Scar Revision Surgery: Can My Scar Be Improved?

What is a scar?

Scar revision is plastic surgery performed to improve the condition or appearance of a scar anywhere on your body. The different types of scars include: Discoloration, surface irregularities and other more subtle scars can be cosmetically improved by surgery or other treatments recommended by your plastic surgeon. These types of scars do not impair function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and prior surgical incisions.

Hypertropic scars are thick clusters of scar tissue that develop directly at a wound site. They are often raised, red and/or uncomfortable, and they may become wider over time. They can be hyperpigmented (darker in color) or hypopigmented (lighter in color).

Keloids are larger than hypertropic scars. They can be painful or itchy, and may also pucker. They extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but they develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.

Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.

The type of scar you have will determine the appropriate techniques your plastic surgeon will use to improve your scar.

What to expect during your consultation

The success and safety of your scar revision procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries

Your surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your scar in detail
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes and any risks or potential complications

Preparing for surgery

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your procedure
• Post-operative care and follow-up

What happens during scar revision surgery?

Step 1 –Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The treatment

The degree of improvement that can be achieved with scar revision will depend on the severity of your scarring, and the type, size and location of the scar. In some cases, a single technique may provide significant improvement. However, your plastic surgeon may recommend a combination of scar revision techniques to achieve the best results.

Topical treatments, such as gels, tapes or external compression, can help in wound closure and healing, or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in healing of scar revision procedures.

Injectable treatments are often used to fill depressed or concave scars. Depending on the injectable substance used and your particular scar conditions, results may last from three months to several years. Therapy must be repeated to maintain results. One form of injection therapy uses steroidal-based compounds to reduce collagen formation and can alter the appearance, size and texture of raised scar tissue.

Surface treatments are most often used for cosmetic improvement of scars. These methods can soften surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of either mechanically removing the top layers of skin or changing the nature of tissue. These treatment options include:

• Dermabrasion is a mechanical polishing of the skin.
• Laser or light therapy causes changes to the surface of the skin that allow new, healthy skin to form at the scar site.
• Chemical peel solutions penetrate the skin’s surface to soften irregularities in texture and color.
• Skin bleaching agents are medications applied topically to lighten the skin.

Step 3 – Sometimes for deeper scars an incision is needed to surgically remove the old scar.

Step 4 – Closing the incisions:

Some scars require layered closure. Layered closure is often used where excision extends to tissue below the skin surface or in areas with a high degree of movement. The first step, or layer, requires sub-dermal closure (below the skin surface) with absorbable or non-removable sutures. Layers of closure continue to build, concluding with closure of the remaining surface wound.
Advanced techniques in scar revision include complex flap closure to reposition a scar so that it is less conspicuous, or improve flexibility where contracture has restricted mobility.

Pharmaceutical tissue substitutes may be used if ample healthy tissue is not present for closure of a scar excision. This is more likely with revision of severe burn scars.

Tissue expansion can be a substitute for skin grafts. In this procedure, an inflatable balloon called a tissue expander is placed under the skin near the scar site. Over time, the balloon is slowly filled with sterile solution to expand the area of healthy skin. Once the skin has been stretched sufficiently, the expander and the scar is removed and the stretched skin is moved to replace the scar tissue. This process can involve multiple surgical stages or procedures in order to achieve the final results.

Important facts about the safety and risks of scar revision surgery

The decision to have scar revision surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.
You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

Some of the risks include:
• Bleeding (hematoma)
• Infection
• Delayed healing
• Anesthesia risks
• Change in skin sensation
• Damage to deeper structures including nerves, blood vessels, muscles and lungs can occur and may be temporary or permanent
• Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
• Skin contour irregularities
• Skin discoloration and swelling
• Skin sensitivity
• Deep vein thrombosis, cardiac and pulmonary complications
• Pain, which may persist
• Possibility of revisional surgery or staged procedures

Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Botox for Migraines

That's right...Botox to treat migraines!

Studies have shown that more than 80 percent of patients who have been treated with Botox for painful migraines experienced immediate relief. Botox has helped decrease the severity and frequency of migraines.

The research has shown that those treated in various sites received the most rapid and dramatic relief. These areas include: the brows, forehead, side of eyes, side and back of the neck.

Doctors believe that the mechanism of how Botox works for migraines is that it interrupts the nerve pain signals, and relaxes the muscles which cause tension. The results and benefits can last up to six months!

Though more studies and research are being done, the evidence is out there! Could this be covered by medical insurance??? It is unlikely at this time, but with continuous studies of its effectiveness on migraines, it could be very likely in the near future.

Still suffering from migraines?...Put your mind at ease!
Call us NOW 310.275.6600

Breast Reduction: Up, Up, and Away!

With so many woman having breast augmentation these days to enhance their chest, it seems almost taboo to want to reduce your natural, well-endowed size.

Bigger isn't always better. Woman with naturally enlarged breast will vow:

-shoulders hurt,
-back aches,
-you can't find clothing that fits really well,
-bras for big breast look like they belong to your Great Grandma,
-physical activity is a bit challenging because "they're in the way",
and not to mention...sometimes the attention you get is not the kind your looking for!

A Breast Reduction may be exactly what you deserve (literally, a weight off your shoulders), AND the aesthetic results are so extremely pleasing as well! The breast volume is reduced and the nipples/areolar complex (which are typically made smaller in circumference) are lifted to a higher, youthful, and more perky position.

The surgery does entail incisions on the breast which heal and fade with time. The recovery is fairly quick, which most claim as being minimal to moderate discomfort, and worth every bit of it!

The surgery can take place in a hospital but most have it performed in a full-accredited ambulatory surgery center. Depending on one's severity, it is possible that some health insurances cover this procedure as a medical necessity.

And the one regret women have after they have it done...
"Why didn't I do this sooner???!!!!"

THIS IS YOUR OPPORTUNITY. MAKE IT HAPPEN! CALL US TODAY! 310.275.6600

BHPSG Nose About Balance

Big. Small. Sharp. Hooked. Long. Up-turned. Cute.

How would you describe your NOSE?

Noses are the most prominent feature on (mostly everyone's) face. Noses are different for us all and certainly can add unique characteristics to one's face.

Not everybody loves the nose they were born with. Some find their nose is not "in balance" with the rest of their face. Sometimes the nose can be deviated (crooked) causing difficulty breathing. Whatever the case may be, Rhinoplasty surgery is in high demand all over the world!

Rhinoplasty surgery can be done by surgically shaping the bone and/or cartilage of the nose. The recovery is fairly painless, though it can be a bit challenging to breathe through the nose right after the surgery has been done due to swelling and there can be some bruising associated with the recovery. It usually takes about 1 week of "down time" and wearing of a splint (cast) over the nose. Though only a week is typical for a splint to be worn, the nose continues to heal, shape, mold, and continue to look better for even up to a year or more!

Rhinoplasty surgery can give you the confidence you deserve to feel good about yourself!!! If you've ever considered a Rhinoplasty procedure, call us for your personalized consultation today!
310.275.6600

The Evolving Facelift: Understanding the Aging Face

We've heard it all: "thread lift", "liquid facelift", "deep plane facelift", "lunch time lift", etc...
with so many different descriptions of facelifts, it is completely understandable to be confused of what is right for you.

The facelift procedure has come a long way! Through extensive studies and understanding of the aging face, the classic facelift has evolutionarily been reformatted. The technique that was once perceived as pulling on skin alone, and resulting in a very artificial "wind-blown" look, should be far behind us. Taking into consideration the under-structure, "the foundation" (muscle, tissue, and facial fat) under the skin, is what should also be addressed.

Developed in 2002, the MACS Lift, short for "Minimal Access Cranial Suspension" involves lifting muscle and tissue vertically and arranging them in a more youthful position. This is stabilized with dissolvable sutures and then re-draping the skin. This is what helps to volumize the face again, and volume/fullness is what often times gives the face a younger appearance. It is also often times suggested that patients with such volume loss in their face also add fillers such as Juvederm, Sculptra, or fat to really rejuvenate their appearance. All of this explained is different than pulling the skin horizontally (towards the ears) and trimming it, as is done in a traditional facelift.

The Benefits??? A beautiful, rejuvenated, and more natural aesthetic outcome with a shorter recovery and less downtime.

The look of Cat-Woman is out! A refreshingly soft, radiant, younger-looking YOU...that's what's in!

CALL US TODAY! 310.275.6600 www.BHPSG.com

Body After Baby

Baby. Body. Blah. After nine, long, child-bearing months, your body now has even more work to do. Time to get back to the body before baby. Let's face it, somethings will never be the same.

The great news is...somethings can be better than ever before! And thanks to the "SIMM" procedure, (an EXCLUSIVE procedure developed by both Drs Layke and Danielpour) mommy never looked so good!

SIMM, stands for Single Incision Mommy Makeover. One incision is all it takes to create a beautiful, sexy, and rejuvenated body. A traditional tummy tuck is performed with a low-set incision (at the level of a C-section scar). Silicone breast implants are place THROUGH the tummy tuck incision, so that there are NO INCISIONS on the breast. The breast augmentation looks completely natural without a single scar on the breast.

A tight tummy, and fuller, youthful breast ...Come On MOMS...YOU DESERVE THIS!

For a beautiful, sexy and rejuvenated body of your own,
CALL US TODAY!!!!
310.275.6600

If We Don't Drastically Age Overnight...How Can We Drastically ANTI-Age Overnight?

Imagine this raisin is like that of an aged face. How can we turn this wrinkled raisin back into a plump, smooth and firm grape again?

Since aging doesn't happen drastically overnight, it makes sense that anti-aging shouldn't as well.

Scultpra. If you haven't heard of this product before now, you surely won't forget it! The most Premium Product and Treatment for ANTI-Aging!

This product is so unique and so profound that it can only be offered by TRAINED, and EXPERIENCED Plastic Surgeons or Dermatologists. So you won't find this product being offered at your local day spa.

Sculptra is a biocompatiable, biodegradable synthetic injectable that works deep with the dermis to replace lost collagen. As a gradual foundation of collagen is being built on, shallow to deep facial wrinkles and folds begin to volumize and correct. This is what produces a rejuvenated, smooth, and more youthful appearance.

Since more than one treatment is recommended for most (usually 2-3 total), Sculptra is praised for being forgiving, correctable, and successful.

The best results occur subtly over time, you achieve a very natural-looking appearance. No incisions. No surgery needed. No down time necessary. Everyone will notice how great you will look...and no one will know you had anything done.

Sculptra is one of very few products to actually last! Though individual results may vary, Sculptra may last up to two or more years.

Out with the OLD, in with the NEW...get started with Sculptra TODAY! 310.275.6600

What are the Benefits of Slim Lipo vs. Traditional Liposuction?

Liposuction has been one of the most in-demand and popular procedures amongst all Plastic Surgery. Liposuction has assisted patients in achieving a more flattering and smooth body contour by removing undesired pockets of localized fat.

Nowadays, many doctors are looking for the most cutting edge technology to allow patients a rapid recovery parallel with exceptional surgical results.

"SLIM Lipo" which stands for "Selective Laser Induced Melting" is one of the newest and profound laser technologies to hit the market, allowing patients less bruising and discomfort following liposuction surgery.

The laser helps the patient's fat to break up easier prior to suction, which in turn results in less bleeding (and therefore less bruising, and bruising is what hurts). Also, since the fat is easier to remove, the incisions are even smaller than standard liposuction. Most appealing to both patients and surgeons are the potential benefits of also tightening the skin in the areas being treated.

It is always advised that a patient review the risks and benefits of any given procedure with their surgeon(s), based on their personal health, lifestyle and expectations.

We are excited to offer SlimLipo to our patients! Find out if SlimLipo is right for YOU!

Call us today!!!! 310.275.6600