Scar Revision - PrudENT Rhinoplasty and Facial Cosmetic Surgery
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      Treatment of Acne Scars

      Scar Revision

      TREATMENT OF ACNE SCARS The procedure for treating acne scars can vary depending on the type of treatment chosen, the kind of acne scars, their severity, and the client’s skin type among other factors. WHAT ARE THE VARIUOS TYPES OF ACNE SCARS? Acne scars come in different types and severities, which require varied treatment approaches. Here are some common types of acne scars: ICE PICK SCARS These are deep, very narrow scars that extend into the dermis. They look like a small hole or indent in the skin. BOXCAR SCARS These are wide, U-shaped scars with sharp edges. They can be shallow or deep. ROLLING SCARS These are wide depressions that typically have rounded edges and an irregular, rolling appearance. KELOID OR HYPERTROPHIC SCARS These are raised scars that stand above the surface of the surrounding skin. HOW DO I PREVENT/MINIMIZE ACNE SCARS? Preventing acne scars starts with effective acne management and proper skincare. Here’s how you can reduce the risk of developing scars: PREVENTING ACNE Consult a Dermatologist: The first step in preventing scars is to effectively treat acne. Our team works closely with qualified dermatologists who can recommend a regimen suitable for your skin type. Topical Treatments: Treatments like benzoyl peroxide, salicylic acid, or topical retinoids can be effective for mild acne. Prescription Medications: For more severe cases, medications like antibiotics or isotretinoin may be prescribed. Hormonal Treatments: Oral contraceptives can sometimes help regulate hormones that trigger acne, particularly in women. PROPER SKINCARE Gentle Cleansing: Use a mild cleanser and avoid scrubbing your face, which can irritate the skin and exacerbate acne. Moisturizing: Even acne-prone skin needs hydration. Opt for oil-free, non-comedogenic moisturizers. Sun Protection: Use a broad-spectrum SPF of at least 30 daily, as UV radiation can darken scars and hinder the healing process. IMMEDIATE CARE FOR ACNE Don’t Pick or Squeeze: Resist the urge to pick or pop acne, as this can push bacteria deeper and spread it to other areas. Ice Application: Applying ice to inflamed acne can reduce redness and swelling, which may minimize scarring. Spot Treatment: Apply a spot treatment containing benzoyl peroxide or salicylic acid to help reduce inflammation. TREAT ACTIVE ACNE QUICKLY Early Intervention: The quicker you address acne, the less chance it will form scars. Intralesional Injections: For large cysts or nodules, a quick intervention like an injection of corticosteroid can reduce inflammation rapidly, thus preventing scarring. POST-ACNE CARE Silicone Gel: This can help in the wound healing process and reduce the risk of raised scars. Vitamin C Serum: May help in collagen production and scar fading. Retinoids: Helps in skin cell turnover and can prevent the formation of depressed scars. REGULAR CHECK-UPS Follow-ups: To monitor your progress and make necessary adjustments to your treatment regimen. Consult our team for a comprehensive approach to acne management, tailored to your specific needs, and thus prevent scarring. TREATMENT OF ACNE SCARS INITIAL CONSULTATION The first step is a thorough consultation with Dr Sandeep to assess the type and severity of the scars. Dr Sandeep will take a detailed history of onset and progression of acne, previous treatments and their effectiveness, clients concern, and their aesthetic goals. A thorough skin examination will then follow to determine the extent of acne, its nature as well as sequelae like scarring. TREATMENT PLANNING A tailored treatment plan is developed for each client based on the type of their acne scars, which could include one or multiple types of treatments detailed below. Topical Treatments Application of creams, gels, or ointments containing retinoids, vitamin C, or other skin-rejuvenating compounds. Usually, daily application for several weeks or months. Chemical Peels A chemical solution is applied to the skin, causing it to “peel” and make way for new skin. May require multiple sessions. Dermal Fillers Fillers like hyaluronic acid are injected into the scarred area to elevate depressed scars. Results are usually immediate but may be temporary. Micro needling A device with fine needles creates tiny punctures in the top layer of the skin, which triggers the body to create new collagen and elastin. Multiple sessions are often required. Laser Resurfacing High-energy light is used to remove damaged skin cells, stimulating the skin to heal with a smoother surface. Can require downtime for recovery. Punch Excision and Grafting Punch excision and skin grafting are surgical techniques often employed to treat deep acne scars like ice pick and boxcar scars. The scarred tissue is excised, and the area is sutured or filled with a skin graft. Subcision A needle is used to break up the fibrous bands that are pulling the skin downwards, freeing the top layer of skin to elevate. Usually followed by other treatments like fillers or micro needling for optimal results. Dermabrasion A high-speed rotary instrument with an abrasive wheel or brush is used to remove the outer layers of skin. Dr Sandeep controls the depth of abrasion based on the scar’s severity. The treated area is covered with a moist dressing or ointment. POST-TREATMENT CARE Aftercare Instructions Clients are usually given a set of aftercare instructions to minimize side effects and speed up recovery. Follow-up Appointments Regular follow-up appointments will be scheduled to assess the effectiveness of the treatment and make any necessary adjustments. Maintenance Treatments Depending on the treatment and the severity of the scarring, ongoing maintenance treatments may be recommended. Outcome Evaluation The effectiveness of the treatment is evaluated, often through before-and-after photos and client feedback. Adjustments The treatment plan may be adjusted based on the results and any side effects experienced. WHAT ARE THE TREATMENT OPTIONS FOR SPECIFIC ACNE SCARS? ICE PICK SCARS Punch Excision and Skin grafting This involves cutting out the scar and stitching or grafting the skin. TCA Cross Application of Trichloroacetic Acid (TCA) to stimulate collagen production. BOXCAR SCARS Dermabrasion A high-speed brush or other instrument is used to resurface the skin and improve the contour of the scar. Laser Resurfacing High-energy light is used to remove or remodel the damaged skin. ROLLING SCARS Subcision A needle is inserted

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      Facial Scar Refinement

      Facial Scar Refinement, Scar Revision

      FACIAL SCAR REFINEMENT WHY ARE SOME SCARS MORE VISIBLE? Here are some of the key reasons why facial scars may be more noticeable: LOCATION Centre of Attention: The face is the focal point of most social interactions, so any scarring is likely to be noticed. Mobile Area: Facial skin is constantly moving due to talking, eating, and expressions, which might affect how a scar heals and make it more visible. Relaxed Skin Tension Lines: Incisions or wounds that are not aligned along RSTL’s tend to heal poorly because there is more tension pulling the wound edges apart. This usually results in a wider and more noticeable scar. SIZE OF THE SCAR The eye can easily catch a long and straight scar, making them more noticeable. SKIN COLOUR AND TEXTURE Hyperpigmentation: Darkening of the scar tissue can make it stand out against lighter skin. Hypopigmentation: Scars may lose pigment and appear lighter than the surrounding skin, making them more noticeable. Texture Differences: Raised (keloids, hypertrophic), depressed or indented (atrophic) scars have a texture different from normal skin, making them easier to spot. HEALING FACTORS Blood Supply: The face has an extensive blood supply, which can aid in better healing. However, any disruption to the blood supply may contribute to more noticeable scarring. Inflammation: Prolonged inflammation during the healing process can lead to more visible scars. Sun Exposure: UV rays can darken the healing tissue and make scars more noticeable. Environmental Factors: Exposure to wind, cold, and dry air can affect the healing process and the scar’s final appearance. Skin Type: The oiliness or dryness of your skin can influence how a scar heals and its eventual appearance. Genetic Predisposition: Some individuals are genetically more prone to form noticeable scars, such as keloids. PSYCHOLOGICAL FACTORS Self-Perception: How one perceives their own scars can magnify their apparent visibility. SCAR REVISION Scar revision techniques aim to improve the appearance, texture, and function of scars. The appropriate treatment may vary depending on the type, size, and location of the scar, as well as the individual’s skin type, age, and overall health. Here’s a detailed look at some of the common scar revision options: SURGICAL TREATMENTS EXCISIONAL SURGERY Dr Sandeep removes the scar tissue and closes the incision, aiming for a less noticeable scar. Z-PLASTY This technique reorients the scar so that it aligns more closely with natural skin lines, making it less visible. It may also be used to treat a contracted scar. W-PLASTY Similar to Z-Plasty but involves multiple small incisions for a zig-zag pattern to break up the linear appearance of the scar. GEOMETRIC BROKEN LINE CLOSURE Scars that are oriented perpendicular to the relaxed skin tension lines of the face are often treated with this technique which converts a linear scar into an irregularly irregular scar, thus making it less noticeable. SKIN FLAPS A flap of healthy skin is lifted from an adjacent area and used to cover the scarred region. SKIN GRAFTS Skin is harvested from another part of the body (usually a hidden area) and transplanted to the scar area. MINIMALLY INVASIVE PROCEDURES LASER THERAPY High-energy light is used to resurface the skin, which can improve the appearance and texture of scars. This therapy is often used to help in achieving better scars after all kinds of surgery at our centre. DERMABRASION A rotating instrument like a diamond burr is used to remove the upper layers of skin to make the scar less visible. MICRODERMABRASION Similar to dermabrasion but less invasive, this technique removes only a very superficial layer of skin. MICRO NEEDLING Fine needles are used to puncture the skin, stimulating collagen production. CHEMICAL PEELS Chemicals are used to remove the upper layer of skin, which can help reduce the appearance of superficial scars. FILLER INJECTIONS For atrophic or indented scars, injectable fillers can be used to elevate the scar to the level of surrounding skin. TOPICAL TREATMENTS SILICONE GEL AND SHEETS These are applied to the scar to hydrate the skin, which may help in reducing the scar’s appearance. STEROID CREAMS These can help to soften and flatten hypertrophic and keloid scars and reduce pigmentation caused by inflammation. BLEACHING AGENTS For scars that have hyperpigmentation, bleaching agents like hydroquinone can be applied. STEROID INJECTIONS Intralesional steroid injections can be effective for hypertrophic and keloid scars, helping to reduce redness, itching, and elevation. SCAR REVISION PROCEDURE Scar revision is a surgical procedure aimed at improving the appearance, texture, or function of a scar. The specific method employed can vary depending on the type, size, and location of the scar, as well as the client’s age, health, and personal preferences. Here is a general outline of what a scar revision procedure may involve: PRELIMINARY CONSULTATION Initial Assessment: Dr Sandeep will evaluate the scar’s type, size, and location, along with your skin type and overall health. Photographs will be taken for documentation. Treatment Plan: Different options for scar revision will be discussed, including surgical and non-surgical methods, to determine the most appropriate treatment for you. PRE-TREATMENT PREPARATIONS Medical Tests: Blood tests and other preoperative evaluations may be conducted. Avoid Certain Medications: Stop taking medications or supplements that can affect bleeding, such as aspirin, ibuprofen, and certain herbal supplements. No Smoking: Smoking can impair wound healing, so it’s advised to quit several weeks before the procedure. Hydration and Nutrition: Maintain good hydration and nutrition to aid in the healing process. DAY OF PROCEDURE Anaesthesia: Depending on the complexity of the procedure, local, regional, or general anaesthesia may be administered. Incision and Revision: Various techniques may be used, including excision, skin grafts, or flap surgery, to improve the appearance of the scar. Closure: The incision is closed with sutures, staples, or adhesive, depending on the specific procedure. Dressings: Sterile dressings are applied to the treated area. AFTERCARE FOLLOWING THE PROCEDURE Immediate Aftercare Pain Management: Follow the prescribed pain medication regimen to manage post-operative discomfort. Dressings: Keep the surgical site clean and protected with the dressings as advised by your healthcare provider. Instructions

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