Case #3 Penile, Pubic, Scrotum HPV 

This is the case study of 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 HPV BCR  treatment was performed on him and completely eradicated his multiple skin growths.  However the patient did  not return for follow-up ever since, this is usual as the patient get 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 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 on after photo, skin in smooth free of any HPV growth and none of the decade old treated growth has grown back. Patient just had some hair follicle and swollen oil gland . He also reported that none of his partner 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 carpet  covering a significant part of genital and pubic area some of which mixed with previous treatment scars. 
Main issue for this particular patient was not being able to date , embarrassment , anxiety and depression. 
One session HPV BCR treatment was able to eliminate HPV infected area of the skin as well as dealing with previous treatment scars and create near perfect results as you see. Before photo was obtained at day of HPV BCR surgery and After 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 wont 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


Case #5 HPV tumor and scar revision removal 

This is the case study of a gentleman with previous  failed HPV treatment presented with HPV related growth and 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 which are present . 
I have performed one session of HPV BCR microsurgical tumor removal beside scar revision surgery. 
Dealing with scar or keloid especially for African American patients is a surgeon 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  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 vulular warts of a middle-aged  Female patient. 
Patient presented with  HPV case that have spread and involved Vaginal fourchette , labia majora, para-labia,  perineum, even in some parts of the gluteal region. This patient had 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. Cosmetic of genitals is important for sexually active patients.  Although every case is different but considering the HPV removal is done under microscope then we pay special attention to cosmetic to minimize collateral damages . 

Case #2 Anal and Perianal Warts 


This is the case of old complicated HPV with  resistant to multiple treatment in the past. When I see this patient I notice that hundreds of different size of HPV tumor populated in 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 reason this patient  has so many different sizes of growth was : 


Autoinoculation

Previous failure treatment and irritation of the area help spreading of his own HPV to himself. That is why you see different sizes of HPV growths with different color due to inflammation and post inflammatory hyperpigmentation process.  I always advice other physicians of not to use any acid or cream or other topical treatment at this area. It is easy to spray the area, apply some acid or simply give a prescription to 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,  to normal looking tissue. There were a lot of detail 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 life style changes and measurement to decrease the chance of getting reinfection.