April 3, 2003
Welcome to the 8th issue of my ezine. It is amazing how many more people keep signing up. Keep telling all your friends and neighbors It's free and a fun way to learn about plastic surgery. I am absolutely overwhelmed by the tremendous number of questions I keep receiving. Again, I will pick out a few that I think are interesting and let you see how I answered them. I again thank everyone for their interest and ideas. Keep emailing your questions.
Just to let everyone know - our Yahoo Store is now fully operational!
About 30% of the emails we received from you begged us to make it easy to purchase all the physician-strength skin care products and anti aging supplements we sell at our office available to everyone on the internet. We would routinely process 4-6 orders a day via email and telephone. Well, we finally listened to you. You can find everything we have at www.prplastic.net - skincare, anti aging supplements, scar treatments.
Back to helping you.
Our first question is from NC:
Email Question - I have a 27 yr old daughter who has a keloid scar on her ear. She received it when her ears were pierced about 8 yrs ago. She has been to one doctor who tried to freeze it off and then she did surgery in it. She told her that it should go away soon, but never told her to make a f/u appointment. Of course the only thing that happened is that the scar got bigger. Last year she went to another doctor and he told her to check back in about 6- 10 months and maybe there may be some new type of laser surgery that can be used. I was wondering is there anything that you and any of your colleagues know that can help my daughter. I have sent her your information by email, but I know she will be afraid to send anything because she is afraid that nothing can be done. So, please let me know if anything can be done. Thank You.
Email Answer - Keloids are an abnormal proliferation of scar tissue. We are making significant headway as to the reason why this happens on a genetic level. There are many treatments for keloids. However, there is always a risk that it can come back, sometimes bigger. I have extensive experience with keloids as I did 6 months of my Plastic surgery fellowship at Cook County hospital where we dealt with this problem quite frequently. The treatment options include steroid injections (Kenalog), injections with a chemotherapy medication (5FU), excision with injections, preoperative retin-A (dramatic decrease in recurrence rate), and radiation therapy. More keloid information can be found at http://www.prplastic.com/new_page_34.htm. Obviously, I would need to see her to evaluate her keloid(s) and give you my recommendations based on size, prior treatments etc. The consultation and procedure are usually covered by insurance. Thanks for your question.
Most scars can also benefit from Fotofacial.
For a better understanding of acne as well as some pictures, check out our web site at http://www.prplastic.com/new_page_5.htm
Our next question is from DI:
Email Question - 1. Hello Dr. Sam Speron. I recently read that 2,500 surgeons meet in San Antonio on 11-03-02. I also read some new discoveries on the science poster section. The one's I was interested in were scar and skin rejuvenation. They are as followed:
#510 P3 (aV intergrin with enhanced collagenase / JAB 1) to control scar remodeling.
#381 P33 (Induction of HSP47 protien) significantly changes scars such as keliod; red, white, and hard hypertropic; and flat or atrophic.
#1025 P59 Hydrogel; bilayer skin regeneration using Pluronic F-127
#506 P72 (AMFSP); (ECM); and Fluphenazine
Anyways, when will these come out? In your medical opinion, do you think we are anywhere near the making of new skin in this day and age? How can I volunteer in this type of research (to be in the experimental or controlled group) to replace my skin?
2. I would like to get a tummy tuck, a little lipo, and perhaps a thigh lift. I am a 24 year old woman who has been weight training for two years, and I am very fit. Although I do have loose skin on my upper thighs and lower abdomen, I also have stretch marks on both which I hate, and I wish they would come out with a magic laser already. I was wondering, can a permanent or temporary tattoo cover the scars from the previous mentioned surgeries? Or do you think I should wait it out because science is SO advanced, and there WILL be a cure soon?
Email Answer - The topics you mentioned are very exciting and the articles in our journal look promising. However, you must understand that some are nowhere near clinically applicable yet. Things like Appligraft skin substitute from neonatal foreskin with added growth factors is great for certain wounds and I use it frequently. There are also several skin substitutes for burn patients that are essentially skin replacements. I'm not sure what you want new skin for or how you mean your comments. I don't think we will be able to take off your skin and put new skin on you without the morbidity (scars, surgeries, etc.). Again, when needed in burn patients and reconstruction cases, it is great. For purely cosmetic reasons (and I'm not sure why since we have other ways to treat a variety of skin problems without needing to remove your skin. Collagenase is an exciting new option for keloids and scars but testing is still ongoing.
I am glad you are in shape. Stretch marks are hard to treat. They are essentially a tear of the dermis (second layer of your skin). If they are red, laser is great to turn them white. If they are white(mature), laser can make them 10-30% better. The best way to get rid of them, though, is to cut them out - tummy tuck, butt lift, thigh lift etc.
You can always tattoo a scar to make it blend better into your natural skin tone. You should wait until the scar is mature or white because the tattoo will last longer and you'll get a better result. Remember, skin color changes with tanning etc. Don't try to match the color exactly.
Science is always advancing and I think nanotechnology (robots performing surgery on a cellular and genetic level), robotic surgery (robots have better technical skills than humans), anti aging medicine (we are even figuring out why cells die and are learning about these triggers and how to control them), genetic engineering (we are learning how to replace any tissue and plastic surgeons are at the forefront of this technology) are just a few of the more exciting revolutions taking place.
Thanks for your questions!
Thinking of visiting a plastic surgeon??
I think a great place for you to start is the 7 critical questions on our site at http://www.prplastic.com/7_critical_questions_to_ask_any_plastic_surgeon.htm. These are the things you should look for in your selection process. I think they will be helpful.
The ASPS site at www.plasticsurgery.org will also give you a list of board certified plastic surgeons in your area.
We are always available if you decide you would ever want a consultation with Dr. Speron. He frequently sees patients from out of town and we try to make special provisions.
Remember, no other plastic surgeon I know has ever had an ezine. They don't know how to tell others about what they do, what they should ask other surgeons etc. Some have a boring stuffy newsletter that is preprinted and they just add their name or something. This is not like that! You will not find useless stuff intended to get you to come in and see me and spend money in my office. Just help. Information. Remember, knowledge is power.
By the way, Happy Easter. I hope you all have fun but stay healthy.
Email me - ask whatever you want. You are the ones that will help make this ezine fun and exciting. What do you want to know?? Ask anything! Ask away.
Dr. Sam Speron
Plastic & Reconstructive Surgeon
P.S. I want everyone to remember I'm doing this for you. I want everyone to become a well-informed consumer. But, I also want it to be easy and fun to read. I want you to look forward to getting it. Email me. What's boring? What's exciting to you? Let me know. You are the heart and soul of this newsletter. Are we still having fun??