Acne Scar Treatment Options

December 7th, 2009

There are many options for treating your scars from Acne Scar Treatment (Acne scar treatment, acne scar reduction, acne scar removal, acne scar revision, scar revision).  A lot of the techniques used are based on what they look like.  Acne scars can be 1. elevated 2. depressed 3. come in different shapes 4. different colors 5. different locations 6. different sizes.  Elevated scars can be excised then followed up with excision 6-8 weeks after the excision. Depressed scars can also go through that same process.  In addition, you can carry subcision for depressed scars instead of completely cutting out the scars.  This entails cutting around the circumference of the scar and elevating it to the rest of the level of the skin. This usually requires suturing the newly elevated skin.  Linear scars that are longer than 7mm may need to be broken up into different directions or shapes to camouflage the straight line better. People tend to see lines that are greater than 7mm in length. Scars can be excised or resurfaced if they are different colors. Resurfacing entails taking away the top layers of the skin to allow deeper skin cells (that reside in the hair follicles that are a lot deeper) to resurface the layers of skin that were taken away by laser, chemical peels, or dermabrasion.  Depending on the location, there are different issues to think of in order to allow the scar to heal in the best possible way.  Depending on the size, other techniques could be considered. Recruitment of tissue is sometimes necessary to get the best possible result.  Local tissue that is next to the scar can be used. Regional tissue that can be rotated in based on definitive blood flow and  sources.  Free tissue that is totally removed from the source and reimplanted into the scarred area by connecting blood vessels is needed on the more extreme end of cases.  Here is a live demonstration video of an Acne Treatment Procedure.

An example here shows elevated scars that were excised at the first stage, closed in different patterns for camouflage, and then resurfaced with a co2 laser(total/max/active/deep fx).

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Before Acne Scar Treatment

Before Acne Scar Treatment

After Acne Scar Excision / Camouflage Techniques

After Acne Scar Excision / Camouflage Techniques

After Acne Scar co2 Laser Treatment

After Acne Scar co2 Laser Treatment

Posted in Acne Scar Treatment, Scar Removal / scar reduction / scar revision / scar treatment | Comments Off on Acne Scar Treatment Options

What is a non surgical nose job and do the results last if I can’t afford a rhinoplasty.

December 7th, 2009

Fillers can be an option for a non surgical Rhinoplasty (rhinoplasty, rinoplasty, nose plastic surgery, nose cosmetic surgery, nasal hump removal, non surgical rhinoplasty) and can be less expensive.  The results though are temporary.  It can be used to fill in volume to augment and make things bigger.  But fillers have a harder time to make things smaller especially the tip area.  A nose hump can be made to look smaller through filling above and below the hump.  Again the results are temporary.  Through my experience, I have noticed that rarely fillers can last for years.  The cause of this is through scar tissue surrounding the filler protecting it from getting dissolved by the body.  Most permanent changes are effected through some surgical type of procedure. Permanent fillers are an option but inferior to surgical means and can have significant complications.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on What is a non surgical nose job and do the results last if I can’t afford a rhinoplasty.

Shortening the long nose and whether you should bring in pictures of people that you would like to look like.

December 7th, 2009

Shortening the long nose is a fairly common thing in Rhinoplasty (rinoplasty, nose job, nose plastic surgery, nose cosmetic surgery, nose augmentation, nose enhancement).  It involves shortening the cartilage that is holding the nose in a long position. Bringing in pictures helps the surgeon know what you are talking about. This can be a vital factor in getting what you want out of Rhinoplasty.  One thing to realize is that you should be realistic about what can be achieved. A rhinoplasty will improve your look, but you may still look like you just better. To totally change your look, a lot usually needs to be done.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Shortening the long nose and whether you should bring in pictures of people that you would like to look like.

What to do for an upturned pixie ear. And are all rhinoplasty surgeons created equally?

December 7th, 2009

What is important is how pleased you are with your nose. A turned up nose can be turned down so to speak through Rhinoplasty(rinoplasty, nose job, nose augmentation, nose plastic surgery, nose cosmetic surgery).  When you go see a facial plastic surgeon, you should ask to see what your nose would look like by altering it on a computer with a special imaging program. The surgeon can get a better idea of how to achieve what you want.  Also rhinoplasty surgeons are not created equally.  There are surgeons who specialize in rhinoplasty more than others.  One thing to realize is that its not how many the surgeon has done, its how many good rhinoplasties they’ve done.  The upturned nose may require lengthening or relative shortening to achieve the look you want.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on What to do for an upturned pixie ear. And are all rhinoplasty surgeons created equally?

Chin reduction and other techniques can reduce a cleft chin, and chin dimpling

December 7th, 2009

Chin dimpling is thought to be caused by a lack of soft tissue in the middle of the chin.  The soft tissue can be muscle (mentalis), fat, etc.  What also contributes is the bony structure.  When the bone forms two mounds on each side of the midline, a cleft can appear. Chin reduction surgery (chin cosmetic surgery, chin plastic surgery, chin shaping, chin reshaping, chin enhancement surgery) ,is one element of removing the cleft by decreasing the mounds of bone that can be contributing to the cleft.  If the soft tissue causes the cleft to persist, the surgeon may need to fill the cleft in with soft tissue brought in from somewhere else.  This tissue can come from fat, muscle, etc or even manufactured tissue. Here is a video on chin reduction for you to see.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Chin Surgery | 1 Comment »

Can the area under the chin in the neck be made to look good even without the help of a chin implant?

December 7th, 2009

A chin implant and augmentation can improve the lax tissue under the chin by pulling up the tissues that are causing the sagging double chin.  It can improve the neck lift even more than when a neck lift is done alone.  A neck lift (Platysmaplasty, Neck Rejuvenation, Lower Face lift, Necklift, submentoplasty, double chin surgery, turkey gobbler surgery, neck enhancement) done well though can significantly tighten the neck.  The key is how the platysma muscle is treated.  This muscle is essential to how the neck looks.  When doing a neck lift, the platysma must be tightened from just under the chin to the bottom of the neck area.  This changes the structures of the neck for a better shape.  There are also other adjunctive techniques that can be done to the fat, tissues and the muscle under the chin which can also improve the way the neck looks.  Another very important key to tightening the neck is by making sure that the skin of the neck has a place to go.  Elevating the skin to a certain degree is essential to allow the skin to shift to a more shapely appearance.  All of this takes experience and knowledge on the part of the surgeon.

Thanks for reading, Dr Young

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Chin Surgery, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands | Comments Off on Can the area under the chin in the neck be made to look good even without the help of a chin implant?

What are the options for removing the dimple on a chin?

December 7th, 2009

Chin dimple removal can be done. The origin of this anatomical variant is due to lack of the mentalis muscle crossing over and leaving a dip.  Some others believe that the dimple is due to other soft tissue deficits.  Whatever the orgin, one may need to elevate the area and fill it in with fat or some other filler.  Because the skin is usually tacked and attached down to the deeper structures, some surgical lifting is necessary.  After lifting, you will then need to place some tissue there to keep it elevated and not associated with the skin again.  This is where grafts can work and there are many options for that.  Fillers are less efficacious in my experience. Chin implants can also serve to make those dimples less apparent as well but may change the way your chin looks in a significant way.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Chin Surgery | Comments Off on What are the options for removing the dimple on a chin?

What results can I expect from scar revision surgery after worsening scars around my ear and face?

December 7th, 2009

It always depends on what your scars look like.  Options for Scar Revision (scar treatment / scar improvement / scar reduction, scar removal) include:

1. excision and reexcision: straight closure, running w plasty, multiple z plasties, geometric closure.

2. skin resurfacing: including laser, dermabrasion, chemical peels

3. tissue expanders to recruit more skin

4. local flap surgery whereby skin and tissue are recruited to reline the areas of scars

5. free flap surgery where tissue from some other part of the body is transferred to the areas of the scars and connected with blood vessels.

Many scars are excised and reclosed.  There are many options with this approach.  You can cut the scars out and close them as a straight line.  Your eye however usually notices anything that is longer than 7mm.  So many times, it helps to close the new incision not in a straight line but broken up into “w’s”, “z’s”, or multiple patterns (geometric line closures).  This is done in attempts to trick the mind by not having any line longer than 7mm.

Resurfacing is always an option to improve the scar by taking the scars away on the surface and allowing new skin to grow over to improve the appearance.  This can be done with lasers, dermabrasion, chemical peels, and dermasanding.

If there is a big area to improve, sometimes having more normal looking tissue is needed. This is where the concern with bringing in tissue comes into play. Tissue expanders allow you to make more skin. You have to go through expansion of your skin with a balloon under the skin near the area you are wanting to correct.  Expansion occurs every 2-3 weeks.  Once you have enough tissue you can then take the expander out and then the new tissue is used to reline the scarred area.  Local flaps can be rotated into the area.  If this is not enough, you can then take skin and tissue from another area and hook up the vessels to reline the scarred area.

The other option includes fillers that are an adjunctive option.  Fillers essentially fill in the volume deficiency that sometimes is present in the scarred area.  Fat injections, which are a filler that uses your own fat can fill in volume and also regenerate your skin through incorporation of new stem cells in the fat.  These stem cells can have a regenerative property on scar improvement.

From a results standpoint, you shouldn’t expect it to make your scar back to complete normal.  This is impossible.  But through scar revision the scars can be really improved.  That is the key to scar revision the word “improve”.  Here is a video on Scar Revision.

Thanks for reading

Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Acne Scar Treatment, Scar Removal / scar reduction / scar revision / scar treatment, Uncategorized | Comments Off on What results can I expect from scar revision surgery after worsening scars around my ear and face?

lumps and bumps 3-4 days after lip augmentation with Restylane

December 7th, 2009

The swelling in the lips usually takes a while to go down after Lip Augmentation (lip filler, lip enhancement, lip plumper, younger lips, lip injectibles) with Facial Fillers. Your lips are very vascular and with that comes easier bruising and swelling. 3-4 days is on the early side. I usually wait for the first 2 weeks for the swelling to go down.  During these first 2 weeks is when massage can really help dissipate the swelling.  Enzyme injections are also another way of removing restylane, juvederm, perlane but they are more of a permanent removal of the restylane.  If enzymes are injected during the first 2 weeks, this may be a mistake.  The swelling that would normally go down the first 2 weeks will further go down more if enzymes are injected the first 2 weeks.  Sometimes waiting at least 3 weeks is even better.  One thing to remember is that restylane and other hyaluronic acid fillers can be shaped though and you shouldn’t have to go through 6-9 months of a less than desirable result.  Enzyme’s can help shape your results after 2-3 weeks.  Notice how in the example that the lower lip in the after maintains the size that is 2 times greater than the upper lip.  From the viewer standpoint, it doesn’t look wierd to them.

Thanks for reading!

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Before Restylane Injections / Lip augmentation

Before Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

Posted in Fillers / Facial Fillers, Juvederm, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, Perlane, Restylane | 5 Comments »

What are some permanent options for Lip Augmentation?

December 5th, 2009

Some permanent options forLip Augmentation (Or lip enhancement, lip filler, lip injectible, lip plumping, lip rejuvenation) exist including Lip Lifts, Mucosal advancements, Lip Grafts, Fat injections, and Permanent Lip Fillers.  Lip lifts include Buffalo Horn Lip Lift (gull wing lip lift, wavy under nose lip lift) which are under the nose that lift the upper lip and shorten the distance from the bottom of the nose to the upper lip. Corner of the lip lifts elevate the corners of the lips to reverse downturn lips. Mucosal advancments including V-Y advancements that can be horizontal, vertical, and double ones that do different things.  These advancements increase the red portion of the lips appearance in both the upper and lower lips. Lip grafts can be done with alloderm, goretex or other natural tissues from various parts of the body.  They can be used to increase the volume of the lips for a fuller more youthful look. Fat injections can be employed to volumize the lips, and increase the red portion of the lips with your own fat.  This is an option that can last for years.  Permanent lip fillers, like silicone, are another option but present a lot of risks. My opinion is that these permanent lip fillers are too risky.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip | Comments Off on What are some permanent options for Lip Augmentation?

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