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Oculoplastic And Cosmetic Surgery
Laser Skin Resurfacing
Laser skin resurfacing is a
relatively new laser procedure to improve the appearance
of the skin. The laser burns the superficial layers of
the skin to treat wrinkles, scarring, or facial pigment
abnormalities. When the skin heals, the new skin layers
are tighter and the wrinkles are less apparent.
The laser can be used to treat the entire face, or can
be limited to the fine wrinkles around the eyes and
mouth. Aging, cigarette smoking and a lifetime of sun
exposure are some of the factors associated with
wrinkles. Laser skin resurfacing is not a substitute for
a face lift procedure, which tightens and repositions
loose skin on the face and neck, but can be combined
with it to diminish some of the fine wrinkles. Younger
patients who are not yet candidates for a face lift may
be candidates for the laser procedure.
Laser resurfacing can be done as an outpatient procedure
using local anesthesia. If the entire face is treated or
if this procedure is combined with other cosmetic
procedures, intravenous sedation or a general anesthetic
may be used. The procedure can last from a few minutes
to two hours depending on the treatment area.
After surgery, the treated skin must heal much like any
wound that removes skin. There is significant swelling
of the treated skin, especially around the eyes and
lips. If treatment included upper eyelids, the eyes may
be swollen shut. New skin layers take five to ten days
to grow, depending on the depth of treatment with the
laser.
Laser skin resurfacing has advantages over traditional
resurfacing methods such as chemical peels and
dermabrasion. Healing is generally quicker and there is
less postoperative discomfort after a laser treatment.
While there is similar redness and swelling after
surgery, there is less chance of scarring or skin
pigment changes.
A consultation with your physician is necessary to
determine if you are a candidate for laser skin
resurfacing in combination with other types of cosmetic
surgery or as an alternative to other procedures. It is
important to tell your physician if you have had
previous cold sore infections, are using the drug
Accutane, or have any other conditions that might
interfere with normal healing. |
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Ptosis
Ptosis is drooping of the upper
eyelid. The lid may droop only slightly or it may cover
the pupil entirely. In some cases ptosis can restrict
and even block normal vision.
Congenital ptosis, or ptosis that is present at birth,
requires treatment for normal visual development.
Uncorrected congenital ptosis can cause amblyopia, or
lazy eye. If left untreated, amblyopia can lead to
permanently poor vision.
Except in mild cases, the treatment for childhood ptosis
is usually surgery to tighten the levator muscle that
lifts the eyelid. In severe ptosis, when the levator
muscle is extremely weak, the lid can be attached or
suspended from under the eyebrow so the forehead muscles
do the lifting. Children with ptosis, whether they have
had surgery or not, should be examined annually by an
ophthalmologist for amblyopia, refractive disorders, and
associated conditions.
Ptosis in adults is commonly caused by separation of the
levator muscle from the eyelid as a result of aging,
cataract or other eye surgery, an injury, or an eye
tumor. Adult ptosis may also occur as a complication of
other diseases involving the levator muscle or its nerve
supply, such as diabetes.
If treatment is necessary, it is usually surgical.
Sometimes a small tuck in the levator muscle and eyelid
can raise the lid sufficiently. More severe ptosis
requires reattachment and strengthening of the levator
muscle.
The risks of ptosis surgery include infection, bleeding,
and reduced vision, but these complications occur very
infrequently. Although improvement of the lid height is
usually achieved, the eyelids may not appear perfectly
symmetrical. In rare cases, full eyelid movement does
not return. |
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Tattoo Removal
Tattooing is the ancient art of
permanent body painting, accomplished by inserting various
pigments into the skin with a needle. These pigments, or
inks, sometimes last much longer than we wish they did.
Attempts at removing tattoos have generally not been as
successful as the initial tattooing efforts.
Dermabrasion and the use of either argon or carbon dioxide
lasers have been used to remove tattoos but these methods
often cause scarring. Tattoo removal is most effective using
a type of laser called a Q-switched laser, which removes
most tattoos with less associated scarring. There are three
types of Q-switched lasers: Ruby, Alexandrite, and Nd: Yag.
The laser emits very short flashes of light called pulses.
Each pulse may produce discomfort similar to the snap of a
rubber band against the skin. The laser uses light to
disperse the pigment within the skin, permitting the body to
reabsorb some of the pigment. Lasers are designed to produce
light at very specific wavelengths. The tattoo pigment
better absorbs the wavelength of light produced by the laser
than the surrounding skin. The light absorption fades the
tattoo pigment without injuring the surrounding skin.
Multiple treatments are typically required to remove a
tattoo. Professional tattoos may require 6 to 10 treatments,
while amateur tattoos may only require 4 to 6 treatments.
The number of treatment sessions depends on the amount and
type of ink used, and the depth of the ink in the skin. Dark
blue, black and red inks respond best to treatment. Orange
and purple inks respond well. Green and yellow inks are the
most difficult to remove, although additional treatments can
produce significant fading. Complete tattoo removal is rare.
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