Not really worth it for significant scarring - Santa Monica, CA

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I just had Total FX, two days ago on July 22, 2008...

I just had Total FX, two days ago on July 22, 2008 in Santa Monica, CA. She is the dermatologist seen on the show "Extreme Makeover", but it was actually one of her nurses that performed the procedure for acne scarring and a few small undereye wrinkles.

I am a 41 year old female with significant rolling scars (depressed scars)on my forehead and cheeks. I have had 3 past Fraxel treatments last year that did not lead to noticeable improvement, and that cost me $900 per treatment performed by a different doctor's office in Los Angeles.

The nurse did 3 passes of Deep FX to my forehead and cheeks using a setting of 17.5 which she said was the highest she was told she could go, at a training session she had. I believe the Deep FX machine goes up to 20 or 21, however. Most people get 2 passes, not 3.

I did not feel pain because I had taken 1 valium and 2 vicodin in her office prior to the appt, and also had put quite alot of EMLA numbing creme all over my face one hour prior to the procedure. I smelled burning skin during the procedure.

When it was time to do the Active FX directly after the Deep FX, this was performed all over my face at a setting of 100. I am not sure what that means or how high that is but I think it is a moderate setting as I do not have skin issues on the other parts of my face. The nurse used the Active FX in the undereye area for fine wrinkles that I have there since she did not treat this area during Deep FX which would have probably caused damage rather than good, since Deep FX is better for scarring.

The Active FX actually hurt a bit so I was trying to control my fidgeting hands as I did not want to affect her treatment or cause her to lower her settings. I just wanted to do this once as I am so tired of getting laser treatments for my skin (I have also in the past, had 4 CoolTouch laser treatments, 2 C02 treatments for scarring, and 1 full face dermabrasion 13 years ago...all of this helped with the scarring but it was still quite visible. Following those past laser treatments I had 13 separate silicon injection appts using micro droplets of FDA approved silicone which actually is not approved for scar injection but there are doctors out there who will do it if you are willing to sign a ton of waivers. The best doctor in the country for silicone is {edited - you must contact this user privately by clicking on their username to receive this information}, in NYC who is a pioneer, along with {edited - you must contact this user privately by clicking on their username to receive this information} of NYC who used to perform silicone injections but no longer does.). I have also used a doctor in Torrance, CA for silicone who is amazing and half the price of {edited} in NY. This has drastically filled in more severely depressed scars but my skin still looks very scarred, thus the laser resurfacing treatments I endure.

Anyway--back to my Total FX review...I am now on my second day of healing. The procedure was done two days ago and on the first day and night there was siginificant oozing and dripping of orangey looking, sticky fluid..I think it was plasma (clear blood). I slept propped up with towels on my pillow and used a giant towel as a blanket near my face because the oozing was so extreme. There were alot of blood spots all over my cheeks from the Deep FX, and swelling but no pain. It looked like my skin had been ripped off..similar to C02.I keep Aquaphor on my skin and yesterday washed my face 3 times and reapplied the Aquaphor. I am on prescribed steroids to help with the swelling, and also on Cipro to fight possible infection.

Since it's 2 days since my procedure, I am still washing 3 times a day and smearing thick layers of Aquaphor on my face. The oozing has stopped and the swelling is starting to barely go down. My entire face is scabbed and crusted, and it's starting to turn brown. It won't peel for another couple of days.

I am not working right now, so I have plenty of time to allow for healing and not wearing makeup. I really think you need atleast a full week of not going anywhere, even outside at all, to do a good Deep FX/Active FX combination, as I never would do this if I was working unless I was on a full week vacation.

I will write again in a day or two and probably post pics of my before and after, as well as my day to day healing.

Updated on Jul 24, 2008:

Here are new pics 2 days after my Total FX procedure. I had Deep FX to my forehead and both cheeks at 3 passes each, on a 17.5 setting. I was told that 20 or 21 were the highest settings the laser would go for Deep FX and that the doctor did not think it was safe to do any patients at anything above 17.5 which is what I received. I am still waiting to see the final results, and know that scars usually show up again post healing at about 2-3 weeks post op. I am sure once the scabby, crusting parts fall off and the swelling goes down some, my skin will look flawless but that's only due to swelling and there will be some scars showing up again within 2 weeks, with the final result at about 3 months post op. I was extremely disappointed with Fraxel, which I had 3 times last year for these scars and it did nothing, but empty my wallet of almost $3000 for 3 treatments. I am very skeptical about the laser hype for scars, so we will see what this does for me.

Updated on Jul 25, 2008:

I am on the 3rd day post Total FX treatment. The oozing and bleeding have stopped, and the itching and peeling of dead brown skin has begun. I still keep Aquaphor smeared all over my face and am taking steroids for anti inflammatory issues, as prescribed by my doctor. The areas where the Deep FX was performed are taking longer to heal, and the areas that were only treated with Active FX (undereye, chin, nose and lip area) have alot of peeling 50% complete, with new pink skin showing underneath. I am still very swollen. There are still bloody scabs and crusting in the Deep FX areas of my cheeks. It is too early to know if there is any significant improvement in scarring.

Updated on Jul 28, 2008:

These are photos taken post-Total FX treatment which was 6 days ago. I have already posted photos of what I looked like, prior to the laser treatment, and also what I looked like one day after the treatment. Now I am showing what I look like today, on the 6th day. All of the scabbing fell off on its own during regular washings, by the end of the 4th day following my treatment. I now have red skin, that is shiny and smooth. My biggest issue in why I wanted to get this treatment was for depressed, rolling scars which Deep FX is supposed to treat, and for fine lines under my eyes that Botox cannot treat, so I hoped Active FX would treat this. I can see the fine lines under my eyes are ALL gone, 100% which is a surprise.

It's too early to know if all of my swelling has gone down yet , because from what I can see, about 90% of my rolling scars to cheeks and forehead are GONE. I do, however, still have the same enlarged pore/icepick type scars I had prior to the procedure, and I am not sure that Deep FX really helped with this at all. This does not bother me, however, because I really cared much more about getting rid of the depressed scars which were really prominent. I would say this procedure took 5 years off of my face (I am 41, so I still have issues with slight drooping to my skin below the cheekbone which you can see in one of my pics.).

I go back to the doctor's office tomorrow for a follow up exam so that they can see how I healed. I am really hoping that my success is not an illusion because I know based upon experience getting 3 past Fraxel treatments, what I thought looked like a great result in diminishing scars actually was a premature opinion since over the following 2 weeks I noticed the scars returned, and it was just swelling that made me think the Fraxel had worked. I hope with Total FX, that is not the case. I will write again and show more pics if I see the scars have returned, but I believe they will not..the Deep FX seems to be very impressive for a change considering alot of lasers promise improvement and then don't deliver.

Updated on Aug 4, 2008:

OK, so it is now 2 weeks post Total FX. I am posting new pics of my healing. The swelling appears to have gone down quite a bit, when I thought there was no more, and many of the rolling scars on my LEFT cheek have returned. The scars on the RIGHT side of my face, as well as my forehead, are not as bad as they were. There has been no change with the enlarged pore/icepick type of scars, so I will have to use a silicon filler type of primer makeup that fills in the pores that I have been using before Total FX(Smashbox cosmetics makes a great one called Photo Finish). I dont think there is a laser procedure out there that will erase icepick scars in one visit..even CO2 can't do that. If you want to reduce those types of scars, figure the laser takes off layers of skin so the pore actually appears BIGGER as it gets down to the lowest center of the scar..sort of like shaving top layers off a crater. You'd have to do it so many times to the surrounding area, so the best I could hope for is to soften them up. I did notice that once of the icepick scars on the left side of my face became LARGER and very noticeable after Total FX. I think because the top layers of the scar were removed by the Deep FX laser, and it opened up the scar more. A filler such as Juvaderm would probably do the trick to minimize it, so I will try that soon.

I did suspect that the rolling scars on my right cheek would heal better and be less noticeable that my left cheek once I had the procedure and was healing, because just after the procedure it was alot more bloody and scabby than the rest of my face. I guess the more skin that is taken off, the better my scar reduction. I wish the nurse had been even more invasive than 3 passes at 17.5 with Deep FX..maybe 5 passes?

I may do this procedure again next year when I take vacation time of a week off...but if you have young children, BE WARNED..the way you look for about 4 days after the procedure is so horrific, you might traumatize them. I would suggest doing it when they are extremely young, or having your significant other watch your children for the first few days. You will feel capable of taking care of them without pain, but you will look like your face has been burned off, to a bright red then brown state for awhile.

Updated on Aug 14, 2008:

3 1/2 weeks post treatment....rolling scars approximately 80%-90% GONE. No improvement to icepick scars yet. Forehead and right cheek are FAR smoother than prior to Total FX but some scars are visible but very faint. Left cheek still in need of treatment..perhaps Deep FX once more next year. Hyperpigmentation in Deep FX areas has appeared in a spotty pattern from cheeks to temple spite of wearing SPF 30 everyday. I do go out in the sun for about 20 mins a day with sunscreen and a big hat covering my skin, but the pigmentation has appeared, regardless. I have Mediterranean olive skin coloring so, like Asian or H/ispanic skin, am more prone to pigmenting. I may trat this with IPL laser treatments to fade the spots or I may just wait 6 months to see if they fade on their own. In my experience with this kind of pigmenting, they do not fade very well and hydroquinone bleaching does absolutely nothing for me. I will probably treat with a few IPL treatments. It was worth the tradeoff..atleast many of the rolling scars are completely gone.

Updated on Nov 23, 2008:

It's November 23, 2008 and I would consider my healing to be complete. Scroll down for new pics and results below. My feeling about Deep FX is now mixed due to the final result. They say it gets better over time but I did not experience this and in fact I think my scars returned over time, especially the rolling scars on my cheeks and forehead. Sometimes laser treatments do not erase scars but instead, just REARRANGE them to or RESHAPE them on your skin.

Take a look at the pics and you be the judge. I also left a comment below at the end of this blog in response to all of the people writing me.

Updated on Nov 27, 2008:

Just take a look at the very first before pics and then look at the final result. Everything else in between is irrelevant since the shadows and dimpling returned. It looked as though my skin and really improved from the procedure but it really did not do that much. I think if I do fillers in CONJUNCTION with the Deep FX I HAVE noticed that the end result is better than it used to be in just getting fillers and NO Deep FX in that A) the derm doc ony needs to use one syringe of Juvaderm now whereas prior to Deep FX he needed to use 2 syringes so right there I do ultimately save about $1000 per year on fillers. Well, take a look at the pics and decide for yourself.

I did not do Fraxel re: pair because I have already had regular Fraxel three times and did not get a result at all from it.

My only negative comment about Dr. Shamban would...

My only negative comment about Dr. Shamban would be after care follow up, when 80-90% of my scars returned within 6 months. When I contacted the office to have a follow up consultation and emailed current skin photos showing the returning scars, a nurse called and left a voicemail saying Dr. Shamban wanted me to come in and show her how the improvement I received on my $3000 Active /Deep FX was minimal after 6 months. I called back and asked the nurse if I was going to be steered to another expensive procedure because I wasn't prepared to pay for more work. She said she'd
find out and would let me know but I never heard back. I tried calling once more but they just never called again.

Santa Monica Dermatologic Surgeon

Ava Shamban offers numerous laser procedures at her Santa Monica facility. The staff is very courteous and sympathetic to each patient's concerns and they will provide you with the most advanced treatments that are available, rather than pushing an outdated laser treatment on you in order to pay their out of pocket costs on buying a laser machine a couple of years ago that is no longer considered viable.

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