LAM FACIAL PLASTICS

i know this photo looks almost too good to be true, and it probably is. anytime you cut out an area of acne scar like that you take a huge risk that there will be a very unattractive line. it is not worth the risk. i have been dealing with a patient who has had 9 surgeries by different doctors for exactly the same thing you are talking about. it left a crater, then it was too thick, etc. please do not do this. if your scars look like that you would be an excellent candidate for silicone and possibly CROSS treatments.
best,
sml

Thank you, I was afraid you might say that. It is just that Im have tried everything (but tca cross) I have had two different drs try resty after subcision with zero results only making the scar look worse, due to the donut hole effect. The scar is very deep and very bound down. I know you have said many times silicone is very different, (going into micro scars) but I don't want to make a permanant donut hole. I have also heard TCA cam make things even worse.

I thought surgery might be an option after looking at some huge defects that have been reconstructed after skin cancer. What about adjacent tissue transfere?

adjacent tissue transfer is like using a bazooka on a fly. usually, older individuals have a much easier time with it because their skin is very lax, there is a lot of extra skin and also their skin is uneven so it hides scars better. plus, they tend not to create hypertrophic scarring unlike young individuals. finally, they had cancer so any result is acceptable. given all of those things, i will not be touching you surgically. i really have no options other than what i have outlined for you. hopefully you find the right doctor to do the right thing for you.
best,
sml

Thank you for the honest reply. It helps me to understand when things are explained. Would I need a few TCA Cross procedures? How much improvement could we hope for with scars like these? Also is it just acne scars that are risky to surgically revise or is it that surgical scar revision in general is risky?

1. i would need to see you to truly figure out what you need and how many times. in general, when i do silicone and CROSS, most individuals need about 2 to 3 rounds of either one (or at times both). i have a few that only need 1 time and i have a few that need 4 to 5. both techniques require a month at minimum between rounds. sometimes with very shallow ones, i spread the CROSS out longer like 3 to 4 months out to make sure that i don't overshoot. also, you can take longer if you want than 1 month. it is just the minimum time.
2. acne scars are problematic because you are not trading a line for a line but multiple holes for a line. that principle alone is fraught with risk. let's say you have an ugly thick, or depressed line and i convert that into a fine zigzag that is barely there. you would be happy with that right? now, let's say you have multiple holes on your face, and i try to make that into a line. not so easy. plus, there is almost no tissue removal with a standard scar revision because it is a line removed (slightly wider) for another line. the other one is i am removing half your face, then trying to rotate younger skin to fill the void. that is a risk that makes me shake in my pants. not going to happen. hope that is clear.
best,
sml

I am currently using acne products by doctor related to acne breakout. I have been using it for months and it really does work and I have less breakout now. The products that I am using are Differin (adapalence) cream, minocycline, and clindamycin phosphate. My face does improve and has less breakout, however, acne scar from the past become more visible.

i would say that i would have to see you to decide what would or would not be the best for you.
best,
sml