Scar Revision / Scar Repair Questions and Answers Archive

Sep
2000

Q&A: Who should I see if I have had 2 pregnancy miss-carriages and I may have an imbalance in my hormone levels?

Question:

I am a 32 year old female with a 3 year old son. I have been trying to get pregnant again since Dec 1999 with a misscarrage in my 7th week in January 2000, and another in my 5th week in May 2000. (both of these had neg. home pregnancy tests, only a blood serum test showed positive) and have been unable to conceive since then even using ovulation tests (showing positive results) I am also experiencing horrible symptoms which I believe may be related to low progesterone levels in the last 2 weeks of my cycle such as depression, rage, sugar cravings, bloating, breast tenderness, and fat gain. I saw my doctor yesterday because the symptoms (mainly depression and rage) are becomming overwhelming. She recommended only that I use an anti-depressant. I don't believe that this solves the problem, and it doesn't address my "infertility" and other symptoms. My doctor also stated that a saliva test will not give a true reading of my hormone levels (she didn't seem to know all that much about progesterone problems-if there is such a thing) How can I find out if my problem is caused by estrogen-dominance, or if it's a chemical imbalance? Do I really need to have another misscarrage before I can see a specialist? PLEASE HELP ME, I'm so frusterated by all the roadblocks.

- Gretchen

Answer:

 SCOTT ROSEFF, MD, FACOG, Director - LocateADoc.com

Hi, I'm sorry to hear about your losses, and that you're not feeling well... You desperately need to see a Board Certified Reproductive Endocrinologist for an expert opinion on the reason(s) for your losses, rapid diagnosis, and timely treatment! You should NOT have to suffer another loss, and since there are MANY potential causes of recurrent pregnancy loss, it's time for a comprehensive evaluation and therapy plan. If you need the name of an RE in your area, please write back with the name of the largest and closest city/state. Just to let you know, I recommend blood testing over saliva testing for hormone analysis. Thanks for your questions. Dr. Roseff Visit us at www.reproendo.com/pages/miscarriage.htm

-- SCOTT ROSEFF, MD, FACOG, Director
West Orange, New Jersey



Aug
2000

Q&A: What can I do to remove a very large planters wart from the ball of my foot and not leave a scar?

Question:

On your list of doctors I wasn't sure who to ask so...I have had a planters wart for three years and have tried everything to get rid of it. Acid, lazer, anti cancer drug, scrapping, but nothing has helped. The doctor suggested surgury, but said I would have lots of scar tissue. Is there anything I can do or anyone I can write to to ask what else I may try. I am in pain and it encompasses most of the ball of my foot. I don't know if you can help with this question, but if you know who I could ask could you please let me know. Thank you

- Denise

Answer:

Gregory Caputy, MD, Chief Surgeon - LocateADoc.com

I have found that the best treatment for severe plantars warts is a combined treatment. What I have my patients do is to use commerically available wart remover but use it in the following manner. Apply one drop on the area then apply very strong tape (like mole-skin) over the drop. The next day, tear off the tape and put another drop of the solution on. Keep doing this until the entire area turns white. It will then be possible to remove the thickened skin. Then continue with the same process until all of the thickened skin is gone and you will see the tiny capillary bed where the wart virus lives. There should be many tiny dark spots at that level. At that point I have my patients come to the office and I use a KTP laser to ablate the individual nests of virus. I have found this treatment very useful so as not to cause scarring on the bottom of the foot. Hope this helps.

--Gregory Caputy, MD, Chief Surgeon
Honolulu, Hawaii



Aug
2000

Q&A: Why will my doctor not let my fiancee be preset during my visits to review my pregnancy?

Question:

I have had 2 previous miscarriages and am pregnant again. My fiancee and I want to make sure we are doing everything right, but my doctor won't talk to him because we are not married. He is very upset and goes to my visits anyway. (Just sits in the waiting room) This concerns me a great deal. My doc seems to be taking my situation very lightly. Am I wrong for being upset? Does the father have the right to also see the doctor? Please help. Thanks.

- Dawn

Answer:

Daniel Potter, MD, FACOG - LocateADoc.com

The doctor-patient relationship requires that both parties are comfortable with each other. If your doctor is not comfortable with your marital arrangement, I would find a doctor that is. After 2 miscarriages, it is most likely that everything will go fine without treatment.

--Daniel Potter, MD, FACOG
Fullerton, California



Jul
2000

Q&A: What should I do if my doctor performed LASIK (double carding) and now wants to performance more surgery?

Question:

DEAR DOCTORS I HAD LASIK SURGERY 4 MONTHS AGO AND MY PRESCRIPTION WAS OD -2.00 +3.00 X 95 OS -1.75 +3.25 X 85 HYPEROPIC ASTIG? OR MIXED ASTIG? MY DOCTOR PERFORMED A DOUBLE PROCEDURE ON MY EYES (DOUBLE CARDING)WITH THE SUMMIT APEX PLUS) I AM CURRENTLY SEEING 20/50 AND MY DOCTOR IS CONSIDERING AN ENHANCEMENT (VERY SCARED) MY QUESTION IS WHY ARE SOME DOCS PEROFORMING DOUBLE CARDING AND SOME DOCS ARE WAITING FOR THE FDA APPROVAL OF HYP ASTIG TREATMENT? I FEEL LIKE I HAVE JUMPED THE GUN AND MADE A MISTAKE. I HAVE SOME ASTIG LEFT WITH SOME MYOPIA NOW. MY DOCTOR TO DATE HAS NOT PERFORMED A TOPO ON ME. ANY TYPE OF RESPONSE WOULD BE APPRECIATED. THANKS JO ANN CISSELL

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

It is hard for me to believe that there are ophthalmologists who do not know that the bitoric treatments give a far superior visual result than "double carding." There are some cases when double carding may be appropriate, but this is the exception. In our practice the patient's best interest is our chief motivation for recomending procedure(s). We place patients with your refractive error on a list so we can treat them the way we would want to be treated. We are not desperate for surgery to do, and we are not motivated by our own economic considerations. I am sorry you are having an outcome that is less than what you could have had. I would go to another surgeon for the rest of your care.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Sep
1999

Q&A: What can I do to correct a very poor breast lift result?

Question:

Hello: After 3 children ages 19, 14 & 5, I saved up for and decided to have a "breast lift" this was 3 years ago. I am left with much scarring, uneven areola sizes and one breast higher than the other. Is there anything that could be done to remedy this? I expressed my concerns early on with the plastic surgeon who said that things would become more "normal" with time. Sometimes I feel like this is my punishment for my vanity. Thank you for your time, Shelly

Answer:

Jonathan Ross Berman, MD - LocateADoc.com

I have performed revision breast lifts. Do not panic. I would need to examine you to see what needs to be done. Do not dispair.

--Jonathan Ross Berman, MD
Boca Raton, Florida



Aug
1999

Q&A: What can be done about the scar below my cheek from a dog attack?

Question:

Hi, On Dec. 29, 1997 I was attacked by a Lab/Chow mixed dog. The animal bit a large whole on the left side of my face, under my cheek. I recieved plastic surgery which involved 30 stitches on the surface and 10 dissolving stitches on the inside of my face. I was left with a scar. It could of been a lot worse than what it is, but I am very insecure about it. I try to do everything in my power so people do not see the scar. I always wear my hair down, I try to cover it with my hand, etc... My question is I would like to know if there is anything (laser or plastic surgery)that can be done to improve the appearance of the scar? My doctor told me that he could cut open the scar again and I would have to go through the same healing process as I did before, but I don't think I could go through it again. Please HELP ME. Thankyou

- Michele

Answer:

Carmen Ann Paradis, M.D. - LocateADoc.com

Sorry to hear about your accident. Without seeing you, I can't give you specific advice about how your scar can be improved. Scar revision usually involves rearranging the skin to make the scar lines fall in less noticeable planes, or recutting portions of the scar so that the texture of the scar is better. Laser is not usually useful for this. Nothing will make a scar disappear; we can only try to make it less obvious. While it is true that if the scar is revised, you will go through a wound healing process again, that process should be less of an ordeal with revision. In dog bites these is a lot of crushing and tearing of tissue which is much more traumatic than scalpel incisions. You migh consider consulting a couple of plastic surgeons about what might be done for you specifically. Another thing to remember is that people are not as concerned about your appearance as you are, especially if you do not call attention to it. Good luck Carmen Paradis M.D.

--Carmen Ann Paradis, M.D.
Cleveland, Ohio



Jul
1999

Q&A: Why do I need a hysterosalpingogram in order to have in vitro fertilization?

Question:

My husband and I are thinking about trying the process of In Vitro Fertilization. My husband has a known chromosome translocation, which is why we need medical assistance. Prior to the history on my Husband, I was pregnant 3 times naturally. My question is, the specialist who wants to perform the in-vitro, wants me to have a hysterosalpingogram. What is this? and, why do I need this procedure? I am a 36 year old white healthy female.

Answer:

Daniel Potter, MD, FACOG - LocateADoc.com

It is an x-ray and dye study of the uterus and fallopian tubes and is needed evaluate your uterine cavity prior to treatment. I am concerned that you are proceding with IVF with a husband with a chromosomal disorder. THis can doom any pregnancy that occurs to miscarriage and you can also transmit this translocation to your offspring. Make sure that you have spoken to a genetics specialist prior to beginning treatment.

--Daniel Potter, MD, FACOG
Fullerton, California



Apr
1999

Q&A: Should I be concerned if a patch on my forehead treated by pulse laser is now very red instead on gray/purple as expected?

Question:

I used a biore pore cleaning strip and the strip removed a piece of skin from my forehead. After two and a half weeks, the wound was essentially healed, but the area was still intensely red. I went to a dermatologist who used a pulse laser to treat it. She said the area would become grayish purple and then, in 7 - 10 days, it would fade. The redness, too, would fade. She also recommneded that I use Mederma lotion on the area. It is now two days later and the area is redder than ever--with no sign of purple or gray. I called the office and was informed that the treatment would still be effective--and that I could expect the same results as predicted before--that is, marked improvement in about two weeks. I am worried,however, about the increased redness. Can you explain this? Can you reassure me that everything is going as planned? Many thanks for your help.

- Marta

Answer:

Jonathan Ross Berman, MD - LocateADoc.com

Unfortunately, I would have liked to see the wound prior to the use of the laser. Post-op wound care as per the dermatologist is recommended. Redness does not mean necessarily that there will be scarring. Just the healing process mostly. Good luck. If you are in our area, give us a call.

--Jonathan Ross Berman, MD
Boca Raton, Florida