Hi, everyone. I'm Dr. Qazi, and I specialize in skin restoration, focusing on acne, scars, pigmentation, and facial balancing from my practice in Newport Beach, California. Today, I want to walk you through a fascinating case that highlights forehead scars and the transformative power of combining subcision, laser treatments, TCA cross, and fat transfer. This journey isn't just about physical transformation; it's also about understanding the emotional and societal impacts of scarring.
Patient Submitted Photos
This particular patient came to me with deep rolling scars on his forehead. At first glance, you might think these are just aesthetic concerns, but theyāre so much more. These scars were tethered and stuck, causing fat destruction and rapid aging. When he expressed himself, deep lines and wrinkles formed around the scars, making him look older than he was. It wasnāt just about vanityāit was about regaining confidence and feeling comfortable in his own skin.
We started with subcision, a procedure where we use a blunt cannula to break up scar tissue underneath the skin. This method is less invasive and avoids the pitfalls of overheating the skin with lasers, which can lead to texture issues, scarring, and pigmentation problemsāespecially in darker skin types. We followed this up with TCA cross and laser treatments to refine the skin's surface and then added volume with fat transfer. The results? Nothing short of spectacular.
Why Forehead Scars Are Unique
The forehead presents unique challenges. Unlike areas like the cheeks, thereās minimal fat to work with, meaning even slight scarring can cause significant fat destruction. This makes techniques like subcision and volume replacement crucial. Many people believe forehead and temple treatments are daunting, but in reality, theyāre often easier than expected. With the right approach, we can achieve remarkable improvements.
The Dark Side of Device Marketing
During my career, Iāve encountered numerous cases where patients received subpar treatment due to misleading marketing by device manufacturers. One patient, Lucky Singh, shared his experience of being pushed into unnecessary laser packages without proper examination. These companies often claim their devices are safe for all skin types, citing poorly conducted studies. For instance, one pivotal study involved only 36 patients, yet it was used to justify widespread use across all Fitzpatrick skin types. This lack of transparency and accountability is alarming.
Device manufacturers frequently sponsor key opinion leaders who promote these products without disclosing financial ties. As a result, practitioners may unknowingly use devices inappropriately, leading to complications like post-inflammatory hyperpigmentation. This issue extends beyond individual practicesāitās systemic. Until we address this, progress in dermatology will remain stagnant.
Empathy and Understanding in Patient Care
Treating scars goes beyond physical healing. Acne and scarring can profoundly impact mental health, self-esteem, and social interactions. One patient confided that he felt God hated him because of his acne and subsequent scars. Such stories underscore the importance of empathy and recognizing the silent suffering many endure.
Scars arenāt merely superficialāthey carry deep emotional weight. By acknowledging and validating these experiences, we create a supportive environment conducive to healing. This understanding drives my commitment to providing exceptional care tailored to each patientās needs.
Questions Answered
Question: Dr. Qazi, thanks for an awesome follow-up appointment today. I totally forgot to ask if laser would be on the table later down the line again.
Dr. Qazi: Absolutely! In fact, we can combine subcision and laser treatments in the same session. Just let my team know, and weāll set that up for you.
Question: Does being younger help with results?
Dr. Qazi: While thereās no definitive data, younger patients often exhibit faster collagen responses and quicker recovery times. However, success depends on various factors, including the treatment method and individual skin characteristics.
Question: Were you on vacation or did you change your live schedule?
Dr. Qazi: I was actually on paternity leave. During that time, I reduced my workload and took a break from live sessions. Now, Iām back and ready to continue sharing insights and helping patients.
Question: How much did the patient pay?
Dr. Qazi: Offhand, I estimate she spent between $5,000 and $7,000. However, Iāll need to verify that figure to provide an exact amount.
A Call to Action
To truly advance scar treatment, we must challenge the status quo. Practitioners should prioritize patient outcomes over profit-driven motives. Device manufacturers must be transparent about their productsā limitations. And society must recognize the profound impact of scarring beyond its physical manifestation.
By fostering collaboration rather than competition, we can elevate the field of dermatology. Together, we can ensure that every patient receives the compassionate, high-quality care they deserve.
Join me tomorrow night at 9:00 p.m. for another live session where Iāll delve deeper into these topics and showcase more incredible transformations. Until then, remember: healing is possible, and together, we can make a difference.
Expanding on Key Topics
Subcision and Its Importance
Subcision is a critical procedure in scar treatment, especially for tethered and deep scars. By using a blunt cannula, we can effectively break up scar tissue without causing additional damage. This method is particularly beneficial for areas like the forehead, where fat loss exacerbates the appearance of scars. My recent self-experimentation with subcision has further refined my technique, allowing me to offer even better results to my patients.
The Role of Fat Transfer
Fat transfer plays a pivotal role in restoring volume and achieving natural-looking results. For patients with significant fat destruction, adding volume can dramatically improve their appearance and confidence. This approach not only addresses the physical aspects of scarring but also enhances overall facial harmony.
Addressing Systemic Issues in Dermatology
The dermatology field faces systemic challenges that hinder progress. Misleading marketing by device manufacturers and the undue influence of key opinion leaders contribute to suboptimal patient outcomes. By advocating for transparency and accountability, we can drive meaningful change and improve the quality of care for all patients.
The Emotional Impact of Scarring
Scars carry more than just physical marks; they often signify emotional trauma. Many patients report feelings of low self-esteem, social withdrawal, and even depression due to their scars. Recognizing and addressing these emotional aspects is crucial for holistic patient care. Through empathetic treatment and support, we can help patients reclaim their confidence and quality of life.
Future Directions in Scar Treatment
The future of scar treatment lies in innovation and collaboration. By leveraging advancements in technology and fostering a culture of continuous learning, we can develop more effective and accessible treatments. Additionally, prioritizing patient-centered care ensures that we meet the diverse needs of our patients, regardless of their background or skin type.
In conclusion, the journey to effective scar treatment is multifaceted, requiring technical expertise, ethical practices, and genuine empathy. By addressing these elements, we can transform lives and pave the way for a brighter future in dermatology. Thank you for joining me on this enlightening exploration, and I look forward to continuing this conversation in future sessions.
