liposuction lumps

thank you for your question. you submittedtwo photos of the area under your chin and you stated that four months after your faceliftsurgery that you are undergoing treatment laser specifically to help a pigmentationissues after your surgery. you stated also that kenalog was injected by your doctor duringthis timeframe. well i think that as far as you asking, “are you doing the right thing,”i can give you some ideas of how i would handle situation like this in my practice. my backgroundis i’m a board-certified cosmetic surgeon, certified by the american board of cosmeticsurgery and a fellowship trained oculofacial plastic surgeon. i am practiced in manhattanin long island for over 20 years and facelifts are a big part of my practice.

just to get to the treatment plan we are toget to first what is likely to be the basis for why you need this treatment. when youlook at the first photo and you look at this area, it is clear that at some point duringyour healing process that some type of collection occurred under the chin. when we describethese collections in medicine we refer to it into several different categories. oneis hematoma or collection of blood after surgery, another is called seroma which is similarto hematoma but it’s actually more of it’s called a straw colored fluid that is relatedto inflammation and the leakage of fluid into the space. last is something called indurationwhich is also based on a healing process that where it can get kind of bumpy and irregular.

now, all these treatments – all these situationsrequire some kind of intervention and it seems like everything is going in a way that i thinkmost of my colleagues would agree where if you recognize there are some type of scarring.that is a common pathway here is that with some degree of chronicity meaning that afterthe first month or so, they’re maybe – there’s normal healing and there’s normal resolutionand then there is persistent inflammation and we call it as organization of the tissuein a way that can form an undesirable scar. when i say scar i’m talking about tissuethat is between the area that’s operated in the skin. now, this intervention of usingsteroid like kenalog is tentative care for any of scarring situation.

for pigmentation the use of lasers definitelyhas its place and has value. where i would probably offer some alternative thought isthat in my practice i have a lot of experience with something called platelet-rich plasma.platelet-rich plasma is a topic or it’s a method that first was developed by oralsurgeons to facilitate the healing after a – or dental implant surgery. it was thenfurther developed in orthopedics for their specialty to help with tendon and ligamentand other types of tissue repair necessary orthopedics. in our field is cosmetic surgery,it has yet to be fully embraced because of not enough doctors get trained in it in theirprimary training nor is it very well understood because of that limited exposure.

what i’m done in my practice is i developedmy own process and systems of using prp or platelet-rich plasma because we use it a lot.in fact, we use it as part of one of our other areas of treatment which we do a lot of hairloss treatment called trichostem hair regeneration. as far as scarring is concern, i’ve hada lot of success with the use of platelet-rich plasma for acne scars for thickened scarsor hypertrophic scars for a lot of areas, wrinkles of fine lines as well as under eyecircles. but for scar tissue, we’ve done combination of platelet-rich plasma plus acellular matrix, we’ve also done platelet-rich plasma alone. now of course all this is beingsuggested and it may not be the right time in your situation may be outside of the bestwindow.

in clinical medicine, we do treatment andwe observe response and i’m sure that’s what your doctor’s been doing, so that’swhy you’re on the path that you’re on. i’m just offering this as a way to maybenot necessarily address scarring or pigmentation for which platelet-rich plasma does have valueand has literally is risk-free because of its – it’s almost risk-free in medicine.we never say risk-free because it’s your own blood and it’s basically using yourbody’s own healing factors and in my hands, i’ve had a lot of success with it in thetreatment of scar tissue. i think that that’s also value in terms of rehabilitation of softtissue. because platelet-rich plasma has a unique quality and that what it does is itstimulates blood supply, it stimulates new

collagen formation. it seems to have an effecton the collagen remodelling process. if anyone questions they value platelet-richplasma all that to do is go on the pubmed or the national library medicine index ofarticles written about platelet-rich plasma. there are hundreds and hundreds of articlesdemonstrating the benefits and the quality of results using platelet-rich plasma in avariety of instances. when i see patients who have had previous surgery particularlyfor like eyelid retraction or complications of facelift scarring et cetera, i find thatthey – even if i’m going to do – plan to do sometime of surgical procedure, i’lluse platelet-rich plasma as a way to rehabilitate a tissue as i described before. stimulatingblood supply improving the vascularity and

the quality of the tissue is always a goodthing. it allows for more successful surgical revision plan. when you think about when people use steroidsor antimetabolites, there is still some collateral tissue loss when used beyond the path of thescar. even if it’s within the scar, you can get adjacent skin and soft tissue atrophy.when you think about platelet-rich plasma this is some way to mitigate that. it canhave some value. again, without the benefit of physical examination, it’s very difficultto offer one meaningful definitive recommendations. suddenly from my perspective your doctor ison the right track. you may want to have a discussion with your doctor about platelet-richplasma as an option. i hope that was helpful.

i wish you the best of luck. thank you foryour question.