Toronto Rhinoplasty Surgeon – Otolaryngologist Head and Neck Surgeon
Surgical scar revision can change the size of a scar, raise depressed scars or lower elevated scars. Scar revision improves the appearance of a scar while leaving another – though less obvious – scar in its place. Scar revision can also be achieved with laser resurfacing and the injection of steroid medications.
Acne Scar Treatment
More than 80% of the population is affected to some degree during their teen years and twenties with a skin condition called acne. For most, it will be a somewhat distressing temporary condition that leaves no significant lasting effects. For others, acne can result in scarring that is disfiguring and affects self image in a negative way for the rest of their lives.
Though there are a variety of topical products that may somewhat improve mild scarring, most acne scars require treatment with laser skin resurfacing, injectable fillers, and/or surgical procedures. Most of these treatments provide long-lasting or permanent smoothing out and lightening of the acne scar. Some treatments also even control future breakouts.
Treatment of acne scarring is often dependent on the size, shape and depth of the scar since some treatments are more effective on certain types of scarring. Accutane use, though very effective in controlling active outbreaks, can be detrimental to many treatments for scarring and should be discussed with your doctor prior to treatment
Until recently, dermabrasion and dermaplaning have been the most common and effective method of skin resurfacing treatment for acne scars. Dermabrasion uses a rotating abrasive wheel to remove the top layer of damaged skin, allowing new skin to grow. The technique takes about an hour and downtime is about two weeks.
However, with the introduction of fractional resurfacing technology such as the new Ultrapulse Fractionated CO2 Laser and Fraxel®, dermabrasion may become less common. Laser skin resurfacing takes less time and allows penetration of the skin layers to be more controlled than in dermabrasion. Because only small “fractions” of the skin’s surface are treated, laser resurfacing results in less downtime and an easier recovery. Results from treatment with the Ultrapulse are dramatic and immediate, often requiring only one to two appointments. The Fraxel laser treatments may take up to six visits to achieve desired results.
Another mode of treatment for acne scarring is injectable therapy. This method involves injecting material such as collagen, fat, hyaluronic acid derivatives, or polymethylmethacrylate (PMMA) microspheres combined with collagen under the scar to plump up the surface to the level of the skin around the scar.
Artecoll® is one product used for treatment that offers permanent improvement in acne scars. Usually only requiring one implant injection, Artecoll uses PMMA microspheres suspended in collagen to plump the scarred area. The formula contains a trace of anesthetic to minimize any discomfort from the injection. The results are not fully seen until about three months after the procedure, but the effects are the longest lasting of any of the injectables.
More temporary results can be achieved with hylaform viscoelastic gels like Restylane®, Perlane®, and Juvederm™ made from natural materials that fill in the scar depression. Though this treatment needs to be repeated to maintain the desired effect, the procedure is simple with little discomfort and the results are immediate.
Fat grafting or fat transfer uses your own body fat that is taken from another part of your body (thighs, for instance) to fill in the scar. The fat is concentrated and then injected into the depression to plump the area. The procedure involves little discomfort, though for longer-lasting results, patients will probably need three to four treatments over the course of several months.
Punch techniques are minimally-invasive surgical procedures that can be highly effective in improving the appearance of acne scarring. There are three types of punch excision and they all use a punch biopsy tool to correct deep acne scars.
Punch excision removes the base of the scar, and the skin is then closed with sutures and allowed to heal. Punch elevation uses the punch tool to remove the base of the scar which is then sutured to the surrounding skin. Punch replacement involves the removal of the scarred skin which is then replaced with a skin graft (most commonly from behind the ear).
These punch techniques are often combined with laser resurfacing to even out the surface and tone of the skin and are highly effective in improving the appearance of the skin.
For some scars, a surgical procedure that will detach the scar from deeper connective tissue may be required. This procedure is called subcision and usually requires one to three treatments. Bruising and swelling may last up to two weeks. This acne scar treatment is also usually combined with laser resurfacing for optimal results.
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