Question: I have chickenpox scars on my face from when I was six years old. I am now 30. Is there any kind of chemical peel that would work now or is it too late?
Answer: For the most part, chemical peels are really not the best option for chickenpox scars though, theoretically, a very deep chemical peel could certainly improve their appearance. I personally am partial to the ProFractional Laser by Sciton as the fractionated Erbium laser treatments spaced a month apart for about three treatments can do a wonderful job of improving textural and surface irregularities due to problems such as chickenpox scars, traumatic scars, surgical scars, and acne scarring.
Question: I am interested in a deep strength laser skin resurfacing treatment. Will this remove deeper wrinkles? How long will my face be red?
Answer: A deep ablative laser treatment, whether it is CO2 or Erbium laser treatment, will definitely improve upon deep wrinkles and depending on what laser is used and how deep it is performed as well as your skin type will determine how long your skin will be red. My personal opinion is that the Erbium laser does not tend to create as much redness as the CO2 laser and that the redness tends to dissipate faster, but I have had a handful of patients, especially those that are redheads, that tend to hold on to this pinkness of their skin for several months. Most other patients, however, this pinkness is gone typically in about three to four weeks and during the time _____ the healing has occurred it can be covered up with makeup.
Question: I am 48 years old but really have an older woman’s face. I have too much sun damage to begin with. This makes my skin look blotchy in coloration. I have wrinkles around my eyes and remnants of old acne. I would love to have a Fraxel laser treatment. What will my face look like after this procedure? Will I be able to drive home afterwards or is there too much pain?
Answer: I personally do not have the actual Fraxel laser but have a form of fractionated laser treatment that is called ProFractional Laser by Sciton. Any fractionated laser whether it is a nonablative treatment such as Fraxel or an ablative treatment such as ProFractional Laser, which is an Erbium laser, or fractionated CO2 laser treatments all can be performed in an office setting and you could drive yourself home though, if you have a relatively long distance to travel, you may want to consider getting a driver just to make it easier on you. Ultimately, fractionated laser treatments can improve on discolorations and wrinkles and the more aggressive the treatment, it seems the more improvement the patients get. For the ultimate in skin rejuvenation though, you may want to consider a full-face Erbium laser treatment, which would involve going to the operating room but can give extraordinarily dramatic results with downtime of about six days. There is some mild discomfort immediately after the treatment that tends to be relieved with a Zimmer cooling unit and after about a half hour to forty-five minutes patients are comfortable and ready to leave the spa.
Question: I have heavy sun damage on the back of my neck and my shoulders. In the future, I will be more proactive about wearing sunscreen but what can be done to improve the look of my neck and back now?
Answer: We can treat the neck and back area with broadband light, which will target the abnormal pigmentation in these areas and help the neck and back look much better. This usually requires a few treatments, but we can use this broadband light in a rather intense way to greatly improve these areas with only a few treatments. Another option would be ProFractional laser treatments, which essentially lasers tiny, little holes in the skin and this healing process causes some new collagen deposition, which tightens the skin and can reduce apparent laxity or wrinkling in the skin. This can be safely performed in areas off the face, but I would highly recommend seeking out someone who has significant experience with this; otherwise, the new Ultherapy device, which uses microfocused ultrasound can also be used on the chest, neck, and back if we are trying to improve laxity in these tissues. A personal evaluation would be necessary to determine which treatment would be the most appropriate and in many of our clients, we perform combination treatments where we will combine broadband light, ProFractional laser resurfacing, and Ultherapy to give them the ultimate result.
Question: I had dog bite when I was a child. The scars are still visible. What procedure do you use for scar revision? Can this be done in the office?
Answer: The nature and depth of the scar will determine what modality I would recommend regarding treatment of it. Frequently, scar revisions can be easily performed in the office setting using local anesthesia and in other circumstances scars are amenable to advanced laser treatments such as the Profractional Laser by Sciton, which can greatly reduce the visual appearance of these scars. Ultimately, a consultation with a board certified facial plastic surgeon would be appropriate so that you ultimately get the result you desire.
Question: I would like to get a large scar taken off of my forehead that I have had since a childhood accident. I have been embarrassed and self-conscious about its appearance for years, and I am finally ready to get it removed. Will a scar revision procedure completely eliminate its appearance?
Answer: Scar revision surgery cannot eliminate a scar. It only trades off a new more aesthetically appropriate scar for the more noticeable scar that existed there. I certainly have had patients where a scar revision in association with other more advanced treatments such as Profractional laser resurfacing can make the scar almost invisible but, nonetheless, there still is a scar present since there has been a prior injury to that tissue. So, patients need to understand that we cannot completely eliminate scars, but we merely are trying to reduce the visibility of the scar and make it much less noticeable.
Question: I have a scar on my cheek from being bit as a child. It has always bothered me, and I would like to see if there is some way that I can get rid of it or at least improve it. I have heard of scar revision and was just wondering what this entails and how significantly improved scars can be.
Answer: Visible scars on the cheek are often significantly improved with scar revision surgery, but it really depends on the particular nature of your scar as to whether that would be the best option. For scars that are overly wide and depressed, I feel that scar revision is most likely the best option. If the scar is simply visible but not overly depressed and not overly wide, we may want to consider more advanced techniques such as Profractional laser resurfacing as I have had outstanding results with old scars using this modality.
Question: I am a lifetime car mechanic and have had my share of burns and scrapes, leaving my arms especially damaged. Would laser skin resurfacing be a good option for treating such a large area of the body?
Answer: No, laser skin resurfacing really cannot be performed on the body the same way that it can on the facial region due to fact that the body does not heal as quickly as the face and, ultimately, we would just create more scarring on the body before the completion of the healing phase. There are various chemical peels that can be performed on the body such as salicylic acid. We can also treat the body skin with fractionated lasers such as the ProFractional laser by Sciton. I would recommend a complimentary consultation at Quintessa Medical Spa.
Question: My son is turning 21 next month and has had an awful time with severe acne that has left him with a scarred face. As a birthday present/college graduation present, I want to help him rejuvenate his face and start his career with some confidence. What is the best approach to cleaning up skin that has been riddled with acne?
Answer: Well, the first part of any approach to treating a face that has been riddled with acne is to assure that the active acne is under control. If he no longer has any active acne and we are now dealing with acne scarring, I would still highly recommend that he stay on a good medical-grade skin care line to minimize his chances of a recurrence of his acne, and I would then discuss various treatment options for the visibility of his acne scarring, depending on his evaluation. I have found that many patients, especially younger patients, have a significant amount of redness to the acne scarring, and that draws the eye even more than the depressions that the acne has caused. To treat this redness, we typically recommend intense pulsed light or broadband light, which works exceptionally well at getting rid of the visibility of the redness in the scars. Many times, this is all we need to perform, as the remaining depressions are relatively mild and really do not catch the shadows very well or draw the eye. For patients with depressions that do draw the eye or create shadows, I would then recommend a series of treatments with the ProFractional laser by Sciton, which is an Erbium laser that lasers small tunnels in the skin. These tunnels then cause the healing response to deposit a significant amount of collagen in the deeper dermis and this in turn then tend to flatten out depressions, whether they be acne scarring, surgical scarring, or chickenpox scarring. We have had very high success rates with extremely significant changes to the appearance of the acne scarring for the better. In my practice, this has replaced dermabrasion and deep full laser resurfacing as my treatment of choice for acne scarring as, in my personal opinion, it seems to provide a better outcome for my patients. Ultimately, an evaluation at Quintessa Medical Spa would be recommended so that a customized treatment plan can be created for his specific needs.
No, I personally do not recommend Jessner TCA peels any longer as technology has improved to the point where these sorts of historical chemical peels really are completely unnecessary. If the Jessner TCA peel is intended to improve the pigmentation of the skin, then I would personally recommend BBL or broadband light as we can rid the patient of their pigmentary issues without the downtime of a Jessner TCA peel. If the Jessner TCA peel is recommended for textural improvement or wrinkle reduction, then I would recommend a micro laser peel and/or ProFractional laser resurfacing as we will get a much greater improvement in the texture and wrinkling of the skin than a Jessner TCA peel will accomplish. I personally discontinued telling patients to expect wrinkle reduction from a Jessner TCA peel many years ago due to the rather underwhelming results that we would get regarding wrinkle reduction. Micro laser peels and ProFractional laser peels; however, can injure the deeper layers of the skin creating significant new collagen growth that will indeed create improvement of the overall texture of the skin and significantly reduce visible lines and wrinkles. All of this can be accomplished with less downtime than a single Jessner TCA peel would cause. I would recommend that you schedule a consultation at Quintessa Medical Spa where we can discuss the various skin care options with you and due to the fact that we do have these very high technology devices, we typically can provide patients a better result with less downtime than our competitors that do not embrace this technology.