Hi everyone, I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My focus is primarily on acne scars, pigmentation issues, and facial balancing through collagen stimulation. Today, I want to share a remarkable case that highlights the complexities and successes of treating keloids alongside other types of scarring.
A Complex Case of Keloids and Scars
Recently, I worked with a patient who had a combination of atrophic, hypertrophic, and keloid scars. This made his treatment particularly challenging because while addressing one type of scar, we had to ensure we didn’t exacerbate the keloids. The journey was intense but rewarding, and after a year, the results speak for themselves.
Initial Assessment and Treatment Plan
When this gentleman first approached me, he was skeptical about whether any improvement was possible. His skin, of Vietnamese origin, presented unique challenges due to its sensitivity to heat and energy-based treatments. We embarked on a multi-faceted approach:
- TCA Cross : For boxcar scars, we used TCA cross, applying it directly into each individual scar.
- CO2 Laser : Targeted thicker parts of the scars with precision.
- Subcision : To break up scar tissue and promote collagen production.
- Bellafill : A specialized filler to address volume loss effectively.
Ongoing Progress and Final Touches
One year later, the transformation is evident. We’ve continued enhancing his results with additional treatments like Bellafill and laser sessions. The patient’s happiness reflects not just physical improvement but also a renewed sense of confidence and well-being.
Comprehensive Approach to Treating Keloids and Other Scars
Treating keloids involves a delicate balance. The key is avoiding excessive heat or energy that might worsen the condition. Instead, localized treatments with surgical handpieces help smooth down thick scars while managing underlying issues.
Importance of Patient Compliance
This success story underscores the importance of patient compliance. Our wonderful patient followed every step meticulously, ensuring optimal outcomes. It’s crucial to understand that such journeys require patience and dedication, often spanning years rather than months.
Advancements in Scar Treatment Techniques
Over the years, advancements in scar treatment techniques have significantly improved outcomes. Here are some notable innovations:
Subcision and Cannula Use
Traditional subcision methods have evolved. While sharp tools like Taylor liberators can be effective, they come with risks. Most scar tissue can be broken up using blunt cannulas combined with Nokor needles. This method minimizes risks while achieving excellent clearance.
Surgical Dermabrasion vs. Microdermabrasion
Surgical dermabrasion stands in stark contrast to microdermabrasion. In surgical dermabrasion, we sand down scars using sterile sandpaper, reaching deep into the scar base. This procedure is bloody and requires precision, but when done correctly, it yields transformative results without the risks associated with motorized tools.
Addressing Common Concerns and Misconceptions
There are many misconceptions about scar treatments. Let’s debunk a few:
Filler Misuse
Fillers can sometimes be misused in scar treatments. Hyaluronic acid fillers may help with volume loss but often displace around scars if subcision isn’t performed correctly. Proper technique is crucial to avoid lumpy results.
Myths About CO2 Lasers
Some practitioners recommend RF microneedling over CO2 lasers for scar treatment, citing safety concerns. However, CO2 lasers offer unparalleled results when used by skilled hands. RF microneedling provides minimal tightening and isn’t comparable in effectiveness for scar resolution.
Questions Answered
Here are some common questions I received during my live session:
-
Question: What treatment is this?
Dr. Qazi: This involves a combination of TCA cross, CO2 laser, subcision, and Bellafill tailored specifically for patients with complex scarring including keloids. -
Question: I'm thinking of doing CO2 laser for scarring. What do you think?
Dr. Qazi: CO2 laser can be effective if used correctly. It's essential to apply it locally and carefully to avoid complications, especially with keloids. -
Question: How many sessions?
Dr. Qazi: Typically, multiple sessions are required. For instance, this patient underwent two laser sessions, several TCA cross procedures, and additional Bellafill injections. -
Question: My doctor suggested me to take hyaluronic acid for my temporary scar removal. Will it work because I have deep scars?
Dr. Qazi: Hyaluronic acid might help slightly with volume loss but won't address deep scars adequately. Subcision combined with fillers like Bellafill offers better long-term results. -
Question: Hi doctor, after an acne scar excision, how long after can the laser resurfacing be done?
Dr. Qazi: Laser resurfacing can often be performed immediately following excision, depending on the specific circumstances and healing progress. -
Question: Is it hard to get results as someone that is closer to 30?
Dr. Qazi: Age isn’t necessarily a barrier. With proper techniques and commitment, significant improvements can be achieved regardless of age. -
Question: What qualifications are necessary when looking for the right dermatologist or what to look for?
Dr. Qazi: Look beyond qualifications; seek practitioners experienced in scar treatments who prioritize manual skill over reliance on expensive devices or products. -
Question: How long after finishing Accutane can you start doing laser treatment?
Dr. Qazi: Depending on the dosage, laser treatments can sometimes commence even while on Accutane. Consultation with your dermatologist is vital. -
Question: What amount of tretinoin 0.025% should be applied on a daily basis and how should it be applied?
Dr. Qazi: Use a pea-sized amount mixed initially with Vanicream for the first two weeks. Gradually increase application as tolerated. -
Question: How do I book a consultation?
Dr. Qazi: Visit doctorqazi.com to view our services and schedule a consultation directly. -
Question: Does PRP work for scars?
Dr. Qazi: PRP aids in the healing process but doesn’t directly treat scars. Combination therapies yield the best results. -
Question: Can subcision treatment work for rolling scars?
Dr. Qazi: Absolutely. Subcision effectively breaks up scar tissue, improving the appearance of rolling scars significantly. -
Question: How deep do you go with surgical dermabrasion? Is it aggressive enough to form a scab?
Dr. Qazi: Surgical dermabrasion goes deep enough to reach the base of the scar, promoting new skin growth and forming protective scabs. -
Question: How long was the recovery time difference in these two photos?
Dr. Qazi: Recovery varies, but noticeable improvements can appear within a year, as seen in this patient’s before-and-after images. -
Question: Fat transfer or Bellafill—does one improve indented scars more than the other?
Dr. Qazi: Both are beneficial. Fat transfer addresses volume loss, while Bellafill provides lasting support beneath scar tissue. -
Question: What is the downtime for combination session? How long until you could put on makeup?
Dr. Qazi: Downtime typically ranges from four to seven days, though residual redness may persist. -
Question: Do you prefer TCA or phenol for cross?
Dr. Qazi: I prefer TCA for its versatility and adjustability in concentration, though phenol has its uses. -
Question: Hi doctor, I've done fractional CO2 laser and Bellafill. That did not work. What would you suggest?
Dr. Qazi: Additional subcision and volume replacement might be necessary. Each case is unique, and tailored solutions are key. -
Question: Hi Dr. Qazi, what is the best stem factor growth factor serum post treatment?
Dr. Qazi: While some opt for Elastin Skin Nectar, I focus on protocols involving microvascular circulation and cleanliness for optimal healing. -
Question: Hi doc, how do you handle patients who are not satisfied with results?
Dr. Qazi: Objectively assess each situation. Sometimes, adjustments or further treatments are needed. Open communication ensures mutual understanding and satisfaction. -
Question: Is the result permanent or does it take multiple sessions just to maintain it?
Dr. Qazi: Results are generally permanent, although natural aging processes will occur. Bellafill remains effective indefinitely. -
Question: How did you help your scars?
Dr. Qazi: Through self-discovery and collaboration with experts globally, I developed innovative techniques that transformed my approach to scar treatment.
Conclusion
Treating keloids and other forms of scarring requires expertise, patience, and a personalized approach. By sharing these insights, I hope to empower others seeking solutions for their skin concerns. Remember, there’s always hope, and with the right care, transformative results are achievable.
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