Tag Archives: changing scars

Adult Acne Scar Revision

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Acne Scar Revision

Acne is most often associated with the angst and turbulent adolescence; at least that is the common perception. In the United States alone the American Academy of Dermatology reports that 40 to 50 million peoples suffer from acne to a level of requiring medical treatment. The numbers appear to be growing and the reason for this unclear.

In a study of 1,013 people, 15% of women and 7% of men over 50 reported having acne. The negative effects on self image are as strong in adults as in teens. Often adults use over the counter treatment that aggravate the condition even further.

WATCH VIDEO of One Acne Scar Revision Technique Below


Women appear to have increased risk


A survey from the University of Alabama was published a study in 2008; significant numbers on women suffering from acne was reported. This study found that acne affects more than 50% of women between the ages of 20-29 and more than 25% between the ages of 40-49. A Massachusetts General Hospital research survey in 2011 reported similar numbers though slightly lower than the University of Alabama report. The hospital study revealed that 45% of women 20-29 and 12% of women 41-50 had acne.

Treatments


Long term acne can leave substantial levels of scarring that require medical intervention to improve the appearance of the skin to enhance the well being and safe image of patients. Myriad treatments from a range of chemical peels, to non-ablative and ablative lasers, to injections, all the way up to surgical techniques. Sometimes the best treatment for may include a combination of these modern procedures. As in other scar revision the goal is to make the scarring less noticeable.

New Cosmetic Procedures for Scar Revision

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Scarring negatively affects a person’s self image. Advancements in cosmetic procedures surgical and non-surgical provide alternatives in revising hair transplant scars or scars in other areas of the body that have hair.

FUE and SMP Transplant for Scalp Scar Revision
Follicular Unit Extraction (FUE) allows a hair transplant surgeon to individually remove donor grafts without a measure incision in the patient’s scalp. This means a small number of grafts can be used and placed within recipient sits within a scar. This means scars in other places that have hair (eyebrows, pubis etc…) can be treated by transplanting of a small number of follicular units into the scar and on its margins to blend it to the surrounding area.

Scalp Micro-pigmentation is used to simulate stubble hair making it also good for obscuring scars.
Scalp Micro-pigmentation is used to simulate stubble hair making it also good for obscuring scars.

Scalp Micro-Pigmentation
SMP for Scar Revision

Scalp Micro-Pigmentation (SMP) is a non surgical cosmetic procedure that can be used in scar revision. It can works well with scalp scars. Special pigments are injected into the scar. The appearance is like stubble hair. It is injected into the scalp in a manner to obscure the scar or make it blend into the surrounding area.

These more recent advances in cosmetic procedures; FUE and SMP are performed in Los Angeles hair transplant centers like US Hair Restoration.

Understanding Scarring and Scar Revision

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The role of scar revision is to restore self-esteem and improve the quality of life. The skin is actually the largest organ of the body and vital to not only our physical health but also it’s health and beauty important to our emotional well-being. Scars have a natural process or progression towards a mature scar. This represents the completion of the healing process.

There are individuals who heal with very little scars and others who scar from the slightest of skin injury. Any injury to the the skin, that is a rupture to the integrity of its’ surface or that results in an opening or damage to the dermis, will heal with a scar.

Facial Scars effect self image.
Life changes that effect our hormones can effect the way our skin heals. Childhood to puberty, adulthood and finally to old age can represent significant changes in how our skin heals. Predicting how a person heals cannot be done with medical certainty. It is a persons observation of their own healing history and familial history that provides the best indicators.

However through observation of certain skin types that we understand their tendencies to produce abnormal scarring and formation:

  • Pigmented skin and Celtic skin have a higher risk of Hypertrophic and Keloid scarring
  • the chest and shoulders, eyelids, lips or labia heal with inconspicuous scarring

    • The goal of scar revision surgery is to make the scar to blend or making it inconspicous. Scars that result from injuries, burns or cancer excision can have a major psychological impact. This impact from the scarring can be profound adversely effecting self-esteem, self-confidence and social interaction. If you suffer from such issues a cosmetic surgeon can often help.

    Laser Technology in Scar Revision

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    Advent of Laser Technology in Scar Revision


    Who doesn’t have a scar? The natural healing mechanism following injury or surgery most often leaves some level of scar. Many individuals bear no adverse reaction to scarring. Of course the location of a scar and its severity can make all the difference to some people’s self image. While the scar appearance is usually quite acceptable, in many other instances the scar can raise, thicken, or become red. This type of scarring is called ‘hypertrophic scarring.’ Some individuals may even develop an extreme form of scarring called a ‘keloid.’

    Laser Scar Revision

    Laser technology Advances Scar RevisionIn recent years the use of lasers in medicine has enjoyed rapid development in medicine. Doctors and researchers are experimenting with the devices in a wide variety of procedures, like opening blocked coronary arteries and reshaping the cornea of the eye to correct poor vision, dissolving kidney stones and in scar revisioning.

    These advances in medical laser technology allows for easier revisioning treatment of scars. Applied in the right cases laser scar revisioning can have remarkable success and can bemore effective than ever.

    Lasers are used in two primary ways in scar revisioning:


    • to treat the surface color of the scar
    • to go deeper and break up the collagen bunches that cause the scar

    The result renders scars smoother, more evenly colored. The application of these new laser treatments appears limitless as doctors and researchers fine tune the levels of laser frequency for different medical applications. Lasers are effective on scars from accidents, dog bites, cesarean sections, orthopedic surgery, plastic surgery and skin grafts have proven quite successful and a large cross section of patients. It is important to note however because scarring is a highly individualized healing process that thorough medical consult is the best option. New laser therapies have ever proven effective on burn scars.

    Laser Scar Revision Results


    Scars cannot be completely removed from any treatment. Scar revision is meant to obscure the scar by making it blend better with your skin in colour and texture.; the more T the scar to blend s naturally with the surrounding skin The better the results. If the scar is uneven in texture, laser scar revision will help smooth out the scar so that the area is flatter. Additional treatments will continue to improve these effects.

    Pressure Treatment in Scar Healing

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    compression garment for torso When an imbalance occurs between the anabolic and catabolic phases of the healing process in a wound somtimes more collagen is produced than the is degradation of collagen in the healing process. This results in the scar growing in all directions. The scar is elevated above the skin and remains hyperemic. This is excessive scar tissue is medically classified either as a keloid or a hypertrophic scar.

    There are several nonsurgical options that are utilized to treat of these abnormal type scars. Pressure is a treatment that has demonstrated a level of success in some patients. The use of pressure to treat scars is thought to decrease tissue metabolism and increase collagen breakdown within the wound. Pressue is sometimes used preventatively in patients who have a history of keloid or hypertrophic scarring.

    There are various different methods for administering pressure to facilitate this type of treatment including:
    • elastic bandages (eg, Ace wraps) for the extremities
    • thromboembolic stockings for the feet
    • Isotoner-type gloves for the hands.
    • custom-fitted compression garments can be used for the more difficult areas ( lower neck and torso).

    ACE wraps or stockings are not useful for areas such as the head and face this is primarily because of discomfort and patient compliance Is not likely. Optimal results with latex-free compression garments are achieved usually in 6 -12 months during the maturation of the wound.

    Do’s and Dont’s of Reducing Scars

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    Scars are made up of the protein collagen which is found in the second layer of your skin. When the integrity of the skin is compromised through injury beyond a superficial this layer must repair itself. It is in the body’s only healing process that scarring takes place.

    The key to preventing scars is to break up the collagen that collects in the dermal tissue during the healing process. When the collagen does not bond to your skin’s top layer scar formation is reduced.
    It is possible to lighten and revision an old scar, your best approach is to limit scars before they form.

    DON’T

    DON’T Use Hydrogen Peroxide: While the solution cleans, it also destroys new skin cells that immediately begin to grow in the wound. This slows down the healing process and increased the risk of scars forming.

    DON’T Treat with Vitamin E. Recent studies show that it, like hydrogen peroxide, vitamin E impairs healing. One-third of people will also develop an allergic reaction to vitamin E.

    DON’T Expose To Sun: Ultraviolet rays slow the healing process and can discolor the scar. The sun stimulates the cells that produce pigment, and when your skin is sensitive and healing, it’s prone to discoloration. Cover the wounded skin with a minimum SPF blocker of higher than 15.

    DO

    DO Cover A Cut: Should a cut “breathe,” or does it require a Band-Aid over it? When you don’t cover a cut, it dries out and scabs over. Scabbing is not a good thing; it only presents a barrier to healing. Treating cuts with Neosporin (or another antibiotic cream) and covering with a band-aid for a week in aids the healing and prevents infections and minor skin wounds. Do this until new skin begins to grow.

    DO Place Pressure On Cut:Use special pads that serve to flatten scars. These scars don’t allow the collagen to pop up above the skin when a wound is healing. Some examples of these pads are: Curad Scar Therapy Cosmetic Pads, ReJuveness Pure Silicone Sheeting, Scar Fx and Sypres Scar Sheets.

    DO Massage The Wound: Once new skin has grown, massage the mark. Massaging helps break down the dense bonds of collagen. If they are not allowed to take hold, the appearance of the scar will be much less noticeable, or may not form at all. Massage – with lotion – in a circular motion for 15 to 30 seconds a few times a day.

    Basic Scar Science

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    Why do scars have different colors?


    New scars would always turn out to be red or purple in color as a result of damaged blood vessels and inflammation. These are hyperpigmented scars. Older scars are white in color. Resulting from the inflammation and damage to the blood vessels and cells loss of pigmentproducing,cells occur. The scar becomes hypopigmented (pale), because of the loss of skin pigment. The skin has a great capacity to regenerate itself. The scars are a sign of the skin attempting to heal itself. Normally when the skin is quickly repaired, the new skin may have a different appearance. This persistent in the formation of the scars that don’t fade away.

    How long does it normally take for scars to fade to their final color?

    Generally, major scars from either surgery or injury take about six to twelve months to fade to
    their final color.

    How good is scar revisioning?

    Do some people have a predisposition to develop more prominent scars?

    It believed that genetic factors play a role in the scarring process. Scarring may be more disfiguring for some people. There has been new treatment developed that can help scars fade
    away.

    What causes scars?

    Scars are a permanent mark that indicates the skin’s attempt to heal itself. When the skin is damaged the top layer occurs, cells to quickly multiply to form new cells to fill in the gap. When the wound is deeper into the underlying skin tissue, the cells that form collagen are stimulated and they fill in the gap by producing abundant fibrous connective tissue. If the density of this new tissue is relatively extensive it is usually replaced by normal skin layer over time. A result of a persistent scar remains, when the mass of new tissue is relatively extensive it is associated to cell damage and the fibrous tissue remains.

    An Overview of Burn Scars

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    Burn Reconstruction

    Burns caused by heat, chemicals and fires can result in the most traumatic types of scaring. The severity of burns is classified as first, second and third degree burn. This designation is based on the dept of damage to the outer and deeper layers of the epidermis (skin) and dermis (inner skin) tissue.

    Burns can leave patients with severe physical disfigurements.
    The emotional trauma can often exceed the physical trauma as self image is an integral part of an individual’s self esteem. Scar revision surgery for all types of scars is often elected to positively affect the patient’s emotional well being.

    Burn treatments usually involve skin grafting and cosmetic reconstruction, and may be performed in an emergency facility or later on. These treatments also focus on restoring function to the burned skin to reduce the risk of complications such as loss of mobility or a loss of one of the senses.
    Acute Burn Care

    Any type of burn on the skin requires immediate medical attention to stabilize the patient, clean the wound and reduce the risk of complications such as infection, scarring, breathing problems and limited bone and joint mobility. Initial burn care focuses on assessing and treating the initial burn symptoms, prevents infections and other potential further risks. Additional treatment may be required at a later time for skin reconstruction. It is also important for patients to remain hydrated after a burn, so fluids may be administered intravenously to prevent dehydration.

    Comprehensive burn care that includes an evaluation of:
    • the burn and any related conditions
    • thorough wound care
    • proper dressing
    • pain mitigation through medications
    • emergency surgery as may be required.
    Burn Scars

    Most burns will usually leave a scar,The appearance of the scar depends on the size, location and severity of the burn. Scars usually become less noticeable over time, however when they scar is obvious patients seek reconstructive treatment to improve their appearance of scars that are physically unattractive or disfiguring. Reconstructive procedures are most often performed after the burn has fully healed, which may be nine months to a year after the original injury.

    Scar reconstruction is usually performed through an outpatient surgical procedure that may involve skin and tissue grafts, skin flaps or injectable fillers to restore a more natural appearance, while also correcting any functional problems caused by the scar and improving the patient’s self-confidence as well.

    Contractures

    A contracture is a complication of burn scarring that involves a tightening and thickening of the burn scar that in turn restricts movement of the affected area. It is important for patients to take precautions to prevent contractures from occurring, by exercising, wearing a splint and continuing to promote everyday activities that require movement.

    Treatment for contracture scars often involves surgery to release the contracture and restore normal movement to the skin. A skin flap or graft may be used to restore the appearance of the skin in the treated area, while also improving movement and flexibility that may have been affected by the contracture. Physical therapy will often be needed after surgery to stretch the joints and restore movement and function.

    Scar Revision from Breast Augmentation

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    All surgeries are going to leave a scar. The leading cosmetic surgeons who specialize in breast augmentation are good at reducing the visibility of the scar. The very best surgeons make sure only very close scrutiny reveal the signature of their work. The techniques for revising scars very and are applied as the surgeon deems best for the patient and their particular case. Often women undergo more than one breast implant surgery. If a woman has suffered from a poor elective procedure the top cosmetic doctors can redo the surgery and also revise the scarring in the same procedure.

    Do breast implants last a lifetime? Women considering breast augmentation ask this question frequently. Breast implants are not made with an expiration date, so you should be able to enjoy the results for many years. However, unexpected issues occur for a certain number of patients. If you think you’re experiencing a problem with your breast implants, call us to schedule a consultation and Dr. Hess will see you as soon as possible.

    Reasons for Revision Breast Augmentation
    Problems that occur after breast implant surgery. Most often they are corrected with a brief revision surgery. Of course, Some of the reasons women seek revision of breast augmentation are :

  • Breast implant rippling
  • Volume adjustment of saline implants
  • Scar revision procedure
  • Change in implant size preferences
  • Switch from saline to silicone implants
  • Areola size reduction
  • Noticeable breast asymmetry
  • Symmastia
  • Nipple ptosis or sagging
  • Breast implant displacement
  • Breast implant rupture
  • Nipple malposition
  • Scar tissue surrounding implant
  • High riding implants

    • Facts about Common Types of Scars

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    Scarring is part of living

    Accidents, surgery, skin disease, burns, acne, and infection are things that are common to the human experience. All of these often leave some type of scarring on a person to varying degrees. It is unlikely that and person living to the edge of five years is without some type of scarring. The skin is the largest organ system of the body and provides us with amazing protection that allows humans an advantage over other mammals on the planet. However it is greatly associated with our personal self image and sometimes scarring has adverse emotional effects.

    Below are common types of scars that occur:

    Flat, Pale Scars – are the most common type of scar.
    They occur as a result of the body’s innate healing process. Initially, they may be red or dark and raised. After the wound heals they often become paler and flatter over time. The final appearance being in a flat, pale scar that can be nearly unoticeble. This process can take up to two years and there will always be some visible evidence of the original wound.

    Hypertrophic Scars – Red or Dark and Raised
    Hypertrophic scars are more common in the young and people with darker skin. Some people have an inherited tendency to this type of scarring. It is not possible to completely prevent hypertrophic scars. It is important to record this tendency as part of one’s medical history. Some scar therapies are available that may speed up the process of change from a hypertrophic scar to a flatter, paler one.

    The body produces new collagen fibers at a rate which balances the breakdown of old collagen. Hypertrophic scars do this in abundance. These scars are red and thick and may be itchy or painful. They do not extend beyond the boundary of the original wound but may continue to thicken for up to 6 months. Sometimes they improve over the next one to two years. Some people complain because these types of scars can cause distress due to their appearance or the intensity of the itching. Depending on their location on the body they can restrict movement.

    Keloid Scars – Red or Dark and Raised
    As in hypertrophic scars, keloids are the result of an imbalance in the production of collagen in a healing wound. Unlike hypertrophic scars, keloids grow beyond the boundary of the original wound and can continue to grow indefinitely. They can also be itchy or painful and in a number of instance not improve in appearance over time.

    Keloid scars can result from any type of injury to the skin, including scratches, injections, insect bites and tattoos. Anybody can get a keloid scar and they can occur anywhere on the body. However, the young and people with darker skin are more prone to this type of scarring and they are more common on certain parts of the body e.g. ears, chest, shoulders and back.

    As with hypertrophic scarring, people who have developed one keloid scar are likely to be prone to this condition in the future and should alert their doctor or surgeon if they are likely to need injections or to have any form of surgery.

    Sunken Scars – are recessed into the skin.

    They may be due to the skin being attached to deeper structures (such as muscles) or to loss of underlying fat. They are usually the result of an injury.

    Acne & Chicken Pox Scars
    A common cause of sunken scarring is acne or chicken pox which can result in a pitted appearance. However, it is important to note that acne scarring is not always sunken in appearance and can even become keloid.

    Stretched Scars
    Stretched scars occur when the skin around a healing wound is put under tension during the healing process. This type of scarring may follow injury or surgery. Initially, the scar may appear normal but can widen and thin over a period of weeks or months. This can occur where the skin is close to a joint and is stretched during movement or may be due to poor healing due to general ill health or malnutrition.

    Stretch Marks
    Stretch marks develop when the skin is stretched rapidly, for example during pregnancy or the adolescent growth spurt. Initially, stretch marks appear red but become paler over a number of years.