Januari 12, 2017
hi this is dr. young seattle plastic surgeon. what were doing is treating acne scarring there are a lot of different ways to treat ice pick scars that's what we are concentrating on today i'm going to talk about all the different options i wanted to show you the different types of acne scarring here. so this is typically what people call ice pick scarring once they start getting bigger, you start calling them box car scars. essentially how that happens your hair follicles grow really deep
in your skin. and when you get infected they cause a lot of scarring underneath your skin that essentially leads to a degradation of the collagen through the inflammation and infection that it causes and tissue underneath it is essentially eaten away by the infection and inflammation and hence what you end up having is adhesions from the skin to the deeper structures. that's why you get you get these little ice pick scars usually its around previous hair follicles that have gotten inflammed before.
there are different ways to try to improve that in general acne scarring is hard to improve but one thing that were doing today is that we have marked here what we have marked here for the bigger ones were going to be doing some excisions they can be improved by some different techniques this is what we elected to do for him. this what we think is the best for these particular scars in order to allow the adhesions to come away from the deeper structures a lot of people do subcision where they take an instrument
to go underneath to try to cause scarring to make these little depressions and ice pick scars to rise up and away from the deeper structures by creating a layer of scar tissue underneath another way of going about doing that is actually grafting fat all through a layer underneath the skin in order to create a layer under the skin that causes the skin to come away from the underlying deeper structures that is leading to these ice pick scars. in addition that fat grafting can bring more vascularity to the whole area to allow the skin to heal in that regard through stem cells, the vascularity and the volumizing that you get with fat grafting. other ways to improve these ice pick scars are to cut around it and elevate the tissue or take punch grafts from behind the ear in the same size then take out the scar tissue and then graft the tissue in the scar
alot of times you will see a circular lesion there that is not as a favorable of an outcome. where you could just excise it and get a better outcome what were doing again here is the excision of these scars and what we are doing now is using a very concentrated form of trichloroacetic acid its eighty percent and this is sort of a technique that you know we're doing it differently right here i'm using a broken off q tip and i'm going right into the ice pick scars and adding some liquid in there. as you can see its turning white as its undergoing a little chemical peel. this is one way to do this. as you can tell its turning white and we've done it in these other areas. too. so we're going to keep doing this for these other little depressions to try to get them to raise up.
anyways i wanted to show this technique of using tricholoracetic acid to cause some of these ice pick scars to come up and other than that the other technique that we could consider for him is fat grafting or subcision to make them elevate the ice pick scars thank you
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