Skin Cosmetic Surgery I
Have you ever wanted to get rid of ugly moles, brown spots or scars on your face? If so, you are not alone. Hundreds of Singaporeans undergo skin surgery each year to improve their appearance.
When it comes to skin cosmetic procedures, it is essential not to make any uninformed decisions. Thus, it pays to arm oneself with the requisite basic information to make an informed choice before going for any skin cosmetic procedures.
1. How do I improve the acne scars on my face? (Fig 1)
Fig.1 Facial acne scars
Chemical peeling causes injury to the superficial layers of the skin and believed to induce new collagen to form in deeper layers. Alpha-hydroxy acid (AHA) peels may help improve very superficial scars slightly. Treatment is easily tolerated and causes minimal disruption to the patient's work schedule. However, multiple treatments are needed. Deep scars do not improve with chemical peeling.
Laser resurfacing of the skin is a new treatment for acne scars. There are several laser systems available to re-surface the skin in a controlled manner. The skin heals and repairs itself with some clearance of the scars. In suitable patients, up to 40% improvement may be expected from a single laser treatment. However, there is risk of complications such as prolonged redness, pigmentation and infections. It takes several weeks to recover from the surgery. It is generally much more effective than chemical peels for the treatment of acne scars.
Dermabrasion is an older technique for skin resurfacing but the principle is similar to that of laser resurfacing using mechanical sanding to re-surface the skin. It involves a certain degree of blood loss and requires greater skill on the part of the surgeon.
Very deep, depressed scars will necessitate excision (cutting) and stitching to correct the defect. Elevated scars (keloids) can be flattened by injecting small doses of steroids into the keloids (Fig 2).
Fig.2 Hypertrophic scars
2 . I would like to remove my moles. How is it done?
Fig.3 Junctional naevi
Fig.4 Intradermal melanocytic naevus
Moles come in various shapes and sizes. (Fig 3 & 4) Moles that protrude (Fig 4) may be shaved off with a blade. This leaves a flat scar with a remnant of mole tissue in it. Shaving is a quick and simple way of getting rid of the protrusion but the disadvantage is that the colour of the mole almost always returns. Complete excision followed by stitching is a surer way of removing the entire mole. The size of the scar will depend on the size of the mole.
3. Can anything be done about my wrinkles?
Fig.5 Frown lines at the brow horizontal forehead wrinkles
The deep frown lines over the brow and the horizontal lines on the forehead (Fig 5) are due to the persistent hyperactivity of the muscles in the forehead area. These muscles can be paralysed or weakened by injecting a toxin (botulinum toxin) into them. Relaxation of these muscles then result in the disappearance of the frown lines. The procedure is safe but the desired effects wear off after four to six months. Repeated injections are necessary to maintain the desired effects.
Finer wrinkles which are not related to muscle activity may improve with chemical peels and/or laser resurfacing.
Face-lifting involves loosening the facial skin from its deep attachments, stretching it back over the ears, trimming off the redundant skin and stitching the tightened skin in place. This procedure has the greatest potential for cosmetic improvement and the highest risk of complications. It is usually carried out by plastic surgeons.
DEDICATED TO EXCELLENCE IN DERMATOLOGY
By National Skin Centre (Singapore)
Copyright (C) 1995 - National Skin Centre (Singapore)