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Cosmetic solutions
Five common problems and the solutions to improve quality of life



Dr. Anthony Krausen, plastic surgeon, The Skin Center of Wisconsin

Problem: Acne and acne scarring

Solution: Clearing up acne begins with a good skin program, according to Dr. Anthony Krausen. Unplugging your pores is essential, and starts with exfoliating your skin on a daily basis. Medical-grade skin care products such as alpha-hydroxy acid preparation cleaners will lead you on the road to a healthier complexion. "You need something with more than 10 percent alpha-hydroxy acid," says Krausen, which can be obtained through a physician or licensed practitioner. Retin-A also works well, but is photosensitizing so your skin can turn red and scaly if exposed to sunlight. Physicians have also used the birth control pill for women as a way to keep acne in check. A superficial topical antibiotic cream can be prescribed for those who suffer an occasional breakout.

Microdermabrasion done by an aesthetician can be used to help alleviate superficial acne scarring, while laser techniques are performed for deeper scars. "For any kind of laser resurfacing you have to be out of the sun for three or four months and follow a skin care program," Krausenadds.

A newer method of treatment for deeper or extensive scarring combines fractional carbon dioxide laser resurfacing with scar release and fat transfer under the skin. A special needle breaks up the scar bands beneath the skinís surface. Fat harvested in micro-parcels is then injected under the skin to raise and smooth the depressed scars.

Dr. George Korkos, plastic surgeon and medical director, Rejuva Skin & Laser Center

Problem: Facial wrinkles after 40

Solution: With todayís technology, people arenít lining up for a surgical face-lift, but instead turning to office procedures to smooth out their facial wrinkles. "Thereís been a paradigm shift in cosmetic surgery today. Itís turned into such an active world people donít want a lot of down time from surgery, so they are electing to have noninvasive procedures instead of surgery," says Dr. George Korkos.

"Using noninvasive lasers combined with fillers and Botox can work really well for people over 40," Korkos says.

One of the latest techniques is called LaViv; Korkos is currently one of about 300 physicians in the country to use the procedure. The technique involves taking a small biopsy of skin from the patient and replicating the cells in a lab. "For the first time we can inject your own cells after they have multiplied in the lab. Once they are injected into a wrinkle they will continue to produce collagen," Korkos explains. The new technique was approved by the FDA several months ago. The difference between LaViv and the other procedures is that it utilizes a personís own cells instead of a manufactured filler, providing a much more natural look and feel. The LaVivprocedure will last a year or more instead of the three- or four-month lifespan of an artificial filler.

Dr. John Yousif, plastic surgeon, Aesthetic and Reconstructive Surgery Associates, S.C.

Problem: Excessive skin after weight loss

Solution: People lose weight in different ways, through diet and exercise or surgery, but whatís left behind can be an excessive amount of skin that stretched from the weight gain. "What they find is after all this work theyíre left with this excess skin, and itís disheartening," says Dr. John Yousif. "Unfortunately, you canít exercise that back. You canít exercise skin."

According to Yousif, our bodies contain layers of fat designed to help keep us alive if we ever were to enter starvation mode. Those layers of fat cells stretch as our caloric intake increases, resulting in weight gain.

Everyone is different when it comes to where their bodies accumulate fat deposits ó abdomen, thighs, arms, breasts, etc. ó and losing fat can be a challenge. "Itís a lot of work to lose the weight, even if they have it removed surgically," says Yousif, who points out that people who opt for surgery typically follow an exercise regimen as well.

Surgically removing the excess skin and tightening the stretched muscles is the only answer. But the outcome is well worth it, both physically and emotionally, after achieving the weight loss you desire.

Dr. Michael Sweet, plastic surgeon,Wheaton-Franciscan Healthcare

Problem: Back pain from large breasts

Solution: Women with large breasts that are disproportionate to their bodies can suffer from a multitude of health issues, including pain in their back, shoulders and neck; numbness in their arms; fungal infections and more, says Dr. Michael Sweet.

In order to rectify the problem, women undergo surgery where an incision is made and skin and breast tissue is removed. The surgeon then lifts and reshapes the breasts so they fit more naturally with the womanís body. Sweet says he occasionally uses liposuction to make the breasts appear more symmetrical.

The good news is that more women are aware they can live a more pain-free life following this surgical procedure. "The new thing is the acceptance of the procedure. I see women of all ages," Sweet says.

Dr. Allan Pasch, vascular and general surgeon, Wheaton FranciscanHealthcare

Problem: Varicose veins

Solution: Varicose vein disease affects about 25 million people in the United States; cosmetic concerns with spider veins affect even greater numbers.

Years ago, traditional vein stripping and ligation surgeries were utilized for vein disease, and are still used for certain situations today. However, this procedure holds far longer recovery and healing times.

Today, surgeons may opt to use a procedure called venous closure, which is minimally invasive.

Physicians use a local anesthetic and make a small incision in the skin where a catheter is inserted into the saphenous vein. After the catheter is positioned, energy is applied to heat the catheter, which causes the vein to collapse and close. In contrast, vein ligation and stripping involves general anesthesia, the saphenous vein is physically removed, resulting in pain and bruising.

If the vein disease is in its early stages, patients may not need to undergo surgery, but rather have injection sclerotherapy, which is generally used to treat spider, small varicose and reticular veins. A special medication is injected directly into the targeted veins, which causes them to collapse and shut down. Eventually the treated veins should disappear, according to Pasch. Depending on the size, it may take a few sessions to successfully get rid of such veins. Shutting down the veins does not impede blood flow, it simply reroutes to more healthy veins in the same area. Injection sclerotherapy is performed by vascular nurse clinicians who are specially trained to perform the procedure, Pasch says. M