LAM FACIAL PLASTICS

Hi Dr Lam,

I had oily skin with severe acne and i finished two course of isotretinoin (6month per course)

Now my face is not oily , but i have dented acne scars all over my cheeks.

One plastic surgeon promised 50% improvement with 1 session of surgical dermabrasion and 2 more sessions to smooth out my skin.

But my dermatologists who prescribed me the medication only suggested fraxel laser and only 40% improvements after 5 -6 treatments. He told me chemical peels or other treaments would not help at all.

Since i took isotretinoin before, am i suitable for surgical dermabrasion?

Looking for more opinions in case i get scarring from this procedures.

Any advice would be appreciated.Thanks

i personally do not believe that fraxel does a whole lot for acne scarring. i am also much more conservative than other docs when it comes to dermabrading after accutane. i personally wait 18 months to 24 months after you stopped. however, if the scars are bigger holes like rolling deformities than silicone can be used and done much earlier. there really is no waiting period.
best,
dr. sam lam

Thanks for ur advice.

But why such a long wait after accutane? Does the skin get thinner or sensitive after accutane treatment?

Would u do tca peel for my condition?

Lastly, is the silicone filler pemanent? Will i be able to feel the silicone in my skin if i touch it?

Thanks again.

But why such a long wait after accutane? Does the skin get thinner or sensitive after accutane treatment? IT GETS MORE "SENSITIVE" IN THAT THE OIL GLANDS THAT HELP WITH SKIN REGENERATION FOLLOWING A SKIN DERMABRASION OR PEEL ARE ABSENT SO INSTEAD OF HEALING YOU LEAD TO EVEN WORSE, UNIMAGINABLE SCARRING. YOU NEED TIME FOR YOUR OIL GLANDS TO RECOVER BEFORE SKIN RESURFACING.

Would u do tca peel for my condition? IF YOU ARE TALKING ABOUT A STANDARD PEEL LIKE 15 TO 35% TCA, THAT IS PRACTICALLY USELESS. USING A 100% IN A CROSS TECHNIQUE TO RAISE DEEP SCARS WORKS MUCH BETTER, AND I USE IT, FOR SMALL SCARS LIKE TINY ICE PICKS. AGAIN, YOU CANNOT HAVE CROSS DONE IN MY OPINION FOR AT LEAST 18 MONTHS.

Lastly, is the silicone filler pemanent? YES. Will i be able to feel the silicone in my skin if i touch it? YOU SHOULD NOT FEEL IT. IF YOU DO LIKE 3 TO 5 ROUNDS SOMETIMES YOU CAN FEEL SOME FIRMNESS BUT IT IS RARE THAT ANYONE COMPLAINS OF THAT.
best,
dr. sam lam

When u said more time for the oil glands to recover, are u saying that when the oil glands recover, my face will get oily again? Because my dermatologist said the effect is suppose to make my face remain less oily .

But I have found out that while taking collagen tablets, my whole face gets oily overnight and continues to get oily as long as i am taking it.

Since the absence of oil production will make my skin sensitive to Tca cross, can i assume that by taking collagen tablets few months before , during and after the procedure and i will be able to do do it much earlier and not having to wait 18 months?

as far as how oily your skin becomes again, that is something you should get a second opinion on. i am not a dermatologist. however, i understand when it may be safe to intervene following accutane. no collagen pills will substitute for time. you must wait or you can lead to uncontrolled scarring that is much worse than your current situation if you are considering some kind of resurfacing.
best,
dr. sam lam