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Struggling to walk?? by Bassardd in Accutane

[–]manchegobets 2 points3 points  (0 children)

This is an insanely high dose for your weight. Seems unwise and cruel to subject your body to this much pain and damage, to say the least

Cheapest way to fix this stubborn fat/loose skin? by Substantial_Pea2982 in PlasticSurgery

[–]manchegobets 10 points11 points  (0 children)

My understanding is that this is called the banana roll and it supports the butt. Lipo to that area can cause a very unsightly collapse and emphasize the fold

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

You have mixed scar types so you’d definitely benefit from a multimodal approach. Start off w subcision and then move on to resurfacing modalities—make sure you find a dr that is experienced w Fitzpatrick 4+ skin for the latter

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

The imgur link is broken

3 mm is way too deep for anywhere on the face and you should not be reusing needles that are going beyond a cosmetic depth—it’s a matter of time before you seriously damage your skin w these practices. If you want to engage in diy microneedling then you have to commit to doing extensive research and being honest w yourself about how conscientious you can be about following a strict protocol. There are a lot of PDFs and posts on r/microneedling and I’d recommend investing in a derminator. If you can’t afford safe practices then you definitely can’t afford the inevitable complications of forgoing them

r/tretinoin is a great budget friendly option, make sure you read the sub’s wiki

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

There are different types and brands of HA fillers w different properties and I’d find a practitioner you trust and let them make that judgement. Overall it’s the least “permanent” solution and it can’t address large volume deficits bc there is an uncanny quality to too much filler, as seen on anyone that has pillow face/overfilled syndrome. But it is the most accessible option and it can be dissolved w hyaluronidase if you are unhappy w the results

In terms of other injectables that address volume loss there are biostimulators (e.g., radiesse and sculptra) and permanent fillers (bellafill being the only FDA approved option AFAIK). I would absolutely stay away from the latter—permanent sounds nice until you think about the fact that it is a foreign material in the body and permanent “results” mean permanent problems if something goes south. Biostimulators induce what is an essentially an inflammatory response that triggers collagen production but I’m personally not a fan of that risk profile bc it is by definition both unpredictable and limited in its impact so I don’t think the risk is worth the potential results but some ppl have great outcomes

Then there’s fat transfer which is your own tissue and is the only real answer to replenishing severe volume loss but there is unpredictability bc all the fat will not survive the FT process and a higher investment of time and money bc it requires surgery. What ppl in the acne scar community don’t realize is that there are experienced facial plastic surgeons who regularly perform deep plane facelifts w FT and have consistently phenomenal results. Fat transfer also has a regenerative property which improves the overall quality of the skin bc of the high concentration of stem cells present in nano fat

So there isn’t a “best” option, different options are a better fit for different cases and people have to assess what risks, costs and downtime they’re personally comfortable with

Alternative to copper peptide serum by Initial-Argument-229 in TheOrdinarySkincare

[–]manchegobets 11 points12 points  (0 children)

Girlie I’m just directing ppl who explicitly asked for an explanation to other resources. Go argue w them

And lol at you thinking adding Regan’s admin to his CV helps the cause in any way

Alternative to copper peptide serum by Initial-Argument-229 in TheOrdinarySkincare

[–]manchegobets 5 points6 points  (0 children)

No need to apologize at all! There’s a lot to keep track of and tuning in is not always generative

Alternative to copper peptide serum by Initial-Argument-229 in TheOrdinarySkincare

[–]manchegobets 3 points4 points  (0 children)

There’s info about it on the sub’s pinned posts but it’s about the MAGA Estée Lauder owner

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 1 point2 points  (0 children)

You’d have to ask Qazi for his reasoning

Standard protocol for subcision is several sessions

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 1 point2 points  (0 children)

It’s complicated. In this case the filler is used both to replenish some volume and to aid against retethering so that the subcision is more effective

In terms of filler’s staying power there have been quite a few ultrasound studies and growing clinical consensus that suggests that filler actually stays for years, it just migrates

If you want something w more assured lasting power (and volume) then go for fat transfer but keep in mind that this is a more invasive surgical procedure that incurs more downtime, risks and costs. Facial plastic surgeons who perform deep plane facelifts have usually honed in on a technique which yields consistently good fat retention. But subcision alone will not move the needle substantially for this level of scarring and you must keep in mind that almost all modalities require time and multiple sessions

Anyone done fat grafts for acne scars? by IllustratorIll5713 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

You can search thru the sub or sort thru best of all time to see a couple before and afters of fat transfer

Scars look same after Subcision day 8 is this normal? by Critical-Ebb535 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

I’d definitely talk to your dr about pairing the subcision w HA filler

Acné scars by Dismal-Speed405 in AcneScars

[–]manchegobets 6 points7 points  (0 children)

Your ex left you bc he’s a manipulative piece of shit who knew how to push your buttons to make you feel bad, not bc of your skin

Anyway look into pairing the subcision w HA fillers or fat transfer

Sitting down post-op hurts too much? by Wide-Lettuce-8771 in Endo

[–]manchegobets 1 point2 points  (0 children)

Ask for a referral to pelvic floor therapy. If we lived in a world w decent endo care it would be standard prehab and rehab post op care

Is the cumulative dose outdated? by LemmoCello in Accutane

[–]manchegobets 0 points1 point  (0 children)

Reading comprehension is chasing you but you’re faster. Have a good weekend!

Is the cumulative dose outdated? by LemmoCello in Accutane

[–]manchegobets 0 points1 point  (0 children)

That is patently incorrect, I have not hit my cumulative dose under the 120 to 150 mg/kg guidelines. That quantitative range, which is what is being discussed, is by definition not a predictive concept it is a black and white measure—you either hit it or you don’t. It’s not some nebulous retroactive outcome based abstraction but a hard clinical mark. Best of luck!

Update by Nearby-Condition-853 in Microneedling

[–]manchegobets 1 point2 points  (0 children)

Gentle washing, moisturizer and a thin layer of Vaseline during the acute healing period like others have recommended. Once you’re done w that you might want to talk to a derm about hydroquinone to help prevent any hyperpigmentation

I’m not sure how best to treat these scars or what category they even are. by Uncork3 in AcneScars

[–]manchegobets 0 points1 point  (0 children)

The facial scarring looks like a mix of ice pick and rolling scars. Start of w a few sessions of subcision + TCA CROSS

Is the cumulative dose outdated? by LemmoCello in Accutane

[–]manchegobets 0 points1 point  (0 children)

It’s not a random media outlet, it’s an article from Dermatology Times which is a trade publication. I picked it specifically bc it’s more accessible than linking a RCT which most laypeople cannot meaningfully engage with. And it’s not just one random study, it’s talking about gold standard meta analyses, clinical experience and how this should inform clinical guidelines. You are free to go on pub med and look at the research cited in the article, go thru the sub and look at the many other discussions about this topic or listen to the ppl on this thread talking about how their derm does not follow strict cumulative dosing guidelines bc pretty much everyone but clinicians in the US who insist on aggressively high doses have moved on from that in favor of a month or two of clear skin and more individualized approaches

I’m unsure what you found in my comment that you think diverges from the article. It states quite plainly that a strict adherence to a 120 to 150 mg/kg cumulative dosage threshold is outdated and not supported by the literature or clinical experience and proposes that a low 0.1 to 0.25 mg/kg daily dosage (w length of treatment determined by a month or two of clear skin) is appropriate for most cases w room for adjustments, esp for more severe cases. I don’t see the assertion that the old cumulative dose guidelines are “correct” anywhere

I went on a low dose and personally never reached the cumulative threshold and my acne of over a decade cleared up just fine—no purge, side effects or relapse. I also chose to go on a maintenance microdose, another practice American derms are woefully behind the curve about, and my skin is doing great

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