Is Laser Surgery Better for Hispanic Patients?

Many patients come to Yager Esthetics after seeing an ad or hearing a television report about some type of laser that can magically eliminate stretch marks or scars, or tighten loose skin so you do not need surgery.  It sounds almost too good to be true.  Unfortunately, it IS too good to be true.

Lasers can do many things in medicine, even cosmetically.  Every year, advances really do occur that make them safer and more effective for patients.  They are not, however, magic.  I hope to demystify lasers for you a bit in this column.

You can cut with a laser as you can cut with a scalpel.  Both incisions leave a scar.  There is no evidence that laser incisions heal better.  In Hispanic skin, I feel the laser is more dangerous, as the heat it generates can cause hyperpigmentation (darkness) in the surrounding skin.  Advantage, scalpel.

Lasers do not remove stretch marks.  There is as of today no treatment, be it cream or laser or magic wand, that can erase a stretch mark from skin.  While early pink ones are easier to fade than old white ones, they do not disappear.  Again, in Hispanic skin, the risk is creating stretch marks with dark spots (manchas) around them.  The only current way to get rid of stretch marks 100% is to remove the skin that contains them.  For example, if your stretch marks are all below the belly button and you have enough skin, you can do an abdominoplasty, or tummy tuck to remove that skin.

Lasers are effective in permanently reducing unwanted hair.  Hispanic patients must seek out doctors with a lot of experience treating latin skin to avoid burns, darkness and other complications. The darker your skin, the greater the danger.

Please do not think I am anti laser – they fascinate me, and I have incorporated them in my practice.  I will continue to follow the advances, and add them when they are safe and effective for my Hispanic patients.


Does Plastic Surgery Leave Scars?

One of the most common questions I get is “Am I going to have a scar after surgery?” The answer is, of course! Every time you cut the skin beyond a certain depth, the body repairs the damage by forming a scar. This is to create strength in the damaged area so as to prevent further injury.

The art of cosmetic plastic surgery is to try and minimize and hide the scar in a way that it is the least visible. In many cases, even the trained eye cannot find the mark. We use many tricks, such as hiding it in natural creases such as the fold of the eyelid or curve of the ear, and using the change in color from dark to light, such as in the edge of the areola in breast augmentation.

The healing process often takes about a year before the scar matures, and it can go through some red and firm stages before the process is complete. I see my patients very often after surgery to insure healing is proceeding in the ideal manner. If the scar looks dark,red, wide, or thick, I can usually recommend medications, tapes, and sometimes injections to improve the final result. If a patient comes back after 6 months or longer, it is often too late to help with these small interventions, and sometimes surgery is needed to correct the scar.

Let me also clear up 2 common misconceptions- lasers and keloids. If you do surgery where you are cutting, a laser is just as likely to leave a scar as a scalpel. It is just a different way to cut. Some lasers can help after a scar is established to help flatten or fade a mark, but do not be fooled into thinking that a laser tummytuck, laser breast lift or laser facial surgery is in any way better than traditional surgery. It is often just hype to sell you a service that is most often no better result wise, and in inexperienced hands can have significantly more complications.

Every ugly or visible scar is not necessarily a keloid. Keloids are a type of abnormal scar that rises off the surface of your skin, and grows beyond the border of the scar onto normal skin. It is often treated with steroid injections and radiation therapy in addition to surgery. They are often resistant to correction.

So, if a plastic surgeon tells you that a surgery in which your skin is cut leaves no scar, be very skeptical. No one can promise you an invisible scar, as even the best surgical technique coupled with perfect patient care afterwards cannot overcome genetics. Do know that the overwhelming majority of scars heal extremely well with time, and this should not deter you from seeking out cosmetic plastic surgery if it is right for you.