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Gustavo Colon, MD Portia Chiou, MD Onelio Garcia, Jr., MD Volney Pitombo, MD Dr. Colon: I would like to start by posing a general question. Is there any approach that you take differently in a patient of medium complexion—whether Latino/Hispanic, Mediterranean, or another ethnicity with generally thicker skin—with regard to the incisions used for facial rejuvenation procedures? Because one of the things you must warn these patients about is that their scars may be hypertrophic. Dr. Garcia: About 50% of my current practice is Hispanic. I am in south Florida. In the very thick, darker, or olive skinned patients that I see, I do not use hairline incisions. I always keep them behind the hairline, and I shorten the postauricular incision significantly, whenever possible. But when I cannot, because of significant extra skin, I always keep it within the hair. The problems I have seen with hypertrophic scars in these patients have been in the postauricular area. Dr. Colon: Dr. Pitombo, what is your approach? Dr. Pitombo: I limit the problem by limiting the incisions. In other words, I do a short scar face lift. Dr. Colon: And Dr. Chiou? Dr. Chiou: For my patients who have medium complexion skin, I place the scar within the hairline, if possible. Postoperatively, I start patients on active scar massage the week after their sutures are removed. In some instances, I recommend using a particular product, such as Mederma (Merz Pharmaeuticals, Greensboro, NC), which when coupled with scar massage seems to help keep scars flat. Dr. Colon: Is there any difference in your approach to Asian patients? Dr. Chiou: I approach Asian patients in the same way as I approach anyone with a medium complexion. Scarring is a concern, especially in the very early postoperative period. For patients at risk for hypertrophic scarring, … |
