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  • Things to Know about Liposuction

    Liposuction is often a viable option for Orange County residents who want to lose body fat but have struggled with conventional weight-loss methods. Although it is not a substitute for diet and exercise, liposuction can eliminate certain fat deposits and change a person’s proportions that result from heredity.

    The Procedure: How is Liposuction Performed by a Board Certified Dermatologist & Dermatologic Surgeon?

    Liposuction can be performed safely in the office of a cosmetic board-certified dermatologist like Dr. Tony Nakhla at OC Skin Institute. Tumescent anesthesia, which consists of saline, lidocaine and epinephrine, is used to numb the surgical area prior to treatment. Small incisions are made into the skin so that a cannula can be inserted. A cannula is a tube that resembles a straw and is used to suck fat out from beneath the skin. Liposuction is an outpatient procedure that can be completed in a single office visit.

    Recovery after Cosmetic Surgery

    Compression garments are worn by patients to reduce swelling after surgery and during recovery. Patients are usually cleared to return home 30 minutes after their procedures. Most bruising and swelling should subside after one week. On average, patients can resume normal activities after five to seven days following surgery. Most people notice differences immediately after this cosmetic procedure, but the final results are usually visible six months after swelling has gone away.

    A cosmetic dermatology specialist can evaluate patients who are interested in liposuction and let them know if they are good candidates. Contact OC Skin Institute to learn more if you are interested in a more permanent weight loss procedure like liposuction.

  • Tests for Skin Cancer & Biopsies

    Basal and squamous cell carcinomas, along with other type of skin cancers that are less common, can often be diagnosed with biopsies. A biopsy involves taking a tissue sample that is sent to a lab to be examined for the presence of cancer cells.

    When a Biopsy is Recommended

    Skin cancer is diagnosed in one of three ways: a biopsy, dermoscopy and mole mapping. Dermatologists often recommend biopsies for patients who have suspicious moles or other skin growths that are cause for concern. Patients may have noticed bleeding, oozing and scab formations in these problematic areas. Skin spots that have irregular borders or have changed in size, shape or color could also be showing symptoms of skin cancer that should be further investigated through biopsy.

    Before the Biopsy

    Prior to a biopsy being performed, a dermatologist will take note of a patient’s medical history and conduct a physical examination to determine if further testing is needed. A physical examination can also be performed by a primary care physician who may refer a patient to a dermatologist if a biopsy is recommended. A special magnifying lens known as a dermatoscope is sometimes used to look for cancer cells in suspicious places on the skin during a physical examination. Surrounding lymph nodes can also be felt for any swelling. Board-certified dermatologist Dr. Tony Nakhla may not recommend a biopsy if the initial findings don’t warrant any concerns.

    The Biopsy Process

    Skin biopsies can be performed by a board-certified dermatologist on an out-patient basis. Local anesthetic is usually used to numb the area so that the patient doesn’t experience any pain during or immediately after the biopsy. Some bleeding and minor scarring should be expected after the tissue sample is removed.

    The type of biopsy performed will depend on the size and location of the suspicious skin spot. Some of the most common types of biopsies that are used to diagnose skin cancer include:

    • Incisional and Excisional Biopsies – In an incisional biopsy, only part of the area in question is cut from the skin to be examined. An excisional biopsy is usually needed to look at deeper skin layer levels and can often remove an entire tumor with a surgical knife.
    • Shave Biopsy – Also known as a tangential biopsy, this involves the use of a small surgical blade to shave off the top skin layers that will be examined under microscope. Ointment or cauterization may be used to stop the bleeding from the area where the tissue was removed.
    • Punch Biopsy – A handheld instrument that resembles a cookie cutter is used in this type of biopsy when deeper skin layers need to be removed. Rotational movements are made with the instrument to remove enough tissue. Stitches are sometimes applied to the biopsy site to close the wound.
    • Fine Needle Aspiration Biopsy – In rare instances when squamous or basal cell carcinoma has thought to have spread from the skin to a nearby lymph node, fine needle aspiration can be a helpful diagnostic tool. Small fragments of lymph node are drawn out through a fine needle that causes minimal discomfort and no scarring.
    • Surgical Lymph Node Biopsy – This type of biopsy is sometimes recommended when a fine needle aspiration biopsy doesn’t find any cancer cells but the doctor still believes that cancer has spread to a lymph node. A surgical procedure that can often be performed on an out-patient basis in a dermatologist’s office can remove a lymph node directly beneath the skin for examination.

    Anyone who believes that a suspicious area of skin may be cancer can see a leading skin cancer surgeon in Orange County at the OC Skin Institute for an examination. Contact us today for a consultation if you are concerned about a potential skin cancer diagnosis or are actively pursuing treatment.

  • What to Know About Rashes That are Called Seborrheic Dermatitis

    Seborrheic dermatitis is a very common type of skin rash that is most often seen in infants and adults between the ages of 30 and 60. The rash, which is harmless, may appear reddish in color, have a yellow or white scaly crust, and give the skin a greasy, swollen appearance.

    Causes of Seborrheic Dermatitis:

    Seborrheic dermatitis is not an allergic reaction and is not the result of poor hygiene. It is believed that the condition may be caused by a combination of factors including genetics, stress, climate, overall health, and the naturally occurring flora on the skin.

    When the Rash is Found in Babies:

    Seborrheic dermatitis typically appears as a cradle cap in babies in which thick, crusty, greasy patches develop on the scalp. The condition normally resolves spontaneously within a couple of months. The rash can also develop in the diaper area and is often confused with a common diaper rash.

    Seborrheic Dermatitis in Adults:

    Adults with seborrheic dermatitis often experience episodic flares for the rest of their life. Flares may be triggered by weather changes or stress. The severity and frequency of flares can be managed with the proper treatment.

    Risk Factors for Seborrheic Dermatitis:

    Seborrheic dermatitis can affect individuals of all ages and skin colors. Certain medical conditions such as acne, psoriasis, rosacea, HIV, Parkinson’s disease, eating disorders, and epilepsy can increase a person’s chances of developing seborrheic dermatitis.

    Board-certified dermatologist in Orange County Dr. Tony Nakhla and his team can easily identify and determine if a skin rash is seborrheic dermatitis or recommend the appropriate treatment. Contact OC Skin Institute to schedule your consultation to find out the proper diagnosis and treatment for the medical skin condition you face.

  • Causes & Treatment of Actinic Keratosis

    An actinic keratosis is a patch of crusty, scaly skin caused by UV damage to the skin. Actinic keratoses are a precursor to various types of skin cancer. They are most often seen in adults over 40 and individuals who live in sunny climates, work outdoors, or who use sun lamps and tanning beds.

    Causes of Actinic Keratosis:

    A pre-cancerous skin lesion, such as acitinic keratosis, develops when the skin is repeatedly exposed to UV rays. Over time, the skin becomes unable to repair the damage caused by the rays, and the skin becomes thick, crusty, and scaly.

    Risk Factors for Actinic Keratosis:

    Individuals who have fair skin, hair, and eyes have less natural melanin to protect their skin from UV rays and are more likely to develop pre-cancerous skin lesions. Individuals who have a weakened immune system, medical conditions that increase sensitivity to UV rays, or who work with coal, tar, or other substances that contain polycyclic aromatic hydrocarbons are also prone to developing pre-cancerous skin lesions.

    Diagnosing Pre-Cancerous Lesions like Actinic Keratosis:

    An OC dermatologist and skin cancer specialist and surgeon like Dr. Tony Nakhla can diagnose such a lesion susceptible to skin cancer, by performing a visual examination of the skin. If a suspicious lesion is identified, a biopsy may be used to determine if the growth is cancerous.

    Treating the Lesion Before it Turns into Skin Cancer:

    Actinic keratoses are normally treated using outpatient procedures or home therapies.

    • Cryotherapy: The damaged skin may be frozen so that it will peel away and reveal new, healthy skin.
    • Chemical Peel: The chemical is applied to the affected area to destroy the damaged skin.
    • Curettage and Electrosurgery: A curette may be used to scrape away the damaged tissue. The doctor may follow this up by using a cautery to burn away additional damaged skin.
    • Laser Resurfacing: Similar to a chemical peel, the laser destroys the cancerous cells by removing the top layer of skin to promote the generation of healthy skin.
    • Photodynamic Therapy: Photodynamic therapy involves applying a solution to the skin to make it sensitive to light. As the skin is exposed to a specific wavelength of light, the acitinic keratosis cells are destroyed, and new skin develops within a couple of weeks.
  • How To Treat Lipomas

    Lipomas are benign fatty lumps that typically develop between the skin and muscle. Lipomas are normally harmless and do not require treatment unless they become bothersome.

    Lipoma Symptoms:

    Lipomas typically develop on the arms, thighs, shoulders, neck, abdomen, and back; however, they can develop anywhere on the body. Most lipomas measure less than two inches in diameter and are slow growing. Unlike tumors that tend to be rigid and fixed in place, lipomas move easily under the skin and feel soft and slightly doughy. Lipomas are normally painless, but they can become painful if they contain numerous blood vessels or grow to the point that they press on the surrounding nerves.

    What Causes Lipomas?

    It is unclear why certain people develop lipomas; however, certain risk factors are associated with a higher incidence of lipomas, including:

    • being between the ages of 40 and 60;
    • having a family history of lipomas; and
    • being diagnosed with certain conditions, such as Gardner’s syndrome, Cowden syndrome, or adiposis dolorosa.

    How Are Lipomas Treated?

    OC dermatologist Dr. Tony Nakhla may recommend treatment for lipomas that become painful or that start to grow. The most common treatment is surgical excision. Lipomas do not normally recur once they are removed. Minimal excision extraction techniques are available that result in less residual scarring and bruising. Steroid injections into the lump may help reduce the size of the lipoma. A form of liposuction using a syringe and needle can also be effective in removing the lump.

    When to See a Board-Certified Dermatologist and Surgeon:

    Orange County patients who notice unusual lumps or swelling anywhere on their body should consult an experienced dermatologist as soon as possible for an accurate diagnosis.

    For more information about treating lipomas, contact OC Skin Institute today.

  • Approved Uses of Dermal Fillers

    Dermal facial fillers are a safe and effective way to reduce the appearance of wrinkles and creases. The filler is injected under the skin in a cosmetic non-surgical procedure in order to restore lost volume and to smooth out the surface of the skin. It is important to note, however, that not all dermal fillers are appropriate for all patients and all situations.

    How are Dermal Fillers Safely Used?

    • The U.S. Food and Drug Administration has approved temporary dermal fillers for use in correcting nasolabial folds and wrinkles. Several absorbable fillers are also available for wrinkle and acne scar correction, facial contour correction, and facial augmentation in adult patients.
    • The FDA has approved a non-absorbable filler to minimize the appearance of acne scars and skin folds in adults.
    • Certain fillers have been approved for use in restoring facial volume in patients with HIV who are experiencing facial fat loss for example.
    • Currently, there is one filler approved by the FDA to add volume to the hands.

    The successful use and application of dermal fillers depends on the quality of the skin, the type of filler used as well as other factors. In addition, more than one application may be needed for desirable results.

    Dermal Fillers Should Not Be Used to Augment the Body, Breasts, Buttocks, or Feet

    Dermal fillers are not approved for use in large-scale body enhancement and contouring or breast or buttock augmentation. Fillers are not intended to increase the volume of the feet or for implantation into muscles, ligaments, tendons, or bones. Inappropriate use of dermal fillers may cause serious complications, including chronic pain, infection, permanent scarring and disfigurement, embolism, stroke, or death.

    Patients considering dermal fillers should consult an experienced Orange County dermatologist like Dr. Tony Nakhla who is not only board-certified but is also a skin cancer surgeon. Although non-surgical in nature, dermal filler injections are still a procedure that require a certain level of skill and experience to be performed properly. Patients should never try to inject fillers themselves or purchase fillers online since they may not be safe or approved by the FDA for use in the United States.

    It should be noted that FDA approval means that the product has been reviewed in clinical studies for certain uses in specific parts of the body. The safety and effectiveness of dermal fillers for use over a prolonged period, by certain patient populations, or in other areas of the body may not have been studied.

    Contact OC Skin Institute today for more information about dermal fillers and our facial rejuvenation services and to schedule your consultation.

  • The Dangers of Precancerous Lesions & Surgical Treatment and Removal

    Precancerous lesions can be precursors to certain types of skin cancer and are commonly found on the mouth or other parts of the face. There are four prominent types of precancerous lesions which include:

    • Actinic Keratosis
    • Atypical Fibroxanthoma (AFX)
    • Atypical Moles
    • Melanoma in Situ

    These types of skin abnormalities are known to develop into skin cancer over time due to genetic mutations. Precancerous lesions don’t always turn into cancer, but it is still important to have them monitored by one of our Orange County dermatologists. Dr. Tony Nakhla is a board-certified dermatologist and dermatological surgeon with over a decade of experience treating patients with skin cancer and precancerous lesions before they evolve into skin cancer.

    Causes of Skin Cancer Lesions on the Face, Neck and Body

    There are certain factors that are known to contribute to the development of precancerous lesions. Some of the main causes include:

    • Smoking
    • Sun exposure (lack of sun protection over the years can cumulatively make individuals more susceptible to precancerous lesions)
    • Heavy alcohol consumption

    Skin cancer prevention can be achieved by making some positive life changes and eliminating or minimizing the effects of these factors and elements as much as possible. These are known risks and the key to detection is also prevention of such risks.

    Importance of Seeing a Dermatologist to Treat Precancerous Lesions Early on

    Orange County dermatologist Dr. Nakhla is able to diagnose and monitor and treat precancerous lesions to see if they change over time. If these lesions end up becoming cancerous, treatments can be implemented to eliminate these cancers in their early stages before they grow into more serious medical concerns. Treatments include surgical removal as well as Mohs micrographic surgery. This is a popular procedure especially when the lesion or cancerous cells are present on delicate skin such as the face. Having cancerous lesions treated early can also result in less scarring and improve survival rates.

    Diagnosis and Treatment of Skin Lesions by a Board-Certified Dermatologist and Surgeon

    Precancerous lesions can often be diagnosed based on observations and behaviors of the lesions. To confirm a diagnosis, a skin cancer specialist may have any suspicious lesions biopsied so that the cells can be examined in a lab under a microscope. If cancer is discovered or is expected to soon develop, there are several minimally invasive treatment options that can eliminate the problem.

    If you think you might have any precancerous lesions, please schedule an appointment to see a board-certified dermatologist and skin cancer surgeon in our Orange County offices.

  • What is Telangiectasia and What are Effective Dermatologic Treatments?

    Frequently referred to as spider veins, telangiectasia is a common medical condition marked by a widening of small blood vessels near the skin’s surface. Affected veins, which can measure from 1 to 3 millimeters in width, are known as telangiectases. Telangiectases typically appear as clusters of thin red or pink streaks that resemble a spider’s web.

    Recognizing Signs of Telangiectasia

    Telangiectases can appear anywhere on the body, but they often develop in uncovered areas that are visible to others, including the hands, lips, chin, and other parts of the face. In some cases, the condition causes mild to moderate itching or pain. Many individuals are bothered less by the physical discomfort and more by the aesthetic ramifications of the condition.

    What Risks do Spider Veins and Broken Blood Vessels Pose?

    Possible risk factors and/or situations for patients struggling with telangiectasia include the following:

    • Frequent exposure to sunlight, wind, and/or extreme temperatures
    • Pregnancy
    • Acne or skin lesions
    • Heavy use of alcohol
    • Regular use of certain oral or topical medications, including corticosteroids

    The elderly, people who sit or stand excessively during the day, and people with certain conditions that affect their skin’s resilience, are also at greater risk of developing telangiectasia.

    Treatment Options

    Individuals who wish to treat their telangiectasia have several options, including laser treatment, conventional surgery, and sclerotherapy, a process that involves injection of salt water or a chemical solution into the affected area. Any cosmetic procedure used for the treatment of telangiectasia should be carried out by a board-certified dermatologist like Dr. Tony Nakhla of OC Skin Institute.

    Hereditary Hemorrhagic Telangiectasia

    Although telangiectasia is generally not harmful, hereditary hemorrhagic telangiectasia, or HTT, is a serious and potentially life-threatening variation of the condition. Also known as Osler–Weber–Rendu disease, HTT is a rare genetic disorder in which vein clusters develop on a person’s internal organs. Affected organs can include the liver, lungs, and brain. Vein clusters that are the result of HTT can burst and lead to major internal bleeding.

    Contact Orange County Skin Institute today if you are struggling with broken blood vessels, spider veins also known as telangiectasia and would like to undergo effective and safe treatment.

  • Kybella Treatment with an Orange County Dermatologist

    Patients in Orange County suffering from weight gain or aging don’t have to dread these issues any longer. Due to a new treatment called Kybella, our patients can safely eliminate unsightly fat cells. With Kybella, patients can enjoy permanent fat loss around the chin area. Also, the jawline will be contoured and redefined offering an attractive appeal.

    With our highly trained and experienced Orange County dermatologist Dr. Tony Nakhla being a proven leader superseding others in the industry, patients are in great hands. In addition to being  a board-certified dermatologist, Dr. Nakhla is a dermatologic surgeon.

    Approved by the FDA, Kybella is a revolutionary procedure with the following benefits:

    • It works quickly- Kybella treatments only last for 15 to 20 minutes.
    • It is minimally invasive– Unlike other treatments, including the risks associated with a facelift or a liposuction, no plastic surgery of the double chin is needed. So, because it is minimally invasive, there is no need for anesthesia.
    • Kybella is cost-effective– unlike previous fat reduction procedures, this procedure is a lot more affordable.
    • It yields permanent results– the results start to show a few weeks following the first session. Four to six treatment sessions are normally required to eliminate all of the chin’s fat cells. And as a result, patients won’t need any more treatments due to permanent results.
    • These treatments are easy– tiny injections consisting of deoxycholic acid are injected in the chin. Fat cells are then broken down which, in turn, will be slowly absorbed and eliminated throughout the body.
    • No downtime is involved– with Kybella being fast and minimally invasive, there is no downtime needed. Patients can automatically get this treatment during their lunch break and return back to work afterwards.

    The Kybella Process

    Up to 50 injections will be applied to the area below the chin where the fat is located. Two to four sessions are required for most patients. Also, the treatment plan is scheduled for every four to eight weeks; however, a more extended time period can be scheduled for the second session.

    Side Effects and Risks

    Induration, bruising, numbness, and redness that last for up to four weeks along with having trouble swallowing are the side effects. Otherwise, an asymmetric smile that comes from the temporary damage of the marginal mandibular nerve is an uncommon side effect that can happen and lasts from days to weeks.

  • Eyelid Blepharoplasty

    Eyelid blepharoplasty is a surgical procedure designed to remove excess skin or fat deposits from around the upper or lower eyelids. The procedure is often used in combination with laser resurfacing and other cosmetic procedures to improve the contour of the eye and to create a more rested, youthful appearance. Blepharoplasty may also be used to remove excess skin around the eyes that is interfering with vision.

    Who Is a Candidate for Eyelid Blepharoplasty?

    Patients undergoing blepharoplasty typically have significant sagging of the upper eyelids, pouches of fat in the upper or lower eyelids that contribute to an aged or tired appearance, or peripheral vision problems caused by excessive eyelid skin. The skill of the surgeon is essential since removing too much skin or fat tissue can lead to an overly tight, unnatural look or even make it difficult to close the eyes fully. To ensure the most natural looking results, it is important to consult an experienced Orange County surgeon and board-certified dermatologist like Dr. Tony Nakhla.

    Upper Eyelid Blepharoplasty:

    An upper eyelid blepharoplasty involves making an incision along the crease of the upper eyelid in order to excise the excess skin. The surgeon must be careful not to remove too much fat from the area in order to preserve a natural, youthful appearance.

    Lower Eyelid Blepharoplasty:

    With a lower eyelid blepharoplasty, an incision is made inside the lower eyelid or just under the lash line to allow the surgeon to remove excess skin and fatty tissue leading to unsightly bags under the eyes. A lower eyelid blepharoplasty may also be combined with a canthopexy if the eyelid needs to be tightened further.

    What to Expect:

    Upper and lower eyelid blepharoplasties are performed as outpatient procedures using local anesthesia with oral or intravenous sedation. It is normal to experience some minor bruising or swelling immediately following the surgery; however, this should resolve within approximately 10 days. A follow-up visit is normally scheduled a week following the procedure to remove the stitches. Because of the location of the incisions, there should be no visible scarring. Most patients resume their normal activities a week after the surgery.