Division of Plastic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Aesthetic Plast Surg. 2011 Dec;35(6):1143-50. doi: 10.1007/s00266-011-9715-y. Epub 2011 Apr 14.
Atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient's quality of life. The appearance of these scars is often worsened by the normal effects of aging. A number of options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, ablative or nonablative laser resurfacing, dermal fillers, and surgical techniques such as subcision or punch excision. Depending on the type and extent of scarring, a multimodal approach is generally necessary to provide satisfactory results. Resurfacing techniques correct surface irregularities, long-lasting dermal fillers address the volume loss resulting from acne, and sub-superficial musculoaponeurotic system (SMAS) face-lift procedures counter the soft tissue laxity and ptosis associated with aging. This article briefly reviews the evolution of individual approaches to treating atrophic acne scarring, followed by case examples illustrating results that can be achieved using a multimodal approach. Representative cases from patients in their 30s, 40s, and 50s are presented. In the author's clinical practice, multimodal approaches incorporating fractionated laser, injectable poly-L: -lactic acid, and sub-SMAS face-lift procedures have achieved optimal aesthetic outcomes, high patient satisfaction, and durability of aesthetic effect over time.
萎缩性痤疮瘢痕是一种广泛存在的疾病,会对患者的生活质量产生负面影响。这些疤痕的外观通常会因衰老的正常影响而恶化。有多种选择可用于治疗痤疮疤痕,包括化学换肤、磨皮术、磨皮或非磨皮激光换肤、真皮填充剂以及整形手术,如皮下分离术或打孔切除术。根据疤痕的类型和严重程度,通常需要采用多模式方法才能获得满意的效果。换肤技术可纠正表面不规则,长效真皮填充剂可解决因痤疮导致的体积损失,皮下浅表肌肉腱膜系统(SMAS)提升术可对抗与衰老相关的软组织松弛和下垂。本文简要回顾了治疗萎缩性痤疮瘢痕的各种方法的演变,随后通过病例示例说明了采用多模式方法可实现的效果。展示了来自 30 多岁、40 多岁和 50 多岁患者的典型病例。在作者的临床实践中,采用多模式方法,结合分馏激光、可注射聚左旋乳酸和 SMAS 下除皱术,已实现了最佳的美学效果、患者满意度高,并且随着时间的推移,美学效果的持久性也很好。