September 29, 2008
Pimple Scars
Illustration by Roberto Regachuelo Jr.
Dear Dr. Perry,
I have a problem about the scars on my face due to pimples. I have consulted a physician and she told me that she's going to inject the scars with silicone.
Please tell me about its complications and possible side effects on a person's health. How long will this treatment take? How much would it cost? Please help me.
Thank you very much.
Very truly yours,
Scarred88
 Dr. Perry replies:
Silicone injection for purposes of augmentation has been abandoned for several years now. Because of its unstable nature, the long term end result after injection is often unpredictsble.
A lot of complications have been observed after the use of large-volume silicone injection especially in the nose, eyes, chin, cheeks, and breasts. These include persistent redness, pain, and migration of the injected material to the more dependent portion of the area injected. Thus, large-volume silicone injection is now taboo in cosmetic surgery.
With our frustration in the use of Collagen injection in the treatment of acne scars, some physicians have used repeated doses of silicone injection in minute amounts to "fill-in" the depressed scars. Compared to the large volume injection, this latter technique does not develop the above mentioned complications.
Now, besides treatment of acne scars, they have extended its use to correct fine wrinkles of the face. So far, as long as the silicone injection was done in series and in very minute quantities, untoward complications have not yet been encountered.
Personally, I haven't tried this since there is still no long term follow-up as to its stability in the human tissue. Presently, my choice of treatments for acne scars are dermabrasion and autologous fat transplantation.
I recommend autologous fat transplantation initially before dermabrasion is considered since this entails a longer healing process. The fat to be transplanted is harvested from the same patient to prevent tissue rejection. Like silicone, the fat acts as a filler to smoothen the depression. This is later on vascularized (new blood vessels develop) and it becomes part and parcel of the recipient tissue.
If there are still unevenness after the transplant, dermabrasion is then utilized. This is like sandpapering with the use of a motor driven rotary machine and diamond fraized abrasive.
However, "ice-pick" marks cannot be corrected by either procedure. In this case, punch-excision with primary closure is done. This basically transforms a circular scar into a less visible linear scar.
More recently, another surgical procedure known as Subcision is being utilized to correct facial acne scars. With the use of a special surgical instrument, the undersurface (dermis) of the skin with acne scars is surgically separated from its attachment to the deeper subcutaneous layer. This "freed" layer of scar tissue will somehow "smoothen out" to make the scars less visible.
DR. PERRY DE LA CRUZ obtained his medical degree from the University of Sto. Tomas. He is a diplomate of the Philippine Board of Cosmetic Surgey; a fellow of the Philippine Society for Cosmetic Surgery, and the American Academy of Cosmetic Surgery; and a member of the Asian Pacific Academy of Cosmetic Surgery. He pioneered research on "Serial Revision of Leg Scars" in 1988.
Clinic:
Asian Hospital and Medical Center
Unit 517 Medical Office Building
205 Civic Drive, Alabang, Muntinlupa City
Telephone no. 771-9299
Visit his web site at www.geocities.com/docperryster or e-mail him at docperryster@gmail.com.
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