Providing your acne has become stabilized there are several things that can be    done.  A choice of chemical peels is excellent for patients that still have some active acne; however, it really does not assist or help in improving the scarring.  For patients who have deep ice-pick type scars, the best choice is direct excision of these more noticeable deep ice-pick type scars.  Shallow rolling scarring throughout the face as well as a combination of shallow rolling scarring with ice-pick type scars is really best addressed using a combined resurfacing technique using the carbon dioxide laser in conjunction with dermabrasion.  Dermabrasion is a technique that has been used for almost 40 years and is effective; however, incorporating the carbon dioxide laser does give us better results with collagen tightening.  These before-and-after photos can be seen on our website and I typically tell patients that they can see 40-60% improvement.  It is virtually impossible to eradicate the scarring completely; however, if someone is willing to accept a significant degree of improvement they are typically very happy.

There are typically several terms used for a mini-facelift, however, the one that we use is what we refer to as a weekend lift.  It is referred to as a weekend lift because it really has a five-seven day recovery period but most patients feel quite good in two-three days and many patients are back to work in that same timeframe.  Specifically, the area that a mini-facelift improves is the jawline and early jowling.  We tell patients that they may see some improvement in the neck but the area that is specifically addressed is the jawline.  Small incisions are placed around the ears which allow us to perform this lift under local anesthesia.

There are several types of implants used for chins and all of them are quite good.  However, the most common type is a silastic (solid silicone) chin implant.  My implant of choice is a silicone silastic-type implant covered by ePTFE which is the generic name for a gortex type material.  The advantage of these implants is you do have a small amount of tissue ingrowth so that the plant becomes firmly seeded and does not move.  These implants do quite well and actually bond to the surrounding tissue.  There are essentially two approaches, namely, the first going through the inside of the mouth or under the chin.  We prefer to make a small incision under the chin for several reasons, especially the fact that an incision on the inside of the mouth can be bothersome to patients.  Additionally, there is a degree of contamination going through the mouth, although the actual infection rate does not seem to contraindicate this approach as an option.