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Skin Cosmetic Surgery

Removing Acne Scars

Removal of moles

Reducing Wrinkles

Removing Brown Facial Spots

Cosmetic Surgical Treatments for Baldness

Foreign body reaction to hair implants

Skin surgery can get rid of ugly moles, brown spots or scars on your face. Hundreds of Singaporeans undergo skin surgery each year to improve their appearance.

Skin cosmetic procedures need to be considered carefully as an informed choice to ensure you obtain the desired aesthetic improvement.

Removing Acne Scars

Chemical peeling causes injury to the superficial layers of the skin and is believed to induce new collagen to form in deeper layers. Alpha-hydroxy acid (AHA) peels may help improve very superficial scars slightly. Treatment is easily tolerated and causes minimal disruption to the patient's schedule, but multiple treatments are needed. Deep scars do not improve with chemical peeling.

Laser resurfacing of the skin is a new treatment for acne scars. There are several laser systems available to resurface the skin in a controlled manner and the skin repairs itself with some clearance of the scars. In suitable patients, up to 40 percent improvement may be expected from a single laser treatment. However, there is a risk of complications such as prolonged redness, pigmentation and infections. It takes several weeks to recover from the surgery, but is generally much more effective than chemical peels.

Dermabrasion is an older technique for skin resurfacing but the principle is similar to that of laser resurfacing, using mechanical sanding to resurface the skin. It involves a certain degree of blood loss and requires greater skill on the part of the surgeon.

Scar revision: very deep, depressed scars will need excision (cutting) and stitching to correct the defect. Elevated scars (keloids) can be flattened by injecting small doses of steroids into them.

Hypertrophic scars

Removal of moles

Junctional naevi

Intradermal melanocytic naevus

Moles come in various shapes and sizes. Moles that protrude may be shaved off with a blade. This leaves a flat scar with a remnant of mole tissue in it. Shaving is a quick and simple way of getting rid of the protrusion but the disadvantage is that the colour of the mole almost always returns. Complete excision followed by stitching is a surer way of removing the entire mole. The size of the scar will depend on the size of the mole.

Reducing Wrinkles

Frown lines at the brow horizontal forehead wrinkles

Deep frown lines over the brow and horizontal lines on the forehead are due to the persistent hyperactivity of the muscles in the forehead area. These muscles can be paralysed or weakened by injecting botulinum toxin — Botox — into them. Relaxation of these muscles then results in the disappearance of the frown lines. The procedure is safe but the effect wears off after four to six months, so repeated injections are necessary.

Finer wrinkles which are not related to muscle activity may improve with chemical peels and/or laser resurfacing.

Face-lifting involves loosening the facial skin from its deep attachments, stretching it back over the ears, trimming off the redundant skin and stitching the tightened skin in place. This procedure has the greatest potential for cosmetic improvement and the highest risk of complications. It is usually carried out by plastic surgeons.

Removing Brown Facial Spots

There are different skin disorders that appear as brown spots. Most seborrhoeic keratoses can be easily destroyed with electrosurgery or carbon dioxide laser. Solar lentigines and freckles respond well to pigment lasers with minimal risk of scarring.

Seborrheic keratosis

Solar lentigines/freckles

Cosmetic Surgical Treatments for Baldness

Small areas of non-inflamed bald scalp that have remained unchanged for many years can be excised and the hair-bearing sides stitched together.

Hair transplantation is a treatment option for male pattern baldness. Hair-bearing scalp skin (grafts) are removed from the back of the scalp (donor site) and implanted into the bald areas (recipient site) where hair growth is desired. Male pattern baldness worsens with advancing age and the severity of baldness is unpredictable. Thus, hair transplantation must be individualised, taking into consideration the person's family history of baldness, age, severity of baldness and hair texture. It may not be suitable for some people.

Male pattern baldness

Synthetic hair implants are polyester fibres, which are embedded in the scalp to simulate human hair. The procedure of implanting the artificial hair is safe and quick and there is no limit to the number of implants available. However, this expensive procedure necessitates specialised aftercare and the implants fracture after one to two years. Some people develop inflammation of the scalp after hair implantation.

Foreign body reaction to hair implants

Should I Undergo Cosmetic Surgery?

The decision to undergo cosmetic surgery — and which procedure to choose — is highly personal. It should be based on facts and tempered with common sense. Here are some points to consider:

Dos

• Allow yourself to be treated only by trained medical practitioners. Check that whoever is treating you has the appropriate training and qualifications

• Know the facts. It is important to understand the nature of the procedure, the consequences and the potential risks and complications so that you can make an informed decision

• Know your options. There is usually more than one method of treatment. Get a second opinion if necessary

• Know yourself and understand your level of risk tolerance

• Have realistic expectations

• Nurture a healthy sense of self-esteem. This will help you to put things in perspective and not attach undue importance to the cosmetic procedure and its outcome

Don’ts

• Don't believe in unsubstantiated claims by unqualified people and establishments that are profit-driven

• Don't expect or hope for the same results as someone else who has undergone the same treatment. No two people respond in an identical manner to a procedure

• Don't take a passive approach. Know what you want and don’t relinquish control of your body to someone who may not understand your deepest concerns

• Don't take the short-term view of things. Understand that things may go wrong. Ensure that your doctor is able to see you through the procedure and handle any complications that may arise

Facial acne scars

This article was last reviewed on Thursday, April 18, 2019