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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Comments (23)

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After your story I went and got filler and OMG did it help my scars! Thanks for your posts.. it helped me to move forward and once again feel good about myself :) HUGS!!!
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I really appreciate the information you have shared. I am impressed by your persistance with the treatments, and boy has it paid off! You are looking beautiful! This makes me want to continue treatments.
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Thanks for the comment, B. Good luck to you. I am persistent. Since I've had the treatment I posted to RS, I've had a couple fraxels, a few IPLs, DeepFX, about a dozen microneedlings, and probably things that I'm forgetting. And to answer the comment below, it IS ridiculously expensive, and I forgo a lot of things to afford treatments. I know that these treatments aren't an option for everyone due to the cost, and it's sad that the expense limits people's ability to seek treatment and feel better.
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wow amazing! thank you, and you look great!
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Your skin looks beautiful! I can't believe the difference. I think me and you have/had the same scars... god I hate them! Curious about the financial situation with this. How do people afford to do these things? Thanks for your posts! You look great! What a difference your research really paid off!
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i did 3 fraxel treatments for acne scars about 8 years ago.. my skin hurts now because the scarring has hardened.. I paid a lot to get this way.. and my scarring looks worse..
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In your update pics your skin looks really good! Are you sure the subcision made your scars worse? They look much better around the chin, but maybe it is the lighting.
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Looks much better than when you started though. I hope you see that too!! The one side that is still real scarred that you dislike may require seeing a plastic surgeon as they may need to pull your skin tight to even it out & make it flush with your face. Don't know if there's anything else your dermatologist can do for you. What you did is a big improvement and id be careful doing much more!! You don't want to permanently mess up your face!!! Too much will really start showing and you won't be able to reverse the damage. There's a new procedure too called the Derma pen. Check it out. Only go to a licensed facility for it but there's great reviews!! Good luck & sometimes we have to accept our flaws, scars & marks & stop trying to do anything to erase the signs because we make them worse. You earned those scars, they're a part of you & regardless, you're beautiful. Accept them and enjoy life. You only live once. Thanks for sharing your story. Don't be so hard on your face, you've come a long way. Don't overdo it or you may regret it. Most of these Dr's. will just take your $ and promise an easy fix because they see green money!! Watch out.

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Thank you for sharing your story. My scars are worse than yours and I've been living with low self-confidence for the past 10 years. I tried IPL, chemical peels and lastly fraxel treatments and none of them worked. Now that I am 59 yrs. of age and I only realized how much worse my skin is making me look much older when I found out from my ex-boyfriend that this is one of the reasons why he broke up w/ me - - that I have too many wrinkles on my face and besides being old!!! I live in CA and I'm only now researching my condition as I am much more aware after my break-up. I hope I can find a doctor like yours who will give me the truth on treatments. Please post a current picture to give me hope. thanks
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What dr did you use? I am currently looking for someone in Phil. for my acne scars
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be careful about laser treatments.. my scars have become worse (hardened) because of fraxel laser treatments.... they sell stuff, but I bet your doctor doesn't have acne issues..
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I live in south jersey and want to find a great acne scar doctor in the philadelphia area. Who did you use as your dr?

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Please I dont live in Phila but I was raised there and I can return and would like to have a consult with your doctor, can you give his name please? Thank you so much.
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Hi there. Thank you so much for being brave enough to share your story with pictures. It truly is helpful to everyone else. I have similar scars around my chin. I have been looking into subcision but now I am scared that you say it has made this area worse, although I can't tell in the pictures. Do you know why the doctor thought this would be a risk in this area as opposed to the cheek? I am also wondering if you could share your doctor's name with me. Thank you so much.
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do you have any pics of your skin now? i am wondering how things are progressing for you?
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Hi what is the Doctor's name? I am also interested in this surgery.
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Can you please tell me the name of the doctor? I also live in Philadelphia area and I am looking for a doctor to help me. Thanks!
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Thanks for posting the pictures. It is so helpful to see the before and afters! It really looks like you got some nice results.   Is there still a lot of redness where the subcision was performed?

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HI, Megan. Definitely pink where the subcisions were done. It's not hard covering those areas with makeup now, though. The depth of the scars is reduced and overall things are progressing very well. I really hope my postings are helpful to your users.
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I can tell you that your postings are helpful for sure. There are a huge number of people that come on and gather information everyday, so even though they might not have a question or comment to leave, they are still finding what you shared to be helpful in making their decision. Often times after they decide to have a procedure they will come back and share their story and mention that they lurked on the site for a long time, then felt they wanted to give back since they had received so much help and insight from those who posted before them, so you can know you are for sure helping others! :)  On top of that, you have great results - so happy for you!

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Can you please tell me what kind of doctor you went to...was this a plastic surgeon or dermatoligic surgeon? Im having trouble finding the later in my area. All the doctors ive seen have said lasers would work the best but im thinking subcision might be better. i have scars similiar to yours. Thanks in advance for your response.

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Hi, Madison. He's a dermatologist. He's a professor at the medical school and also department chief at the hospital. And yes, I had the same experience. Doctors that I saw wanted to use the tools they had on hand, but my research and experience said that lasers alone wouldn't do it. I narrowed my search to the "good doctors" and then called their offices to see who did subcision. There aren't many. Good luck and I hope you find the right doctor and get good results.
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You gave some very good advice, especially when you were stressing the importance of researching both the procedure and the doctor who will do it.

I really, really hope you see some great results from all of this, and look forward to seeing your pictures.

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