Case #2 Anal and Perianal Warts 


This is the case of old complicated HPV with resistance to multiple treatments in the past. When I see this patient I notice that hundreds of different sizes of HPV tumor populated in the anal and perianal area. This was a very difficult case and it was very hard to treat this patient HPV and transform it to after photo on the right of the screen. 
Indeed, one of the reasons this patient  has so many different sizes of growth was : 


Autoinoculation

Previous failure treatment and irritation of the area help to spread his own HPV to himself. That is why you see different sizes of HPV growths with different colors due to inflammation and the post-inflammatory hyperpigmentation process.  I always advise other physicians not to use any acid or cream or other topical treatment in this area. It is easy to spray the area, apply some acid or simply give a prescription to the patient and send them to self treat but there is always the thought that the patient might face autoinoculation complications and live with disabling consequences for the rest of their lives. 

 So we performed HPV BCR  treatment on him and we removed them one by one, millimeter by millimeter, took hours of micro removal. It was not easy to transform this highly infected area, into normal-looking tissue. There was a lot of detailed work done but the result is spectacular. Take a look at the after photo, the skin surface is smooth without any visible growth or bumps and it appears natural. 
This patient is back to his normal life with lifestyle changes and measurements to decrease the chance of getting reinfection.




Case #3 Penile, Pubic, Scrotum HPV 

This is the case study of a male patient with HPV presented in 2009 after multiple failed treatment approaches. 
HPV benign tumors have spread to his pubic, penile, and scrotum. 
One session of HPV BCR  treatment was performed on him and completely eradicated his multiple skin growths.  However the patient did not return for a follow-up ever since, this is usually as the patient gets back to his or her life after one usual successful treatment. On the next slide, you will see his after photo after 11 years when he returned to our HPV treatment center today concerned if he got re-infected and he just has a skin pimple cyst which I reassured him. That was the time we get the chance to look at my work after more than a decade.
As you see after the photo, skin is smooth free of any HPV growth and none of the decade-old treated growth has grown back. The patient just had some hair follicles and swollen oil glands. He also reported that none of his partners ever since complained of getting infected with  HPV  from him in his particular case. 
When he saw his 11 years old photo in-person in our center,  that brought back many unpleasant old memories which brought tears to his eyes. 
There are 3 main goals I constantly  try to accomplish with my HPV BCR treatment 

1)Complete tumor removal 

2)Prevention of relapse,,in this case, 11 years is long enough to support our success

3)Natural cosmetic appearance so patient's partner not being able to easily point on the scar and treatment site


Case #4 Penile HPV 

 28 years old male suffering from HPV genital warts for 10 years. 
According to the patient,  He was treated in the past multiple times with excisional surgery, Cream, Acid, and other topical treatment. Apparently with no help and HPV continued infecting surrounding tissue and expanded and increased the size of infected skin with genital warts. 
genital warts in this case appear like a carpet covering a significant part of the genital and pubic area some of which mixed with previous treatment scars. 
The main issue for this particular patient was not being able to date, embarrassment, anxiety, and depression. 
One session of HPV BCR treatment was able to eliminate HPV-infected areas of the skin as well as dealing with previous treatment scars and create near-perfect results as you see. Before photo was obtained on the day of HPV BCR surgery and After the photo was taken 3 months later. 

This BCR  case treatment belongs to 2 years ago and the patient is doing very well with only one session removal with no further treatment needed.  This area of HPV infection is gone and warty growth won't grow back again. 

4 Main treatment goals in this case were  

Complete eradication of HPV related Genital warts

No relapse 

Good cosmetic outcome 

No collateral damages


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Case #5 HPV tumor and scar revision removal 

This is the case study of a gentleman with previously failed HPV treatment presented with HPV-related growth and an unpleasant scar which is more visible than HPV growth as you see in the photo. 
 In this particular case, cosmetic concern was very important for the patient as he had this big scar on his penile which is more visible than warts that are present. 
I have performed one session of HPV BCR microsurgical tumor removal besides scar revision surgery. 
Dealing with scars or keloids especially for African American patients is a surgeon's nightmare. You really can’t give any guarantee or reassurance with 100% certainty on scars.
In one session operation, I address both of these problems and the result is near perfect. 
Take a look after the photo as the skin is flat, normal looking. No HPV tumor is visible as well as the disfiguring scar is gone. Results might vary in every patient but I pay so much attention to cosmetics anytime when I pick a case or agree to a treatment or surgery. 
Disfiguring scars will refresh bad HPV infection memory and bring concern and questions during intimacy. 
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CASE #1  Vaginal and Prineum HPV 

This is the case report of an ongoing HPV infection with Vaginal and valvular warts of a middle-aged female patient. 
The patient presented with an HPV case that has spread and involved a Vaginal fourchette, labia majora, para-labia,  perineum, even in some parts of the gluteal region. This patient had an interest in water sport and being single and actively dating.  I believe both of which can exacerbate her condition, an act of sexual intercourse might transmit the infected area to all surrounding as you see. considering My experience,  ongoing Moisture also lets HPV mobilize easier on the surface of the skin.
One session HPV BCR treatment was done on this patient and all her growth,  one by one were removed with detailed work … take a look at after photo on this case, all the area is smooth free of HPV growth and you can hardly even see any scar. Cosmetics of genitals is important for sexually active patients.  Although every case is different considering the HPV removal is done under a microscope then we pay special attention to cosmetics to minimize collateral damages.