Acne Scar Subcision TCA Deep Chemical Peeling Healing Photo Diary - Seattle Dr. Young Award Winning Facial Plastic Surgeon Specializes and Discusses the healing after Subcision and Deep Chemical Peeling with Trichloroacetic Acid (TCA):

Before treatment using our Subcision Technique where we elevate the layer under the scar to allow the scar to rise up to the level of your normal unscarred skin. We are also going to apply Trichloroacetic Acid for a deep chemical peeling as well. The goals are to get the scar to elevate from above and below. We are going to now display the healing of this process. This is are more aggressive technique and it will be tailored to your preferences and willingness to take on more risk for better results. These are some of the things that we will discuss with you in your consultation and other appointments that will follow.

This is 2 days after the procedure. The scars are grey and pink to red. At this point, it is important to clean with the etaphil and vinegar and water rinses at least every 2-3 hours and more if you need to in order to keep the crusting from accumulating and to keep the scars pink, red and raw. This raw, better termed fresh, healing wound is more likely to heal better. Crusting serves as nutrients for bacteria to cause more scarrring. So crusting is bad. Importantly, you don't want to tear or pull off the crusting, but it is the frequency of washing and the hydration that it accomplishes that allows the crusting to come away. Also you want to keep the vaseline applied as a thin coat. If it is thick, it will make cleaning more difficult. Here is a link to our laser resurfacing page that explains this in more detail. The laser resurfacing cleaning is exactly the same as for chemical peels.

This is 4 days after the procedure. This is the scary stage where the scars appear wider and more inflammed. The key here is to keep the areas clean and avoid any yellow, filmy crusting. The goal is to have the area, raw red and pink and covered with vaseline. The vaseline will help the skin heal faster. As you will see the scars and healing process makes a huge change in the next couple of days.

This is 6-7 days after the procedure. It is starting to look better but there is still a long way to go from here. Depending on how aggressive we were, you could look much better at this stage. This is probably the more extreme healing for this type of procedure. We can discuss this in more detail during our consultation with you. Based on the pictures, the left picture above has some crusting in the right part of the left picture. This patient would need to do more frequent cleaning on that part especially with the application of a thin coat of vaseline.

This is 10 days after the procedure. More of the same but not as inflammed. The scars are still wide but they will start to close up more and more and build tissue up for better healing and more level scars.

This is 13 days after the procedure. The wounds are a little less inflammed and filling in even more. This situation is about the same and it gets better and better with time. We are going to show you how they progress below:

This is 21 days after the procedure. The scars are getting more level with the surrounding more normal and less scared skin.

This is 2 months after the procedure. The scars are much more level with the surrounding more normal skin and less scared skin. The wounds are still pink and still undergoing some subtle healing. But the scarring in general is improved from the before pictures. Now that the scars are more leveled we can then consider co2 laser resurfacing and dermabrasion and dermasanding.

This is 4 months after the procedure. The before pictures are above it for your comparison. The scars are softer and much more level with the surrounding more normal skin and less scared skin. The wounds are still pink and still undergoing some subtle healing. But the scarring in general is improved from the before pictures. Now that the scars are more leveled we can then consider co2 laser resurfacing and dermabrasion and dermasanding.