Minimally Invasive Whole Body Procedure
surgical Scar removal of nevi,
Lipomas, & skin lesions /
Melanoma
LENGTH:
15 minutes to 1 hour.
ANESTHESIA:
Local outpatient / usually office surgery.
SIDE EFFECTS:
Swelling, bruising, prominent scarring (requiring further surgery).
RISK:
Bleeding, infection, poor healing (ALL RARE).
RECOVERY:
Cold pack for 24 to 48 hours. Wound care for 5 days. Full activity in less than one week.
DURATION of RESULTS:
Usually permanent, unless recurrence.
OFFICE VISITS:
1st 5 to 7 days unless Steri Strips, then 6 weeks. / 2nd Visit 6 weeks to 3 months / Estimated 3 visits TOTAL.
BANDAGES WORN:
24 to 48 hours.
PAIN MEDS:
Ibuprofen.
» back to top
More Information About
Scars, Wounds, & Healing
Pulse Dye Vascular Laser:
We are presently suggesting to patients that they consider early intervention into the healing process, by treating some scars with the Pulse Dye Laser. We believe that both early and late scar quality will be significantly improved by this technique in patients whose scars are prone to over healing (hypertrophy), and the need for late revisional procedures will be reduced dramatically.
The Pulse Dye Vascular Laser has allowed treatment of scars in their early bulking up phase, reducing the length of time a scar is red, raised and thickened, and accelerating the transition to the maturation phase of wound healing. This treatment actually modifies scar growth by interfering with some of the blood vessel ingrowth into the scar, and the way collagen makes up the characteristics of a prominent scar on the face or body. Blood vessel overgrowth in scar tissue usually leads to collagen overgrowth that then leads to scar prominence. With active red, raised acne scars, control of skin bacteria and shrinking of oil glands with the pulse dye laser, is another reason for the effectiveness of the treatment.
We are able to make early scars better and less visible sooner in the healing process, and treat older poor scars and some acne scars as well. This is a very exciting breakthrough in the treatment of a sometimes difficult problem using presently available techniques.
The Pulse Dye Vascular Laser is still not a cure for all scars. It must be applied individually, especially to established keloid and hypertrophic scar deformities. The technology is very promising, especially when combined with other appropriately applied scar treatments.
Laser Treatment is by no means a substitute for careful, atraumatic and meticulous closure of elective cosmetic incisions or the less controlled traumatic or reconstructive wounds. Some wound healing characteristics are unpredictable, even in the face of apparently ideal circumstances for a good outcome, and the final scar is unacceptable.
Laser treatment of scars is quick and very tolerable with no downtime. The treatments are usually started 3 weeks following surgery, at 2-3 week intervals, depending on the response. A minimum of 4 treatments are required, but more may be needed depending upon the response. Active acne scars that are red and raised respond well to Pulse Dye Vascular Laser Treatment, but inflammation and pustules must first be controlled. This is one of the few treatments for acne that can have a significant, positive emotional impact, especially on teenagers, when improvement does occur.
"The redder the better" is a basic premise for scar treatment with the Pulse Dye Vascular Laser. With stretch mark scars, for example, we combine Particle Skin Resurfacing (PSR) prior to the Laser Treatment, to redden the scar for a more effective laser treatment and response.
» back to top
The treatment of scars:
The treatment of scars, especially facial scarring, can be one of the most gratifying surgical procedures that a plastic surgeon performs. On the other hand, it would be unfair if we did not point out that it is also one of the most difficult and challenging aspects of surgery. Unlike most cosmetic procedures, scars due to trauma usually cannot be hidden as well, due to an unfavorable location.
The effect of scarring on the body is more than skin deep. Often it is very difficult to evaluate the emotional impact of such injuries. This is especially true with children who are unable to verbalize their feelings about the scars, or in males who are taught to minimize their concern about their appearance. It is apparent that many people undergo unnecessary deformity because either they or their families have failed to seek advice on what can be done to improve the appearance of scars.
When dealing with traumatic scars, we must operate in the area predetermined by the accident. Most cosmetic procedures involve the placement of scars in inconspicuous areas or areas that are known to heal with minimal scarring. Any time an incision is made, a scar will result. Unfortunately, the thickness and the texture of the scar is only partially related to the skill of the surgeon and the procedure itself. In no case will scar revision surgery eliminate a scar completely. In nearly all cases, it will minimize the scar. In very rare cases, the scar could be made worse.
» back to top
OTHER TYPES OF TREATMENT
AVAILABLE FOR SCARS:
Pressure and Massage:
It is important to remember that sometimes conservative treatment is the best form of therapy. Repeated massage using vitamin E can greatly improve the appearance of scars. In some cases, special pressure dressing may also be of use.
Cortisone Drugs:
Various types of cortisone drugs may be used either as injections, topical preparations, or in the form of special tapes. These may well improve the scar to a point where surgery is not required.
Re-excision:
In many cases, simple excision and re-closure of the wound will greatly improve the result. Furthermore, what was originally a jagged cut may now be changed into a clean surgical incision.
Zig-Zag-Plasty:
The Zig-Zag-Plasty is a technique of excising a scar and replacing the line with a geometric broken line. This type of wound tends to heal with less tension, and replaces a straight-line scar with a broken line scar that tends to be less apparent to the eye. This is one of the most common and successful techniques of dealing with facial scars.
Dermabrasion or Laser Resurfacing:
Dermabrasion is a surgical planning technique that can be used to smooth down raised or uneven scars. Most commonly used for acne scarring, it is frequently helpful in the treatment of other injury scars.
Collagen Implantation:
Collagen implantation involves the injection of a collagen material into the scar. It can be helpful in the treatment of depressed scars. In some cases, it can flatten the scars and make them almost imperceptible. Collagen does not result in permanent correction and treatment must be repeated after several months.
Silicone pressure therapy:
In many cases, a silicone dressing can be applied to a raised scar and helps to soften or thin out the scar. The mechanism of this effect is unknown at the present time, but it has proven useful in many cases. It is very safe and simple to use. The special silicone sheet is cut to size and applied to the scar. It should be kept in place for 12 to 24 hours a day, depending on tolerance. Effects are not immediate, but results are usually seen within several weeks to months.We encourage most of our patients to use silicone scar strips beginning early in their healing to minimize scar visibility.
Serial Excision:
In many cases, wide or extensive scarring cannot be adequately treated with one operation. A planned, staged approach may be required in which several operations are utilized to lead to the best possible result. In some situations, a device called a tissue expander can be used to hasten this type of reconstruction.
» back to top
Testimonials
Thank you for taking such concern and care for me -- I'm very pleased with my results. You listen to the patient and that means a lot. Your staff is wonderful and everyone made my surgery go smoothly. I had very little pain or discomfort and attribute this to post-op plan and your fantastic skills. I appreciate you very much! KM
Thank you for working so quickly to get my surgery scheduled. Your staff is very professional and well organized--a rarity these days. And, thank you again for seeing me on such short notice. DG -- Oh by the way, you do great work!
