SECOND QUARTER 2006, VOLUME 20, NUMBER 2

Worried about your dermal imperfections? We may be able to help you

IN THIS ISSUE

Spring Ahead with a Rejuvenated You

Worried about your dermal imperfections? We may be able to help

Ask the Surgeon / Health Tip / What’s New

Little or lot: How can you restore your hair to fullness?

Everyone would like to enjoy glowing, flawless skin. The reality is that most of us have to deal with dermal imperfections. Peruse these common skin conditions to see what your facial plastic surgeon recommends to improve your appearance.

Dull skin
Restore the glow of your youth by following a simple skincare routine. This will help you reap the benefits now and for years to come.

(1) Wash your face twice a day with a mild soap. Avoid dyes and perfumes. Rinse thoroughly and pat dry.

(2) Apply a water-based moisturizer with a sun protection factor (SPF) of 15 after cleansing.
(3) Make an effort to protect your skin. If your moisturizer or foundation does not provide sun protection, then you need to apply sunscreen or sunblock before venturing outside. Shade your face with a wide-brim hat and refrain from smoking, which inhibits blood circulation and increases wrinkling.

Blemishes
If you are self-conscious about a blemish, there are treatment options available to make you more comfortable in your own skin. Vascular blemishes, hemangiomas, are made up of blood vessels clustered together in the skin and can be flat, raised, pink, red, or bluish in color. In order to control growth, steroids may be injected or given by mouth. Long-term or repeated treatment may be necessary. Lasers may also be a consideration for removal or to control the growth. For example, spider veins of the face are successfully treated with a laser.

Pigmented blemishes, i.e., moles, café au lait spots, and lentigines, are composed of abnormal clusters of pigmented cells usually tan or brown in color. Surgical removal of the lesion is the preferred treatment in cases where it may be malignant. Laser surgery, surgical scraping, and cryotherapy (freezing) are not permanent solutions; the lesion will reappear eventually. Ask your physician to evaluate the blemish to determine what options might work for you.

Scars
Different scars require different treatments. For example, severe burns that destroy large sections of skin cause the skin to heal in a puckered way. As the skin heals, muscles and tendons may be affected in this “contracting” movement. These contractures are usually revised by cutting out the scar and replacing it with a skin graft or a flap, thus releasing the pulling on the skin.

Keloid scars are a result of the skin’s overproduction of collagen after a wound has healed and often grows beyond the margins of the original wound. The scar is a thick, protrusive mound of scar tissue, often red or darker in color than surrounding skin. Injecting steroid medication directly into the scar tissue will reduce redness, itching, and burning. The steroid also stops collagen production, which may allow the scar to flatten and fade over time. If more revision is necessary, the scar tissue can also be excised and closed with one or more layers of stitches.

Hypertrophic scars are thick, red, and raised, however, unlike keloids, the scar remains within the boundaries of the original incision or wound. Topical applications or steroid injections may improve the appearance of the scar. Dermabrasion and laser resurfacing can be used to remove the top layers of the scar, making it less pronounced. Surgically, the incision can be repositioned so it heals in a less visible pattern; this does not remove the scar.

Scar revision surgery made this woman’s scarring from a car accident barely noticeable. Before and after photos courtesy of The Face Book, published by the American Academy of Facial Plastic and Reconstructive Surgery.

Sun Damage
If you have been exposing your skin to ultraviolet radiation from the sun, skin cells have been destroyed. Over time, this leads to wrinkles, a weathered look, and a higher risk of skin cancer. Chemical peel or microdermabra-sion remove the tired, damaged layers, allowing a fresh new layer of skin to emerge. For more extensive rejuvenation, consider a facelift, which focuses on the lower two-thirds of your face. The aging face is revamped by removing accumulated fat, resupporting muscles that have stretched, and removing excess skin.

Crow’s Feet
Botulinum toxin, BOTOX®, is used in your facial plastic surgeon’s office as a wrinkle reducer. A small amount is injected under the skin to paralyze the muscles in the face that pull the skin and cause wrinkles. BOTOX can weaken muscles in the forehead and around the eyes. This means that BOTOX is a great option for reducing the appearance of crow’s feet. The procedure is minimally invasive, so there is no need for sedation or local anesthetic. After treatment, the overlying skin remains smooth and unwrinkled from three to six months.

Injectable fillers, or soft-tissue fillers, can be used to plump up the skin around the eyes. There are various options available depending on how long you want the results to last and what you can afford. Collagen requires allergy testing and lasts three to five months. Naturally modified hyaluronic acid fillers (Captique™, Restylane®, Hylaform®, and Hylaform Plus®) last typically six months. Autologous fat extracted from the patient’s own body lasts from three to six months. Radiance™ is an injectable filler that can last up to two years. Artecoll® is a permanent treatment that is pending approval by the U.S. Food and Drug Administration (FDA). Research these options and discuss your optimum plan with your facial plastic surgeon.