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Some plastic surgeons join their practice with dermatologists to share expertise on laser. Dr. Won-jae Cha says “I learned about dermatological laser techniques that were different from those used in plastic surgery by joining my practice with a dermatologist.”
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“I used laser when I ran my practice alone. However, I was often overzealous with tattoo removal and occasionally experienced slight scarring or depigmentation after laser treatment. As laser was not widely used back then, I asked for my patients’ understanding by saying ‘laser is the only treatment option for tattoo removal.’ I persuaded them to continue treatment over time rather than expect a one-time cure and patients did not mind mild side effects too much. This is no longer possible as laser therapy is more widespread now. I learned a lot more about laser after joining my practice with a dermatologist. In the beginning, I did not even dare tackling difficult conditions like melasma but I can now achieve some improvement. On the other hand, I could advise the dermatologist on indented scars. I suggested using AccuSculpt to separate fibrous tissues that pull the scar from underneath and applying fractional laser on the surface for drastic improvement. For wrinkle treatment, I consulted the dermatologist to combine elasticity laser with botulinum toxin, filler or surgical procedure, etc. for synergistic effect.”
Plastic surgery should follow dermatology’s lead on post-laser care
Dr. Won-jae Cha has now separated his practice from the dermatologist’s but still tries to learn the knowhow of dermatologists.
“Plastic surgeons may have expertise in wound care but laser treatment should not inflict wounds. It is important to soothe the erythemic or irritated skin after the procedure by providing post-laser soothing care. At dermatologists’ offices, beauticians provide post-laser care programs including vitamin injection, cosmetics and home care, etc. I think plastic surgeons should keep up with dermatologists to provide effective post-treatment care.”
Dr. Jung-hwan Baik of H Plastic Surgery Clinic believes that dermatologists and plastic surgeons should learn from each other when it comes to laser.
“I once attended an academic conference in Jeju Island. There was a dermatology conference being held nearby at the same time so I decided to attend. A dermatologist gave a presentation on fractional laser and showed before and after photos. I did not see any difference between the images, but the dermatologists gave an applause when the talk was over. I was baffled. Their reaction was very different from that of plastic surgeons who only commended drastically different before and after photos. I had another enlightening experience with a patient. I did not see any changes in the before and after photos of Ulthera treatment. I had paid a fortune for the device and was worried that it did not bring any effect. I thought I had to apologize to the patient and discuss how I could make amends. Contrary to my concern, the patient was very satisfied with the outcome. I looked at the photos again but still could not see any differences. The morale of the story is that a plastic surgeon expects visibly drastic differences from a procedure, whereas the patient may be satisfied with more subtle changes. Patients do not always expect drastic outcomes. Some even want the outcome to be hardly noticeable. Laser cannot replace surgery but can definitely satisfy the needs of those patients who want more subtle changes.”
-To be continued-
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