Dr. Alexander Uskov

A great first day at the EADV Congress in Vienna.

Our ESLD session was a wonderful opportunity to meet colleagues and friends, exchange ideas, discuss the future of laser dermatology, and start shaping new projects together.

These meetings always remind me how much energy comes from being part of a community that shares the same passion and keeps moving the field forward.

An excellent start — and there is so much more ahead.

Scars after facelift surgery can be especially frustrating because they appear in an area where the whole purpose of the operation was to make the face look better, not to leave a visible reminder behind.

The good news is that even mature scars around the hairline and preauricular area can often be improved significantly.

In this case, we are working on reducing redness, thickening and textural irregularity so that the scar blends more naturally into the surrounding skin and becomes much less noticeable.

This is not the final result yet, but the change is already very clear.

Scar treatment after facelift surgery has to be delicate. The skin is thin, the anatomy is demanding, and an aggressive approach can easily create new problems. That is why treatment is planned step by step using Dr. Alexander Uskov’s individualized scar treatment protocols, with the choice of technology and parameters adapted to the scar’s depth, maturity and response over time.

And as always, results are individual.

For me, the goal is simple: not to make the patient forget the surgery, but to help the scar stop reminding them of it every day.

A large, mature, deep facial scar is a very different challenge.

These scars are not simply lines on the skin. They can be fibrotic, tethered, uneven in depth, and structurally different from the surrounding tissue. By the time they are mature, the skin has already completed most of its natural healing — which means treatment has to be precise, patient, and strategic.

This is still an intermediate result.

But the change is already significant.

The scar is becoming softer, flatter and less deeply anchored. Its edges are blending more naturally into the surrounding skin, and the overall facial texture is becoming more even.

There is still more work ahead.

Complex scars like this are rarely treated with one laser or one procedure. They usually require a combination of technologies and a step-by-step approach, adjusted according to the way the tissue responds over time.

This is exactly the principle behind Dr. Alexander Uskov’s individualized scar treatment protocols.

And as always, results are individual.

For me, the most important moment is when a scar that once dominated the face starts to become just one small part of it.

That is when treatment begins to change more than the skin.

Skin tightening without surgery is possible — within certain limits.

Not every patient needs an operation, and not every degree of skin laxity should be treated the same way.

In selected cases, we can improve skin firmness, texture and overall quality using carefully chosen energy-based treatments and individualized protocols. The goal is not to promise a surgical result without surgery. The goal is to understand what this particular skin can realistically achieve — and then use the right combination of technologies to get there.

This case shows exactly that.

The skin looks smoother, tighter and more compact, while still remaining completely natural.

For me, this is where good aesthetic medicine begins: not with the device, but with proper patient selection, realistic expectations and a treatment plan designed for one specific person.

Sometimes surgery is the right answer.

And sometimes, with the right indication, we can achieve a very meaningful change without it.

I’m looking for one patient with ice-pick acne scars for a clinical case report.

What are ice-pick scars?
They are small, narrow and deep acne scars that look like tiny holes or punctures in the skin. They are usually much deeper than ordinary enlarged pores and may remain noticeable even when the surrounding skin is relatively smooth.

If you have one or several individual ice-pick scars that particularly bother you, I am currently looking for one adult patient to document a new Er:YAG laser treatment protocol as a clinical case.

The procedure for the selected patient will be provided at no charge.

If you would like to be considered, please send me a DM with 2–3 clear photographs of the scars for preliminary assessment.

I will select one potentially suitable case based on the photographs and contact that person directly. Final eligibility will only be determined after an in-person medical assessment.

Treatment will be performed only after informed consent. Any use of photographs or clinical information for scientific publication will require separate consent, and identifying information will not be published.

Treatment results are individual. Treatment parameters are selected individually according to Dr. Alexander Uskov’s treatment protocols.

And… it happened again. 😄

Every year, somewhere around kilometer 15, I become absolutely certain:
this is my last half marathon. Ever.

No more running.
No more suffering.
No more asking myself why normal people spend Saturday mornings doing this voluntarily.

Then some time passes, the legs recover, the hard memories mysteriously disappear… and somehow Laura and I are standing at another start line again. 😂

Apparently, this has become our little annual tradition:
run 21.1 km, question all our life choices, cross the finish line smiling… and then completely forget what we promised ourselves.

See you next year?
Absolutely not.

…probably. 😅

RunningLife NeverAgainUntilNextYear

This is still far from the final result.

But the change is already enormous.

When a postoperative scar becomes thick, irregular, discolored or simply impossible to ignore, it can affect much more than the skin. It can change the way a person looks at their own body, the clothes they choose, the way they feel undressed, and sometimes even the memory of the surgery itself.

We have already completed several stages of treatment, and the scar is becoming softer, flatter and much less visible. The surrounding skin is starting to look calmer and more natural.

We are not finished.

There is still more remodeling ahead, and the protocol will continue to evolve according to how the tissue responds.

But even at this stage, the difference is profound.

For me, scar treatment is never only about making a line on the skin less visible.

It is about helping that scar take up less space in a patient’s life.

And this is exactly why I believe complex postoperative scars deserve to be treated — patiently, individually and seriously.

Treatment continues according to Dr. Alexander Uskov’s individualized scar protocols.

Sometimes the scar left after surgery becomes more troubling for the patient than the condition that surgery was meant to correct.

And this can be incredibly difficult emotionally.

It is also important to say that in many cases this is not the surgeon’s fault. Scar formation depends on individual biology, skin tension, inflammation, postoperative complications, genetics, and simply the way a particular body heals.

This case is still far from the final result.

But the change is already dramatic.

The scar is becoming flatter, softer, less vascular and much less dominant visually. The tissue is gradually returning to a more natural texture, and with every step the patient gets a little more distance from what had become a constant reminder of the operation.

For me, this is one of the most meaningful parts of scar treatment.

Not simply changing collagen or color, but giving the patient hope that the story of this scar is not finished.

We will continue.

The treatment is based on Dr. Alexander Uskov’s individualized scar protocols, combining different laser technologies and adjusting the strategy according to how the tissue responds at each stage.

Scar treatment is rarely a single procedure.

It is a process.

And when the skin changes, quality of life often changes with it.

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Back from Bristol — with a lot to think about, and a lot to be grateful for.

It was a real pleasure to be part of the faculty of the 16th ESLD Hands-On Laser & EBD Teaching Course, hosted at the Bristol Laser Centre, North Bristol NHS Trust – Southmead Hospital.

Two very intense days of lectures, hands-on teaching, clinical cases and, perhaps most importantly, conversations with colleagues who work with lasers every day.

For me, it was particularly rewarding to teach fractional photothermolysis and laser treatment of scars — subjects that are very close to my everyday clinical practice. But these meetings are never only about teaching. I came back with new ideas, different perspectives and several things I want to reconsider in my own work.

A huge thank you to my ESLD colleagues Prof. Ashraf Badawi, Prof. Albert Wolkerstorfer, Dr. Ahmed Sadek, Dr. Johan Snauwaert, Dr. Paolo Bonan and Dr. Mara-Mădălina Mihai. It is always a pleasure to teach, discuss and learn together.

And I was especially happy to meet and work alongside our Bristol colleagues, including Dr. Daniel Keith and Dr. Charankumal Singh Thandi, and to get a closer look at the work of the Bristol Laser Centre. Thank you for the warm welcome, the clinical exchange and for sharing your experience so openly.

One of the things I value most about ESLD is exactly this: people from different countries, different medical systems and different schools of laser medicine coming together around the same patients and the same clinical problems.

You teach. You learn. You argue a little. You change your mind about something. And you go home better than you arrived.

Thank you, Bristol. Thank you, ESLD. See you at the next one.