Archive for the ‘Dermatology’ Category

Seattle Acne Scar Treatment Webpage Released by

Monday, December 26th, 2011

Seattle Acne Scar Treatment Webpage Released by : We have made a new webpage on Seattle Acne Scar Treatment  on our website We added some new pictures / photos and some links to help people understand a little more about how we are treating scars that were created by Acne. We would also like to explain a little about our thought process when it comes to treating Acne Scars.Acne Scar Treatment Before After

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. We have topics on depressed white acne scars, box car scars, elevated white acne scars, pock mark acne scars and more.

Thanks for reading

Our team at Aesthetic Facial Plastic Surgery!

Ice picks scars and why I like subcision / fat grafting / with chemical peels question and answers Dr. Young of Seattle:

Wednesday, September 28th, 2011

Ice picks scars and subcision, fat grafting, with chemical peels Dr. Young of Seattle:

This is what I wrote someone on Sept 28,2011:


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 to our plastic surgery AAAHC certification page

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

ice pick scars tca cross


Thanks for Reading Dr. Young

Learn more on our website

Dermabrasion for dark complexion and option for acne scarring by Dr. Young of Seattle | Bellevue

Monday, June 6th, 2011

Dermabrasion for dark complexion and option for acne scarring by Dr. Young of Seattle | Bellevue:

Dermabrasion for Acne Scar Treatment can help with Acne Scars but their are other alternatives that should be discussed for more improvement. I opine that  fat grafting / Young Volumizer is one way of improving your acne condition. It does this be breaking up the scars underneath and allowing them to rise, giving your skin more vascularity (more blood flow to the skin) to heal from future procedures.  Excisions and cutting out some of the scars can help.  Subcision is another way of getting the scars to heal in a less depressed fashion, fat grafting is an extension of this idea.  After these procedures, I think resurfacing is then best done next and after all of the significant cutting out of the lesions is done. I have more information on my website and other pages. The question about getting max dermabrasion for dark complexion can be done.  I think the only group that could have a detrimental affect are african americans and darker indian asian groups.  In your case, I think you can have the maximum in terms of resurfacing / dermabrasion / laser resurfacing. We have a great new option for Acne Scar treatment called the Acne Scar Vitalizer Treatment.

acne scar treatment, acne scar reduction

Thanks for reading, Dr Young

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

Come visit our website

Can a diabetic get a microdermabrasion?

Friday, April 30th, 2010

Microdermabrasion should not lead to any issues in a diabetic.  You should be under good control however just to decrease any reaction or possible infection with the microdermabrasion.  Even if you sugars were not under total control the chance of something happening with superficial microdermabrasion is extremely small.  Microdermbrasion is a very superficial skin facial treatment and should not affect the skin’s water tight barrier to a great degree.  So introduction of foreign material, bacteria past the defences is much less likely with microdermabrasion as opposed to deeper chemical peels, laser resurfacing and dermabrasion.  Even with these deeper treatments, you can get them if you are a diabetic.  One thing to make sure is to have your sugars under control.  If this is not your current state, infections can be more risky for a diabetic with poor sugar control.

Thanks for reading, Dr Young

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

What is the muscle that causes crows feet?

Sunday, March 7th, 2010

The muscles that cause crows feet are the orbicularis oculi and the smiling muscles: levator labii superioris, zygomaticus major and minor.  Here is a picture of these facial muscles.  When we try to improve crows feet with botox, these are some of the muscles that we try to weaken to decrease the formation of wrinkles.  Botox is injected in the sides of your eyes in the skin to weaken these muscles.  By doing this, we make the muscles weaker so they are less likely to form these dynamic wrinkles.  Dynamic wrinkles are the wrinkles that show up when you move the muscles of your face.  They are more pronounced when you move your facial muscles.  Static wrinkles are the wrinkles that are so etched in that they are present when you are not moving your facial muscles of expression.  Dynamic wrinkles are mostly effected by the actions of botox.  Over time, with continued use of botox, the static wrinkles can become more improved.  This is done because with botox, eventually allows the skin to remodel and reduce the static wrinkles.  This action of improving the static wrinkles however takes a long time and requires regular and consistent use of botox.

I hope that was interesting for you!

Thanks for reading, Dr Young

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

Facelift for Acne Scarring and other options by Dr. Philip Young of Bellevue | Seattle:

Wednesday, March 3rd, 2010

Facelift for Acne Scarring and other options by Dr. Philip Young of Bellevue | Seattle:

Question: Is a facelift the best option for acne scarring? What other options do I have?

Answer: A Facelift is not the first option but I have noticed improvement in Acne Scarring from this procedure.  I personally have many patients that have noticed a significant improvement on their acne scarring  from a facelift procedure.  Is the facelift a procedure that is usually recommended to a person to improve their acne scars? The answer is “no”.  But I usually present all options to the patient.  Among these options include laser resurfacing, chemical peels, dermabrasion, dermasanding, fillers, fat injections, and excisional techniques.  It depends on how your scars look like.  If you have alot of deep ice pick scars you may need some excisions to completely remove them.  Of course if they are everywhere you might have to pick and choose which ones to excise or cut out.  This excisional approach is usually followed by some resurfacing.  I usually prefer to excise and then resurface the areas at the earliest 6-8 weeks.  One important point to remember is that the goal is improvement.  Your skin is probably not going to ever look like your skin when you were a baby of course. But we can make it better!  Fat injections and fillers can be used to break up the scarring that sometimes holding the skin down to the deeper layers.  This often causes the scars to be held down.  Fat injections is the best way to soften up the adhesions of scarring to allow the skin to come away from the deeper scarring. Here is a live demonstration of fat injections being done in the face (Dr Young is a fat injections specialist from Seattle, Washington). Fillers can also do this, but less well.  Here is a live demonstration video of an Acne Treatment Procedure.

I hope that helps.

Thanks for reading,

Dr Young

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

How painful is dermabrasion? How would you rate the pain level? What are some anesthesia options for dermabrasion?

Monday, January 25th, 2010

Intense Pulse Light is a procedure where a wire brush is used to take down superficial and deeper layers of the skin to reduce scars, improve wrinkles, decrease pigmentary problems, etc.  It works under the same principle as Usually dermabrasion is not done without some type of anesthesia.  The types of anesthesia include local, regional, oral / iv sedation, general anesthesia.  Most physicians use a combination of above to do dermabrasion.  If it is a concentrated area like a scar, local anesthesia can be the only thing needed depending on the normal anxiety levels that a person usually gets in this type of situation.  If the person is likely to get anxious than oral or iv sedation can help.  For the whole face and larger areas, some type of whole body sedation through oral or iv sedation is helpful.  Regional anesthesia where the nerves are anesthetized can help the whole situation.

Thanks for reading, Dr Young

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

What is a glycolic peel best for treating?

Sunday, January 24th, 2010

Glycolic acid peels are superficial but can be important for regular skin care. They are superficial peels and the aggressiveness of the peel is dependent on the percentage of the glycolic acid in the preparation.  They are fairly safe and it is very difficult to make them deep and thus complications are much lower as compared to other peels.  One thing to remember is that sometimes the more aggressive you are the more results you will get for the most part.  Glycolic acid peels that are from 0-30% can be done at home with some guidance.  Anything stronger would be wise to be carry out with the guidance of a physician.  At home glycolic peels are a great way to keep up your skin from a maintanence stand point.  I usually start patients on a skin care program with retinols, hydroxy acids, buffing cleansers, gentle cleansers and see how they do and tolerate it.  Once this basic regimen is tolerated for a couple of weeks then I start them on the at home glycolic peels and guide them through this.  With this regimen, you can get your skin to turnover much quicker (from 28 days to 10-14 days or less).  This will help with unwanted pigmentation, decrease the size of pores, improve texture, and decrease fine wrinkles.

Thanks for reading, Dr Young

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

How often should you do chemical peels to maintain the results.

Sunday, January 24th, 2010

How often you do peels can be subjective and dependent on how you feel your skin is doing and for what condition you are treating.  Chemical peels can be varied in terms of how deep you want the peel and how deep the issues you are trying to treat. Superficial wrinkles and pigmentation issues can be improved by superficial peels.  Deeper wrinkles and pigmentation can be improved by more aggressive and deeper peels.  Deeper peels should not be repeated for several months and even up to a year.  Your physician can monitor how you are healing and determine this.  Superficial peels allow a faster recovery and thus you can do these much more frequently.  Glycolic peels can be done 2-3 times per week depending on how a person is tolerating the treatments.  Your doctor can help you determine this.  To maintain the results you need to determine with your doctor how your results are coming along.

Thanks for reading, Dr Young

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

Difference between co2 laser resurfacing with Lumenis and their active fx / deep fx / total fx / max fx technical advances explained

Monday, December 7th, 2009


skin anatomy

skin anatomy

A knowledge of skin anatomy can help with understanding resurfacing (laser peel, laser skin rejuvenation) of all types including laser, chemical, dermabrasion.  Taking a look at the cross sectional area of the skin, you can see that the skin is broken up into basically two areas, the epidermis and dermis. All resurfacing progressively take away layers of skin and by doing so remove skin lesions, unwanted pigmentation, wrinkles etc.  What happens is that the deeper skin cells located in the depth of the hair follicle eventually resurface and repopulate the skin.  during this process a layer of scar tissue and collagen is formed under the new basement membrane.  This new layer of collagen is thought to be responsible for some of the benefits of resurfacing including tightening of the skin and maintaining the decrease state of wrinkles.  The basement membrane is the connective tissue floor that the stem cells rest on where they reside and repopulate the more superficial layer of skin cells.  Active Fx essentially takes away more superficial layers confined to just above or just below the basement membrane depending on how many passes are done, what power and what density is chosen.  The basic principle of active fx is the use of a fraction of the spot size.  When you look at the picture above you can see that active fx has some wide dots, wider that the deep fx.  But the key are the areas in between the dots that represent untreated skin.  This untreated skin allows a faster recovery and less down time.  The goal is to get some of the effects of resurfacing without the downtime.  To help with the results of active fx, deep fx was added to create more tissue tightening to a deeper level.  Notice in the picture that with deep fx the dots are thinner.  Deep fx is thinner but it reaches to a deeper level heating up deeper layers and leading to more tissue tightening to a thicker amount of skin.  When deep fx is combined with active fx you can get better results than when each are used alone and this is done with less downtime than traditional resurfacing.  Total fx is when active fx is combined with deep fx.  Traditional resurfacing can be explained by active fx and that approach.  The difference is that the dots are much closer together and depending on whether you increase the density of the dots the dots may overlap to a varying degree.  When the dots start to overlap at a density of 4-5 you start to get into more traditional type of resurfacing where all parts of the skin are taken away or ablated per spot.  This approach does not leave healthy skin in between the treated dots, so the downtime is like older approaches. This use of active fx with dots touching or overlapping is more appropriately called max fx, or traditional co2 resurfacing. One thing to remember is that the more aggressive you are the more results but also the more risks are involved.  Total fx tries to get more results than you would normally get with a certain amount of risk. Here is a live demonstration of my use of a co2 laser and laser resurfacing.

Thanks for reading, Dr Young

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