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Archive for October, 2011

Skin Cancer Treatment in Chattanooga, Tennessee
About a million people in the U.S. are diagnosed with skin cancer every year. According to current estimates, 40 to 50 percent of Americans who live to age 65 will have skin cancer at least once in their lifetime. Although anyone can get skin cancer, the risks are greatly increased if you have fair skin that freckles easily — often with red or blond hair and blue or lightcolored eyes. Fortunately, even though skin cancer is the most common type of cancer, it is not the reason for most cancer deaths.

Types of Skin Cancer

The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma — often called non-melanoma skin cancer. Basal cell carcinoma accounts for more than 90 percent of all skin cancers in the U.S. It is a slow-growing cancer that seldom spreads to other parts of the body. Squamous cell carcinoma also rarely spreads, but does so more often than basal cell carcinoma. Melanoma is another type of cancer that occurs in the skin in the melanocytes or the pigment cells. Of the three, melanoma is the most aggressive, and with metastasis can result in death.

Causes of Skin Cancer

Ultraviolet (UV) radiation from the sun is the main cause of skin cancers. Even artificial sources of UV radiation, such as sunlamps and tanning beds, have been linked to causes of skin cancer. People who live in areas that get high levels of UV radiation from the sun are more likely to get skin cancer. And, as you guessed, in fair skin colored people. Most skin cancer appears after age 50, but the sun’s damaging effects begin at an early age. Therefore, protection should start in childhood. Protective clothing such as sun hats and long sleeves can block out the sun’s harmful rays. Also, lotions that contain sunscreen can protect the skin. Sunscreens are rated in strength according to a sun protection factor (SPF) which ranges from 2 to 30 or higher. Those rated 15 to 30 block most of the sun’s harmful rays.

Skin Cancer Treatment

Surgery is often used as a treatment for skin cancer. There are several types of surgery depending on the stage and location of the cancer. Shave biopsy — simple excision and formal excision of suspicious skin lesions — are the first steps for diagnosis and treatment. Management of skin cancer is based on the cell type, location of the tumor and extent of the tumor. Superficial skin cancers can often be “cured” by surgical excision alone. Dysplastic or abnormal appearing moles are sampled using a scalpel. The skin sample is sent off for a more detailed microscopic control so it can be determined whether all cancer has been removed.

When the doctor suspects a cancer has gone beyond stage 0, samples of the nearest lymph nodes may also be taken using a biopsy. The surgery is normally done using local anesthetic as an in-office procedure. The removed moles or skin samples will be analyzed and if they prove to be melanoma cancer, it may be necessary to have a second surgical operation to remove the entire melanoma, including some of the health skin around it to allow for safety margin. Possible treatments for advanced melanoma tumors are chemotherapy or radiation. At least 80 to 90 percent of all patients who have been diagnosed with a melanoma cancer can be cured with a good prognosis.

Develop a regular routine to inspect your body for any skin changes. If any growth, mole, sore or skin discoloration appears suddenly or begins to change, see a surgeon. Each of the skin cancer types can be treated if detected early.

Symptoms of Skin Cancer

The ABCs of skin cancer include:

A – Asymmetry. You should notice the general look of your moles or growth. For example, if one half of the mole or growth does not match the other half.
B – Border irregularity. If the edges of the growth are ragged, notched or blurred.
C – Color. The pigmentation of the growth is not uniform. Shades of tan, brown and black are present. Dashes of red, white and blue add to the mottled appearance.
D – Diameter. A width greater than six millimeters (about the size of a pencil eraser), can be an indicator of an abnormal skin growth. Generally, any new mole growth or non-healing skin ulcer should be a concern.

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As we age, the accumulative effects of wear and tear damage begin to show in our skin. We loose the glow of youth to be replaced by aged leather-like skin with areas of color blemishes. Skin resurfacing has been used to trick the body to replace the old skin with new skin. Deep chemical peels and CO2 laser skin resurfacing are techniques that have been used as ablative skin resurfacing. Basically, the upper layers of the skin are “burned” by the chemical peel or laser like a second-degree burn. The upper layers of skin slough off over three to four weeks, being replaced by new pink, smooth skin. The results are impressive; however, the down time and pain involved is extensive.

A Minor Outpatient Procedure

Recent technology with laser fractionation has decreased the down time to a minor outpatient procedure with minimal discomfort, resulting in 12 hours of skin pinkness without all the slough. Laser energy is passed through a special lens causing the laser energy to fractionate into thousands of microbeams. These microbeams penetrate the upper layers of the skin surface to cause areas of microtreatment zones which the body replaces with new skin.

Think of pixels in a digital photograph when you think of fractionated skin resurfacing. If you look at a digital image in extreme magnification, you’ll see that the image is actually comprised of thousands of tiny spots of color (pixels). Similarly, fractionated laser skin resurfacing produces thousands of tiny treatment zones on the skin known as microthermal zones. These laser microbeams penetrate deep into the dermis and eliminate old epidermal pigmented cells. The fractionated laser is so precise that it penetrates through the outer layers of the skin as if it were a window and leaves it and the surrounding tissue completely intact.

This “fractional” treatment allows the skin to heal faster than if the entire area were treated at once, using the body’s natural healing process to create new, healthy tissue to replace skin imperfections. Just as a damaged painting is delicately restore one small area at a time, or a photographic image is altered pixel by pixel, fractionated laser treatments improve your appearance by affecting only a fraction of your skin at a time with thousands of tiny microscopic laser spots.

Areas improved by laser resurfacing

Fine to deep wrinkles, acne pitting scars, old surgical scars, discolorations and rough skin texture are just a few of the areas improved by fractionated laser treatments. Laser treatment targets between 20 and 25 percent of the skin’s surface at each treatment. Clinical studies suggest that, on average, an effective treatment regimen is four to six treatment sessions spaced about two to three weeks apart. Depending upon your condition and schedule, you and your physician may choose to space treatment sessions even further apart. Results are immediate and progressive. Optimal improvement is usually visible in four to six months after completion of the treatment series. Because fractionated laser treatments spare the healthy tissue, it is effective even on delicate skin areas, such as the neck, chest and hands.

What to expect

Fractionated laser skin resurfacing is completed with minimal discomfort. Patients experience a mild sunburn sensation for about an hour and then minimal discomfort. The treated skin will have a pinkish tone for 12-24 hours. This is a sign that the skin is healing normally. Swelling is minimal and generally resolves in 12 hours. One may apply makeup or shave soon after treatment. Some patients are able to return to routine activities the same day of treatment. Others require a little more time, depending upon their skin condition and treatment.

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As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling and chewing. The underlying tissues [collagen and elastin] that keep our skin looking youthful and plumped-up begin to break down with age. As we continue to use our facial muscles, the thin stiffened skin shows signs of wrinkles often leaving laugh lines, frown lines, smile lines and facial creases over the areas where this muscle movement occurs. Some of the wrinkles are related to genetics; but most are related to sun exposure.

Facial Fillers

Facial soft-tissue fillers can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face erasing years away. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser skin treatment, chemical peel or a recontouring procedure, such as liposuction, fat transfer or mini facelift.

Facial fillers or injectable fillers are primarily used to improve the appearance of the skin’s texture. They can help fill out deep facial wrinkles, creases and furrows, “sunken” cheeks, skin depressions and some types of scars like acne pits. They can also be used to add a fuller, more sensuous look to the lips and improve “lipstick lines.” Many fillers are available on the market; common fillers include: Restylane, Radiesse,Juvederm, Sculptra and Selphyl. Each of the listed fillers are made from different substances and have different characteristics and modes of action. Effects and length of time effect are greatly different for each of the common fillers.

Botox: Neuromuscular Blockades

Botox is not a filler; but rather a neuromuscular blockade medication. It is used in conjunction with fillers to help smooth creases caused by overactive muscles (such as forehead wrinkles, crow’s feet and frown lines). The fillers help lift the cracks in the skin, while the neuro-blocker causes the underlying facial muscles to be weak. The weakened muscle is then not able to contract exposing the wrinkle. Excess facial skin, fatty deposit or neck skin is more appropriately treated by skin tightening surgical and non-surgical face and neck lifts or forehead lifts in conjunction with fillers and or neuromodulators. Depending on the type of facial filler used, the results may last anywhere from a few months to a year and a half or more.

Facial rejuvenation is very individualized. That’s why it’s important to discuss your hopes and expectations during the initial facial consultation with your surgeon. In your initial consultation, make sure to discuss and select a treatment option based on your goals and concerns, your anatomy problems and your lifestyle. Make sure that your aesthetic ideals match what your cosmetic surgeon invisions. There is a definite art involved for appropriate filler injections. It is NOT paint by numbers; but rather face sculpture—the key is not the filler; but the artist who is completing the procedure. When injectables are administered by a qualified surgeon, complications are infrequent and usually minor in nature.

It is wise to search the internet for effects and characteristics of the above listed facial fillers prior to a facial evaluation and treatment planning. Well educated, you will be better prepared to discuss options and choices with your physician artist.

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Tumescent liposuction of the face and neck are less complex surgical procedures completed in the office to remove unwanted fat deposits. The phrase liposuction of the “face and neck” is somewhat misleading. To be more specific, liposuction in this general area involves the submental (below the jaw) chin, the jowls and a small area of the cheeks.

Liposuction Combined with laser resurfacing better than a facelift?

Women who have local deposits of subcutaneous fat in the face and neck and who have excessively wrinkled skin will often get better results from liposuction combined with either a laser resurfacing or a chemical peel, than they would from a facelift. Younger women who have good skin elasticity, liposuction alone can also produce dramatic improvement and is a much simpler and safer procedure than a facelift. Men often choose tumescent liposuction over a facelift because the tell-tail scars and the surgical-look of a facelift are difficult to hide with short hair and are not acceptable for a man.

Not all patients are good candidates for liposuction of the face and neck. For some patients a mid-face lift would be the preferred procedure according to the goals for facial rejuvenation. Short scar mid facelift may be pre- ferred by a woman who has large folds of skin on the neck with little subcutaneous fat. Submental chin includes the area below the margin of the jaw, and extends onto the front of the neck. Regardless of one’s age, an inherited localized collection of excess fat beneath the chin makes one look chubby, older and less athletic. Liposuction is usually the simplest, safest and least expensive way to treat this cosmetic problem.

Treating Jowls with Liposuction

Jowls represent a small focal accumulation of fat on the lower cheek overlying the jaw bone. Prominent jowls make a person look old and are a cosmetic concern for both women and men. Cheeks with too much subcutaneous fat can make a person appear chubby. These types of fat deposits are usually the result of an inherited tendency that is resistant to exercise and diet. Tumescent liposuction using very small cannulas (less than 1.5 mm in diameter) can correct this cosmetic problem totally by local anesthesia and with virtually no scars.

Liposuction does not eliminate facial wrinkles, but there are modern cosmetic facial resurfacing techniques that do.Facial wrinkles, blotchy pigmentation and acne scars can all be treated by any one of several techniques, including laser resurfacing, chemical peel, dermabrasion or a combination of these techniques. A combination of liposuction plus wrinkle removal can often provide a better overall cosmetic improvement with less down time than a formal facelift.

The tiny incisions used for liposuction of the neck and face do not require sutures. Not closing in- cisions with sutures and allowing open drainage of the blood-tinged anesthetic solution minimizes postoperative bruising and edema. Absorptive pads are applied to absorb the drainage and are held in place by an elastic compression garment. An elastic compression garment is worn after liposuction of face and neck during the first 18 to 36 hours after surgery. As soon as the drainage has ceased, a compression garment is no longer necessary. In the old days of liposuction, surgeons required that patients
wear a compression garment for two to six weeks, but there is no evidence that this prolonged compression provides any benefit.

Liposuction: Safer alternative to traditional facelift?

Tumescent liposuction is the safest and usually the most effective technique for removing fat from the chin, cheeks and jowls. Liposuction involves fewer complications, fewer scars, avoids the dangers of general anesthesia, has a more rapid recovery, lowers cost, and typically gives a more natural appearance when compared to a formal facelift.

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