People can go about this in many ways guided by the advice and expertise of a skilled surgeon and backed with state of the art products and methods that are practiced in Dubai. The main logical way is to use non-invasive techniques for cosmetic treatments. But every procedure has its limitations, requirements, eligibility, benefit – risk ratio, and goals. Time may also vary in cases of downtime and repeat sessions where necessary. Regardless of what you choose, or more specifically what suits you and your expectations, cosmetic surgery can still treat scars with and without surgery as well. Listed below are some of the popular non-invasive treatments for scar revision.
Non-surgical procedures aimed at reducing scarring or treating scarring caused after a primary procedure can be addressed in scar revision through scar excision. Other alternatives however do exist.
Certain compounds can be injected within scar lesions to dissipate the scar and allowing it to naturally camouflage with the surrounding healthy skin. Corticosteroids and 5-FU (short for 5-fluorouracil) are organic compounds that delivered through injection achieve superior penetration and assimilation through agent reaction to treat protruding scars. Concentrations of substances can be regulated to achieve a proper end result. This has an advantage over topical application of agent owing to its direct treatment strategy.
After various extensive studies on intralesional corticosteroid injection it has been theorized that it is effective in reducing protrusion in hypertrophic scarring as well as keloids. Indeed the results were promising enough to declare the treatment as the primary recommendable treatment for keloids and secondary preferred treatment for hypertrophic scarring. The steroids work on fibroplast networks in scar tissue cutting them down in volume and preventing the formation of further vasculature. Side effects may include such lack of pigmentation in the scarred area and neighboring tissue.
5-FU and related agents are injected into scar tissue to curb the propagation of scar tissue. The combination of 5-FU to intralesional injection with certain laser therapy can bring about remarkable results unrivalled from using one treatment singularly.
However there are limitations to 5-FU usage especially on patients diagnosed with anemia, are pregnant, suffer from bone marrow depression or have simultaneous infection. Temporary side effects to 5-FU are mostly limited to the treatment area and may include mild discomfort in the injection area, skin irritation, ulceration and hyperpigmentation.
Laser therapy is among the most contemporary and successful tools in a surgeon’s arsenal. Cosmetic scarring treatment has joined the ranks of the various aesthetic treatments that can be employed with the use of lasers. Chromophores in the skin absorb light rays emitted in the form of laser beams inducing a rejuvenating or ablating reaction depending on various technical variables. Pulsed-dye, Erbium (Er: Yag), CO2 and fractional lasers provide promising solutions for scar management upon appropriate administration. Any side effects to lasers are hugely minimized due to the accuracy and efficiency of the laser treatment and if any do occur they are limited to the sub-dermal layers. With the epidermis unaffected elevation of scars can be reduced up to an efficiency rate of 72%. Without puncture wounds and long operating times, the chances of infection are eliminated. Yet subtle adverse effects associated with lasers can be experienced – even if only very rarely.
In cases of elevated or depressed scars leaving very apparent marks on the skin that cannot – for a number of reasons – be treated with other techniques, dermal fillers provide soft tissue material as means of reshaping such deformity. Even in areas heavily populated with skin fibrosis where dermal filler therapy is not optimal, it can still be attempted. It works best in depressed scarring areas such acne scars and facial lines to elevate the area and provide a smoother aesthetic effect. Autologous fat transfer harvested from other areas of the body through suction-assisted lipectomy can also be used as filler with no chances of allergic reaction and retention. This method is increasing in popularity due to more advanced techniques and decreased eventual discomfort as well as better aesthetic outcomes.
Animal derived fillers made from bovine or porcine collagen can also be used but only after skin tests have been carried out to rule out the 1-4% of possible allergic reactions. Hyaluronic acid derived fillers popularly known under names of Juvéderm, Restylane and Perlane can also be used without the necessity of testing. But all these options are only temporary treatments that are suitable in various situations.
Resurfacing can be carried out with laser and chemical peels as well as dermal abrasive techniques that work well to disguise minor contour irregularities.
The technique involved removes the top layer of skin to allow a newer, healthier layer skin from below to grow out eventually. Logically there is a time period involved and usually more than session is required. Lasers have shown remarkable capability in some patients through one session. Chemical peels can range in usage from between 6 weeks to 6 months and have provided increased evidence of success with atrophic scarring. Chemical peels stimulate stimulates inflammation in the skin resulting in neocollagenesis and scar tissue remodeling naturally carried out by the body.
Dermabrasion resurfacing is another efficient procedure useful in the treatment of slightly elevated scars. With manual manipulation and engineered materials on a roller ergonomically designed to strip away layers of the external dermis to an extent required by the surgeon. Dermal appendages are not affected and allow for the regeneration of new layers of skin. In raised hypertrophic scars these epidermal appendages are usually decreased in number or damaged which makes this method not suitable for such scarring.
There is immense expertise and technique involved with this technique and it cannot work anywhere on the body for optimal abrasion or minimally superficial stripping of the dermal layer. Patients having certain skin types (Fitzpatrick type 3 – 6) may not be good candidates for this procedures since adverse effects for them include hyperpigmentation making the aesthetic result sub-optimal in their case. Because it involves small parts of the skin and epidermis being punctured, there is a slight risk of infection associate with dermabrasion and respective medication is always prescribed.
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