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dr. Garland Boyd's five layers of
dermatologists today we'll be talking
about birthmarks look at many different
types of birthmarks that we'll be
concentrating on Brown birthmarks and
the option once again is the option to
have them removed because some patients
actually embrace your birthmark and
don't want to have them removed while
other patients request birthmark removal
so you can see with this video I'll go
through how to remove two types of
birthmarks
and these are brown birthmark one school
of cafe au lait macula and the other
school of congenital melanocytic nevus
now it's very important to get the
diagnosis right because some birth marks
such as C aom's or cafe au lait macules
can easily be removed with the later
what other birthmark such as congenital
knee by are resistant to laser so you'll
see in this video how this one patient
goes through this journey which takes in
an entire year
everything from surgical through to
vascular and co2 lasers to get to the
very end well motivated patient who
wants his birthmark out and he gets a
very good result so thanks for watching
this video and yeah I hope you learned
something too most common Brown
birthmark arpa general form malonic
stick maneuvers the one on the Left
which occur in one in a hundred births
compared to the cafe au lait macula
which occur in 20% of patients this is a
congenital learned melissa levers and so
is this and so is this so these are all
congenital melanocytic nearby they can
occur at medium sized lesions or
extensively at large lesions so the
story begins with mr. s we saw me
approximately a year ago he had a
medium-sized congenital melanocytic
nevus now the treatment of choice yes
this is graphic is excision Laser
certainly can help but they really
frequently occur with later therapy so
the treatment of choice is actually
serial X isms so you can see me exciting
the division closing it up and the whole
idea is actually treat this birthmark
whilst giving him the least amount of
scarring since them to retinol in one
procedure
you can see I'm actually removing the
birthmark within the birthmark to give
him the smallest possible scar so he
comes in for a second procedure about
two to three months later and I remove
more of the birthmark
once again I'm cutting up the scar but a
tiny bit more birthmark so you can see
right at the end he's got this star
shape black which I'm just about to do
and a little dog here and then after
that what I do is a laser the area so I
later the residual bit with a carbon
dioxide laser and alter the dog years in
other words the razor is the scar then I
flip over to what's known as a
extraction or laser so the fractional
laser can cook with this overall scar
making it softer but as with all scars
they evolve over time so the next six
months Ascar becomes red so what do i do
then I then use a Basque Euler lasers
you can see it's almost gone we're using
a vascular load in the vascular length
as bandages target the blood vessels so
let's have a look twelve month later
from beginning to end this is what the
end result is minimal scarring sure if
you would like a beard in that area we
can actually do follicular unit hair
transplantation so at the end of the day
it can almost be a scarless procedure
because the beard can hide the residual
scarring so beginning to end that is one
year my friends it's not an easy process
but if you're motivated certainly seeing
a good plastic of dermatological
surgeons can help now the second lesion
we're talking about is the cafe au lait
Michel which is much more common
occurring in about 10% of patients
ordinarily I would use the Pico laser
however this laser even as an excellent
laser has not got the energy level at
the wavelength I want at 5:32 so I swap
back to my old laser which is the red
light this uses nanosecond technology
but it works
so let's have a look at the before so
this is what I'm treating a cafe or Lane
macule so cafe au lait macules are very
common but when they occur in certain
areas like the base certainly that can
be from soon so here I am treating this
vision would be a 5/32 laser you can see
I've put into a nice you pick the eyes
and I'm laser and round down this is
third treatment so you can see a marked
improvement and the endpoint which I
want is just a little bit of frosting in
that area and that's perfect
the skin let's have a look at the
perform and let's have a look at how she
feels up this is what she feels like at
day six so it takes about seven to eight
days before the grades go this is what
she looks like after the second
treatment difficulty some residual
areas of brownish and then what she
looks like
after that third treatment so she has a
fourth treatment just to clean up the
areas and at the end of a she's
extremely happy because birthmarks
you've had the 2050s itself gone okay
guys so you can see from that video it
can take anywhere up to a year to remove
a birthmark
especially with surgical methods but
certainly with laser it's a lot quicker
a lot easier but you've got to actually
identify the type of birthmark before
you remove it and remember not all
people want birthmarks removed because
that's part of them is they've grown up
and it's just part of them sir always
respect their their wishes ok guys
thanks very much for watching this video
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I'll see you next week bye
