Archive for the ‘Acne Treatment’ Category

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What results can I expect from scar revision surgery after worsening scars around my ear and face?

Monday, December 7th, 2009

It always depends on what your scars look like.  Options for scar revision (scar treatment / scar improvement / scar reduction, scar removal) include:

1. excision and reexcision: straight closure, running w plasty, multiple z plasties, geometric closure.

2. skin resurfacing: including laser, dermabrasion, chemical peels

3. tissue expanders to recruit more skin

4. local flap surgery whereby skin and tissue are recruited to reline the areas of scars

5. free flap surgery where tissue from some other part of the body is transferred to the areas of the scars and connected with blood vessels.

Many scars are excised and reclosed.  There are many options with this approach.  You can cut the scars out and close them as a straight line.  Your eye however usually notices anything that is longer than 7mm.  So many times, it helps to close the new incision not in a straight line but broken up into “w’s”, “z’s”, or multiple patterns (geometric line closures).  This is done in attempts to trick the mind by not having any line longer than 7mm.

Resurfacing is always an option to improve the scar by taking the scars away on the surface and allowing new skin to grow over to improve the appearance.  This can be done with lasers, dermabrasion, chemical peels, and dermasanding.

If there is a big area to improve, sometimes having more normal looking tissue is needed. This is where the concern with bringing in tissue comes into play. Tissue expanders allow you to make more skin. You have to go through expansion of your skin with a balloon under the skin near the area you are wanting to correct.  Expansion occurs every 2-3 weeks.  Once you have enough tissue you can then take the expander out and then the new tissue is used to reline the scarred area.  Local flaps can be rotated into the area.  If this is not enough, you can then take skin and tissue from another area and hook up the vessels to reline the scarred area.

The other option includes fillers that are an adjunctive option.  Fillers essentially fill in the volume deficiency that sometimes is present in the scarred area.  Fat injections, which are a filler that uses your own fat can fill in volume and also regenerate your skin through incorporation of new stem cells in the fat.  These stem cells can have a regenerative property on scar improvement.

From a results standpoint, you shouldn’t expect it to make your scar back to complete normal.  This is impossible.  But through scar revision the scars can be really improved.  That is the key to scar revision the word “improve”.  Here is a video on Scar Revision.

Thanks for reading

Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment, Scar Removal / scar reduction / scar revision / scar treatment, Uncategorized | No Comments »

What are the options for reducing the size of your pores. Does a facelift work for this?

Thursday, September 17th, 2009

This is a question that I answered for a client who had questions regarding whether a facelift would work to reduce the pore size as well as acne scars:

Fat grafting, laser resurfacing, ipl are better options than a facelift (face lift/ lifestyle lift / quick lift / lunch time lift / mini lift / weekend lift / s lift / lifelift / thread lift ). Some newer studies and results from physicians more recently are showing that these modalities may be more beneficial to reduce pore size for people.  A facelift will not effectively do this but it can improve your wrinkles to an extent.  Fat grafting (or fat transfer / fat augmentation / facial fat transfer / fat injections) has been shown by some to regenerate the skin including reducing the size of your pores.  Stem cells in the transferred fat can rejuvenate the skin for years.  Laser resurfacing through the creation of new collagen can also reduce the size of the pores as well.  Ipl is another newer treatment for pore size.  Out of all the options fat grafting might be the best option for pore size and acne scarring.  More and more surgeons are using fat grafting as a way to improve acne scarring.

I refined an amazing volumizing procedure called “the YoungLift”. This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done. This is not a facelift and requires no incisions. Only pinpoint puncture sites are used and these heal imperceptibly. The YoungLift can be done without general anesthesia and without drains, and large bandages. You also have sometimes a lot less downtime and discomfort compared with traditional facelift procedures. I employ the very best techniques from around the world into one volumizing procedure and I use my internationally acclaimed understanding of facial beauty to create the youthful volume you once had. In your case, the Younglift could help fill in the acne scars and volumize your face which will reduce your pore size

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Laser Resurfacing, YoungVolumizer | No Comments »

Approach to small pox scars through excision, resurfacing and hair transplantation?

Wednesday, July 8th, 2009

Small pox scars are a lot like Acne Scars. The pox scars can appear very differently in people.  Depressed scars can be excised or they can be elevated and then resurfacing can then be done.  Excision of the scars will likely need two stages.  You would need to excise them at the first stage and then allow them to heal. At 6-8 weeks or later, we can then do the resurfacing procedure to smooth over the incision from the excision.  If you want to do it in one stage, you can elevate the scars through punch excisional techniques where the depressed scar is incised completely around it and then elevated so that the skin is at the same level.  Once this is done with all of the depressed scars you can then resurface the face or area at the same time.  Results can be as good as the two stage approach.  When the scars are raised, you can use resurfacing techniques to lower the raised portion and then the area can be healed over by the migrating cells.  Hair transplantation can help but they can be placed in areas that you might not want hair located at.  You have to make sure you don’t mind hair in the area that you transplant hair.  With the above techniques you may not need hair transplantation given the excellent results that you can attain. Here is a live demonstration of my use of a co2 laser and laser resurfacing.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Acne Treatment, Laser Resurfacing, Scar Removal / scar reduction / scar revision / scar treatment | No Comments »

What is the best laser for Acne scars or other treatments?

Monday, July 6th, 2009

Active Fx would be a great choice and most definitive. There are many ways to improve Acne scars.  It really depends on how they look and what are the characteristics of the scars. If they are depressed the scars need to be elevated and then allowed to heal. Many times you can carry the laser resurfacing at the same time the depressed scars are elevated to the level of the rest of the skin.  If they are white, excision of the white scar is the most definitive way of improving this.  If they are raised, sometimes the laser can be used to level the scar down to the rest of the skin.  There are times when the leveled scar doesn’t heal as perfectly and then requires more extensive resection reclosure and then delayed resurfacing 6-8 weeks later.

Fraxel and fractionated lasers can help but usually take more treatments then more traditional laser resurfacing.  These results are more subtle but usually people heal faster and have less downtime but this is not sometimes the case in many situations.

More aggressive peels combined with dermabrasion can also help acne scars.  Dermabrasion uses a machine that spins a wire brush that can take down the layers of the skin to the right depth to remove scars.  Dermasanding is another technique that uses medical grade sandpaper to do the same in a more conservative and safer way with less aerosolized particles that can transmit infections.

Before these treatments, optimized medical treatment is prudent to try first.

Here is a live demonstration of my use of a co2 laser and laser resurfacing.

Thanks for reading,

Dr Young

Dr Youngspecializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment, Chemical Peels, Laser Resurfacing | No Comments »

Long term treatment of depressed scars and options

Wednesday, June 24th, 2009

You can have long term improvement in some acne scars. For depressed scars, a strong chemical peel using a toothpick can help raise the depressed scars/pock marks. Also, this can be done with the co2 laser.

The other way to improve those scars is just to incise them and remove the scars and carry out a reclosure. This new incision can then be resurfaced with a chemical peel or laser to improve the appearance of the new incision. This can be done all throughout your face. It takes a lot of work but it can be done and a noticeable improvement can be accomplished.

Here is a live demonstration video of an Acne Treatment Procedure.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment | No Comments »

Fillers and their use in depressed scars

Wednesday, June 24th, 2009

Fillers are a temporary way to fill in depressed scars. Restylane can last about 6-9months, and radiesse 1-2 years. Fat can be another option to fill in scars and can last many years like 10 years give or take a few years when done right. In my experience, using temporary fillers gives one only modest results and most people are left desiring more improvement. Other ways to lift the scar include subscision technique where you use a needle to lift the scar up so that it sits level with the plane of the rest of the skin. This can be done in conjunction with laser resurfacing. Other ways to lift up the scar is to use biopsy instruments to incise around the depressed scar and this is then lifted up into the right plane. Another way is to cut the scar out and follow this with resurfacing.

Posted in Acne Treatment | No Comments »

There are multiple options to improve your acne scars

Monday, June 22nd, 2009

There are multiple ways to improve your scarring from acne (Dr Young from Seattle Washington). You want the simple answer. Yes, there are a lot of lasers out there but most simply put lasers are used to take away the top layers of the skin to remove the scarring and then what happens is that your skin cells deep within your hair follicles grow out and “resurface” your face and skin. The newer fractional lasers essentially manipulate your skin deeper to cause skin tightening to help improve the wrinkles such as Fraxel and Deep FX.  Lasers are just part of the treatment. You want to either have a co2 or erbium laser. Co2 allows more aggressive treatment.

All of the other names are just company names for either the co2 or erbium. Just ask your doctor to tell you what laser it is and the most important is knowing the wavelength and the name that is associated with the wavelength. Sometimes it requires other procedures for certain type of scars. Some of your more depressed scars require surgical excision or subscision where you use a needle to elevate the depressed scars so that the depressed area is more level with the rest of the skin. At times, this entails cutting around the whole part of the depressed scars to allow it to elevate. Laser resurfacing after this helps with the healing. Here is a live demonstration video of an Acne Treatment Procedure.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment | No Comments »

Fraxel Repair and Acne Improvement

Monday, June 22nd, 2009

This discussion was directed at a question on why fractionated lasers haven’t worked on a particular person’s acne scars. Fractioned lasers will gradually improve your scars. It also depends on how your scars look. Some scars need to be excised first before they actually can get really better.  Other times require subcision techniques which require you to use different instruments, such as punch biopsies or needles to elevate depressed scars so that they match the surrounding levels of the skin. You may need more significant approaches for the scars such as co2 resurfacing as well to get the results that you really want. Also, some scars require excision and closure and further resurfacing to improve them.  Here is a live demonstration of my use of a fraxel co2 laser.

Thanks for reading,

Dr Young

Dr Youngspecializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Treatment | No Comments »

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