As a skin restoration specialist based in Newport Beach, California, I focus primarily on treating acne scars, pigmentation issues, and overall skin quality. One of the most rewarding aspects of my work is witnessing the transformative results that can be achieved through comprehensive treatment plans like CO2 Laser, Bellafill, TCA Cross and other treatments. Recently, I had the pleasure of working with a patient whose journey exemplifies the potential for remarkable improvement with just a single combination session.
When he first came to me, her primary concerns were acne scars and uneven pigmentation. We performed a single combination treatment in April of last year, and when she returned in January for a follow-up, the results were truly remarkable. His skin tone had improved significantly, the pigmentation was more even, and the overall texture of her skin was smoother. This success was due not only to the treatment itself but also to her diligent post-treatment care, particularly her commitment to avoiding sun exposure and managing oil production effectively.
Approach to Skin Restoration (CO2 Laser, Bellafill, TCA Cross, Sculptra)
In treating him, we utilized several techniques, each targeting different aspects of her skin concerns. We began with TCA Cross, an effective method for addressing deep scars by applying trichloroacetic acid directly into the scar tissue. This process stimulates collagen production and helps to lift depressed scars.
We complemented this with both ablative and fractional CO2 laser treatments, which are excellent for resurfacing the skin and reducing the appearance of scars. The erbium laser was another tool in our arsenal, providing a gentler alternative for skin resurfacing while still achieving significant improvements in texture and tone.
Additionally, we incorporated Bellafill, a long-lasting dermal filler, to provide volume replacement where needed. Through the laser tunnel holes created during the procedure, we introduced a diluted form of Sculptra, which further enhances collagen production over time. Subcision was also performed to break up the fibrous bands tethering the scars to deeper tissue layers, allowing the skin to rise and heal more evenly.
The Importance of Post-Treatment Care
Her success was not solely due to the treatments themselves. She adhered strictly to post-treatment guidelines, which included meticulous sun protection and maintaining a consistent skincare routine. These factors played a crucial role in ensuring optimal healing and minimizing the risk of complications such as hyperpigmentation.
Addressing Common Concerns and Misconceptions
One common question I often encounter is about the Vbeam laser. While it's useful for red marks and rosacea, caution is necessary when using it on darker skin types due to the risk of rebound hyperpigmentation. In our practice, we prefer using the Excel V device, which offers excellent contact cooling, making it safer for use on all skin types.
Another frequent concern is whether lasers alone can address deep acne scars. Rarely is a single laser treatment sufficient; multiple modalities like TCA Cross, subcision, and volume replacement are often required to achieve the best outcomes. The atrophic areas need careful attention and may require additional sessions depending on the severity of the scars.
Advanced Techniques and Their Applications
For those curious about specific techniques, let’s delve into some advanced methods:
- TCA Cross: Ideal for ice pick scars, this technique involves applying trichloroacetic acid directly into the scar. It stimulates collagen production and lifts the scarred area.
- Subcision: This procedure breaks up the fibrous bands that tether scars to deeper tissues. When done carefully, it prevents sagging, especially in sensitive areas like the lower face.
- Volume Replacement: Using fillers like Bellafill or Sculptra, we can add volume to areas where fat cells have been damaged or destroyed, creating a smoother skin surface.
Tailoring Treatments to Individual Needs
Different skin types and conditions necessitate tailored approaches. For instance, Asian skin requires precise handling due to its susceptibility to pigmentation changes. By using sharper settings along scar edges and lighter blending elsewhere, we ensure optimal results without prolonged healing or pigmentation issues.
Forehead scars respond exceptionally well to subcision and filler treatments, especially when volume loss is present. Conversely, back scars benefit more from volume replacement and strategic use of Bellafill rather than aggressive laser treatments, given the higher risk of friction-related complications.
Managing Expectations and Long-Term Results
It's essential to manage expectations regarding recovery times and final outcomes. Some patients see significant improvements within six months to a year, while others may require longer periods for complete results. Factors like cost and personal satisfaction often influence how many sessions a patient chooses to undergo. My goal is always to make scarring less visible and improve overall skin quality, not necessarily to chase perfection.
Frequently Asked Questions
- What do you think of Vbeam laser?Dr. Qazi: The Vbeam laser is quite useful for addressing red marks and rosacea. However, caution is necessary when using it on darker skin types, as there's a risk of rebound hyperpigmentation. In our practice, we prefer using the Excel V device, which offers excellent contact cooling, making it safer for use on all skin types.
- How many times do you perform CO2 laser treatments?Dr. Qazi: The frequency depends on the severity of the scars. Sometimes, one or two sessions suffice, but thicker scars might require additional treatments. It's important to note that lasers are often just one component of a multifaceted approach. Techniques like TCA cross, subcision, and volume replacement are equally vital.
- Do acne scars equal damaged skin barrier?Dr. Qazi: Not exactly. A damaged skin barrier typically refers to over-exfoliation or extreme dryness. Acne scars, on the other hand, result from a hyperimmune response that leads to scar tissue formation and sometimes fat cell destruction, creating atrophic areas.
- Do you offer laser facials?Dr. Qazi: Yes, we do. Our laser facials involve applying a black mask followed by laser treatment to exfoliate the skin gently, similar to what some call a "Hollywood facial."
- Could you perform a fully ablative CO2 laser in this case?Dr. Qazi: While I did use fully ablative CO2 laser on specific scar edges, I generally avoid full-face ablative treatments. Instead, I focus on targeted areas where precision is key.
- What is the best laser for hyperpigmentation and sun damage on brown skin?Dr. Qazi: The Pico laser is highly effective for hyperpigmentation and sun damage on brown skin. However, it's essential to manage expectations and be prepared for potential rebound pigmentation, which can be mitigated with proper suppression techniques.
- What is the best treatment for deep forehead and back scarring?Dr. Qazi: Forehead scars respond well to subcision and filler treatments, especially when volume loss is present. For the back, I tend to favor volume replacement and Bellafill rather than aggressive laser treatments, given the higher risk of friction-related complications.
- What can I do for textured skin if I've never had severe acne but have textured skin and mini pimples?Dr. Qazi: Start with over-the-counter retinoids like Differin cream. Consistent use can help improve texture and reduce the appearance of mini pimples. Ensure you're moisturizing adequately to prevent excessive dryness.
- Can you use pigment control cream in the morning and tretinoin at night?Dr. Qazi: Combining these products may lead to excessive dryness. I recommend using pigment control cream alone and focusing on intensive moisturization, especially with products like Vanicream.
- Can you suggest something for ice pick and boxcar scars?Dr. Qazi: For ice pick scars, TCA cross and excision are effective. Boxcar scars benefit from similar treatments, along with laser resurfacing and possibly some volume replacement with fillers like Bellafill.
- Is there anything from the drugstore that will help with these types of scars?Dr. Qazi: Over-the-counter options like Differin cream can be beneficial, though they may not address deeper scars as effectively as professional treatments.
- Does subcision cause sagging?Dr. Qazi: If performed improperly, subcision can potentially cause sagging, particularly in the lower face. However, with careful technique and attention to detail, this risk is minimized.
- How can I get rid of PIE (Post-Inflammatory Erythema)?Dr. Qazi: Lasers like XLV are effective for treating PIE. Additionally, topical treatments such as Aklief can be beneficial, although cost and insurance coverage may be limiting factors.
- What are the best scar treatments for Asians?Dr. Qazi: All the treatments mentioned can be effective for Asian skin, provided they are executed with precision. Using sharper settings along scar edges and lighter blending elsewhere ensures optimal results without prolonged healing or pigmentation issues.
Contact Qazi Cosmetic Center Today
Treating acne scars and improving skin quality requires a personalized and comprehensive approach. By combining advanced techniques like TCA Cross, laser resurfacing, subcision, and volume replacement, alongside diligent post-treatment care, we can achieve remarkable transformations. Whether you're dealing with deep scars, pigmentation issues, or textured skin, remember that patience and consistency are key.
If you're interested in having a consultation with me, you can call/text us at 949-336-7293 for more information or you can self-schedule a consutlation here.
