I am a 25 year old male. I have two questions. One about implant/filler and the other about scar.
I have a light brownish skin complexion. I have been diagnosed with En coup de Sabre Morphea on the right side of the face 3 yrs ago. Because of this decease I have almost totally lost fat/muscle below my right cheek – just beside nose area. I also have partial lipoatrophy. So far I have not lost hairs although I have hair-fall problem for some years now. I also have a dark linear band type mark on the right side of forehead. This area is also depressed slightly but visibly. The disease progression ‘appears’ to have stopped but doctors say they are not sure about lipodystropy.

So, I wish to know the opinion of other doctors about it. First, what is the best laser treatment for an atrophic hyper-pigmented scar on the cheek caused by Morphea? Is there a way to remove or lightened it? Note: it is my report which says it is an atrophic hyper-pigmented scar.
Secondly, my doctor has suggested Artefill to fill the cheek depression. Is it the best option or should I go for silicone implant or for some other option? According to my doctor I cannot have autologous fat grafting because of partial lipoatrophy.
Thanks and regards

When patients come to me with large surface areas of volume loss, such as what you are describing, I think that Sculptra is the best option out there. Hyaluronic acid and Artefill are for lines and areas of small surface area. Sculptra is a collagen stimulator – if you can imagine a fertilizer that grows collagen. It is a thin
suspension, so it distributes evenly and smoothly within the tissues. The results are gradual, over three or four monthly sessions, but the effect is very reliable and lasts for several years. It is important to go to an injector who has extensive experience with Sculptra because there is a technique to injecting it safely and most effectively. This is an injectable that was used extensively for lipodystrophy among the HIV population and has demonstrated its ability to provide significant re-volumization of cheeks, temples and other large surface area regions.
As regards the hyperpigmentation, that should be correctable with the appropriate laser – which one would depend on what we see in the consultation.

Really?

I thought better of Newsweek. Perhaps the next article will be about how you don’t have to do all that messy surgery and nasty chemotherapy anymore. Just wear a few crystals and your cancer will melt away like butter!

I swear, I am so close to opening my cat poo spa at the Four Seasons. All cat poo, all the time. Tabby poo for cellulite, rare, expensive persian kitty poo for wrinkles, etc. I figure that if I price it high enough, there will be a waiting list in no time!

Seriously, though – be careful out there. There are few laws governing beauty treatments. As long as it is not harmful, no-one is going to prosecute a company for promoting treatments that do not work. So try to do some research on the treatments you are considering.

Do the cat poo test.

Is there any scientific evidence that the procedure you are considering works? If not, then it might be in the same wrinkle fighting category as cat poo.

Hi Melissa,
The dent is not going to be a major problem. It does sometimes happen from kenalog injection, but its easy to fill it in. It generally will not get worse and worse. It just happens and then either improves on its own, or we fill it in. Once it is filled in, collagen stimulation happens and we usually do not have to fill it in a second time.