LAM FACIAL PLASTICS

Dear Dr Lam, I've been beating around the bush asking you about TCA CROSS for scarred pores, when I have the feeling that not even that is going to work for my problem. Almost a year ago, I had a series of 40% glycolic peels (once a week for three weeks) to help with breakouts (which I no longer suffer from). Twelve days after I went in to get a facial, intending only to have extractions on some remaining acne, as things were clearing up. The esthetician insisted on using microdermabrasion to "assist" in the extractions and, although I had a terrible feeling about it, I consented. Over the next few weeks, pores (all of which were previously invisible to the naked eye -- I used to have lovely skin) opened up all over my face -- cheeks, nose, forehead, chin..... And now I have probably 1-3000 broken, open pores that will not close. I have read accounts of this very thing happening to others after strong chemical peels or laser procedures. I can only surmise that it is due to the skin swelling and the pores clenching shut tightly while still producing oil. This puts pressure on the pore wall and BAM they burst open.

I am heartbroken beyond words and feel deep in my gut that there is nothing that will help, even though I long for a solution. It's the first thing I think about when I wake up and the last thing I think about when I go to bed. In my devastation, I've created a nonprofit foundation dedicated to ending acne scarring and other types of facial scarring, as I now understand first hand how psychologically and emotionally devastating it really is to have the skin on your face damaged. Hopefully there will be solutions in the next decade or two that could dramatically help scar sufferers. You are a wonderful man, and are spoken of very highly on acne scar forums. You have already helped many people. You are one of the few who is honest, sincere, and a true artist. Even if you cannot help me, I wanted to thank you for being the rare gem that you are in the field of plastic surgery and acne scar revision.

Anyways, attached are two photos of my skin at present. In the first photo, I am squeezing my cheeks together a bit so you can see the broken pores better.

Anyways, any opinion would be appreciated.

Thanks again for your time.

i'm sorry to hear of your plight, and i thank you for your kind words. pores are really tough to treat. they stand as distinct to traditional acne scarring. the TCA Cross treatment really works for very well spaced and enlarged pores and not just regularly spaced pores. with your condition the cross method might risk worsening it, which is not worth it. the only thing that i can think of that might help your situation is something that i am aware of done in the Far East, called micro botox. Now, I do that for the forehead and around the eyes but really not for the face. It is a technique usuing 100s of micro injections of botox where the treatment permits the skin to heal. remember that the skin is managed by shutting down the smooth muscle which controls the pores. attached is found a lady in whom i do my standard "microbotox" technique for the forehead and she is shown 4 years after consistent usage with me with the after shown 6 months after her last dose, i.e., there is no botox left on the right image. notice how the botox affects everything. i don't know if this is permanent or not but it is interesting. on the face, there is a risk of the botox going to the deep muscles and affecting the smile or speech. as said, i don't have experience in that regard. it might be worth a shot in your case since you sound so desperate.
best,
sml