With his 20 year of experience in Plastic surgery , Dr Philippe Wound bad reviews of poor healing or good healing is a good source of information. Healing and scarring is a natural restorative response to tissue injury. Dr Philippe Chout studied the good or bad healing leading to scars and reviews the interaction of a complex cascade of cellular events . They generates resurfacing, reconstitution, and restoration of the tensile strength of injured skin.

Healing is a systematic process, traditionally explained in terms of 4 overlapping classic phases: hemostasis, inflammation, proliferation, and maturation. While platelets play a crucial role in clot formation during hemostasis, inflammatory cells débride injured tissue during the inflammatory phase. Epithelialization, fibroplasia, and angiogenesis occur during the proliferative phase. Meanwhile, granulation tissue forms and the wound begins to contract.

There is only one type of scar. The appearance of a scar depends on the nature of the wound that produced the damage, the anatomical location of the wound, and a variety of genetic factors that are different for each individual. A defective healing process can result in a keloid, an unsightly, itchy, thick, red, knobby bump that often continues to enlarge over time. Keloids often are larger than the margins of the original wound. Finally, during the maturation phase, collagen forms tight cross-links to other collagen and with protein molecules, increasing the tensile strength of the scar.

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According to Dr Philippe Chout , the treament of bad scar is difficult and long. Dr Chout techniques reviews

The final quality of a scar is never predictable. This means that despite a correct surgical technique, a scar may be too thick, too broad and/or too noticeable. The purpose of scar revision is to improve the appearance of unsightly facial/body scars, blemishes and moles by making the scar less conspicuous. There are a variety of methods available for scar revision. For superficial scars, laser technology or corticosteroid injections may be used. Chemical peels provide a similar effect, whereby an acid solution is applied to the affected area and removes the first few layers of skin so that it can heal to a smoother texture. Peels are usually used on facial scarring, such as acne and chicken pox scars. Although scars cannot be removed completely, they can often be made less visible. However, more research is required to assess the effectiveness of the different treatments. Your GP may refer you to a dermatologist or a plastic surgeon for treatment.


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Bad reviews of poor scar and reveision treatments

The most common type of scar is the flat, pale scar that forms as a result of the body's natural healing process. Initially, they may be red or dark and raised after the wound has healed, but will become paler and flatter naturally over time as the injury heals. This process can take up to two years, and there will always be some visible evidence of the original wound. If the skin at the edges of the wound has come together neatly, the scar will usually heal as a thin, pale line. In wider wounds, where more surface skin is missing and more scar tissue is needed to bridge the gap between the edges of damaged skin (such as a bad graze on the knee), the scar may be less neat and may take longer to heal. These scars are not usually painful, although they may be itchy for a few months. They can also be quite dark in colour and unsightly. If you have a darker skin type, scar tissue may fade to leave a brown or white mark. These are often permanent, but can sometimes improve over time. If your skin is tanned, the scar may appear more obvious, as scar tissue does not tan and remains pale.

Cheloid scar are abnormal scars When skin is injured, fibrous tissue, called scar tissue, forms over the wound to repair and protect the injury. In some cases, scar tissue grows excessively, forming smooth, hard growths called keloids. Keloids can be much larger than the original wound. They’re most commonly found on the chest, shoulders, earlobes, and cheeks. However, keloids can affect any part of the body.

Dr Philippe Chout states that More complicated bad scars may be treated with surgery either z-plasty or y-plasty, so called because of the shape of the incision made. During z-plasty or y-plasty, the existing scar is removed and a new finer scar is created level with its surrounding tissue. Dr Chout will be able to determine which procedure is most suitable, having examined the scar(s). Scar revision procedures usually take place under a local anaesthetic, however if the scars are more serious a general anaesthetic may be administered. There is not a great amount of discomfort experienced by most scar revision patient. Following is a general description of the surgery. Remember, each patient’s individual needs and features are considered before surgery. When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely. Skin flaps, composed of adjacent healthy, unscarred skin, are then lifted and moved to form a new incision line. Where a flap is not possible, a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another. Time must be allowed following surgery for new blood vessels and soft tissue to form. Z-plasty is a method to move a scar from one area to another, usually into a natural fold or crease in the skin to minimize its visibility. While Z-plasty does not remove all signs of a scar, it does make it less noticeable.

Some treatments – such as laser therapy – are not widely available on the NHS, so you will need to pay for them privately.
Corticosteroid injections are used to treat some keloid and hypertrophic scars.Corticosteroid injections for sact treament. Multiple small injections are made into the scar to reduce any swelling (inflammation) and to flatten the scar. Depending on the type of scar, these may need to be repeated. Injections are usually given on three occasions, at four- to six-week intervals, to assess your body’s response. Treatment may sometimes continue for several months if the scar is improving. This treatment cannot remove scars, but it can improve their appearance.
Silicone gels or sheets are available from some pharmacies. They are used on healing skin (not open wounds) to reduce redness and to try to minimise hypertrophic or keloid scars. To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day, for at least three months. You can ask your GP, dermatologist or pharmacist for more advice about a range of silicone-based scar treatments.

Plastic Surgery for scars

Surgery can sometimes improve the appearance of scars, as it can be used to: change the positioning of the scar change the width or shape of the scar release a tight scar that is close to a joint, to improve movement Be aware that having surgery on your scar will leave a new scar that will take up to two years to improve in appearance. If surgery is used to treat a hypertrophic scar, there is a risk that the scarring may be worse after the surgery. Surgery alone is not advised for keloids, as they tend to grow back larger. Surgery for keloids is often combined with corticosteroid injections at the site of the removed scar immediately after surgery. Some plastic surgeons also add other treatments, such as X-ray therapy and oral antibiotics, to try to minimise the recurrence of a keloid that has been surgically treated. You can talk to your surgeon about this treatment. Scar revision can be considered for wide, depressed, or irregular scars with the goals of a narrower, smooth scar that is oriented within natural skin tension lines so it is less conspicuous.

Pressure dressings for scars

The aim of pressure dressings is to flatten and soften scars. They are most often used for large burn scars or after skin grafts. Pressure dressings are usually made from a stretchy, elastic material. They are worn over the scar 24 hours a day, for around 6 to 12 months. They can also be used in combination with silicone gel sheeting, to improve the appearance of scars over a long period of time. Pressure dressings are usually used under specialist supervision.

Laser or light therapy (pulses of light) can reduce the redness in a scar

by targeting the blood vessels in the excess scar tissue. For some pitted scars, laser surgery (laser re-surfacing) is used to try to make the scar flatter. This involves using a laser to remove the top layers of skin, which stimulates collagen production in the deeper layers. However, there are very few long-term studies to prove the effectiveness and safety of this therapy. If you have laser therapy, it's important to make sure that the person carrying it out is a fully trained medical practitioner with experience in improving scars.

Dermal fillers are injections (often of a man-made acid) used to "plump up" pitted scars.

Treatments can be costly and the results are usually temporary. Repeat treatments are needed to maintain the effect. Skin needling Skin needling, which involves rolling a small device covered in hundreds of tiny needles across the skin, is also reported to be helpful, but repeat treatments are often needed to achieve an effect, and results vary considerably.

Radiotherapy and Traetment of cheloid scars

Low-dose, superficial radiotherapy may reduce the recurrence rate of hypertrophic and keloid scars after surgery. It is effective in about 70% of cases but, because of the possibility of long-term side effects, it is only reserved for the most serious cases. Scars and skin creams Although Vitamin E cream is sometimes recommended for the self-management of scars, there is no medical evidence to suggest that it has an effect. However, the massaging of a moisturiser such as E45 into the scar will keep it from becoming dry and help make it supple. Scars may be sensitive to the sun. Sunscreen can be used to protect them.

Caesarean section, also known as C-section, is the use of surgery to deliver one or more babies.

A Caesarean section is often performed when a vaginal delivery would put the baby or mother at risk. This may include obstructed labour, twin pregnancy, high blood pressure in the mother, breech birth, problems with the placenta, umbilical cord or shape of the pelvis, and previous C-section. A trial of vaginal birth in some of these situations, including after C-section, may be possible. Some C-sections are also performed upon request. The World Health Organization recommends that they should be done based on medical need and in many cases they are lifesaving for the mother and baby.

Review Acne bad scars improvement by Doctor Philippe Chout

Dr Philippe Chout : Acne bad Scars and pimple scars treatments reviews

Contrary to popular belief, you don’t just get acne scars from picking at your pimples. According to Dr. Philippe Chou t there are acne lesions that are prone to scarring — even if you leave them completely alone. “They are mostly cystic lesions that feel painful underneath the skin and they don’t really connect with the surface easily,” said Dr. Philippe Chout “The inflammation gets trapped in there.People with darker skin often see post-inflammatory hyperpigmentation — marks that appear brown. Those with lighter skin often develop post-inflammatory erythema — which show up as purple or red marks. Acne scars are deep indentations that are usually caused from picking at a blemish (though not always). They take much longer to remove and and can only be erased with laser treatment. Atrophic scars appear as indentations in the skin. One type of atrophic scarring commonly seen as a result of acne is often referred to as an “ice pick” scar, Hypertrophic scars appear as thick, raised bumps on the surface of skin. “A true acne scar is when your body takes that healing process one step further and is not able to actually form the collagen the normal way. All the enzymes that are in the area of the acne lesion eat away at things like collagen and elastin, “In the case that the inflammation is so great, the collagen and elastic tissue is not able to regenerate completely, or it does in a sort of disorganized or pathologic and not healthy fashion, and you’re left with a scar. Treatment can diminish acne scars that cause depressions in the skin. Treatment can also safely reduce raised acne scars. Many treatments are available. Treatments include laser treatments, minor skin surgeries, chemical peels, and fillers. A dermatologist or a dermatologic surgeon can perform these treatments in a medical office.