Monthly Archives: April 2013

Understanding Scar Revision

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Purpose of Scar Revision


Psychological and physical considerations

Many patients who present themselves for reconstructive surgery suffer from PTSD (post traumatic stress disorder.) In order to provide the best solution for the patient a cosmetic doctor will address the psychological trauma with a therapeutic adjunctive consult. In such cases it is paramount that therapist have exceptional experience in PTSD for the patient negotiating serious psychological trauma. Though elected the scar revision surgery can exacerbate the patient’s fears.

Scar revision in most instances requires a waiting period. This time allows for patients not suffering from PTSD to psychologically adjust to the prospect of one or more additional surgeries to bring about reasonable consideration of their proposed surgical treatment plan.

Realistic perspective is critical in scar revision and reconstructive surgery. Healing time is quite often lengthy; the patient’s understanding of this is important to their well being. Many cases present the need for adjunctive medical treatments such as dermabrasion, steroid injections or laser resurfacing.

Preparation for Scar Revision

Timing of scar revision

The location of injury and type of scar combined with an individual’s psychological readiness are all critical to the timing of scar revision. Following the initial injury a six to twelve month wait is not unusual. Surgical intervention can only take place after a thorough consult an assessment. This assessment will most often define the following five major factors:

  1.  the characteristics and nature of the initial injury
  2. the relationships to anatomic location and relaxed skin tension lines (RSTLs)
  3. likelihood of pathologic healing (such as  hypertrophic scar , keloid )
  4. any regional functional impairment by deformity ( such as  oral or ocular impairment)
  5. surgeons should also recognize that conservative nonsurgical methods may be applicable as a primary treatment method

 
These are just some of the general factors in scar revision. This is a complex and highly individualized medical treatment. Availing oneself for scar revision takes expert medical consult. It is best to research the best cosmetic surgeons in this area and interview with several.

Scar Revisions New Horizons with Lasers

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Laser Instrumentation for DermatogistsScars are immensely varied and come in all shapes and sizes. Surgery remains the best option for more severe scars, other scars can be treated with the advance development of lasers for dermatological use. Treatment of scars with laser has steadily grown, giving both patients and physicians more flexibility to determine the best method of treatment.

Two Main Goals of Treatment
Scars appear different, depending on the injury sustained. According to some experts the color be it, white, red, or brown, can be an indicator of the type of texture the scar will show.
• Make the scar smooth without the is not depressed or elevated
• Blend the color around and within the scar so that it blends with the outlying pigment

Ablative Technology

For larger and more severe scars, such as burns and contractions associated with scars, ablative technology is a better option. Ablative technology is a process of placing tiny holes in the skin with lasers that allow tissue to bend more easily, thus potentially increasing the range of motion in severe scars. This technology continues to improve through the enabling deeper penetration of the lasers.
With lasers now offering the ability to go deeper into the skin scar treatment will continue its dramatic changes.

Some dermatologists and researchers theorize that deeper treatments will allow for more range of motion in scars that restrict movement; this may open up whole new possibilities for scar treatments. Lasers in the future will allow for even deeper penetration of the dermal layers.

Given the nature of scars, there will likely never be a definitive treatment for all scars, no matter how much the technology advances. Still the current levels of laser therapy provide wonderful new treatments to diminish scarring; with greater promise on the future.

Innovative Treatment for Scalp Scar Revision

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Follicular Unit Extraction (FUE)

Innovative Treatment for Scalp Scar RevisionFUE for Scar Revision

Follicular units (FUs) are the individual removal of the tiny organs that produce our hair shafts. Hair loss is a growing elective surgery but very beneficial for people who are suffering from low self image and quality of life issues from hair loss.

Like all surgeries hair transplants leave a scar. Dr. Parsa Mohebi, medical director of US Hair Restoration center is pioneering method of combining two procedures to render these scars virtually undetectable in many cases. The combination of FUE and SMP are small procedures that can be used in the revisioning of a hair transplant scar.

Donor Hair Scar Revised

The surgeon can extract a small number of grafts from the permanent zone and artistically and strategically place them in the scar. This process of using FUE uses hair to obscure and blend the margins of the scar to the surrounding scalp. Scalp Micro-pigmentation (SMP) can be used to further blend the scar in many cases.

Scalp Micro-Pigmentation

SMP for Scar Revision

Scalp Micro-Pigmentation is the process of using special pigments and fine needles to create the shade of stubble or shaved hairs on the scalp. SMP utilizes dermal pigments that match the patient’s hair color. Used in scars like FUE it can artistically applied revises the margins of the scars. This revision results in the obscuring or blending of the scars margins to the surrounding scalp.

FUE and SMP

FUE and SMP are a very non invasive way of revisioning a hair transplant scar. Patients can consult a hair transplant surgeon for recommendations on achieving the best results. These modern advances in scalp scar revision are performed in Los Angeles leading hair transplant centers like US Hair Restoration.

Abdominal Scars

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Abdominal Surgical Revision

Abdominal scar tissue is forms through the healing of the connective fibers surrounding incision sites or traumatic wound. These are the natural fibers the body creates to heal tears in the skin. Abdominal scar removal is a way to repair or replace damaged skin. The severity of the wound surgical or traumatic helps determine the realistic level of success of any abdominal scar removal technique or revision.

Surgical Revision

Surgical scar revision is often used to reduce the abdominal scar. Surgical revisions work by moving the scar toward a natural crease in the skin. Scarring is ofthen cause by too much tension on the wound. In an abdominal surgical scar revision a less prominent scar will result because of he conrol of the woud tension which is lessend by the surgeons expertise.

View an actual abdominal scar revision with dermabrasion.

Punch Graft Scar Revision

A punch graft is a surgical technique designed to minimize the appearance of a scar. By removing an area of tissue from another area (normally less visible area of the body) and replacing it where the scar was located. If the abdominal scar is severe, a punch graft may be used and the skin is placed over the abdomen and stitched in place. Again, the tension in the stitching or closure of the surgical wound lends to a more aesthetic or less obvious scar. In addition after full healing of the punch graft dermabrasion or laser resurfacing can be utilized to diminish the appearance of scars.

Considering Scar Revision Surgery

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Enhancing your appearance with scar revision surgery

There is not a person on the planet who is scarless or a tleast it is highly unlikely. Scars are visible signs that remain after a wound has healed. Scars are unavoidable results of injury or surgery, and the results of this natural healing process can be very unpredictable. Some people naturally heal well; others do not… Poor healing may contribute to scars that are unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

Facial Scar on Young GirlYour treatment options vary based on the type and degree of scarring and can include:
• Simple topical treatments
• Minimally invasive procedures
• Surgical revision with advanced techniques in wound closure

Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.
Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Should I Elect Scar Revision?

Scar revision is a highly individualized procedure and you should do it if it adversely effects your self image and esteem.. Scar revision can be performed at any age and is a good option if:

• You are upset by a scar anywhere on your body
• You are physically healthy
• You do not smoke
• You have a positive outlook and realistic goals for your scar revision surgery
• You do not have active acne or other skin diseases in the area to be treated