What is Laser Scar Removal?

Scars are the way the body naturally repairs the skin from an injury, burn, bite, acne or surgery. While everyone wants the healing, nobody wants the scars. Laser scar removal uses laser technology to improve or minimize the appearance of a scar. There are various lasers available to treat a wide range of skin and scar types. A plastic surgeon, or certified dermatologist who specializes in laser scar removal, can help you determine which type of scar treatment is best for you.

Scar removal by laser

Types of Laser Treatments

Laser Resurfacing involves using a high-powered laser to minimize the appearance of the scar by removing the top layers of skin. The procedure can be performed as an outpatient procedure in a skin laser clinic or doctor’s office and only takes between 1 and 2 hours. A local anesthetic numbs the area and goggles will be placed over the eyes to protect them from the bright light. During the procedure, the doctor will move the hand-held laser wand over the scar to remove the damaged skin cells. Each pass of the laser eradicates more cells. As the laser penetrates the scar, it also reaches the middle layers of skin and can provide smoother, tighter skin.

The doctor may choose between two skin resurfacing lasers and they are the CO2 laser or the Erbium: YAG laser. Both lasers work well for most scars including acne scars.

  • The CO2 laser is more powerful than the Erbium: YAG laser and can penetrate far deeper into the skin. This type of laser is best for removing thick and deep scars. The procedure can be slightly more painful and the recovery time is a little longer at about 2 weeks.
  • Erbium: YAG laser is often used to treat shallow scars. Since it is not as powerful as the CO2 laser, there is less sedation needed and less pain. Furthermore, the recovery time is also minimized at about 1 week.

Fractionated laser resurfacing uses tiny beams of light which penetrate deep into the skin. The laser causes microscopic holes where the damaged skin cells used to be. These holes stimulate collagen production and the creation of fresh, new skin cells. This type of laser allows for a quicker recovery since the surrounding skin is left unharmed. Because it is a less invasive technique, this type of procedure only requires topical anesthetic. Plus, there is little to no recovery time. On the other hand, fractionated laser resurfacing cannot produce the same immediate results that laser resurfacing can provide. Therefore, additional procedures will be needed for best results. You may need 3 to 5 sessions at one week apart.

Non-ablative laser resurfacing involves using infrared lasers to heat the inner layers of skin to encourage collagen production and produce fresh skin cells to replace the damaged cells on the scar. The heat from the procedure can be slightly painful, as the laser moves across the scar, but a cooling spray will be released with each pass. This cooling spray prevents any damage to the surface of the skin. This type of laser treatment can be done in a doctor’s office and only takes about 15 to 30 minutes per treatment. However, you may need 4 to 6 sessions to benefit from this type of laser and it can take months before you see the results.

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How To Avoid Scars

Unless you cloak yourself in bubble wrap and tape yourself to the couch, you will end up with a scar at some point. Precautions, such as wearing gloves when working in the garden or protective gear when bicycling, can help to circumvent scrapes and cuts which lead to scarring. It is strange to think that scarring is not supposed to be a bad thing. Scar tissue is the body’s way of healing itself after surgery or an injury but nobody is pleased to see a scar form. Scars that are raised, red, itchy or wide may need a form of scar revision to minimize their appearance. However, the best way to avoid a scar is to treat the wound properly. While a doctor will establish proper wound care for a surgical scar, here are some tips to help you avoid scar development:

  • Cleanse the Wound

Wound Care to Avoid ScarsIt is very important to keep the wound properly cleansed. Gently wash the wound with a mild soap and lukewarm water to get rid of germs and remove debris. If dirt and particles remain in the wound after a thorough washing, use tweezers to carefully remove them. Be sure to clean the tweezers with alcohol before removing the fragments. A wound that is clean will heal quicker, neater and is less likely to develop into a scar than one that becomes infected. Hydrogen peroxide and rubbing alcohol are not recommended since alcohol can be irritating to damaged skin and hydrogen peroxide destroys white blood cells needed to repair the wound.

  • Keep the Wound Moist

While some people say to let the wound have air so it can scab over, scabs are not our friends. Scabs allow scarring to occur so keeping the wound moist and covered is a better way to avoid scars. Moisture prevents a hard scab from being able to form since it slows the development of new tissue but it does allow cells to regenerate faster. If the wound is properly cleansed, don’t grab Neosporin or other ointments since they can impede wound cleansing. Instead, apply petroleum jelly to the wound and a bandage. Keeping the wound moist with petroleum jelly can keep the scar from becoming too large, deep or itchy. If a scab does form, do not pick at it. Otherwise, you are likely to get a worse scar.

  • Cover it Up

Research has shown that keeping a bandage on a wound speeds healing by as much as 50%. Cleanse the area, reapply ointment and change the bandage daily to keep the wound clean and free of infection as it heals. Anyone who has sensitive skin can use a non-adhesive gauze pad and paper tape. A large cut should be examined by a doctor to determine whether stitches are needed. However, you may be able to close small cuts or gaps with a butterfly bandage. Butterfly bandages can help keep a fresh wound closed for better healing and minimal scarring. These bandages can be found at most drugstores.

  • Consider Silicone Gel

If you have large scrapes, burns, sores or persistent redness, you may want to consider using silicone gel sheets or hydrogel. Silicone gel sheets can help to promote healing while minimizing scar formation. Silicone gel sheets can also be used after a scar has already formed. They can help to flatten raised scars and tone down redness and/or itchiness. Follow the directions on the package or the advice of a doctor for changing the gel sheet.

  • Eat Healthy and Exercise

Eating a balanced diet and getting exercise can help ward off scars. While protein and vitamins are essential to the body, getting adequate zinc is especially important for wound healing. Grab some roasted pumpkin seeds, sunflower seeds, peanuts, Brazil nuts, lean beef or dark-meat turkey to help avoid scarring. Exercise can speed the healing process because exercise increases circulation and regulates the immune system and hormones that influence the healing process.

  • Apply Sunscreen Religiously

Once the wound has healed, frequently apply a broad-spectrum sunscreen whenever going outside. The sunscreen should be a SPF of 30 or more since scars are very vulnerable to sunburns. Scar tissue lacks the ability to develop a tan since it has less pigment than the surrounding skin. Furthermore, UV rays are known to slow healing since they interfere with new collagen production. Sunscreen may help to decrease red or brown discoloration and help the scar fade at a quicker rate.

Scar Tissue after Surgery

People often wonder what their scar is going to look like after surgery. Surgeons can give a general idea of the size, color and appearance of the scar but each person heals differently. According to the National Institutes of Health (NIH), scar tissue is usually thicker than the surrounding skin as well as pink or red in color. However, the appearance of a scar largely depends on the size and depth of the wound. Also, the age of the patient, location of the wound and the time it takes for the wound to heal are all aspects which can influence the look of the scar.

Understanding Scar Tissue

After Surgery ScarsAfter surgery, the body uses its ability to create scar tissue to heal the new wound. However, excess scar tissue beneath the skin can be troubling even after the wound has healed. The tough, fibrous tissue can cause pain and significantly reduce function or range of motion. This decrease in function may transpire due to the direction of the incision and/or the depth of the wound.

For example, bend and straighten the elbow. The folds that form in the skin are known as Langer’s lines. These lines characterize the direction and orientation of the collagen fibers. While making an incision parallel with the Langer lines can happen in some cases, it is not always possible. This is because most surgeries involve cutting into multiple layers of the anatomy. Each layer that is severed must be repaired. As the collagen fibers begin to rebuild, they tend to be erratic and can cause a tightening which can impede some functions. Likewise, surgery on the knees, wrists, shoulder or ankles is often meant to improve movement and function but scar tissue that forms around the joints can create the opposite effect. Frozen shoulder, a condition some patients experience after surgery, is a buildup of scar tissue around the shoulder joints that can cause irritation and inflammation. This can lead to post-surgical pain and impair the range of motion.

Abdominal and Pelvic Adhesions

Abdominal incisions, such as when a person has their appendix removed, can cause abdominal adhesions. Adhesions are bands of tissue which form between the abdominal tissues and the organs. These bands often cause the usual slippery internal tissues and organs to stick together. This can lead to a twisting and pulling of the small or large intestines which create bowel obstruction and chronic pain. Likewise, pelvic adhesions can form after gynecological surgery and cause pain and infertility in some cases. Using certain surgical techniques, such as creating adhesion barriers, can help reduce these pelvic adhesions. Therefore, patients are encouraged to ask their surgeon how they plan to minimize the risk of adhesions.

Scar Prevention and Treatment

Prior to any surgery, patients should ask how much scarring is expected and what type of preventative treatment is recommended. Anytime the patient is undergoing a procedure that involves surgically manipulating a joint area, the surgeon will recommend moving the joints immediately after surgery. This improves function and also helps to prevent excess scar tissue from forming. Patients are always advised to follow post-surgical recommendations and perform targeted exercises to help stretch the skin and guide joints back into the proper position. Massage therapy and ultrasound therapy may also be used to help soften scars and maintain motion after surgery. Although these scar prevention treatments can help to eliminate an accumulation of scar tissue in many patients, some people still develop debilitating scar tissue. Nevertheless, there are numerous scar treatment options which can improve or lessen the appearance of scars and help patients regain motion.

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Benefits of Microdermabrasion

Microdermabrasion is a popular dermatology skin care treatment that is often overlooked since many people do not really know what it is. Microdermabrasion is a non-chemical and non-invasive exfoliating procedure, which uses a handheld device to gently remove the top layer of skin. The treatment does not require recovery or downtime on the part of the patient. The device is made up of superfine crystals, which scratch the surface of the skin. A suction process is then used to immediately remove the dead skin cells and crystals. The process minimizes facial blemishes and fine lines while causing the body to produce new cells. The end result is healthy and more youthful looking skin.

How Microdermabrasion Benefits Patients

MIcrodermabrasionMicrodermabrasion is for all skin types and can benefit a person who has:

  • Fine lines
  • Wrinkles
  • Age spots
  • Clogged pores

It can also minimize acne scars and improve oily or dull skin through the process of gentle exfoliation.

Since the skin is not wounded or abraded below the epidermis, the treatment is painless and no anesthesia is needed. Although microdermabrasion does not abrade the lower levels of skin, it can help promote healthier internal skin by enhancing the circulation. According to the American Society of Plastic Surgeons, patients will only feel a scratching or mild stinging during microdermabrasion. There is no need to take time off work since recovery time is not necessary. Since microdermabrasion can be completed in as little as 30 minutes, it is often called a “lunchtime facial”. However, patients may need several sessions to gain the desired outcome. The skin may appear pink and slightly swollen but these side effects generally subside in one day. Nevertheless, a dermatologist will apply a moisturizer after the treatment and recommend a sun protection plan since the new layer of skin will be subject to burns.

DIY Microdermabrasion

Patients that dislike the sensation of the microdermabrasion device, or those who want to gain results at home, may benefit from a manual microdermabrasion product. Pumice Peel can be used at home or in a spa setting to buff away fine lines and dullness and to improve the condition of the pores with ultra-fine pumice crystals. Pumice crystals are known to naturally exfoliate and smooth the skin. Pumice peel contains hydrogenated polydecene, vitamin E and vitamin C for hydrating and brightening the skin. While performing the treatment at home is convenient, patients may not get sufficient results with home kits. To get optimal results, and to avoid potential complications, it is best to seek the services of a qualified medical professional for microdermabrasion.

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Are Scar-less Wounds Possible In The Future?

No Scar Incision

Have you ever stopped to think about how miraculous the human body really is? Each component in the body works in different ways to heal itself, sustain functionality and maintain its own lifecycle. The skin can heal the most horrific wounds leaving only scar tissue after it heals. Although it is effective mechanism, scar tissue is not visually appealing. Luckily, the possibility of scar-less wounds is making headlines thanks to to a recent study by The Perelman School of Medicine at the University of Pennsylvania

The University conducted a study using mice and human skin samples to do what was previously believed to be impossible. The team of scientists is confident that they discovered a means that allows skin to regenerate using fat cells. “Essentially, we can manipulate wound healing so that it leads to skin regeneration rather than scarring,” stated George Cotsarelis, MD, the Milton Bixler Hartzell Professor of Dermatology at Penn and chief investigator of the project.

Adipocytes are fat cells which are normally found in the skin but are lost when wounds heal as scars. Consequently, the most common cells found in the tissue during wound healing are myofibroblasts which are thought to only create scar tissue. Researchers also know that scar tissue does not have any hair follicles which gives it an atypical appearance from healthy skin. The research team used these distinctive features as the foundation for their thesis to manipulate the myofibroblasts into fat cells that won’t cause scarring. “Typically, myofibroblasts were thought to be incapable of becoming a different type of cell,” Cotsarelis stated. He went on to add that “our work shows we have the ability to influence these cells and that they can be efficiently converted into adipocytes.”

During the study, the researchers found that they must influence the tissue to regenerate within a specific time period after the wound occurs. Otherwise, they lose the opportunity and a scar will form. To determine the window of opportunity, researchers had to discover where the signals were coming from. Eventually, they determined that Bone Morphogenetic Protein can instruct the myofibroblasts to convert into fat. They also found that the key is to regenerate hair follicles first and then the fat will regenerate in response to the signals from those follicles. In other words, the study showed that fat and hair develop separately but cannot develop independently. The hair follicles form first but the fat will not form without the new hairs. Converting the surrounding myofibroblasts by regenerating the hair follicles is crucial to creating fat cells. Once the new fat cells are formed, they are identical to the pre-existing fat cells. This discovery has opened the door to the possibility of scar-less wounds. Adipocyte loss, or fat loss, is a natural result of aging which results in saggy skin, gauntness and wrinkles. The loss of adipocytes is also a known side effect of certain medical conditions and treatments including HIV treatments.

The study is still in its earliest stages and was merely used to demonstrate proof of the concept. The experiment has not reached the point of successful hair follicle growth from a wound on a living human. Until then, doctors and patients can still use various types of scar treatments including injectable fillers, laser treatments and dermabrasion.

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Don’t Be Ashamed Of Your Scar

Be Proud of Your Scar

Everyone reacts differently to having a scar. Some people simply accept having a scar as part of their appearance while others work to find ways to treat or remove it. One thing everyone should realize is that there is no reason to be embarrassed about having a scar. The current hit song, “Scars To Your Beautiful,” addresses this very issue.

Don’t believe there is nothing to be ashamed of when it comes to having a scar? Here are 5 reasons you should not be ashamed of having a scar:

  1. The story they tell

Scars interest others and leave them wanting to know more about you. They are a daily reminder of your journey in life. The scar can be from an accident or even a birth mark scar you’ve had your entire life. Look at the scar as a way that your body shares your history with others.

  1. Scars can encourage others

Scars can raise awareness for a number of issues and causes. In fact, scars that are related to an illness can often give others the encouragement they need as they battle the same disease.

  1. They show the passage of time

Many scars tend to fade and change color as they heal. The appearance of your scar shows others how long you’ve had it as well as how far you’ve come in life since the scar first appeared.

  1. A scar can be educational to others

While you might not like to discuss the reason you have a scar, some people just can’t help asking questions about it. Talking about your scar can help others learn more about certain diseases or situations and even make them more open-minded.

  1. They make you unique

Scars can add character to your body as well as your personality. They make you just a little bit different than others and help you stand out in a crowd. Embrace your unique status and show others that you are someone to be noticed.

Treating Scar Formations

Scars and scar formation are some of the most commonly misunderstood medical concepts. If a person undergoes surgery, for cosmetic reasons or otherwise, having a scar is one of the things they should expect. Most patients assume if the operation was performed by a plastic surgeon, there won’t be any scarring. Scars always form but some surgeons are better than others at hiding them.

Scarring is the body’s way of healing itself after an injury. In fact, it is the final phase of the body’s wound healing process. A scar is a direct result of damage from accidents, burns, skin conditions, surgery and trauma. Something as simple as having piercings in your body can cause scars to form.

The body’s wound healing process comes in multiple stages. The first phase involves the sealing of the wound by blood clots to prevent further blood loss and infection. This is followed by a series of events that lead to the formation of collagen to actually repair and fully heal the wound. Wounds that are left to heal on their own produce scars that are a bit worse than those which are closed through stitches. It can take at least a year for a scar to completely heal. Once healed, a scar may appear as a fine line that is minimally visible or as a thick scar like hypertrophic scars and keloids.

Scars are treated using various methods. The choice of treatment depends on how thick and big the scar is. Small and soft scars are best managed by massaging them with moisturizer once or twice a day for a few minutes. The moisturizer should contain ingredients like vitamin E and cocoa butter for maximum results. Sun exposure must also be avoided as much as possible to keep the scars from turning dark. On the other hand, thicker and more extensive scars such as hypertrophic scars, keloids and burn scars can heal properly by using silicone gel sheets.

In recent years, steroids have also been prescribed as a treatment for scaring. Topical steroids alone, or in combination with other scar treatment products, have been proven to improve scar formation in some patients. Steroids administered through injections are said to be effective on hypertrophic scars and keloids. A series of injections is required when using steroids in intervals ranging from six to eight weeks. The most common side effect of injected steroids is the formation of a dent on the site where it is administered. Steroids may be combined with surgical excision especially in cases involving keloids. This combination treatment is usually effective although there is still a possibility for recurrence.

If the treatments listed above fail to produce any response, the patient may try a less common treatment option like radiation therapy. Stubborn keloids respond well to low-dose radiation following surgical treatment. Radiation therapy does raise some concerns due to the risk of long-term complications. Laser treatment is another option but the results vary and some patients find using lasers to be an ineffective treatment.

Scarring should be expected by a patient no matter what type of plastic surgery procedure they are having performed. The key to effectively managing the lasting effects of a scar is knowing how to treat and minimize the long-term effects of any scar formations.

Do’s and Dont’s of Reducing Scars

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.

Scar Revision from Breast Augmentation

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
  • Risk of Scar Revision

    Pre & Post Operative Risk of Scar Revision

    Cosmetic procedures involve the placement of scars in inconspicuous areas heal with minimal scarring. Any time an incision is made, a scar will result. Unfortunately, the thickness and the texture of the scar is only partially related to the skill of the surgeon and the procedure itself. In no case will scar revision surgery eliminate a scar completely. In nearly all cases, it will minimize the scar. In very rare cases, the scar could be made worse. This is a risk that a patient needs to accept. The doctor’s knowledge of your healing history is critical to making the most educated decision for the benefit of the patient.
    In developed countries risk in surgery has greatly been diminished. However, a person considering elective scar revision surgery as with any surgery should discuss risks with their surgeon. Here is a partial list a person can ask their doctor about.

    Scar Revision Surgery Risk

    • Allergies (tape, suture materials,blood products, topicals, injected agents etc…
    • Anesthesia Options & risks
    • Changes in skin sensation post-surgery
    • Excessive Bleeding (hematoma)
    • Delayed or Slower healing
    • Deeper Tissue damage e.g. nerves, blood vessels, muscles and lung
    • Pain tolerance or changes to pain sensitivity
    • Possibility of revisional surgery or staged procedures
    • Post-Surgery Infection
    • Skin contour irregularities
    • Skin discoloration and swelling
    • Temporary or permanent damage possibilities

    Take the time to ask questions!. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress.