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Others

Subcision

Subcision is a minimally invasive surgical technique widely utilized in aesthetic medicine for the treatment of facial scars, particularly those resulting from acne, surgery, or trauma. This procedure aims to improve the appearance of depressed scars by releasing the fibrous bands that tether the skin to underlying tissues, allowing for improved skin texture and contour.

Mechanism of Action

Fibrous Adhesion Release
Facial scars often form as a result of collagen remodeling and fibrous tethering of the skin to deeper structures. Subcision involves the use of a specialized needle or cannula to create controlled trauma beneath the scar tissue, disrupting these fibrous connections. This process allows the skin to elevate and fill in the depressed areas.

Collagen Remodeling
The micro-trauma induced by subcision stimulates the body's natural healing response, leading to increased collagen production and remodeling in the treated area. Over time, this results in improved skin texture, reduced scar visibility, and enhanced overall skin quality.

Subcision is particularly effective for treating rolling and boxcar scars, which are often resistant to other treatments such as laser therapy or chemical peels. It can also be employed to improve the appearance of scars from surgical procedures or injuries, making it a versatile option for scar management.

Technique

The procedure is performed under local anesthesia to minimize discomfort. The practitioner inserts a fine needle or cannula into the subcutaneous layer beneath the scar, carefully disrupting the fibrous bands while preserving the surrounding tissue. The entire process typically lasts between 30 minutes to an hour, depending on the extent of treatment.

Combination with Other Treatments
Subcision is often used in conjunction with other modalities, such as fillers, microneedling, or laser treatments, to enhance overall outcomes and provide comprehensive scar management.

Subcision is a highly effective and minimally invasive treatment option for individuals seeking to improve the appearance of facial scars. By targeting the underlying fibrous structures responsible for tethering the skin, subcision not only enhances skin texture but also promotes natural healing processes. As part of a comprehensive scar management strategy, it continues to be an invaluable tool in aesthetic medicine, helping patients achieve smoother, more rejuvenated skin.

Corticosteroid Injection for Keloid Removal

Corticosteroids are commonly used to reduce the size and appearance of keloids due to their potent anti-inflammatory and immunosuppressive properties. Keloids are overgrowths of scar tissue that form due to an excessive healing response after skin injuries, surgeries, or inflammation. Corticosteroid injections, particularly triamcinolone acetonide, are a popular treatment option for managing keloids.

Fibroblasts are the cells responsible for producing collagen, the protein that forms scar tissue. In keloids, fibroblasts become overactive, leading to excessive collagen deposition. Corticosteroids suppress the activity of fibroblasts, which reduces the production of collagen and other components of the extracellular matrix that contribute to the bulkiness of keloid scars.

Keloids often result from chronic inflammation during the wound-healing process. Corticosteroids work by reducing inflammation in the keloid tissue. By decreasing the release of inflammatory mediators, such as cytokines, corticosteroids help calm the overactive healing response that leads to keloid formation.

This reduction in inflammation helps shrink the keloid and prevents it from becoming thicker or more raised.

Corticosteroids cause vasoconstriction (narrowing of blood vessels), which reduces blood flow to the keloid tissue. By limiting the blood supply, corticosteroids help minimize nutrient and oxygen delivery to the overactive fibroblasts, slowing their activity and reducing scar growth. It also reduces the release of growth factors such as TGF-beta (Transforming Growth Factor-beta), which plays a key role in promoting excessive collagen production and scar formation in keloids. By inhibiting these growth factors, corticosteroids prevent further expansion of the keloid.

Chemical Peel

Chemical peels are a widely used cosmetic procedure in aesthetic medicine, designed to enhance skin texture, tone, and overall appearance. By applying a chemical solution to the skin, these peels facilitate the exfoliation of the outer layers, promoting the regeneration of new, healthier skin. Chemical peels can effectively address a variety of skin concerns, including acne, hyperpigmentation, fine lines, and sun damage.

Chemical peels utilize various acids, such as alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), and trichloroacetic acid (TCA), to induce controlled exfoliation. The type and concentration of the chemical used will depend on the specific skin issue being addressed and the desired depth of penetration. The applied solution causes the outer layers of dead or damaged skin to slough off, revealing fresher, healthier skin beneath. This process stimulates the body's natural healing response, promoting collagen production and cellular turnover, which can improve skin texture, reduce the appearance of fine lines, and enhance overall skin radiance.

Superficial Peels

These peels, often using AHAs or BHAs, exfoliate the outermost layer of skin. They are ideal for improving skin texture, minor pigmentation issues, and enhancing overall skin radiance. Superficial peels require minimal downtime and can be performed frequently.

Medium Peels

Typically utilizing TCA, medium peels penetrate deeper into the skin, targeting more significant concerns such as moderate sun damage, fine lines, and more pronounced pigmentation. Patients may experience redness and peeling for several days post-treatment.

Deep Peels

Utilizing stronger acids, deep peels penetrate significantly into the dermis to address severe skin damage, including deep wrinkles and advanced sun damage. Recovery time is longer, often requiring several weeks for complete healing.

Chemical peels can effectively treat a variety of skin conditions, including:

• Acne and acne scars

• Hyperpigmentation and melasma

• Fine lines and wrinkles

• Sun damage and uneven skin tone

• Rough texture and enlarged pores

Chemical peels are a powerful tool in aesthetic medicine, offering patients a versatile and effective solution for a variety of skin concerns. By promoting exfoliation and regeneration, chemical peels can significantly enhance skin quality, delivering noticeable improvements in texture and tone. As part of a comprehensive skincare regimen, chemical peels continue to be a valuable option for those seeking to rejuvenate and revitalize their skin.