Acne is a process that can affect all layers of the skin. The process originates from the hair follicle. The hair follicle depending on the point of the growth cycle that it is in will have a certain length that it goes in the skin. At times, the hair follicle will be very deep and sometimes less deep. The point is that when acne erupts, the process can extend deep into the skin and affect all the layers even the area deep to the skin. When scars form from Acne, they also affect all the layers of the skin. So the scarring is really pervasive. That makes treating acne difficult as well. When it comes to excisions, acne scarred skin is less pliable and it doesn’t stretch as much. This makes for a more difficult time with healing. Better results are harder to achieve. So you want to heal your skin. We believe that you have to prep the skin before you actually do other things like excisions, subcisions, punch grafting, flap reconstructions, and deep chemical peeling.  We have a 3-4 step process that we like to do for people. It entails 1. tissue grafting, 2. more invasive work such as excisions, subcisions, deep chemical peeling, punch grafting, flap reconstructions, 3. More refinement, 4. co2 laser resurfacing and dermasanding. Our goals are to heal the skin first, treat the skin with more invasive procedures to get the scarred skin to the same level, repeating the second step until the goals are reached, then refining our results with a polishing technique that entails co2 laser resurfacing and dermasanding.

You can go through our webpages with this in mind to better understand what we are aiming to do.

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Our team at Aesthetic Facial Plastic Surgery!

Once you have the procedure you waited a long time for, it is time to be patient and wait, again, for your body to heal.  Unfortunately, a surgeon’s scalpel is not a magic wand and healing will occur at different rates for different people.  You must allow yourself to heal and be aware it is natural to be impatient for the results and a little anxious because you often look worse before you look better.  Being aware this can happen will help you understand these normal feelings.

Sharing your experience with friends and family can help give you a support system during your recovery, but realize they may unintentionally make you question your decision with concerns during your recovery.  While you may think that you are looking pretty rough around the edges, we may tell you that you are healing beautifully.  Trust us.  We will share with you if there is a concern, so if we tell you that everything is healing normally, it is.

Your healing will depend on many things such as your general health, your willingness to follow instructions, and your mental attitude toward recovery.  While I can perform the surgery, I cannot “heal” you.  It is up to you to be an active participant in your recovery process to help your body heal the best that it can.  Following all of our instruction is very important, as is working with us to address any complications that may arise.  Even surgeries that are done exactly right can have complications during recovery.  It has to do with the human factor.  We are not machines and every person can react differently and heal differently even when the surgery is done exactly the same.  Every surgeon has unexpected results from time to time.

It is important you approach your surgery and especially your recovery with the mindset that we are a team, and you are an integral part of that team.  We must trust each other to be working for a common goal, your successful result.  As the surgeon, I enjoy my work and strive to achieve an ideal result during every surgery for every patient.  I have rigorous standards that my staff must meet in order to be involved in your care.  I am looking forward to working with you to achieve a great result and do not anticipate any post-operative problems.  I will do everything I can to make sure that you are happy with your result.

 

Laser resurfacing involves using a laser monochromatic light (co2, erbium) to remove the top layers of your skin. This action leaves the remaining skin cells located within the hair follicles to “resurface” the areas that have been removed from the laser resurfacing process. In that process you get a renewal of brand new skin over the treated areas. The healing that takes place (under cover) over the next year, leads to an increase in collagen production under the skin cells that tightens the skin layer and reduces fine wrinkles. This gives you an overall improvement to your skin. The lasering of the top layers also removes unwanted skin pigmentation issues, DNA damaged skin cells in the more superficial layers, and other damaged cells and tissue elements. The end results that is achieved is fresh renewed skin with more even pigmentation, decreased fine wrinkles, and more even texture.

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Our team at Aesthetic Facial Plastic Surgery!

Dr. Young,

Patient: I wanted to thank you again for your personable consultation the other day.  It’s never easy talking to a stranger about one’s insecurities, but you certainly made it comfortable enough that I am considering your recommendations.  Just a few questions I first need to ask.

Dr. Young: It was my pleasure.

Patient: Why did you choose the subcision with the chemical peel over other procedures? .

Dr. Young: I think that laser resurfacing may not fully cause those ice picks scars to come up to the level of the rest of your skin.  They (laser resurfacing / dermabrasion / Dermasanding) are better when the surfaces are more closely aligned. and leveled.  The chemical peel will get the ice picks to come up and the subcision will make them rise by stimulating from below.  Alternatively you can add fat grafting with the subcision for more of an effect. I would do the subcision / fat grafting first and then 1-2 weeks later do the chemical peels so that your skin is not too traumatized.

Patient: What are the alternatives?  And do they offer similar or less satisfactory results?

Dr. Young: You can cut around the ice picks and then raise them. This could help. They are more work though. You can add filler underneath them. You can excise a group of ice pick scars that are oriented in a pattern. You can do Dermabrasion but again resurfacing would be the last step. You can laser just the ice pick scars to get them to rise up (not as effective in my experience)

Patient: What are the side effects of these procedures?

Dr. Young: The side effects are mostly swelling, bruising.  Sometimes if you are too aggressive the scars could get wider but flatter. That is why I stage the subcision and chemical peels sometimes if the scars are deep and prominent and numerous.

Patient: How long is the procedure, and is it performed at the same clinic?  Do you schedule surgery on Fridays?

Dr. Young: The procedure will take about 1-2 hours. We can do Friday’s. We do the procedures here. We are AAAHC certified  here is a link http://www.drphilipyoung.com/aaahcplasticsurgery.php to our plastic surgery AAAHC certification page

You can see more of our Acne Scar Revision Before and Afters here.

Thanks for Reading Dr. Young

Thanks for reading, Dr Young

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

Intense Pulse Light, Medium depth chemical peels, fractional co2 resurfacing, skin care can improve back pigmentation. With Fraxel resurfacing the pigmentation could be at many different levels. More superficially, I would consider more aggressive skin care light lightening products (retinol, hydroquinone, hydrocortizone), 15% alpha and beta hydroxy lotion, at home glycolic peels.  Also for superficial pigmentation, lighter chemical peels 10-25% TCA (Tricholoroacetic Acid) peels, and active / deep fx could help.  For dermal pigmentation, active and deep fx could improve the pigmentation intense pulse light with varying filters could improve this, as well as different longer length lasers from 585-1064.  Dermal depths are deeper and not accessible to most superficial treatments.

Hope this was interesting

If you ever want some questions answered you can always email me here.

Thanks for reading, Dr Young

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

Accutane is generally a contraindication to any resurfacing. However derma rolling is a form of fractionated type of resurfacing which may not have as significant risks.  This would be highly dependent on your surgeons experience. There are other ways to control your acne including hormonal control, antibiotics, chemical peels, directed skin care.

Hope that helps!

Thanks for reading, Dr Young

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

Thanks for reading, Dr Young

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

Areas of redness and scratches should heal after Active FX and co2 laser resurfacing. This could be scratches that you did while you were sleeping but could also be from the laser resurfacing itself.  I would continue your current cleaning regime.  Six days after your procedure you should still be healing and with fractional co2 resurfacing, your skin should be totally healed over.  If it were more traditional resurfacing your skin could still be healing over.  The areas that are red will take some time to resolve.  As some of the other authors have suggested sunscreen and sun avoidance are crucial during the first month and up to 6 months after the procedure.  The redness will take some time to resolve but not as long if you had the traditional resurfacing.  Some suggest steroids after your skin has healed over, but this could affect the healing and collagen production and most people would suggest against it.  Intense Pulse Light or the v beam, or any laser that concentrates light in the 585nm range, your doctor should be able to determine what is best, can help with some of this redness by attacking the vessels that are causing the redness.  Otherwise the healing will just take some time.  One thing that could be important to determine is if there is significant swelling, redness and tenderness that could indicate scarring.  This is something that your doctor should determine and in this situation, a high dose topical steroid could be needed to stem possible scarring.

Thanks for reading, Dr Young

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

Thanks for reading, Dr Young

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