Mixto Laser on Asian Skin for Acne Scars - Los Angeles, CA

I am an Asian with acne scars, which makes my...

I am an Asian with acne scars, which makes my condition particularly tricky to treat with lasers. I was doing Lux 1540, but I will be heading back into school this fall and, thus, will have much less time for treatments, thus I wanted to try something faster.

As such, I turned to the Mixto laser as done by Dr. David Rahimi in Beverly Hills, CA. He proposed a Mixto + minor subcision followed by a touch-up after healing. He warned that I would not get rid of all of my scars, that the scars would mostly return by the end of the first month but then get better by around the third or fourth month, at which point he'd do the touch-up.

I am posting this as a blog for my progress and to answer any questions people may have about the procedure itself.

Dr. Rahimi's process, as he explained to me, was a little different than others, because he uses a different head on the Mixto laser to "shave down the edges" of the ridges of the scars as well as the Mixto itself. He also did a subcision immediately after the procedure to raise some bound-down scars, which I think was very necessary on the left side of my face.

Also, btw, when I say "harshest lighting I could find," I mean that, each time I took a picture, I went out of my way to find the worst lighting possible for my scars at that particular time with a light coming down from straight above. My bathroom has a single 120 watt pure-white light bulb, which is kind of like a weaker version of the side lights that dermatologists use to find acne scars. This does mean that the angles are possibly off with each picture, but this is the most objective way I can figure to do it, since there is no way the scars can actually look "worse" than they are with the angles I took them.

April 27, 2012:

Day before procedure. Had to take some sort of Doxycyclin the night before in order to prevent infections. I was also given two microdermabrasions each spread a week apart before this point in order to prep my face for the procedure.

May 9, 2012:

About five days after stopping applying Aquaphor, which means it's been 11 days since the procedure. I've mostly finished peeling. The scars look better, especially on the left side of my face, but they are still pretty evident in the right. It is difficult to wait for the full three or four months to see how these scars will develop.

Some acne broke out, and I was given an oral antibiotic to treat it, but it hasn't worked too well (I've always been pretty resistant to antibiotics). Fortunately, the outbreaks are pretty minor, nothing even approaching the levels that caused the scarring in the first place.

May 28, 2012 Happy Memorial Day everyone. It's...

May 28, 2012

Happy Memorial Day everyone. It's been exactly a month since I had the procedure, I've posted my result pictures. Note: my left side has a bit of acne. I assure you, it's actually exactly the same.

Now, it LOOKS like there has been a lot of improvement on my right side, and there has, but really, it's not as much as it looks compared to my older picture. My older picture was a little blurred, made the scars look worse than they actually were. What you can REALLY notice is the bridge of skin between my two scars clusters, that was not really there before. Exciting stuff.

Anyway, in case you were wondering, this is has been my post-op treatment routine:

Morning:
Shower.
Wash face with cold water and glycolic cleanser. Pat dry.
Sunblock.
Spot treat any acne with Acanya (2.5% benzoyl peroxide/1.2% clindamycin mix).

Night:
Wash face with cold water and glycolic cleanser. Pat dry.
Acanya all over face.
Kojic acid all over face.
Neocutis Bio-Gel all over face (this is my moisturizer, essentially).

Every week, I will forego all of my topicals in the night treatment for a treatment with Atralin (topical tretinoin .05%)

So yeah. Steady as she goes, but there is definitely improvement. Also, the redness is much more noticeable in these pictures because I took off the color correction.

Hope ya'll had a great long weekend.

June 28, 2012 Pretty much exactly two months...

June 28, 2012

Pretty much exactly two months since I had the treatment. I added two more photos that I took last night, when my scars are at their worst after a long day:

As you can see, left side still pretty much the same (I'm still wondering why the left side resolved so damn well) whereas there is still room for improvement on the right, but it's definitely getting a bit better. I also have a bit of active acne still ongoing, but it appears to be on its way out, as far as I can tell.

There are some days where they look worse. For instance, on the left side of my face, a slight crater may show up at the end of the day, and on the right it'll look a bit messier, but overall this is generally how they look at their worst.

I scheduled my touch-up for July 28. After consulting with Dr. Rahimi some more, I have confirmed that it is, indeed, basically another regular Mixto treatment (in fact, he said he would be going more aggressively on my right side than last time), except he'll be attacking only the scars and not the entire face. He also said any subsequent treatments, if I would want any, would be $500 each. However, considering that I'll be starting grad school, I don't think I'll have time for more treatments until at LEAST winter vacation, so yeah.

Had my second procedure exactly two weeks ago. It...

Had my second procedure exactly two weeks ago. It was a TCA Peel + Mixto + Subcision, and it was free. Check it out.

August 28, 2012 New pictures, a month after my...

August 28, 2012

New pictures, a month after my last Mixto.
Los Angeles Dermatologist

I have been to quite a few dermatologists for my acne scars, and Dr. Rahimi has been the only doctor I've met who's board-certified for both Dermatology and Cosmetic Surgery. Furthermore, he actually has a pretty measured approach to procedures and prefers patient happiness over profit. For example, when I first met with him, I was undergoing Lux 1540 at another office, and he suggested that I should probably go back to Lux 1540 and give it another chance before trying his procedure. He was more worried about my convenience than his own making of money.

5 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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Comments (23)

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How about the pain? was it very painful during and after the laser treatment? thanks

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i am considering doing this next October. i was a bit worried reading some other reviews, but the difference in your skin is nothing less than DRAMATIC! as a person who also suffers w/acne scars, i can relate to how it can....make you so insecure. you look incredible! thank you for sharing so much of your experience w/me!
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Thanks for all your posts and time, it really helped me feel confident about getting this done!
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August 28 is probably going to be my last update.
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Its been about 4 weeks since your last laser, how do you feel now? Do you see improvement between this one and your first one?
Thanks!
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Hello,
Just wondering how your 2nd treamtment went and what you noticed on your three month mark. I heard you heal faster when you get a 2nd treatment, hopefully thats the case for you :)
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Yes, I took my second treatment on July 28. It was actually a 20% TCA peel, then the Mixto (which was done much more aggressively), and then a pretty aggressive subcision (I heard a lot of popping noises when he did it).

I am actually still somewhat swollen, more so than last time, but the peeling of the skin went a lot faster than last time. I plan to post a picture maybe 10-14 days after treatment, since all of the swelling (or most of it, at least) would be gone by then.
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I think the microswelling went away after about a month.

I think, so far, the percentage of improvement has been about 70% on my left and 30% on my right. There are still portion on my left that very much bother me, and my right can obviously use more work, so I am looking forward to my second treatment at the end of July.
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Thanks for keeping up with the updates!! Your improvement looks amazing, how much pertcentage of improvement do you think you got so far? At this point is there still microswelling or is that gone?
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I just noticed, I use SUNSCREEN 45 UVA/UVB. But I'm pretty much like a vampire, I don't go outside if I don't need to, and if I do, it's only in the car like to run to the store, etc.Yeah I hope it clears up soon too!!! I hate looking at myself like this.
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Yes, I used the Vaseline for the first 8 days. So the peeling was very smooth, no complications, no problems. At first I could not see my acne scars because the skin was swollen, and now that it went back to normal, now you can see my acne scars. At 10 days after the treatment, the skin was very pink, actually a pretty pink. Now it's dark-red-brown, I see tiny white spots. I uploaded a pic on my profile. I will upload more with time. But I see your pics and one of your cheeks looks very good, it almost looks flawless, the other one needs more work done, but you look great!!!
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I'm sorry, I don't know what went wrong with your procedure. I hope it clears up.
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That is a strange reaction. I've only ever had the pink skin, however I had been treating with kojic acid (which is like a weaker form of HQ [I can't take actual HQ due to an allergy]) as soon as I was able to, which was around 11 days after the procedure.

Had you been using something like Aquaphor or Vaseline to coat your skin during the 8 days it was healing and peeling? And is it a sunscreen or a sunblock? Sunblock actually completely blocks out the sun, sunscreens do not and have to be constantly reapplied. The active ingredient in a sunblock is a zinc dioxide, and by law the labeling needs to make the distinction between "screen" and "block" depending on where there is zinc dioxide or not.
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3.5 weeks before the treatment, I used the cream (Retin-A 0.5% & Hydroquinone 0.2%) my Dr. gave me. I always wear sunscreen 45-50. The procedure went well, I had the regular symptoms, swollen-red skin, and then the peeling. 8 days all the peeling was over, so I had beautiful PINK SKIN. Now the older the skin gets, the red gets darker, and it's turning more into a brown color. My Dr. said I have to be patient with the results,she said the redness might last 2 months, and she said for the brown I will have to use that MELASMA cream again. I hardly ever go outside, I only make short trips to the stores, etc. always wear sunscreen, I wear a hat. So I don't get much sunlight. Before my procedure I had pretty olive color skin (hispanic) and zero brown patches, my only problem was the deep acne scars, deep ice pick scars, etc.
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That is a strange reaction. I've only ever had the pink skin, however I had been treating with kojic acid (which is like a weaker form of HQ [I can't take actual HQ due to an allergy]) as soon as I was able to, which was around 11 days after the procedure.

Had you been using something like Aquaphor or Vaseline to coat your skin during the 8 days it was healing and peeling? And is it a sunscreen or a sunblock? Sunblock actually completely blocks out the sun, sunscreens do not and have to be constantly reapplied. The active ingredient in a sunblock is a zinc dioxide, and by law the labeling needs to make the distinction between "screen" and "block" depending on where there is zinc dioxide or not.
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My acne scars are exactly the same as yours were before your procedure. I got Mixto Laser done 19 days ago. Now my scars look exactly the same way and my face looks very dark-red-brownish color, it looks horrible.
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I'm sorry it turned out that way.

May I ask what your care was before the procedure, during the procedure, and after the procedure? If it turned dark-red-brownish color, that sounds as though your skin may have been exposed to the sun post-treatment.
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Great update, thank for following through on your progress posts.
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Looking good!  Keep up the good work and care.

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Welcome to RealSelf and thank you for sharing your journey with us.  I will be anxious to hear how the healing is going and if you will need future treatments.

Keep us up to date on your process.  And thank you for posting the pictures.

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Yeah, I'm definitely gonna go for a touch-up at two months. According to Dr. Rahimi, a "touch-up" pretty much entails a second treatment, except just in the areas that still need improvement instead of the entire face.

Also, note, I am not looking for 100% improvement. Dr. Rahimi cited that, when all was said and done, there should be around a 60-80% improvement, which is exactly what I am looking for.
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I should mention that the touch-up is also complimentary. Dr. Rahimi is a boss.
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60-80% improvement sounds exellent!   The complimentary work is also very nice.  Good doctor!  Do keep us up to date on everything.

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