Dr Rui Ming Ho

Yes, some swelling and bruising may be expected after subcision. Swelling generally takes a couple of days to subside while the bruising may take up to 2 weeks. Medications can also be prescribed by your treating physician if the swelling and bruising are uncomfortable/tender, and to aid in the swelling post-procedure.

The main muscle associated with teeth-clenching is the Masseter (jaw muscle). Botox is administered into this muscle to relax it so that the bite/clench will not be as strong. This helps to alleviate the symptoms/discomfort of teeth clenching such as headaches, widened jaw, teeth damage, facial pain and pain in the jaw joint (Temporomandibular Joint). Once treated, results can last up to 6 - 8 months before the procedure is repeated again. I will personally recommend administering the injection to a relaxed jaw since it will be less painful and uncomfortable for the patient.

The scars that you have are pigmented scars due to inflammation and injury to the skin caused by the flea bites. Treatment will be a combination of: lightening creams and pigment lasers. Untreated, these scars will eventually fade. However, these scars can take a long time to do so. It may take up to several months or even, more than a year. Medical treatments (as mentioned above) are aimed to quicken this fading process. Thus, improvement can be seen as quickly as within a month. There are many types of pigment lasers available. Therefore, you should always consult a doctor.

The eMatrix is a Sublative Radiofrequency device and it does help with acne scars. However, its penetration depth and strength are not as deep and strong as other devices such as the Fractional CO2, which may result in less desirable results. The pros of the eMatrix are that the downtime is less than the other Ablative Fractional Lasers and it has a lower risk of PIH (Post Inflammation Hyperpigmentation). It is appropriate only for scars that are new/"fresh" and scars that are shallower. For more severe scars, I would still stick to the stronger Fractional Ablative Lasers.

Dermabrasion is a very superficial treatment. Thus, this type of treatment will probably have no significant effect on scars. Personally, I would recommend a combination of types of treatments. In this case, subscision and skin resurfacing treatments such as the eCO2 Laser to optimise results. Good results will be in the range of 80% improvement.

High concentration TCA acid works by stimulating collagen and by inducing new "scar formation" to fill up the depressed scar. However, there are different types of acne scar. It could be Icepick, Rolling or Box Scars. Not all treatments are suitable for every type of acne scar. It is important to get an accurate diagnosis and make sure that the treatments you get are individualised for your specific condition. TCA CROSS might not be the ideal treatment of choice for Rolling and Box Scars. Their effectivity would be quite limited in this instance.

Thank you for your photo. It does look like you have a combination of different types of acne scars: Rolling and Box Scars.

For your acne scars, personally I would recommend: Subscision Fractional CO2 Laser Treatment (you will most likely require stronger settings as Dr Chin has mentioned) TCA CROSS for some of your ice pick scars. Ice pick scars respond greatly to Chemical Peels, TCA Cross. Dermal Rollers will not have effective results. Dermal Rollers are treatment tools with microneedles that are used to create micro punctured holes so that the skin will secrete collagen to the micro punctured holes in order to repair the damaged skin cells.

Hi there, It depends on the extent and severity of your active acne in those areas that you are considering injectables. It is generally safe to proceed with the abovementioned procedures as long as the areas that are to be treated are not inflamed / currently have active acne. If those areas are still fraught with active acne, then it is best to get it under control first as Dr Chin has mentioned. Hope that helps. All the best!

Hi there,The most important factor before the start of any acne scar treatment is determining the type of scar(s) that we are dealing with. Different scar types will require different treatment modalities as not all scar types will have the same response to a particular treatment. For eg. some scars will respond well to Fractional Lasers whilst others may not. Secondly, machine based treatments (fractional lasers/ RF etc) have hundreds of different settings and results are generally dependent on effective settings used and the method of administering these treatments. Same goes for subscision.

Hi, Thank you for your photos. From the photos, you do have rolling and box scars. I personally combine Subscision and a Fractional Laser (eCO2 etc) for such scars so as to treat each scar type optimally. Besides the machines/methods used, experience also plays an important part as there are hundreds of settings for each laser and different techniques for each treatment. Downtime and redness is to be expected from a few days to a week on average. Multiple treatments are required and spaced at least a month apart. Hope that helps. All the best!

Hi there,You do have a combination of deep Box scars, Ice pick scars and some that are tethered down. Personally, I would recommend a combination of treatments involving Subscision, TCA CROSS and Skin Resurfacing modalities (Co2, Erbium, Microneedle RF) as these treatments are able to treat each scar type optimally. Multiple sessions will be required and treatment is to be done at least 4 weeks apart. Downtime / redness will be expected for a few days to a week on average. Do speak with your treating physician on the pros / cons of each treatment. Hope that helps. All the best!

Hi there,Grading scales are used to grade the severity of acne and these can be in the form of pictorial scales, location of acne, number of acne lesions and type of acne lesions. Using a combination of both and from your photo, the entire area is affected with the addition of nodules and cysts. This does put you in the severe category and should seek treatment asap so as to help prevent subsequent scarring as mentioned by Dr Chin. Hope that helps. All the best!

Hi there,Generally, you would have to wait for 4 weeks before commencing any dentalprocedure. However, if you still experience discomfort and tightness inthe area where the thread lift was performed, then the dental procedure mayhave to be postponed to a later date (more than 4 weeks) or as reviewed andadvised by your doctor. Hope that helps.

Acne scars should improve with each treatment session and personally I do expect to see a 20% improvement with each session. That being said, other factors that have to be taken into consideration would be whether each scar type is being treated optimally with the most appropriate treatment method as each scar type do respond differently to different treatment methods, machine settings etc.