| In my 10 years as a practising
Beverly Hills plastic surgeon, I have seen countless
men and women walk through my door in hopes of reversing
the ravages of time. Where facelifts do produce a younger
look, scars in front and behind the ears often leave
prominent tell tale signs of plastic surgery. Facelift
scars have always been a dead giveaway and stigmata
of facial surgery and a major deterrent for many patients
considering facial rejuvenation. Being a plastic and
cosmetic surgeon gives me the ability to use my creativity
and establish new and innovative ways of making patients
look even better. At the June 2002 annual meeting of
the California Society of Plastic Surgery, I introduced
Laserclosure, developed to reduce facelift scarring.
Poor scarring may be genetic, yet it also occurs in
facelifts when an excessive amount of tension is placed
on the scar. When a facelift is completed, the extra
skin is pulled tight and cut off and the skin is sewn
up in front or behind the ears at the post-auricular
incision.
All of the tension is on that line of stitches/ which
can cause thick keloid or hypertrophic scars to form.
With Laserclosure, instead of cutting off the excess
skin at the closure line, I use that extra piece to
absorb all of the tension that would usually be placed
on the scar/ hence minimising it greatly.
The Laserclosure procedure takes a little more time,
yet the end results are quite remarkable. At the time
of closure, the facelift flaps are redraped under tension
in a standard fashion and the excess skin is marked
off behind the ears near the hairline. At this point,
the excess skin is de-epithelialised with the assistance
of the C02 laser, leaving the dermis fully intact.
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I then create two small
pockets opposite the incisions, making sure they are
large enough to accommodate the deepithelialised portions
of the flaps. The portions are anchored in place with
absorbable sutures. The skin edges are then permanently
sutured almost tension free leaving the incision line
to heal favourably. The result is a double-breasted
type of closure, where the de-epithelialised areas under
the skin carry all of the tension that would normally
be placed on the scar line. A very light incision line
is visible, but this procedure does not lead to the
formation of keloid and hypertropic scars.
All skin types
The Laserclosure procedure may be used
on all skin types. It is especially useful for darker
skinned patients that may be prone to keloid scars.
Laserclosure is also used on patients wanting scar revisions,
because of poor scarring on the incision line after
facelift surgery. Lately, many people have been shying
away from facial rejuvenation for fear of scarring that
may be worse than how he or she looked before surgery.
Large thick scars can be unattractive as well as embarrassing
for those who would like to keep their surgery a secret
and count other nature as blessing them with great genes.
But large scars belong to the past. |
