LAM FACIAL PLASTICS

dr. lam, i believe i am a candidate for you to perform treatment on me for my acne scarring. my main concern is the immediate post treatment redness and recovery time of the tca treatments. would i be able to fly in for a treatment on a thursday(or friday) and return to work on Monday(just 2-3 days after tca) without it being obvious to my co-workers that i had this procedure done? i'm sure your answer will be that every situation is different and it depends, but can you give me any kind of best guess type answer that i am looking for? how have previous patients of yours handled going back to work after treatments? i suppose i could just plan to take an entire week off of work, however, i would guess i would need 2-4? tca treatments. please offer me some insight on my concern. thank you very much.

yes, unfortunately it does vary. i have seen it where a day or so later you see almost no change. other times, people scab over for a week. a few times i have seen hyperpigmentation last months. i would say what would make the recovery longer is if you are darker skinned (risk of hyperpigmentation) and the holes are larger (risk of scabbing and longer healing time). in general, the recovery is a few days. it also depends on how many there are. if only a few it may not be as noticeable. sometimes you just go to work and deal with the fact that you are not 100%. i know that sounds like a cop out but i don't have a solid answer to give. most people do not take time off from work but go just looking not their best. your plan sounds reasonable, which you could modify in the future based on your recovery from the first round.

Dr. Lam,

I am also interested in TCA Cross and have read quite a bit of info on the internet on it.. There seems to be different modalities of treatment from what I've seen. Some use a small wooden stick and press it very firmly into the scars.. Others seem to lather it on in a much more conservative manner. Does the risk of complications increase when the TCA is press aggessively into this skin? Kind of a risk/reward benefit?? Would appreciate your thoughts. Have you ever published any formal articles or texts on TCA?? Where could I find this?? Thanks - Kerouc

hi,
1. lathering it on is dangerous. the risk is how much surface area is covered with the acid not how deep you press unless you break through the skin then that is not safe.
2. i wrote the first textbook on how to it but it will cost you several hundred dollars to buy. it is entitled Cosmetic Surgery of the Asian Face (2nd edition). it is a textbook for physicians.
best,
sml

Can anyone help?

I have pitted scarring and went to see an aestician regarding this.

He first carried out derma roller on my skin 1.5mm and took a four week break and the again. I didn’t see much difference in the formation of the scarring except my skin started to look almost burnt and very dry.

He then carried out a cross TCA on my skin on about 12 pits on each side of my cheeks. the holes frosted and scabs formed. They were there for about 5-7 days. When they eventually fell off, they looked like new scabbed scars like when you have a cut in your hand or knee and your skin is trying to heal and repair itself. After four weeks the scars look like they had spread and my face looked quite blotchy in the area of my cheeks. I went back to my doctor and he said that we he will do another DERMAROLLER and thought it were really going to help this time.

After the derma roller, my skin looked quite bruised and again very dry, which lasted for about 4 days.

Now 4 weeks after that last procedure, my skin is looking worse than it did before having any treatments. The scarring looks quite spreaded and the edges of the holes look raised (like dents in my face now rather than pits).The scars look more prominent now. I now have an orange peel texture to my face. Is this normal? The doctor says that he now wants to try the e matrix on me, as this is something new to his practice.

Please advise on what the best way forward would be for me. I am suffering from depression because of this and just feel like my life is over!

Your prompt response is very much appreciated.

Kindest regards

Sara

i have reposted my answer from my private message you sent me:

unfortunately, this can happen with aggressive cross treatment. i would probably leave things alone to see if the skin will repair itself. if not, i have to do silicone to fill in the holes.
best,
sml