Hi, everybody. I'm Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My primary focus is on treating acne and scars, pigmentation issues, facial balancing, and collagen stimulation. Today, I want to walk you through an incredible case study of a patient I've been working with over the past year and a half. Her transformation has been nothing short of amazing, and it's a testament to what we can achieve with patience, dedication, and the right combination of treatments. We used lasers for acne scars, TCA cross, subcision and some collagen fillers.
The Patient's Journey
When this patient first came to me, her journey had already been long and arduous. She expressed frustration initially, feeling that her progress was slow and that her collagen production wasn't sufficient. However, after several sessions and consistent treatment, her results have been truly remarkable. Recently, she returned for another session, and her follow-up photos are astonishing—her skin is incredibly smooth, and her deep scars have significantly diminished.
The Treatment Plan
Achieving these results involved multiple steps and sessions:
- Ablative CO2 Laser : I performed two sessions using ablative CO2 lasers combined with erbium lasers and fractional CO2.
- TCA Cross Technique : We conducted seven sessions of TCA cross, which involves applying trichloroacetic acid directly into the scars.
- Subcision : This technique breaks up scar tissue beneath the skin.
- Bellafill Injections : For volume replacement, especially crucial for deeper scars.
Each step played a vital role in transforming her skin, proving that a multifaceted approach often yields the best outcomes.
Understanding Acne Scar Treatments
Treating acne scars requires a personalized strategy tailored to each individual's unique needs. Here’s how different treatments contribute to the overall success:
- Lasers for Acne Scars : Ablative CO2 and erbium lasers work by removing damaged skin layers and promoting new collagen growth. Fractional CO2 adds precision without extensive downtime.
- Volume Replacement : Products like Bellafill provide lasting support by integrating with the tissue and stimulating continuous collagen production.
- Chemical Peels : Techniques like TCA cross target specific areas, breaking down scar tissue and encouraging healing.
The Importance of Patience and Persistence
One crucial aspect of treating severe acne scars is understanding that results won’t appear overnight. It takes time, multiple sessions, and sometimes even maintenance treatments to achieve the desired outcome. Patients must be prepared for a journey rather than a quick fix.
In my practice, I emphasize setting realistic expectations. Many patients come to me after trying numerous treatments elsewhere without significant improvement. I explain that while some changes might be noticeable after the initial sessions, achieving a polished look often requires ongoing commitment.
Patience isn't just about waiting; it's about trusting the process and allowing your skin to heal properly between sessions. Each treatment builds upon the last, gradually improving texture and appearance. As seen in my patient’s case, persistence pays off, leading to smoother, more refined skin over time.
Combining Treatments for Optimal Results
The key to effective scar treatment lies in combining various modalities tailored specifically for each patient. Not every scar responds the same way to a single type of treatment. Therefore, a combination approach ensures comprehensive care.
For instance, while lasers for acne scars address surface irregularities, subcision targets deeper fibrous bands pulling the skin down. Meanwhile, fillers like Bellafill provide structural support and stimulate natural collagen production. Using TCA cross alongside these methods ensures that even the most stubborn scars receive targeted attention.
This multi-pronged strategy allows us to tackle different aspects of scarring simultaneously, enhancing overall effectiveness. Patients benefit from both immediate improvements and long-term enhancements as their skin continues to regenerate and heal.
Questions Answered
Here are answers to some of the questions I received during my live session:
- Question : What is the best treatment for grade four acne scars? I have tried fractional laser and TCA and subcision but no big difference.Dr. Qazi : It sounds like you might need more sessions or additional treatments focusing on volume loss. Not everyone responds similarly to the same methods; sometimes, combining techniques such as lasers for acne scarring along with fillers provides better results.
- Question : Hey doc, looks results look amazing. Could she keep doing TCA to get a polished look?Dr. Qazi : Absolutely! Continuing with lower-level lasers and periodic TCA applications helps refine texture further. Future sessions can enhance softness and overall appearance.
- Question : Is there a limit to how many erbium laser sessions one can get? I've had 10 sessions and not where I want to be.Dr. Qazi : There isn’t a strict limit, but effectiveness varies per person. Sometimes, other modalities complement laser treatments better, depending on your specific type of scarring.
- Question : How do I schedule an appointment?Dr. Qazi : Visit my website at doctorqazi.com. All prices and booking details are available online, making scheduling consultations straightforward.
- Question : Is it a great idea to get microneedling with PRP for boxcar scars and ice pick scars?Dr. Qazi : While popular, microneedling with PRP alone may not suffice for complex scars. More comprehensive approaches involving lasers for acne scars and subcision tend to yield superior outcomes.
- Question : What can I do if I can't afford laser?Dr. Qazi : This case wasn’t achieved with laser alone. Several steps were involved, including TCA cross, subcision, and Bellafill. There are cost-effective options depending on the scar types and required treatments.
- Question : How long does hyperpigmentation fade?Dr. Qazi : It depends on the kind of pigmentation. Post-laser hyperpigmentation might take a few weeks, while melasma could require ongoing management due to hormonal fluctuations and sun exposure.
- Question : When doing Sculptra for acne scars on the cheeks, do you inject Sculptra as normally injected or directly into the scar?Dr. Qazi : I typically inject it directly into the scar, usually quite deep, especially along the bone process. For superficial volume loss, I use a very dilute form.
- Question : How long would I have to wait after finishing Accutane before starting scar treatment, particularly lasers?Dr. Qazi : You can start while on low-dose Accutane, but avoid aggressive treatments. Usually, I wait about three months post-Accure session to ensure stability.
- Question : Do you usually do subcision once for the initial acne scar treatment and not again for following maintenance treatments?Dr. Qazi : Yes, typically subcision is done once initially, focusing on breaking up fibrous bands. Maintenance treatments focus more on refining texture and addressing any remaining issues.
- Question : How soon after Accure do you think we could resume scar treatments?Dr. Qazi : Generally, I recommend waiting about three months after the Accure session to ensure everything stabilizes, though minor treatments like TCA may still be okay.
- Question : Hey doc, is it possible to improve fat loss in the lower face area?Dr. Qazi : Yes, but proceed cautiously. Using dilute forms of Radiesse or Bellafill can help without causing excessive volume changes in animated areas.
- Question : Is it okay to do fillers in the cheeks and under eyes after the initial big scar treatment?Dr. Qazi : Yes, fillers can be done either the same day or after swelling subsides, typically around a month later. Maintenance treatments continue to improve results over time.
- Question : Is filler temporary?Dr. Qazi : Most fillers are temporary, but Bellafill is the longest-lasting FDA-approved product for acne scars, lasting at least five years, often much longer.
- Question : Do I treat PIE?Dr. Qazi : Yes, PIE (Post-Inflammatory Erythema) is part of comprehensive scar treatments. Pico lasers and other modalities can address redness effectively.
- Question : If you had to pick one best treatment overall for atrophic scars: subcision, microneedling, laser?Dr. Qazi : Subcision tends to be most effective for rolling scars, although combining multiple treatments usually yields the best results.
- Question : Can you recommend that sunscreen you use? I'm considering switching off to Alta MD soon.Dr. Qazi : I'll double-check and remind myself tomorrow; feel free to ask again if I forget!
- Question : What do you think about 3D printing human tissue for skin?Dr. Qazi : I’m excited about it, especially for burn patients. It holds immense potential for advancing skin restoration techniques significantly.
- Question : How to treat papular nose scars?Dr. Qazi : Use CO2 or erbium lasers to smooth down raised areas, apply steroids through laser tunnels, and follow up with silicone tape to keep the area flat.
- Question : How many days do I stay in the area post phenol peel? Is there a minimum?Dr. Qazi : We recommend staying for the full journey, but if necessary, plan for at least four to five days with a caregiver before traveling back.
Conclusion
Treating severe acne scars is a nuanced process requiring expertise, precision, and a willingness to adapt strategies based on individual responses. Through innovative techniques and personalized care plans, we aim to restore confidence and improve quality of life for our patients. If you're considering treatment options for acne scars, remember that persistence pays off, and finding the right specialist makes all the difference.
Feel free to reach out via my website for more information, call us at 949-336-7293 or click here to self-schedule a consultation. Together, let's embark on your journey towards smoother, healthier skin.
