I plan to have subcision done by a different doctor than my laser treatment, that's why I can't do it on the same day. Would like to know if the results will be less effective if the subcision is done several days or weeks before the laser vs. having both done on the same day? Also, how important is subcision in combination with laser for correcting rolling scars? Will laser do anything on its own or is subcision necessary to see good results? How long is the skin bruised/swollen from subcision?
August 11, 2017
Answer: You'll be fine Yes, generally, lasers are also required for best results. Each are doing their own work with different targets. These types of procedures are commonly performed at the same time. Therefore, week or two later shouldn't negatively impact your subcision. However, the cost will likely be more when performed separately than at once. There will also be some duplication of down time. In terms of cost, I prefer and believe it is beneficial to use PRP with each procedure. It takes roughly as much PRP for a single combined treatment than a single treatment. Prep time is another factor that will add cost. Such an approach doubles things up. Time is money. Both in terms of physicians time and your extended amount of recovery time. The extra PRP will certainly be beneficial. However, being so close together I doubt you'll get your moneys worth of benefit. Lasers on their own with PRP can work, but highly dependent on many factors. Absent photos or evaluation it is impossible to make a determination or hazard a guess. Bruising is again another multi factorial issue that is impossible to estimate with the scant information available. Wish I could help more. Warmly, Arbella Sarkis, MD
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August 11, 2017
Answer: You'll be fine Yes, generally, lasers are also required for best results. Each are doing their own work with different targets. These types of procedures are commonly performed at the same time. Therefore, week or two later shouldn't negatively impact your subcision. However, the cost will likely be more when performed separately than at once. There will also be some duplication of down time. In terms of cost, I prefer and believe it is beneficial to use PRP with each procedure. It takes roughly as much PRP for a single combined treatment than a single treatment. Prep time is another factor that will add cost. Such an approach doubles things up. Time is money. Both in terms of physicians time and your extended amount of recovery time. The extra PRP will certainly be beneficial. However, being so close together I doubt you'll get your moneys worth of benefit. Lasers on their own with PRP can work, but highly dependent on many factors. Absent photos or evaluation it is impossible to make a determination or hazard a guess. Bruising is again another multi factorial issue that is impossible to estimate with the scant information available. Wish I could help more. Warmly, Arbella Sarkis, MD
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August 20, 2017
Answer: Yes, in fact both can be combined. For tethered and rolling scars, subcision is the stand out procedure, most often I combine this with CO2 high energy, but low density - namely DEEP CO2 if downtime is not an issue. All the questions and more answered in the web reference below- it really depends on your scar type and tissue response. Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments and not just one device. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars. The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.
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August 20, 2017
Answer: Yes, in fact both can be combined. For tethered and rolling scars, subcision is the stand out procedure, most often I combine this with CO2 high energy, but low density - namely DEEP CO2 if downtime is not an issue. All the questions and more answered in the web reference below- it really depends on your scar type and tissue response. Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments and not just one device. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars. The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.
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