I was thinking he must have went easy on me. It's now 12 hours since my procedure was done and the skin looks sunburt and a little scabby. It looks more intense now. It doesn't really hurt too bad. It was more painful earlier when it looked normal, now it hurts less and looks like it feels terrible. irony! My face is swollen. Right now the scars look great because of the microswelling. I have done enough research to know that this is going to fade, and i am going to be dissappointed at first. I am going to remain optimistic though. In about three months we will have an idea of what the actual results are. Dr. Duplechain said I would see at least 40 percent improvement and at most 70 percent. I hope he cranked it p enough. Since it doesn't hurt that bad and my face doesn't look like raw hamburger, i am worried he didn't go deep enough. He has done it a hundred times before though so he knows more than me. Time will tell and the results will speak for themselves. I think he had it at 3/4 of the way cranked up. I am gonna ask again tomorrow to be sure. The photos are from 12 hours out.

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I posted a detailed recap of the experience above. It went pretty well but i am hoping he went deep enough. Since he suggested being put under i figured he would really crank it up- he probably went about 3/4 of the way. I wish he would have done a bit more but it's done now. i hope his discretion pays off in some nice results. time will tell though. :)

day 2

feeling a little bummed out today because I don't think i am gonna get the results i wanted, judging by the research i have done. i wish he would have taken the time to talk to me right before the procedure so we could discuss the depth and the fact that i wanted him to do under my eyes - they said i would get to talk to him and before i knew it I was out and it was over and nothing could be done about it at that point.. It doesn't seem like he went very deep. i thought that was the whole point of talking me into anesthesia. i think the nurse said it was set to 15 m/j from my research that's like medium. it looks like he stopped short where some of my scars are- my skin turned brown where the laser was passed more deeply it turned brown. i am posting a photo below of what i mean. if you look at where my scars stop at my hair line you will see that it isnt as deep halfway before my scars end.The red v's show where the deep ablation ends, the black dots show where my scars end. i am not very happy about that right now. Hopefully i am wrong though. I emailed two people at his office today and did not get a reply back. It looks pretty good close to my nose on my cheeks, just fell short a little on one side and that really has me bummed out and also that it wasn't cranked up. This was probably a once in a lifetime or at least once in a decade chance for me that i saved for such a long time for- plus my wedding is in the summer and if I dont have any results that will be devastating- especially since we are cutting corners left and right and that money could have got us a nicer photographer or honeymoon hotel. Kinda bummed, hope i am wrong. i am holding off on udpating the rating i give for the doctor til i see the results.

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The fun begins

Today I woke up with my face swollen and very dry. I think it's going to start peeling in the next couple of days. I washed it with water only per my aftercare instructions and put some cutagenix on. It kind of stings a little but it's not intolerable. i have also been misting my face with evian mist- my doctor doesn't want me to wash my face with anything for 7 days, just use the water (no water pressure, just splashes) then the cutagenix, and alternate cold compresses. The nurse said the evian mist was an alternative to the compresses, so i opted for that because the other was very time consuming and kept me stationary a lot. I have been avoiding the sun like a vampire. I haven't went out at all. My skin is very brown today. I got a call from Dr. D's office today to talk about my concerns so i am quite relieved. The lady I spoke to said he reviewed my photo, and he feels like he covered everywhere correctly, but they will touch up that area for free if need be. I am gonna print out my pic for him so he can see what i mean. I also talked with her about not getting to speak with him before my procedure about under my eyes and the settings and she said i can discuss that with him when i go for my post op. Hopefully he will just touch up the small area so i can feel better about the whole experience. I still feel like everyone at his office is very nice. I hope they take care of my concerns and don't make it hard on me to just get it done. There are pros and cons to every experience i guess. I am going to go over that once i see the final results. I am remaining optimistic until i see a reason to feel otherwise. He did say at the least i will see 45% improvement and that would be acceptable to me. I hope for more of course, and I will keep following his directions to a T and doing everything within my power to get optimal results. When i went to get my makeup done for my graduation they didn't even know what to do with my skin- they couldn't even fill it with primers and cover it up. I want my wedding makeup to look beautiful. I am not saying my scars were so severe, they weren't they were moderate. Still, I feel like I have to put makeup on (at least foundation) just to even go to the gas station. it shouldn't be that way! I am attaching a photo of my skin today- super crispy. Will have to stay extra hydrated today!

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the itching! ah!

Today the itching and peeling has begun. It's annoying but not as bad I thought it would be. Last night i looked at some video diaries and it kind of made me sad to see that people's scars were still pretty prevalent once the swelling went down. I really wish he had set my settings higher on the scars area and that i would have been able to speak with him about that. I mentioned it to the nurses and they assured me he would go over it with me. From the research i have done- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580980/ " Acne scarring is more difficult to treat " and "Laser settings for rolling scars should be aggressive." The acne scars patients deep fx settings were at 22 m/j and active fx at 125. My settings were 15 m/j and 100. Since I sprung for the anesthesia at his urging, I really expected him to get in there agrressively. I was really surprised to learn my settings for the deep fx were so low. I will be going in for my post op in about five days and hopefully this will be addressed and he will stand by his word of touching up at least the area that was missed if nothing else. I know he has a good reputation so i think he will honor his work and results by going back over it. That's what his office told me on the phone so I am going to try to relax and stop worrying about it until i have reason to think otherwise.

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they're baaaack

Well, my skin is returning to normalcy somewhat. I have peeled pretty much all the way. The skin underneath is bright pink, but less so than yesterday. There are some textural issues- I have some bumps on my skin now that I am hoping will go away. I have also started breaking out. I hope that subsides when i return to my ormal skincare routine in the future. The swelling has gone down quite a bit and my scars have reappeared. In some spots they do look lessened but they still look pretty prevalent in the spot that he missed. I am uploading a photo of those scars and how the line looked after the peeling- you can still see a pretty clear line where the treatment cut off. I am not going to get upset because his nurse said he would touch it up for free. Wish me luck on my post op.

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apt cancelled

Got a call from the doctor's office today, he has went on vacation and won't be able to keep my appointment. I spoke on the phone today with a couple of his nurses, and they said he would be able to touch up the spots he missed and probably go over the other scarred areas again since we had not discussed the depth prior to the laser. I hope he does! We'll see. My skin looks a lot better, as far as the scarring, I can't be sure that these are the final results just yet. i'd like to make sure all selling has subsided before posting any more photos, and then if he lases again I will save those photos for after and give him a much better review. I am waiting for final results to update the review portion. My skin has broken out so bad since I haven't been able to wash it properly in a week. I haven't broken out like this since I was in my early 20's. I feel like a teenager lol. I am not too worried about the breakout, I figure once I return to my normal skin care routine it will improve. The scars that he missed look the same but the rest have definitey improved. i was surprised at how fast my skin healed, the turnover time was really quick. Maybe it's because I am still young? idk. I have an apt with him next week, one week from today, will update the reslts of that visit afterward. :)

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oops

swelling not selling- my keys are a lil sticky

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post op

I went in for my post op apt. yesterday. I am feeling relieved because I got to talk to Dr. Duplechain about all my concerns and he made me feel a lot more at ease. He said he would go over the areas on my face that needed touching up. We are going to do it next week. He said he wants me to be happy with the result and I could not ask for more than that. They also sent me home with another product, called cutavive. It's from the same line as the cutagenesis. It's more of a skin cream than a healing agent though but it does still have the oxygenating properties. I just started using it so I will write more about it later. I am really, really, happy that Dr. Duplechain is going to go over my face again where it needs it. I think I made the right choice in selecting a doctor. I definitely wouldn't have trusted a technician with my face! No way! He is a smart man. He said he writes journals pretty often for laser procedures. I knew he had good credentials but sometimes it's hit or miss with things like this. I am a lot more confident about it now, knowing that he really does care about the results and wants me to be happy with it. I will take some more photos next week before having it done then again after round two. Once I have my final results I will post final photos and write the final review. :) Will keep the community updated along the way...

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That's awesome, look forward to hearing how the cream works!
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second laser

today I had the touch up, second laser done. I had it done under local anesthesia only (lidocaine) Prior to the procedure, I was able to speak to the doctor about where my concerns were and he drew on my face marking the area to be lased.The nurse put a topical numbing agent on my skin. We took photos twice. I took an ativan before the procedure. I waited for a very long time. I went back in the surgery room and got a lot of lidocaine shots to the face- no really- so many. This was probably the worst part but not too bad, just a little stinging. I knew that the lidocaine would make the procedure more tolerable so I didn't mind them. The deep fx was first. I barely felt a thing for the most part. He really took the time to go over all of my areas of concern. Every now and again I would feel the effect of the laser around the edges of the area being treated. Even that wasn't so bad. The smell of burning flesh was pretty strong. It didn't bother me though. I actually smelled more than I felt. Next we did the active fx- was a bit more intense then the deep fx but it was completely fine and nothing to cry about. He did subcision on one of my worst scars, right on mycheek near my nose- I will be praying to see huge improvement there. My face bled more today and looks worse than it did day one last time- not sure why that is. The whole thing didn't take too long- maybe 30-40 minutes. He seemed to be very thorough today and I appreciate that a lot. I am hoping I see some really great results this time. I follow the aftercare instructions very closely and I am using the cutagenix again which speeds up the healing time quite a bit. I really liked the cutavive. I have to use the cutagenix again for at least a week, maybe more before I can return to cutavive. I will be following my doctors orders down to the letter. Will update more once I have an idea of what the results will be.

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round two photos

see added photos of second laser procedure

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more photos round two

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day after laser 2nd time

for some reason, my skin looks wayyy more red and bloody this time. it's very dark, much darker than the 1st time. maybe that's a good thing? :) If it means better results, I am all for it.

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I would recommend the cutavive. It's pretty good. I kinda preferred it to cutagenix, but I think that's more because the texture of my skin was better after I started using cutavive- (I.e. the peeling and scabbing were done when I used cutavive, but scabby and rough for cutagenix... so the cutagenix had a lot more work to do.) It made my skin feel very smooth. Normally I have some dryness/flaking around my nose but the cutavive seemed to absorb really fast into my skin and feel lovely. It has a kind of medical smell which some people may not like right away but I like it. Extra fragrance and dye makes my skin breakout so I don't want the perfumes anyway. I only got to use the cutavive for like 5-6 days before having to switch back to cutagenix. Once my skin heals I can switch back. It's still swollen and red right now! Hope it goes down soon. It is much more red and intense this time.

Getting better I think ?

I went out to the store with no make up on- with my face all red. People were staring so much! Some gave sympathetic smiles, some stared, some people whispered to each other- "oh, look at her face!" I was a little worried I might scare children but that didn't happen. One clerk recognized me and said what's going on with your face. That made me laugh so much. My skin has mostly peeled off but it's itching a lot and it's still bright pink. I can't tell just yet how much improvement I am going to see overall. I am praying for great results, esp. having gone through this twice now. Once the swelling subsides I will have a better idea of my results. I am a little worried about hyper pigmentation since we did two rounds so close to each other. The original redness wasn't completely gone yet. I am staying positive and thinking it's going to be great! I hope I see at least 50% improvement, maybe even more! That would be so amazing! Aren't acne scars just the worst!

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after pics

here are some before and after pics. I will write more about the results later.

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wow

the website is resizing my photos down so much it's almost pointless to post them. here they are once again

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pic

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pics

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How many days post op was the after picture taken?
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initial results.

Today I am gonna write about my initial results of the laser procedure, total fx. I had two passes of total fx. I have mixed feelings about the procedure. For my actual scars, I am kind of disappointed with the results, especially the scar on my cheek which was an icepick type of scar. Overall, for my complexion and pore size, I am pleased with the results. My skin does look better and I do see a very nice improvement in the rest of my skin. On my scars, the results vary. Some have improved, some look exactly the same to me. I spoke with the doctor about the scar on my cheek, he only offered to upsell other products and treatments to me. He said I could buy a cream (which I can't afford and i will not be purchasing, I don't have the money for it honestly.) or he could do dermabrasion on that spot for $150. No thanks! $150 for a tiny spot! Guess I will just live with it for now. I'd like to either try TCA + subcision on it, or punch excision. I don't see dermabrasion having a significant effect on it other than relieving my wallet of $150 and I'd rather apply that money toward something that will yield significant results. In fairness to the doctor, he did go over my scars again with the laser, and he really got in there and went over it again pretty well. I do appreciate that. Of course, at this point I am only a week out so I can't say that these are the final results though in all likelihood I don't think I will see a whole bunch more improvement. Hopefully I am wrong and it will look significantly better in the future. It could happen I suppose. My skin does look better even if some of my scars don't and that's a victory. I don't know how people are seeing signifcant results with even worse scars unless their doctor is willing to crank it up. Mine wasn't, he said the risk was too high at that level. These are things to speak with your doctor about in advance- if it seems he wants to run out the door you might have to be firm about speaking to your doctor about it. Don't let yourself be put off. I will pdate my review and give a final review of my doctor and the procedure in about three months, once I am certain the results are final. They probably are now from what I have seen but I want to be fair and if there is more improvement, great.

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It's about 7 days after the second pass

final review

Today I am writing my final review of the deep fx laser for acne scars. Bottom line, there was some improvement on my rolling scars/box scars but not much improvement on the icepick scars. So I'm saying half worth it, dependent on which type of scars you have. Attached are final pictures. I am going back to dermarolling, at home, which I am also reviewing on realself, and I am trying to find someone to do punch excision/subcision for me. I would suggest punch excision/subcision first for anyone just starting out, followed by a deep laser later.

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Thank you for posting your final results, I saw some great improvement based on your pictures, icepick scars are much deeper so I can see them being more difficult to treat...good luck on your Dermarolling look forward to seeing if that helps - fingers are crossed for you. 
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Finally

I am quite some time post procedure now. I just wanted to say I wish my doctor would have went deeper with the laser. From what I have seen on these boards the only way to see significant results is to crank up the juice. My advice to anyone who doesn't have the money to keep going back for more and more laser treatments ( like me, I hate my scars, my bumpy skin texture, and I don't have any more money now to repeat the process) anyway my advice to you would be to find a dr who will be willing to go deep enough to eliminate the scars. I have seen improvement but I'm still not happy with my results.

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I gave my dr a 4 instead of a 5 because of my results, I wish they were better. He did go over it again with a second pass. I really would have liked to give him a 5 but I just wish my results were better, I still have pretty prominent acne scars on my cheeks. :(
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Lafayette Facial Plastic Surgeon

4 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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