Acne Scar Surgery

It has now been over 3 years since my acne scar surgery with Dr. Young. Virtually all of my scars have slowly reappeared.
I should emphasize that I don’t hold any grudge against Dr. Young, personally. I think he’s genuine and he is sincerely invested in his work. He also seems like a principled man. Sometimes there are unique factors that influence how a body responds to surgery. It’s all a science experiment at the end of the day.
It is clear that many people have been very happy with their acne scar surgery with Dr. Young. And chances are you will be, too.
Dr. Davin Lim (the famous acne scar doctor) says that scars won’t improve if there’s inflammation in the skin, such as active acne. I did not have active acne when I went to Dr. Young. But perhaps, my body had systemic inflammation in other ways. After all, I developed a limp in my walking gait after acne scar surgery and intense heat in that leg. Dr. Young told me to go to the ER to check for a blood clot. I did NOT have one. But maybe that was indicative of my body’s inflamed reaction to the extensive surgery, which in turn canceled out any good. I don’t think of myself as someone who has chronic inflammation or chronic disease, disability, or metabolic issues.
I’m going to proactively lower my body’s inflammation before getting further treatment for my scars. I plan to see a naturopath to do this. But I think that this last very aggressive acne scar surgery, itself, caused lots of inflammation I didn’t have before, so I don’t know to what extent this will help.
As I said before, my scars only improved very slightly, with only one recent scar disappearing and a new scar appearing as a result of the aggressive needling in surgery. Dr. Young has also noted this lack of improvement after seeing me in person and listening to my account. He texted me before and after photos. In one of the after photos I see mild improvement in the lines that interlock between my scars on one cheek. A shadow obscures some of my face in the after photos, which superficially makes my skin look better. But I can attest that my skin is not improved in the areas that are shadowed in the after photos.
Dr. Young was concerned with my lack of improvement, because according to him, I’m the only patient who improved so little. And yet, a woman had reached out to me on RealSelf before my surgery, telling me about how she also improved very little, if at all, after acne scar surgery with Dr. Young. Maybe he is unaware of the ways his surgical methods affect everyone because so few patients may travel to see him afterwards (as many of us travel out of state to see him). Albeit, this woman told me that she did travel to undergo the surgery a second time but was dissuaded when she showed up because she was told she would have to pay more the second time because prices had increased for everyone. (Dr. Young offered to do my second acne scar surgery and forehead reconstruction surgeries without the primary cost of the surgeon’s fee.)
If Dr. Young was anything like he was with me the time I came to improve my forehead side effects, then he may have been initially uninterested in that other lady’s scar improvement, and so did not offer to give her the second surgery cheaper, as he did with me. This attitude may be because he genuinely believes his surgical technique always makes significant improvement, so he assumes he doesn’t need to check. I had to firmly and repeatedly say and show how little my skin had improved. The before and after photos in his office did a poor job at showing my skin quality and the individual scars. It would stand to reason he would benefit from learning lighting and angling techniques that best showcase scars in all their glory.
Since my surgery, I have had work done on my scars by two doctors. Dr. Steven Weiner did a series of things in one session. I left a review on here about that experience. Suffice it to say, I had very mild improvement (20% on one cheek and 0% improvement on the other cheek and 0% improvement on the scars on my forehead…similar to my improvement with Dr. Young.) I also went in this year to get HA filler in my scars from Dr. Stella Desyatinkova in Seattle because she had proven herself a skilled filler when I went to her for help with my botched forehead. It’s really hard to give a percent improvement after one session of 2 syringes of Juvederm (1.5 hours). It’s sometimes hard to see all of my scars in even the “worst” lighting. But I’d maybe say a couple of my scars are gone. The rest look the same. It is really hard to say what kind of improvement I’ve had because initially my skin looked a lot better and then the swelling disappeared and the scars reappeared, so it’s messed with my ability to assess differences.
At this point, I think I need more subcision sessions before getting any more filler (or fat). I’m playing with the idea of getting treatment from Dr. Mark Taylor because his subcision technique is the most aggressive (Taylor Liberator tool). BUT I’m scared that I could be part of the percentage of people who develop permanently lumps and swelling as a result. I’m also playing with seeing Dr. Rullan in California to get the phenol peel to treat my boxcar and ice pick scars. Apparently, he is the best at giving the phenol peel of anyone (I’ve heard this from a couple sources). He also invented the cannula technique of subcision. I would only go to him for everything, and not bother with Dr. Taylor, but I’ve already had 3 cannula subcision sessions from different providers and they didn’t do much. I know I need extensive subcision at varying levels in my skin’s layer that the Taylor Liberator offers.
(I’m just nervous about potential side effects.)
I’m also playing with the idea of seeing Dr. Davin Lim in Australia if I don’t improve significantly from Dr. Taylor. His clinic is now seeing out of country severe acne scar patients. In the past, he discontinued seeing severe scar patients. But I guess now he is seeing people like us again. I like the idea of seeing him because he seems to have the most individualized approach to everyone’s scarred skin.
Dr. Young says that he thinks what I most need is more fat grafting into my scars. But my first surgery with him shows that the grafted fat went into changing the structures of my face, rather than the ripples of my scars. It would seem that the fat was administered too deep. At this point, my face cannot accommodate any more fat into its structure without making me unrecognizable. My face is far more round than ever before. It is clear to the keen eye that I’ve had plastic surgery.
Over this time, my preoccupation with my skin has been partially replaced with the severe lumps and dents in my forehead that are a result of the surgery. I went back to Dr Young to get more fat to fix it, but that surgery only had very mild improvement on the overall picture. I was lucky to find Dr. “Stella” who is the only plastic surgeon who administers HA filler into the high risk forehead areas with the help of ultrasound, in order to prevent severe health complications in the arteries.
Combined, I have spent $10,000 fixing my botched forehead, and probably have to spend $20,000 more: filler and an open brow lift to smooth out the dented and lumpy tissue, smooth out the bizarre wrinkle patterns, and allow my eyebrows to raise. Thankfully, I have seen gains from my forehead reconstruction procedures.
I may also need a buccal fat removal to make my face less round after what the fat grafting did.
I now have permanent rosacea now that flares up sometimes, like when I wash my face or some evenings before bed, which I never had before. Dr. Young was uninterested in this side effect and said there was nothing he could do. (The redness persisted for many months and now is intermittent.) Another plastic surgeon told me that this is the result of having fat grafting because of the vascular nature of the fat.
My prized freckles are gone. This wouldn’t bother me in and if itself, though. Many people try to get rid of freckles.
But on a good note, the etched horizontal lines from wrinkles that used to cross my forehead are completely gone. I used to be self conscious about my forehead wrinkles but now the pattern is different and is bizarre, including arches above each of my eyebrows, which look like a second set of eyebrows.
I have also been worried with permanent patches of fat that are on the upper sides of my cheeks and my now wider chin structure. I don’t think much can be done to fix those areas. At least they don’t bother me as much.
I’m fortunate now to be earning enough money to treat these disfigurements over time. But I’m unlucky enough to have had to deal with severe acne scars for 20 years (in addition to other facial disfigurements that I haven’t mentioned on RealSelf). It’s wearying to have had to put up with this all these years.
I’m genuinely amazed with myself that I’ve not become suicidal over this. Albeit, it’s likely because I didn’t allow myself to think much about my disfigurements during the years I couldn’t afford to do anything. I was affirmed as gorgeous by everyone before puberty, so I always maintained that inner sense of self. I viewed my disfigurements as distractions from my beauty, rather than things that made me ugly. And now I see it as merely needing MORE surgery, which is doable.
It’s tough when I feel all alone, even within the acne scar community, for having worse scaring than nearly everyone. Fortunately, my skin has gone from a 9.5 severity to a 6.0 severity after years and $30,000 worth of treatments from multiple providers. I’ve only ever seen a handful of people who had worse scarring than I started with (albeit, there are different scar patterns and types of scars out there, so I never looked the same as anyone). I hope to have normal (not perfect) skin someday.
Some of you commenting have expressed how you’ll “pray for” me. I appreciate the sentiment, but saying this kinda affirms what a disfigured mess I am, that I am deserving of such pity.
I see this as an achievable process. It’s just taking a LOT longer than anyone anticipated. Meanwhile, I’ve tried to compensate by improving my looks in other ways. I’ll update the acne scar community in years to come.

I’ve been touched at the concern he’s expressed at my lack of progress and his commitment to try out methods other doctors have found useful (except for filler and probably updated energy devices like Genius). He’s offered me his future services without a surgeon fee, just fees for anesthesia and the facility. I mentioned TCA cross and a series of subcision procedures with saline in order to keep the scars from re-attaching and then ultimately fill them in with fat. He seems open to it, which I think shows his humility, which is a huge asset in surgeons. I’m thinking the fat from my stomach was not the most amenable to fat grafting. We’ll find out in a few months if the fat from my thighs holds with my forehead procedure and then decide if we want to use it in a possible next scar surgery. He’s also mentioned not doing dermabrasion (I think) as a means to help speed my recovery next time.

I was confident at the five month mark to post a review and recommend it to others, even though my scars had only improved a touch (and on one cheek and my forehead and chin scars). HOWEVER, in the months past (9 months out now from surgery) my scars have all come back to how they were before, except for three scars. I just saw Dr. Young yesterday in order to fix the dents in my forehead from the surgery and he expressed concern that my scars had not improved much, if at all (he even didn't think the three scars I thought were improved, were improved much). He told me I was the ONLY patient whose scars did not improve. I was hesitant to update my review until I got his opinion, but now I have it.
You can understand his negative opinion means all the more because he's self invested in believing his stuff works. He wants me to go through the procedure, again, but I'm really not confident. He thinks the reason it didn't work was because my body dissolved the fat grafting. He asked if I had lost weight, but I've only gained weight.
I'm planning to go to Dr. Stephen Weiner, a surgeon who specializes in acne scars and is a close peer and friend of Dr. Davin Lim, the famous acne scar doctor in Australia. Dr. Young does not believe in filler for acne scars but Dr. Weiner's wife told me they think fat grafting is good for large areas that need to be raised but not good for individual acne scars.