1) tab: operation, I-II operation.
2) technical principle
Dermatization is one of the commonly used methods to treat rosacea. The depth of rosacea invading the skin is about 2 mm Abnormal skin of nose can be removed by controlled mechanical grinding of nasal epidermis and/or superficial dermis with grinding equipment. After grinding, when the nasal wound heals, it can improve the lesions on the skin surface, rearrange the collagen fibers and elastic fibers under the skin, and the remaining skin appendages, such as sebaceous glands, will quickly form a new epidermis.
3) Adapt to the crowd and taboo crowd
① Suitable for people: those who have rosacea in the early stage of mild rhinoplasty and those who are willing to face up.
② Taboo crowd
A. hemophilia or abnormal bleeding.
B. Patients with active infectious hepatitis.
C. those who are emotionally unstable and demanding.
D. keloid constitution, with large and deep scars.
E. The skin lesions are suspected to be malignant or have been diagnosed as skin malignant tumors.
F. there are obvious infections in local skin.
G. having a history of radiotherapy or radiation dermatitis within half a year.
H. menstruating and lactating women.
4) Technical methods
① Disinfection of the operating area and surrounding tissues.
② Anesthesia: Subcutaneous anesthesia is generally used.
③ Grinding with a grinding instrument, and determining the grinding range according to the specific conditions of the lesion.
④ Rinse repeatedly with disinfectant after operation.
⑤ Covering vaseline gauze and thick gauze for pressure dressing.
5) Risks and complications
① Penetrating the skin: If the grinding force is out of control during operation, it may penetrate the skin.
② Pain: Most people have no pain or only slight pain after operation, so they can take general painkillers according to the doctor's advice.
③ Edema: Sometimes slight edema appears after grinding, and usually disappears in 3-6 weeks.
④ Skin redness: it is the first complication after grinding. The duration varies from person to person, and generally disappears within 65,438+0-3 months.
⑤ Miliary rash: It often occurs 2-6 weeks after operation and should be further treated in the hospital.
⑥ Scar hyperplasia: It can appear in any part of grinding, mostly women. Generally, mild scar hyperplasia can subside and flatten itself after about 1 year. If necessary, grind the skin after 1 year to flatten the hyperplastic scar.
⑦ Infection: The incidence rate is low, which is mainly caused by excessive wound pollution and improper postoperative treatment.
⑧ Pigmentation: The incidence rate is high, which generally appears around 1 month after operation, and the peak period is 2 months, mostly 6-1 February, and a few of them are over1year.
6) Recovery time
There may be blood oozing 1-3 days after operation, so it is enough to change gauze. At the same time, the external dressing will be removed after 3-5 days of antibiotic use, and the internal dressing will generally fall off on its own in 10- 14 days. After the wound is healed after operation, pigmentation after flushing can appear within 2 weeks, and the normal color can be recovered after 2-6 months, and appropriate vitamin C can also be taken to prevent it. If multiple polishing is needed, the polishing interval is usually 3-6 months.
7) Precautions
1)
① Stop drinking and taking vasodilators such as aspirin and vitamin E one week before operation.
② Don't make up before the operation.
2) Matters needing attention after operation
(1) direct sunlight should be avoided after operation, and masks or wide-brimmed hats can be worn.
② Make-up is not allowed within two weeks after operation.
③ Keep the operation site clean and sanitary, and try to avoid water accumulation in the operation area within 7 days after operation.
4 avoid eating irritating foods, such as peppers.
⑤ Strictly follow the doctor's advice for medication and follow-up.
2. Rosacea incision
1) label: operation, first-class operation.
2) technical principle
Rosacea resection is mainly aimed at middle and late rosacea. This method can destroy and cut off dilated capillaries, hyperplastic sebaceous glands and fibrous connective tissue, cut off excessive nasal vegetation, regenerate hair follicle epithelial cells, and form normal or nearly normal epidermis after wound healing, thus achieving the purpose of treatment.
3) Adapt to the crowd and taboo crowd
① Suitable for people: those with rosacea in severe rhinoplasty stage and those with beauty will.
② Taboo crowd
A. hypertension, heart disease, etc.
B. people with infectious diseases.
C. people who are allergic to blood diseases.
D. people with scar hyperplasia.
E. menstruating and lactating women.
4) Technical methods
① Disinfection of the operating area and surrounding tissues.
② Anesthesia: Infiltration anesthesia is generally used.
(3) Choose a suitable blade according to the condition, and repeatedly cut the affected area at a proper speed and strength until the skin surface is hairy.
④ gauze was pressed to stop bleeding, and vaseline gauze was applied and bandaged.
5) Risks and complications
① Pain: Most people have no pain or only slight pain after operation, so they can take general painkillers according to the doctor's advice.
② Edema: Mild edema sometimes occurs after operation, and usually disappears within 3-6 weeks.
③ Skin redness: It may be caused by injury to normal capillaries during operation, or it may be caused by the color caused by infection.
④ Infection: There is the possibility of infection during operation. Once found, you should seek medical advice in time.
6) Recovery time
Vaseline gauze can fall off on its own 5-7 days after operation, and the wound scabs and heals. Taking antibiotics at the same time can gradually return to normal in about 3 months after operation. If reoperation is needed, reoperation can be performed within 3 months after wound healing.
7) Precautions
① Precautions before operation
A. Stop drinking and taking vasodilators such as aspirin and vitamin E one week before the operation.
B.don't put on makeup before the operation.
② Precautions after operation
A. no makeup for two weeks after operation.
B keep the operation site clean and sanitary, and try to avoid water accumulation in the operation area within 7 days after operation.
C. avoid eating irritating foods, such as peppers.
D. strictly follow the doctor's advice and make follow-up visits. 1. Laser rhinoplasty
1) Label: Non-surgical.
2) technical principle
Laser treatment of rosacea is based on the principle of selective absorption. Laser has a specific absorption effect on hemoglobin of red blood cells in blood vessels. Laser with wavelength of 452-577nm is usually used in clinic. When it irradiates the nose, the energy of laser is absorbed specifically, hemoglobin is coagulated, and red blood cells are destroyed to form microthrombus, thus blocking capillaries, leading to local hypoxia and capillary destruction. The local temperature of the formed microthrombus increases, and the heat diffuses to vascular endothelial cells, which causes irreversible damage to the latter and achieves the purpose of treating rosacea. However, laser is difficult to completely cure and needs multiple treatments.
3) Adapt to the crowd and taboo crowd
① Suitable for people: those with mild rosacea and desire for beauty.
② Taboo crowd
A. Absolute taboo population
I. Systemic lupus erythematosus and other autoimmune diseases;
Two. The prone parts of keloid;
Three. Photosensitive skin and people who are using photosensitive drugs;
Four. Users of isotretinoin in the past year;
Verb (abbreviation for verb) pregnant woman;
Intransitive verbs are suspected of skin cancer patients;
B. Relative taboo population
I. Those who have recently undergone chemical peeling, physical polishing, other skin rejuvenation and skin radiotherapy;
Two. Smokers;
Three. Diabetic patients;
Four. Those with a history of hypertrophic scars;
Verb (abbreviation of verb) patients with abnormal pigment;
Have high expectations.
4) Technical methods
① After cleaning the face, the patient lies on his back and applies condensation cream. .
(2) Apply surface anesthetic cream as needed or not.
③ Laser is aimed at rosacea and irradiated.
5) Risks and complications
① Pigmentation: After treatment, most patients are hypopigmentation at the initial stage, but pigmentation may appear soon. Generally, no treatment is needed, and the pigmentation will subside spontaneously within 2-4 months.
② Local swelling: All patients had mild and moderate local swelling after laser treatment, which was the heaviest in 2-3 days after operation and gradually subsided in 5-7 days.
③ Itching: rare. It may mean wound healing, but we should also be alert to the possibility of infection.
④ Infection: If the wound is scratched or polluted by water, erythema may appear. In case of infection, seek medical attention as soon as possible to promote wound healing as soon as possible, but superficial scars may be left after healing.
⑤ Scar formation: Because of the high precision of laser, the size and depth of treatment can be strictly controlled, and no scar will be left after operation. However, a few of them can form concave scars or stimulate the formation of hypertrophic scars. Seek medical attention as soon as possible after scar formation to reduce the degree of scar.
6) Recovery time
After about 2-3 weeks, the skin lesions scabbed off. Generally, laser treatment of rosacea needs 2-4 times according to the specific situation, and the treatment interval is generally 8- 16 weeks.
7) Precautions
① Clean your face before treatment, and don't leave any cosmetics.
(2) the recent exposure, should explain to the doctor before treatment.
(3) After treatment, don't touch the water in the treatment area, don't rub it, avoid spicy food, alcohol and tobacco before the scab falls off, and fast dark food such as coffee and cola in recent days, so that the scab falls off by itself, and don't peel it off forcibly.
④ Don't take part in strenuous exercise before the scab falls off, so as to avoid infection after sweating.
⑤ Pay attention to sun protection after operation: avoid direct sunlight, wear a sun hat, take an umbrella and use sun protection products externally. Choose products with high safety and good sun protection effect: UVB sun protection index (SPF) >; 30; UVA sun protection coefficient (PFA)& gt；; ++; Physical sun protection with large R index.
2. Photonic rosacea plasty
1) Label: Non-surgical.
2) technical principle
The specific principle of photon therapy for rosacea is that hemoglobin and oxygenated hemoglobin in blood vessels can highly absorb light energy and generate heat. When the blood temperature is high enough, it will coagulate and destroy the blood vessel wall (the effect is best when the temperature rise ratio of blood vessel to epidermis reaches the maximum), thus destroying the dilated capillaries and achieving the purpose of treating rosacea.
3) Adapt to the crowd and taboo crowd
① Suitable for people: those with mild rosacea and desire for beauty.
② Taboo crowd
A. people who have recently been in the sun or will be in the sun;
B. Photosensitive skin and people who are using photosensitive drugs;
C. recent oral isotretinoin;
D. pregnant women;
E. diabetic patients;
F. people with scar constitution;
G. suspected skin cancer patients;
H. those who have high expectations.
4) Technical methods
① After cleaning, the patient lies flat.
② Wear an eye mask to protect your eyes.
③ Apply cold glue to the nose.
(4) The test point under the earlobe.
⑤ Observe the test reaction and choose the appropriate treatment parameters.
⑥ Treat rosacea.
All landowners local cold compress at any time.
8 Repeat the treatment according to the response.
5) Risks and complications
① Postoperative reaction: slight burning sensation may occur for 0.5-2 hours; Slight redness, which may last for 12 hours;
② Pigmentation: There may be different degrees of pigmentation after treatment, and whitening drugs such as vitamin C can be taken according to the doctor's advice.
③ Burn: Photon therapy can cause different degrees of burn, showing as temporary purpura, blisters and so on.
④ hypopigmentation or alopecia: It may appear in people with dark skin or sun exposure. For such patients, it is necessary to explain the situation to the doctor in order to make preventive treatment in advance.
6) Recovery time
① Once every 3-4 weeks, the average number of treatments needed to achieve ideal curative effect is 3-6 times.
② Photon therapy has slight postoperative reaction, lasting for several hours at most, and generally does not affect normal work and life.
7) Precautions
① You can't do laser, peeling and fruit acid skin-changing beauty projects one week before treatment.
(2) the recent exposure, should explain to the doctor before treatment.
③ Clean your face before treatment, and don't leave any cosmetics.
(4) Within a few days after operation, hot water should be avoided, but cold water should be used to clean the skin, and attention should be paid to cleaning and protection.
⑤ Make-up should be avoided for a few days after operation.
⑥ Avoid direct sunlight, wear a sun hat and an umbrella when going out, and use sunscreen products for external use. Choose products with high safety and good sun protection effect: UVB sun protection index (SPF)= 30；; UVA sun protection coefficient (PFA)& gt；; ++; Physical sun protection with large R index.
⑦ Photon therapy should not be too frequent, especially in summer, long sunshine time and hot climate.
3. Cryotherapy for rosacea
1) Label: Non-surgical.
2) technical principle
Cryotherapy of rosacea is a process in which low temperature technology acts on rosacea skin, and then ice crystals form inside and outside the tissue, which makes cells dehydrate, shrink and skin tissue necrosis, and then turns white, scabs, falls off and restores color, thus achieving the effect of treating rosacea.
3) Adapt to the crowd and taboo crowd
① Suitable for people: those with mild rosacea and desire for beauty.
② Taboo crowd
A. People with a history of temperature allergy, limb paralysis, skin sensory or local circulation dysfunction, and poor blood supply.
B. Women's menstrual period or pregnancy.
C other systemic diseases, such as hypertension, cardiovascular diseases, coagulation diseases and diabetes; Old people or young people; Immunodeficiency and other conditions, such as radiotherapy and long-term hormone therapy.
D. people with scar constitution.
E. people with mental disorders.
F. Severe cold urticaria, cryoglobulinemia and cryofibrinemia.
4) Technical methods
Disinfect the operating area and its surroundings, put the refrigerant into a special spray device and spray it on the rosacea to whiten the local ice surface, and wait for the process of scab, shedding and color recovery after the operation for about a week.
5) Risks and complications
① Pain: There is local pain within 1-2 days after cryotherapy, especially within 1-2 hours.
② Edema: After thawing, local swelling began, reaching the peak in 24 hours, and gradually subsided in 3-4 days. If the edema is obvious, glucocorticoid cream can be used externally as directed by the doctor, 2-3 times a day.
③ Blister: For those who have been frozen for a long time, blisters or bullae may appear locally 2-3 hours after operation. You should see a doctor immediately.
④ Infection: rare. It is often caused by blisters after operation, carelessness in cleanliness and hygiene, and secondary infection. Once infected, you should go to the hospital for treatment immediately.
6) Recovery time
Cryotherapy of rosacea is a cold melting cycle from whitening to restoring its true color, each cold melting cycle is about one week, and the freezing cycle can be flexibly selected according to the size of different rosacea invasion areas. Generally, edema began to subside gradually 3-4 days after operation.
7) Precautions
① Precautions before operation
A. Stop drinking and taking vasodilators such as aspirin and vitamin E one week before the operation.
B.don't put on makeup before the operation.
C. try to avoid sun exposure during treatment.
② Precautions after operation
A. Don't touch the water and tear the scab for one week after freezing.
B. no makeup for two weeks after operation.
C keep the operation site clean and sanitary, and try to avoid water accumulation in the operation area within 7 days after operation.
D. avoid eating irritating foods, such as peppers.
E. strictly follow the doctor's advice and make follow-up visits.