TCA Cross

Filler Dissolving, PIE, PIH, TCA Cross - May 20th 2025

Hi everyone, I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. Over the years, I’ve dedicated my practice to helping patients with acne scars, pigmentation issues, and facial balancing through advanced techniques like collagen stimulation and scar tissue remodeling. If you’re reading this, chances are you’re curious about how we can transform scars that seem impossible to treat. Let me walk you through one of my most rewarding cases—a patient whose journey spanned more than a year and a half—and break down everything step by step. I will talk about treatments like TCA Cross, Subcision, Lasers, and much more.

This isn’t just about showing before-and-after photos; it’s about understanding the patience, persistence, and trust required to achieve life-changing results. Along the way, I’ll also share insights into the treatments we use, why they work, and how you can determine if these options are right for you. Let’s dive in.

TCA Cross

New Case. Lasers, Fillers, TCA Cross

Recently, I shared a case on social media that sparked numerous questions from followers. This particular patient had deep, stubborn scars that took over a year and a half to improve significantly. When she first came to me, her scars were thick, textured, and hyperpigmented. The process wasn’t overnight—it required multiple sessions combining ablative CO2 laser, TCA CROSS (a chemical reconstruction technique), and volume replacement with fillers like Bellafill. 

One of the things that stood out about this patient was her commitment. She traveled long distances, endured downtime, and followed every post-treatment instruction meticulously. Her reward? A dramatic improvement that continues to evolve even today. We recently added more TCA CROSS and Bellafill during her last visit, which will further enhance her results. This is what I love about scar treatment—it’s not a one-and-done deal. With proper care, the results keep getting better, offering a “gift that keeps on giving.”

But let’s rewind for a moment. Why does it take so long to see significant improvement with scars? And why do some treatments fail while others succeed? These are questions I hear often, so let’s explore them in detail.


Why Some Treatments Fail

Many patients come to me after trying micro-needling, CO2 lasers, or other popular procedures—only to find their scars worse than before. For example, Mike Swimdream reached out to ask why his professional micro-needling treatments left him with lined scars, dehydration, and worsening texture. Here’s the truth:

Micro-needling and radiofrequency (RF) devices can be effective, but only when used correctly. Too much heat or energy can destroy superficial fat pads, leading to hollowed-out areas and worsened scarring. Additionally, certain types of scars, like boxcar or icepick scars, respond poorly to these modalities because they require deeper intervention. In such cases, manual techniques like subcision, TCA CROSS, or excisions are far more effective.


The Emotional Impact of Scars

Scars aren’t just physical—they carry emotional weight. Many of my patients tell me that their scars have held them back in life, affecting their confidence and self-esteem. One patient, Daniel, flew all the way from Atlanta to participate in a giveaway we hosted two years ago. After just one combination session, he saw incredible progress. Now, he’s returning for additional treatments to refine his results further. His story reminds me why I do what I do: to help people feel like the best version of themselves.

Similarly, Xiomara, another patient who inspired many, has been dealing with personal challenges lately. While she hasn’t scheduled her next appointment yet, the door remains open for her whenever she’s ready. Every patient’s journey is unique, and I’m honored to play a role in theirs.


Beyond Facial Scars: Addressing Other Types of Scarring

While facial scars are a primary focus of my practice, I also treat scars from injuries, surgeries, and even self-harm. Take, for instance, a patient who struggled with cutting scars on her arms. Now happily married with children, she wanted to erase those reminders of her past. Using vascular lasers for redness and resurfacing lasers for texture, we achieved remarkable results. It’s incredibly fulfilling to help patients reclaim their lives by transforming scars that once defined them.

Surgical scars present another challenge. I recently treated a man who underwent a facelift elsewhere. Though the surgery itself was successful, poor scarring left him feeling self-conscious. By addressing the scar tissue and improving its appearance, we restored his confidence. These stories highlight the importance of tailoring treatments to each individual’s needs.


A Holistic Approach to Scar Treatment

Scar treatment isn’t just about removing imperfections—it’s about restoring confidence and improving quality of life. Whether it’s through collagen stimulation, scar tissue remodeling, or volume replacement, my goal is always to create lasting change. Patients often ask me about recovery times, costs, and risks—and rightfully so. Each procedure requires careful consideration, and transparency is key to ensuring realistic expectations.

For instance, TCA CROSS may take months—or even years—to show full results, depending on the scar type and skin tone. Similarly, subcision requires precision and expertise to avoid complications. As a practitioner, I prioritize safety and efficacy above all else, which is why I continuously refine my techniques and stay updated on advancements in the field.


Questions Answered

  • Question: What are the options for rosacea?
    Dr. Qazi: Rosacea requires a tailored approach depending on its severity. Typically, I recommend medications like Metronidazole or low-dose antibiotics like Doxycycline. For resistant cases, antimicrobials may be necessary. Controlling inflammation is key since it can exacerbate scarring and oil production.
  • Question: Can tretinoin help with erythema post-inflammatory?
    Dr. Qazi: Yes, tretinoin has anti-inflammatory properties that can reduce redness. However, combining it with moisturizers or azelaic acid (10%) might yield better results without over-drying the skin.
  • Question: How often do you recommend your combination sessions for maximum results?
    Dr. Qazi: It depends on the type of scarring. Most cases require 2-3 major sessions, including TCA CROSS, subcision, and volume replacement. Maintenance treatments may follow to ensure continuous improvement.
  • Question: Does filler help with boxcar scars, and what type works best?
    Dr. Qazi: Fillers like Bellafill support surrounding tissue and address fat loss, but they don’t completely resolve boxcar scars. Combining them with resurfacing techniques yields better outcomes.
  • Question: Can you talk about why some people scar with microneedling?
    Dr. Qazi: Over-aggressive treatments, especially with RF microneedling, can damage superficial fat pads, causing new scars. Not all scars respond well to microneedling, particularly deep boxcar or icepick scars.
  • Question: Any updates on Xiomara and Daniel?
    Dr. Qazi: Daniel is coming back soon to showcase his continued progress. As for Xiomara, we’re waiting patiently for her return once she’s ready.
  • Question: What are your thoughts on YAG laser treatment for scars?
    Dr. Qazi: YAG lasers aren’t ideal for scars. They lack the precision needed for texture and pigmentation issues. Other modalities, like CO2 lasers or TCA CROSS, are more effective.
  • Question: Is treating scars on the nose more challenging?
    Dr. Qazi: Scars on the nose heal slower due to tension in the area, but they’re not inherently harder to treat. Patience is crucial here.
  • Question: Is there any procedure I need to try now as a last option?
    Dr. Qazi: Subcision is excellent for rolling scars, while TCA CROSS targets boxcar scars. Laser resurfacing may complement these treatments depending on the scar type.
  • Question: What about scars on the forehead?
    Dr. Qazi: Forehead scars respond well to volume replacement and resurfacing. They’re generally easier to treat compared to areas like the smile lines.
  • Question: My skin looks like the second picture right now. How can I make it better?
    Dr. Qazi: Address volume loss with fillers and target texture with TCA CROSS. Consistency is key to achieving gradual improvement.
  • Question: How should I treat PIH that’s pink inside with a dark brown ring outside on fair skin?
    Dr. Qazi: Start with 10% azelaic acid and incorporate Eucerin Anti-Pigment Cream as tolerated. This combination addresses both redness and hyperpigmentation.
  • Question: I had a TCA peel, and my skin looks stained. How can I remove it?
    Dr. Qazi: Staining from TCA peels is usually reversible. Seek a provider skilled in pico lasers and topical creams to suppress pigmentation safely.
  • Question: How to tell if a med spa provider is trustworthy?
    Dr. Qazi: Look at their results, videos, and testimonials. Pay attention to their technique and consistency. Trustworthy providers prioritize safety and transparency.
  • Question: Are there downsides to subcision?
    Dr. Qazi: Subcision is safe in skilled hands. However, improper technique can lead to complications. Choose a provider with proven expertise.
  • Question: Do we need an appointment to visit you?
    Dr. Qazi: Yes, consultations are by appointment only. Scheduling ensures we have adequate time to focus on each patient’s needs.
  • Question: Is CO2 suitable for boxcar and icepick scars?
    Dr. Qazi: CO2 lasers can help with edges, but TCA CROSS, excisions, or subcision are often needed for deeper scars. Each case requires a customized plan.

Final Thoughts

Treating scars is both an art and a science. It requires patience, precision, and a deep understanding of each patient’s unique needs. Whether you’re struggling with acne scars, hyperpigmentation, or rosacea, know that solutions exist—you just need the right guidance. Treatments like TCA Cross, Lasers or subcision may help.

If you’re ready to take the next step, don’t hesitate to reach out. Together, we can create a personalized plan to help you look and feel your best. Remember, it’s never too late to invest in yourself. Your journey starts here.

Feel free to schedule a consultation by clicking here. Let’s work together to make your goals a reality.


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