LAM FACIAL PLASTICS

Dear Dr. Lam,

I have a sort of academic question specifically with regards for the potential of radical acne scar/skin rejuvenation.

I am sure you are well aware of ACeLL matristem wound sheets as I know you also perform hair restoration procedures and they are being used to heal donor sites.

But I have pretty bad boxcar, rolling and icepick scars and I want a major improvement. Could one simply induce a very deep wound or very deeply resurface the skin of the face down to the actual scar tissue and then apply matristem wound sheets to then induce new scarless skin to heal!!?? So first, do you think this is possible --the current state of acne scar therapies(and I've researched them all) is less than exemplary to me, so I'm interested in something more radical.

This is from the acell website, apparently a fairly deep wound was created to remove a cancer lesion, and then a matristem sheet was applied. Certainly in the third pic no real sign of a wound can be seen(and this is 2 months post-op).

I AM SKEPTICAL HOWEVER, why is the ostensibly healed/new skin so aged looking? One would assume that if the acell truly did help the body regenerate new skin, this would look like new skin, and not the same sun damaged wrinkled skin with brown spots the person must have had before she developed cancer in that area? Or are my assumptions completely flawed? That is, even though acell may help the body regenerate tissue it simply regenerates the tissue to the subject current biological age(and thus has no rejuvenating effect?). But even so, why does this supposedly newly healed skin still appear to have environmental stress/wear and tear? After all this is supposed to be only two-months post-op? Are you skeptical of these before/after photos and the purported results uses of the acell technology?

http://www.acell.com/files/Full_Thickness_Repair.pdf

So these are my questions:

1) Do you think acell can be used in conjunction with some kind of laser/abraiding technology to radically reduce or eliminate acne scars in the future? or now?

and

2) Why does the regenerated tissue from the acell treatment not also appear produce a rejuvenated affect?



thanks as always for your considered response,

Declan

hi,
yes, i am excited about acell but only for hair restoration now. i will be doing my first acell case in november for hair. i am charging the patient at cost for this procedure and mixing it with PRP. what i saw at the recent hair meeting in anchorage is that in a presentation on acell by a reputable unpaid speaker is that it did very little for the donor scar but it did help with graft growth. in another doctor's work he showed a single case (so take it with a grain of salt) of a split scar with PRP and acell and showed that there was a very good difference. i honestly believe that it is still a bit experimental at this stage. i am not yet interested in applying this technology to the face but maybe soon i will be. i don't think we know if it does anything real. could be voodoo but i am always open to thinking about new things.

sml

Thank you Doctor Lam for your preternaturally expedient response. I take it that you did not comment on my specific question regarding the rejuvenation of the skin on the hand in the patient with melanoma because you're not sure(which I totally understand) why her skin, though healed looking DOES NOT look REJUVENATED. I simply don't understand why, if this skin (in the third picture) truly displayed newly healed skin, it still bears all the marks of the subject's aged skin(brown age spots etc.). I suppose we would need to see what a healed example (without matristem) on a side by side comparison would look like to note the difference. This is why I am skeptical of the photograph on their site --the third pic looks rather like the hand perhaps before it even developed cancer.

Regardless, I am glad you are testing this new technology and I am cautiously hopeful that some such regenerative technology will soon be developed for my rather severe acne scarring. Thank you once again!

Declan

Yes, in short I do not know, and I am always cautious in answering out of ignorance.

Dr. Lam,

on an unrelated note, may I ask you a kind of personal question. Your CV is very impressive, plus you are quite a skillful and knowledgeable artist AND you are so thorough and consistent in maintaining this site and providing answers. You just seem to be such an accomplished and well developed person. I am not in any related field, but I would just like some lifestyle advice. You went to Princeton, then Columbia and all the while have been very driven and seem to enjoy life.

Could you give us a glimpse into your daily routine? Do you need very little sleep? What time do you wake up in the morning? Do you exercise or practice some kind of meditation? What is the philosophy or ideology that has informed your accomplishments? I know there is no easy answer and ultimately hard work and practice are really the two common denominators of every successful person.

But I find myself often wrought with anxieties(not clinical) about my vocation and indecisiveness and an inability to follow through with a lot of things I set out or plan and sometimes poor self-esteem. I know your on these topics is not as a doctor, but I'm just curious, I don't have an older brother, but I did, I wish I had one like you to give me advise. Thanks --and I didn't mean that to sound too sycophantic! I truly mean it.

no worries. love to give some inspirational words if i can. i am not a genius but i lead well. i have an amazing team that work with me to achieve our mutual goals. Steve Jobs said that one man cannot make a product but a product can only be made by a team. He hired Tim Cook as COO (now CEO) as his foil: someone who executes his vision and handles the operations. When I did my fellowship with Ed Williams, he taught me how to lead. Through great leadership, you can inspire those around you to buy into the same vision you have and to accomplish things you as a single person could not. If you have not read the 21 Irrefutable Laws of Leadership by John Maxwell, you should.

My strengths are in creative vision for my company, design, and leadership. My weaknesses are organizational structure, management, and operations. I am primarily a right brain thinker (creative, emotional, intuitive) rather than analytical and logical (although i am probably 60/40). My point is twofold: know your weaknesses and hire against them (if you are in that position to do so).

Yes, exercise and good diet are key for me, especially since i lost about 40 pounds in the last 2 years I have totally changed my relationship to food and exercise now. They are integral to mental health, self esteem, etc. It is important to have somewhat of a zen philosophy, to let go of the hunger for materialism but at the same time i have a deep appreciation for all things beautiful and well designed. If you read my blog lfp-blog.com, you can learn more about my overall life philosophy points. I have over 600 blogs on that site that you might find interesting. Btw, I sleep 7 hours. I just work efficiently and delegate well. For a core principle, read The 4 Agreements if you haven't yet.

If you have not seen Steve Jobs 2005 Stanford Commencement address, you should. You can find it on Youtube. We are all on this planet for a very short time. We need to make the most of who we are so that we can make a difference. You must follow your own passion and your own heart and no one else's. Do not live in the shadow of another person but find where you want to be in life and accept no compromises and no shortcuts. Put your 10,000 hours in to become a master at your chosen art. If you chase money, you will have none. You must chase your passion relentlessly. As Jobs finished in his talk, "Stay hungry. Stay foolish."

sml

THANKS!!

Thanks for the info, I have been curious about this procedure myself. If it proves to be legitimate, I think that it is something that I would be interested in! Are you aware of any doctors who may be experienced in this procedure yet? I this that this would be life changing for me, so I might even consider being a guinea pig if that's what it takes. Do you think that I might be able to find someone to perform this on LocateADoc? I have not yet had a chance to check out the site yet, so I'm not really sure what to expect. Thank you for any advice you can give me!

cool.