Starlux 1540 + Subcision - done - Philadelphia, PA

I have moderate acne scarring on my cheeks and...

I have moderate acne scarring on my cheeks and rather severe scars on my chin. (Rolling scars). I took Accutane in my 20s, and it was a wonder drug. It cured my cystic acne and plumped up my skin. About ten years later, a slow progression of scar visibility began. Now, in my 40s, I am very unhappy with my appearance. Evidently, being thin and losing "volume" in my face as I've aged is the culprit of my sunken and rolling scars becoming more apparent.

I had Fraxel laser treatments: one in 2009 and and one 2010. They cost $1,100 each, so I had no choice but to wait a long time in between. I never really gleaned any result from them. I live in a small town in Pa. and I felt like I did not have any other option but to pay an arm and a leg to the one guy who had a Fraxel laser nearby.

Fast forward to 2012 and I'm even more unhappy. So, in the summer of 2012, I finally did my research. (This is my first cautionary tale to everyone reading this. DO YOUR RESEARCH.) I checked scientific papers, government websites, this site, doctor rating sites, etc. I read everything; not just personal accounts, I decided to make the drive to Philadelphia and seek out "the best of the best." That is my second caution: CHOOSE YOUR DOCTOR CAREFULLY. Make sure this person does a lot of what you want for yourself. Do not use someone who "dabbles." You want experience and you want reputation. I cannot stress this enough.

The doctor was very frank. He said he did not think he could help me with some very sunken, odd scars on my chin. He did not want me to have unrealistic expectations. He also said that he did not know if a laser would help because my previous Fraxels did nothing. BUT. He admitted that the Fraxels may not have worked because they were spaced so far apart. (This is anot another thing I want to share. Find someone who does not take advantage of you price-wise. I know none of these treatments are cheap, but I wish I had shopped around and not wasted $2,200 on two Fraxels. Everything I've read indicates that these laser treatments work best when they are done relatively close together.)


So, this new doctor agreed to help me because I admitted that I was desperate, that I was willing to give it a try, and that I fully understood that it may do nothing. Because, bottom line: some treatments just don't work on some people. Not everyone's bodies work the same. We agreed on a $2,500 package: three Starlux laser treatments and two subcision treatments for the scars on my chin. The schedule went: laser / wait one week / subcision / wait two weeks / laser / wait one week / subcision / wait two weeks / laser.

I just had the "last" laser yesterday (December 11, 2012). And yes, my skin has improved, particularly the scars on my cheeks. I would say cheeks 80% better; chin: 30% better. Now, remember, collagen in my skin is still remodeling, so I may not see the full benefit until three to six months from now. Or, this could be it. I did, however, ask if I can have one more laser treatment a month from now. (Additional $400) My doctor knows how much my skin bothers me, that I know the risks, but that I want to be aggressive. Again, this is my choice, and no one is guaranteeing results. However, he feels it is safe and that whether or not I do it is up to me. My feeling is, it is worth the money to at least try and feel like I did everything I could to help myself. But, I am keeping my expectations low.

Couple things: 
1) One bit of advice from the "Fraxel doctor" that I think is helping: take 500mg of vitamin C 2x per day. Your body needs C to make collagen. The new doctor agreed. Ask your doctor.
2) I am appalled at how many reviews I read on real-self where people are not communicating with their doctors and/or they are self-treating between laser treatments. I've seen people advocating Advil, fish oils, Retin A, etc. You should not be taking ANY medications without the consent of your treating physician. All the things I mentioned can seriously impact your results! Drugs like Advil and fish oil thin your blood, affect healing and can cause bruising. Retin A is a powerful topical drug that should not be applied to delicate skin without consent from your doctor.
3) You are going to look BAD after these treatments. Do not let anyone tell you otherwise. You will be self-conscious. You will be in pain. You will swell and you will be ridiculously red. This is why the research is important. If you do your research, you will know what to expect realistically. In my case: it takes at least 7 days after each treatment where the texture of my skin is relatively normal and where I am not self-conscious about redness.
4) These treatments HURT, at least at the power level I've had them. I agreed to very aggressive treatment understanding that it would hurt. 
5) If you have really sunken scars, find someone SKILLED in subcision. These doctors are not easy to find, But, in the areas where I had the most sunken appearance, the subcision is working! Again, it hurts horribly when he puts the numbing needles in your face, and you basically have long-lasting, bloody marks on your face. If your doctor tells you to use antibiotic cream on your subcision sites -- do it without fail. You don't want more scars.

I truly know how demoralizing and upsetting it is to have scars on one's face, and I know it's not easy to resist doing ANYTHING we think of to get better. Please make good choices and take care of yourself. Go slow and don't take the first bit of advice you get. If I can post some photos and give you an update in a month or two, I will.

01/10/13 -- It's been one month after my last...

01/10/13 -- It's been one month after my last Starlux treatment, and I have to say, I do think the laser made a big difference. I think the subcison may have made two spots on my chin worse (deeper and wider), but it helped one spot on my cheek a lot. Making things worse was a risk I was told of, and it was my choice to take it.

One lesson I think I learned is that I wish I had asked the doctor about before and after photos. I might have had a clearer expectation of results and how previous patients compared to me.

I decided not to have a fourth Starlux. Instead, I'm going to see about filler as the last step. I will try to post one more set of photos before I have anything else done so that you can make up your mind about the "before" and "after" specific to this post.

A few people have asked for an update and new...

A few people have asked for an update and new pictures. I've had a few additional procedures since my last post. Two IPL treatments (03/19/13 and 4/24.13) and facials with light peels every six weeks. If I had to do it all over again, I would not have done the subcision -- just the laser. The facials make a huge difference.
Not applicable

He is extremely honest. He sees 40 to 50 patients per day, so sometimes I have to MAKE him stay in the room and answer all my questions. The esthetician is great about answering emails.

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