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'Dr Pimple Popper' Season 8: Dr Sandra Lee helps to fulfill Casey's lifelong dream by removing her facial birthmark

Dr Sandra Lee's patient Casey was bullied all throughout school because of a birthmark, which covers much of her face, head, and neck

What happens if you are unable to take family photographs because of a birthmark on your face? One of the patients from the 'Dr Pimple Popper' Season 8 episode from Wednesday, August 10, fantasizes about having her picture taken without having to worry about her birthmarks.

Casey, 40, of Macon, Georgia, has a birthmark on her face. She has a severe condition that extends from the tip of her nose to the middle of her head, down the left side of her face, and gradually darkens in the neck area. She dislikes the highly bumpy, "cobblestone on a driveway" feeling that the region behind her left eye gives off. Because she doesn't like what she sees when she looks in the mirror, Casey hates doing it. Casey was born with this condition, however, it wasn't as obvious. But the birthmark started to show about the third grade; it grew with her. When Casey was about 12 years old, she was sent to a dermatologist. He wanted to use a laser for the first time ever in a free trial run. He began with the area on her nose and then moved to the area surrounding her lips, where there is now some minor scarring. But he didn't want to do too much at a young age. He just did it once, but Casey is unsure if it can be rectified at this point. She is unsure about the best course of action. Casey was bullied all throughout school when she was younger. The self-esteem is gone after so much. Casey must conceal her marks by maintaining a suitable parting on her head at all times. She despises being seen in public. She has three children and a grandchild, but she believes she is failing them by not being there in their lives. Furthermore, she feels bad for missing out on so much and wants to do everything she can to preserve memories with her family.

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Casey goes to see Dr Lee in Upland, CA, hoping to gain a definitive response from her that whatever she has is fixable. Dr. Lee examines the skin growth on one side of her patient's face. Casey's skin growths have gotten more noticeable over time, according to the doctor. Dr Lee suspects Casey has Epidermal Nevus, a type of mole that appears at birth. She notices that these marks have a wavy look and a line. Dr Lee thinks the previous doctor did a good job because the marks on her face aren't as dark as the ones on her neck. Casey says that the lesion on her neck and the marks under her left eye bothered her. Dr Lee agrees to do anything she can to help, but it is evident that she will not be able to do so in a single session.

In a confessional, Dr Lee expresses her admiration for Casey and describes how the birthmark has affected her life. She admits, though, that the markings are notoriously difficult to remove. Dr Lee says that she can only treat little pieces at a time and that it is impossible to guarantee that some regions would not regenerate. She tells Casey that they will not return to the same hue because the ones on her face have been treated and are in good condition. Dr Lee does not want to give Casey the notion that things were better the other way around. Casey recognizes that her condition cannot be totally resolved, but she is happy to have a starting point that she believes would be good. Dr Lee is unlikely to perform a miracle, but any progress is wonderful.

The extent of Casey's birthmark is really rather daunting, as Dr Lee sincerely wants to help her, but she recognizes the complexity of the endeavor. Dr Lee devises a strategy to conduct an excision below her left eye and shave the region surrounding her neck to see how that goes. Dr Lee applies numbing medicine to Casey's face birthmark, who is scared of the pain she expects to experience. Dr Lee considered doing an excision at the neck region as well, but she is unable to do so because there is no skin to stretch the area close. That would need grafting, which may not look much better than it currently does. So Dr Lee shaves a smaller and darker area around Casey's neck to see if things improve. Dr Lee removes a tiny strip of the birthmark beneath her eye and undermines the edges, reducing strain on the incision and allowing it to heal primarily. Dr Lee's objective is to make the neck growths seem as natural as possible, therefore she moves them with a loop cautery. It melts the skin growths, leaving a sticky residue that makes it difficult to perform it easily since everything sticks to the loop cautery. She next scrapes and cleans off some of the birthmark's remnants with a little curette. She treated the most visible region of the neck, which seems a little red after the treatment but will look better once healed. Dr Lee hopes the skin growths on her neck do not return; if they do, she hopes they are less conspicuous and more flesh-colored. She chooses to monitor Casey's progress over the next few months before deciding whether to proceed with the larger region on her neck.

Casey returns for her second procedure two weeks later. Since the first round, when Dr Lee addressed more of her birthmarks on her chin and neck, she has recovered rather well. Casey's face looks great two months after her second operation. Dr Lee's treated areas are smooth now.

'Dr Pimple Popper' Season 8 airs on TLC every Wednesday at 9 pm.