Wednesday, July 30, 2014

Scarring After Surgery: Management and Treatment

The skin is amazingly self-sufficient. Though it requires lifelong care and protection, it has its own complex healing process to deal with trauma. Scar formation is a normal part of the skin’s natural healing after surgery, and with proper care and vigilance by both patient and doctor, this healing process can be monitored without damage to the skin.

Scar management is three-fold: Use proper clinical judgment, follow the patient closely and intervene as soon as possible if signs of problematic scarring occur. For a surgeon, the first priority is to ensure the best medical and aesthetic outcome for my patient. This may mean making a larger incision in order to achieve a better contour; however, I can take necessary steps afterward to control scar formation. The goal is management, not prevention, of scars.

Scar tissue forms as the skin’s natural healing response to trauma, whether from a cut, puncture, burn or controlled injury to the skin as the result of surgical incision. The skin reacts by contracting and closing over the open wound (or sutures) and rushing collagen-producing fibroblasts to the site of the injury to produce the new skin cells that form a scar.

The skin can reveal the whole general condition of the patient—and in the case of scarring, it also allows me to ascertain how well a patient will heal. A host of variables affect the severity of scarring, including the area of the body, skin laxity, age, ethnicity and skin tone. For example, darker skin tones and redheads are both more susceptible to problematic scarring, while most fair skins tend to scar very well.

Patients with loose, saggy skin and decreased elasticity due to age or significant weight loss will develop very little scar tissue because there is less tension when closing the skin together after surgery. And on the contrary, if you have taut, tight skin, you will be more apt to develop noticeable scars because of the tension that occurs when stretching the skin back together during the suturing process.

The ideal scar develops into a flat, thin line that fades over time. However, scar tissue may become hard, raised, itchy or red as a result of excess collagen growth. This fibrous tissue extends above a scar site in the form of a raised growth known as a hypertrophic scar. Hypertrophic scars are fairly common and respond well to treatment when caught early.

A similar type of scar called a keloid is indicated by uncontrolled collagen growth beyond the trauma site. Keloid scars most commonly occur on the earlobes, jaw line, face and sternum; because of their severity, they typically require an aggressive treatment plan combining surgical excision with steroid injections to stop collagen growth.

The primary goal of scar management is to control collagen fibroblasts and stop the growth of additional scar tissue. Steroid injections effectively treat raised or hard scars by paralyzing fibroblasts. If the patient has a history of keloids, I focus on preventative measures to keep the scar under control, often doing a steroid injection at the time of surgery. It’s important not to overcorrect with steroids, as this can lead to hypopigmentation, or lightening, of the skin.

After an elective surgery on the face, abdomen or breasts, patients apply a pressure garment to the scar site and firmly massage the scar several times a day. I also suggest a series of in-office laser treatments to treat redness. I use a vascular laser that targets the red pigment in the skin to effectively reduce discoloration.

Patients should play an active role in the healing process. It is crucial to avoid sun exposure and commit to vigilant use of sunscreen, as any burning of the skin will cause additional redness and irritation. Smoking decreases microcirculation and is the worst thing patients can do to delay healing. Most importantly, any itching, increased redness or significant change in a scar should prompt a call to your doctor.

As with most skin conditions, there is no singular approach to scar treatment. A qualified doctor understands the anatomy of the skin and can develop a clinical plan of action to manage scarring and help you achieve the best result from your surgery.




Mokhtar Asaadi, MD, FACS; Plastic Surgeon, Asaadi Plastic Surgery, West Orange, NJ
 
Dr. Mokhtar Asaadi is a board-certified plastic surgeon with practices in West Orange, NJ, Bedminster, NJ and New York City. He received his medical degree from the Pahlavi University Medical School in Iran. Dr. Asaadi serves as the chairman of the plastic surgery department at New Jersey’s Saint Barnabas Medical Center, where he also completed his residency. Dr. Asaadi is credited with patenting the MasterTuck liposuction procedure using VASER Lipo. He is a member of numerous medical societies, including the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery and the American Medical Association.

Tuesday, July 29, 2014

LAST CHANCE: Only 6 seats remaining for Summer Sunset Sangria - July 31

Last chance, ONLY 6 SEATS REMAINING for our Summer Sunset Sangria event featuring one-time only Ultherapy specials.  RSVP now: http://www.chicesthetiq.com/#!ultherapy-event-summer-sunset-sangria/c18r5

Monday, July 21, 2014

What is Ultherapy?

Check out this short video and learn all about this amazing procedure to lift sagging skin on the face and neck.


To schedule a complementary med spa consultation to discuss what facial skin-tightening can do for you, call us today at 713-909-3088.

Saturday, July 19, 2014

Steam, Sauna and Hot Yoga: The Effects of Heat on the Skin

When the mercury starts to dip, heat seekers looking for a warmer-weather fix can head indoors: to a sauna, a steam room or even a hot yoga studio. Not only do these practices relax the body, reduce stress, and release endorphins essential to proper nerve function, they increase circulation to the skin to improve its health—and appearance.


Our bodies react to any increase in temperature by perspiring. Sweat is released from the body via sweat glands located in the dermis, and this sweat-secretion process helps the body maintain its temperature as sweat evaporates from the skin.

So why does getting hot and sweaty give us a healthy glow? While little scientific data exists supporting the link between sweating and detoxification (as the body’s other exocrine glands are sufficiently equipped to get rid of what it doesn’t need), sweating is a form of excretion, so it makes sense that perspiration will aid in toxin and waste removal, leading to healthier skin overall.

Heat also increases circulation, enabling blood to bring vital oxygen and nutrients to the skin’s surface. This increased blood flow gives the skin an instantly healthier appearance by creating the rosy, flushed glow that’s synonymous with optimal health and vitality.

In high-humidity environments like steam or hot yoga rooms, added moisture in the air encourages the skin to maintain suppleness and hydration. In addition, the process of steaming cleanses skin from the inside out by encouraging the release of bacteria and debris from the pores. Though pores cannot technically open and close, loosening pores via steam helps expel bacteria and debris that may lead to enlarged pores, blackheads, whiteheads, and other acne symptoms.

Sweat dissipates more slowly in moist environments and may breed bacteria if allowed to sit on the skin, potentially worsening skin disorders such as acne and psoriasis. Therefore, it is important to remove makeup before a sweat session, as it blocks pores and prevents sweat from escaping; properly cleansing the skin after a steam room, sauna, or hot yoga class is another simple way to keep bacteria at bay. Sauna-goers should also moisturize after cleansing, as dry sauna air can dehydrate the skin.

Heat, too, is a known aggravator for patients suffering from rosacea, a disorder characterized by bouts of skin redness, flushing, and pimple-like bumps. Case in point: In a 2010 survey published by the National Rosacea Society, 56 percent of participants reported that indoor heat was a trigger for rosacea flare-ups. Patients with rosacea should minimize their exposure to extreme heat, or better yet, skip extreme heat-related activities altogether.
Finally, as our bodies are composed of approximately 70 percent water, replenishing water lost to sweating is absolutely critical during, before, and after activities that significantly raise body temperature. And, as with any lifestyle change, check with your doctor before spending any time in saunas, steam baths or hot yoga rooms to confirm whether or not they’re right for you.




Reference:
http://www.rosacea.org/press/archive/20100525.php
 

Wednesday, July 16, 2014

Ultherapy® Décolletage Treatment Now FDA-Cleared

Ulthera® System Receives Third FDA Clearance

MESA, AZ--(Marketwired - Jan 30, 2014) - Ulthera, Inc. -- a global medical device company focused on developing and commercializing technologies for aesthetic and medical applications -- announced today that its ultrasound platform device, the Ulthera System, has been cleared by the Food and Drug Administration (FDA) to visualize the dermal and subdermal layers of tissue during the non-invasive lifting treatment, Ultherapy.
This marks the third FDA clearance the Ulthera System has received. The first two -- in Sept. 2009 and Oct. 2012 -- cleared the Ulthera System to non-invasively treat the face and neck with specific, first-and-only indications to lift skin on the neck, under the chin and above the brow.
"While the Ulthera System had already been cleared to safely image the face and neck, with this new, stand-alone clearance, it is now officially recognized as a tool to help providers visualize tissue layers while they are treating," said Matthew Likens, president and CEO of Ulthera. "This ability to 'see while you treat' is unique in the aesthetics category and is an asset to providers performing the treatment to ensure optimal treatment experiences for patients."
Likens continued, "This clearance demonstrates Ulthera's continued commitment to advancing the Ulthera System and underscores our dedication to add more value to the platform during each year of physician ownership. Providers and patients recognize ultrasound as a major factor in aesthetics, and Ultherapy is at the forefront of that movement."

Dr. Kratschmer Issues Warning About Tummy Tucks

Dr. Kratschmer personally asked that I share this article with his patients.  Often we hear about patients traveling to other countries for cheaper plastic surgery, but this happens far too often --

Bronx woman died seeking cheap tummy tuck surgery in Dominican Republic; her shocked family demands answers

Beverly Brignoni, 29, flew to Santo Domingo with her boyfriend, Lesley Martinez, for a tummy tuck at a reduced price. But she did not survive the procedure. A doctor told her stunned family she died of a pulmonary embolism.

A Bronx beauty who traveled to the Dominican Republic for affordable plastic surgery died on the operating table — and now her family wants answers.

Beverly Brignoni, 29, was an upbeat and happy single mother when she flew to Santo Domingo on Feb. 19 to get a tummy tuck at a clinic her friends had recommended.

A day later she was dead — the victim of a pulmonary embolism, the doctor told her stunned family.
“I’m still trying to understand it. I can’t really comprehend that she’s gone,” said boyfriend Lesley Martinez, 32, who made the fateful journey alongside his girlfriend of one year.

“I was with her right up until she went into the surgery. We kissed goodbye, said we loved each other, and they wheeled her away,” he said. “That was the last time I saw her.”


When Martinez and Brignoni flew into Santo Domingo on the night of Feb. 19, they made a brief stop at the Vista del Jardin Medical Center, where her surgery was scheduled.
The nurses did a quick check of Brignoni’s blood pressure and cleared her for a 7 a.m. start the next day, Martinez said.

The couple spent the night in the house of a woman who frequently hosted clients of the clinic. Brignoni’s friends had given her the name, Martinez said.
Brignoni, who worked as a receptionist in various salons, lived with her daughter, Madison, 4, in the house she owned in the Bronx.

“She had recently lost a lot of weight and she just wanted some surgery to tighten things up,” said her godmother Bernadette Lamboy. “I can’t believe this happened to her. We want to know exactly what went wrong.”

Lamboy said the young mother spoke to surgeons in New York and the Dominican Republic before settling on Dr. Guillermo Lorenzo at Vista del Jardin.  She was lured by the cheap price, Lamboy said. Brignoni paid $6,300 to get a tummy tuck and have her backside and breasts lifted.

But at the last minute, she and her doctor decided only to do the tummy tuck and they worked out a partial refund. Shortly after his girlfriend’s surgery started, Martinez was handed her clothes and brought to a recovery room to wait for her. When Lorenzo appeared, at 3 p.m., he brought the worst possible news.

“He said he was so sorry, that she was gone, that he had lost her,” said Martinez. “He said she had an embolism and died.”


The family has now secured a lawyer on the island and plans to sue the clinic and Lorenzo. Vista del Jardin was briefly shut down after Brignoni’s death when Health Ministry officials inspected it and found bacteria and violations of bio-sanitary regulations. The doctor did not respond to calls for comment.

The U.S. Centers for Disease Control issued an alert March 7 when at least 19 women in five states developed serious wound infections involving a virulent from of bacteria over the previous year following cosmetic procedures in the Dominican Republic.

Reference: http://www.nydailynews.com/new-york/cheap-plastic-surgery-kills-bronx-woman-article-1.1741120




Tuesday, July 15, 2014

Join Us For a Special Event - Featuring Ultherapy

Join us for a Summer Sunset Sangria and listen to Dr. Kratschmer speak about Ultherapy, the ONLY FDA cleared treatment that actually lifts -- face, neck, and now décolleté!  Say goodbye to sagging skin.

  • One-time only special pricing
  • One-time only special financing options

Limited seats available, RSVP right away!  The first 20 guests to RSVP will receive the NEW SkinCeuticals Physical Fusion Eye (full retail size) FREE.  Don't wait, RSVP now by clicking here: http://www.chicesthetiq.com/#!specials/cdh1