Category Archives: Revision

An Overview of Burn Scars

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Burn Reconstruction

Burns caused by heat, chemicals and fires can result in the most traumatic types of scaring. The severity of burns is classified as first, second and third degree burn. This designation is based on the dept of damage to the outer and deeper layers of the epidermis (skin) and dermis (inner skin) tissue.

Burns can leave patients with severe physical disfigurements.
The emotional trauma can often exceed the physical trauma as self image is an integral part of an individual’s self esteem. Scar revision surgery for all types of scars is often elected to positively affect the patient’s emotional well being.

Burn treatments usually involve skin grafting and cosmetic reconstruction, and may be performed in an emergency facility or later on. These treatments also focus on restoring function to the burned skin to reduce the risk of complications such as loss of mobility or a loss of one of the senses.
Acute Burn Care

Any type of burn on the skin requires immediate medical attention to stabilize the patient, clean the wound and reduce the risk of complications such as infection, scarring, breathing problems and limited bone and joint mobility. Initial burn care focuses on assessing and treating the initial burn symptoms, prevents infections and other potential further risks. Additional treatment may be required at a later time for skin reconstruction. It is also important for patients to remain hydrated after a burn, so fluids may be administered intravenously to prevent dehydration.

Comprehensive burn care that includes an evaluation of:
• the burn and any related conditions
• thorough wound care
• proper dressing
• pain mitigation through medications
• emergency surgery as may be required.
Burn Scars

Most burns will usually leave a scar,The appearance of the scar depends on the size, location and severity of the burn. Scars usually become less noticeable over time, however when they scar is obvious patients seek reconstructive treatment to improve their appearance of scars that are physically unattractive or disfiguring. Reconstructive procedures are most often performed after the burn has fully healed, which may be nine months to a year after the original injury.

Scar reconstruction is usually performed through an outpatient surgical procedure that may involve skin and tissue grafts, skin flaps or injectable fillers to restore a more natural appearance, while also correcting any functional problems caused by the scar and improving the patient’s self-confidence as well.

Contractures

A contracture is a complication of burn scarring that involves a tightening and thickening of the burn scar that in turn restricts movement of the affected area. It is important for patients to take precautions to prevent contractures from occurring, by exercising, wearing a splint and continuing to promote everyday activities that require movement.

Treatment for contracture scars often involves surgery to release the contracture and restore normal movement to the skin. A skin flap or graft may be used to restore the appearance of the skin in the treated area, while also improving movement and flexibility that may have been affected by the contracture. Physical therapy will often be needed after surgery to stretch the joints and restore movement and function.

Risk of Scar Revision

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Pre & Post Operative Risk of Scar Revision

Cosmetic procedures involve the placement of scars in inconspicuous areas 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. This is a risk that a patient needs to accept. The doctor’s knowledge of your healing history is critical to making the most educated decision for the benefit of the patient.
In developed countries risk in surgery has greatly been diminished. However, a person considering elective scar revision surgery as with any surgery should discuss risks with their surgeon. Here is a partial list a person can ask their doctor about.

Scar Revision Surgery Risk

• Allergies (tape, suture materials,blood products, topicals, injected agents etc…
• Anesthesia Options & risks
• Changes in skin sensation post-surgery
• Excessive Bleeding (hematoma)
• Delayed or Slower healing
• Deeper Tissue damage e.g. nerves, blood vessels, muscles and lung
• Pain tolerance or changes to pain sensitivity
• Possibility of revisional surgery or staged procedures
• Post-Surgery Infection
• Skin contour irregularities
• Skin discoloration and swelling
• Temporary or permanent damage possibilities

Take the time to ask questions!. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress.

Evolution of Scars – Part 2

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Why Do We Have Scars?

“Human wound healing appears to have been optimized for quick healing in dirty conditions,” Mark W. J. Ferguson, Ph.D., University of Manchester.

Part II
Before and After Facial Scar Revision of Young Woman
Anthropologists and science have yet to explain why humans develop larger and thicker scars than other animals. Our response to scars reaches back through the eons of human evolution. A physically weaker structure than most mammals; humans live longer than any other mammal it perhaps is our species wound healing that allows us to thrive. When we’re injured; cut or burned, the immune system is immediately activated to close the wound and heal it.

Surgeon N. Scott Adzick, M.D., researches and studies scarring at the Center for Fetal Diagnosis and Treatment at the Children’s Institute for Surgical Science in Philadelphia, he notes:

“If you’re a caveman or cave-woman running around, and you get bitten by a saber-toothed tiger, it makes sense to patch that wound together as quickly as possible in order to survive, as opposed to devoting the body’s energy and resources to healing perfectly”

The result is that our bodies’ rapid immune response to inflammation leads to the larger and thicker scabbing and scarring. Some social anthropologists theorize that scars served as sexual attractors. Heavily scarred early men would be more attractive because it indicated there bravery and strength in survival.

No matter the theory or culture scars are part of human life; if you know someone who is experiencing anxiety from scars. Today’s cosmetic medicine may have the answers.

Evolution & Psychology of Scars

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Part 1

How Scars Make Us Feel

Man with extensive facial scar
There is unlikely an adult human on the planet without a scar. Most scars are not of consequence to cause severe emotional or physiological issues. Wound research has proven that the age of the person, gender and location of the scar are factors on how it will affect a person. In addition how the scar occurred can make it more of a problem. Facial scars cause more duress and scars that may be disfiguring or near around intimate areas of the body. Society premium appearance contributes to the anxiety associated with scarring. Stereotypes in moving show scarred people to be unpleasant, sadistic and mean.

However in some cultures consider scars desirable and are intentional and deliberate. Some tribes identify their clan and families by scar markings this was very common in Nigeria though the custom is no fading. Traumatic scarring is often very different. I greatly distress the person suffering from the scar and detract from their quality of life. Some anthropological studies indicate that facial symmetry seems to be innate attraction within humans; clearly facial scarring moves a person further away from what maybe a pre-programmed ideal. People who have adverse reaction to the scars can experience embarrassment and loss of self-image. Over long term this can lead to isolation, anger and self-loathing. In worse case scenarios psychological conditions that need to be treated can develop.

Today’s modern surgical techniques in the field of cosmetic surgery now provides many options in scar revision. Birth Marks, skin anomalies as well as scars can be treated with much success.

Read Part II of the Evolution of Scars

Scar Revision Surgery

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Scar Revision of orbital facial scar.Enhancing your appearance with scar revision surgery

Several people are unhappy of having scars. Facial scarring is the most affected source of self-consciousness, even though scars may be disturbing anywhere in the body for a person. Facial scar revision is taken in consideration after any cosmetic procedure. Scar revision is a surgical procedure which may greatly improve the appearance of scars and increase one’s self-confidence.

Scar revision techniques vary. Finding the best technique for the right person would depend on the type of your skin, the individuality of the scar and other factors. Scar revision does not completely remove a scar but minimizes the appearance of it as much as possible.

Scars are visible markings, the formation or the discoloration on the skin is shown after the complete healing process of a wound. They are unavoidable consequences of minor traumatic injury or surgery. The development of a scar cannot be predictable. Poor healing may cause scars to be obvious, unsightly and have some sort of disfiguration. A wound that heals well can still result in a scar that adversely affects your appearance. Scars may be raised or recessed, may also differ in color or texture from the surrounding healthy tissue or particularly be noticeable due to the size, shape and location.

Treatment Options

Based on the degree of the scar and the scar classification the treatments can vary. Treatments may include:

• Over the counter topical treatments
• Prescribed topical treatments
• Minimally invasive dermatological procedures
• Cosmetic surgical revision with advanced techniques in wound closure

The one purpose of scar revision surgery is to minimize the scar so that it is more consistent with your surrounding skin tone and texture; basically to reduce the scars visibility. Scar revision provides a more pleasing cosmetic result to improve scar that has healed poorly. However, they may not be erased completely.

Enhancing Self Image with Scar Revision

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Enhancing your appearance with scar revision surgery

Most people are not happy about having scars. Facial scarring is often a source of self-consciousness though scars almost anywhere can be disturbing to a person. Scar revision is a surgical procedure which can greatly improve the appearance of scars and enhance one’s self confidence. Facial scar revision is a sought after cosmetic procedure.

There are different scar revision techniques. The best technique that is right for a person depends on the type of individual scar, your skin type and other factors. Scar revision does not completely remove a scar but rather minimizes its appearance as much as possible.

Scars are visible marking, formation or discoloration on the skin after the complete healing process of a wound. They are often unavoidable consequence of minor and traumatic injury and or surgery. A scars development is not predictable. Poor healing can cause scars that are obvious, unsightly and disfiguring. A wound that heals well can still result in a scar that adversely affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

 

Treatment Options

Treatment options vary based on the type and degree of scarring. Treatments can include:

  • Over the counter topical treatments
  • Prescription topical treatments
  • Minimally invasive dermatological procedures
  • Cosmetic surgical revision with advanced techniques in wound closure

The purpose of scar revision surgery is to minimize the scar so that it is more consistent with your surrounding skin tone and texture; in plain terms to reduce the scars visibility. Scar revision provides a more pleasing cosmetic result or improve scar that has healed poorly. However, a scar cannot be completely erased.

Determining if Scar Revision is Right for You?

Scar revision is a very personal decision. A person should do it for their self, not fulfill an ideal image Scar revision can be performed on people of any age and is a good option for you if:

  • You are bothered by a scar anywhere on your body
  • You are physically healthy
  • You have a positive outlook and realistic goals for your scar revision surgery
  • You do not have active acne or other skin diseases in the area to be treated

The Scar Revision Procedure

Surgical scar revision techniques are usually performed with local anesthesia and sedation or with general anesthesia. Excision techniques are commonly used for scar revision. Another technique, often referred to as Z-plasty, repositions the existing scar so that it is hidden in a less conspicuous area, typically within a natural skin crease.

The Scar Revision Recovery
The recovery after surgical scar revision may involve some minor swelling and bruising. Patients may also experience some discomfort which can be alleviated with medication. Bandages may be applied after surgery and these usually remain in place for one week. The scar will likely appear red immediately after surgery but it will eventually fade to a fine line. Most patients find that they can return to work within one to two weeks.

 

Healing of Surgical Scars

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AFTER-SURGERY SCARS

 Cosmetic Scar Revision in process.An open surgery is when they form an incision through the skin to reach the organs that are going to be operated, at the site of the incision you are left with a scar. The scar may be small or prominent. There are no current ways to completely remove a surgical scar, but there are many methods to reduce it appearance. Left: Photo Credit Laparoscopic Surgery Image by Grzegorz Kwolek from Fotolia.com

Most scars have an extremely unsightly appearance at first, usually red and thick, according to the American of Dermatology. However, these scars turn out to fade with time. During 6 to 18 months, a surgical scar typically fades into a thin white line. For the young ones, tend to have more problems with oversized scars than older people, for the reason that the young skin may attempt to over-heal the area, resulting in larger scar.

TYPES

Some scars develop abnormally after surgery, but the normal surgical scars follow the standard pattern of shifting from red and thick to thin and white. The American Academy of Facial Plastic and Reconstructive Surgery quote, “keloid scars develop when the scar material outgrows it original boundaries, creating a thick, dark, raised area around the scar. Hypertrophic scars are similar to keloids but remain within the boundaries of the original incision, creating a thick, raised line instead of flat, white surface that would result from a normal scarring pattern.”

COMPLICATIONS

Complications may arise with a surgical scar, even years after the original surgery. According to the Penn State Milton S. Hershey Medical Center, an incisional hernia is one problem. Incisional hernia is when a part of the intestines or other abdominal organ protrudes through the internal portion of a surgical scar in the abdomen. Gaining weight, pregnancy or other conditions that cause and abdominal scar to stretch out and become thinner may lead to an incisional hernia.

REVISION

A revision is the process of making a scar look better or less noticeable. Many methods exist to be able to have this revision performed. According to the American Academy of Dermatology, plastic surgery is one option, another having your skin rejoined in more aesthetically pleasing fashion, and sometimes many scars can successfully be removed. Other treatments for treating post-surgery scars include dermabrasion, laser resurfacing, skin grafting and injectable fillers.

ALTERNATIVES

There are alternatives to getting a scar in the first place, or ways to limit the degree of scarring. Laproscopic surgery uses miniature cameras and tools that are threaded into the body through a small incision, allowing the surgeon to create only a few cuts for surgeries that would have required large incision years ago. The Cleveland Clinic article: “The Forefront of Surgery, Without Scars,” mentions a type of surgery called single-port surgery. The tools go through a single, tiny incision that may be placed in a location as the belly points of entry, such as the mouth.

Rejuveness – A Method for Changing the Appearance Scars

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Changing the Appearance Scars

 Is there any way to change the appearance of scars or make them fade away?

 The leader in treatment options that truly affect the appearance of scars is rejuveness. With our scar treatment we try to completely make the scars imperceptible or reduce the appearance of scars to a minimum.

Changing the appearance of scars with RejuvenessSilicone Occlusive Sheeting

Rejuveness is silicone occlusive sheeting that is durable, reusable and soft. This pure silicone sheeting is a medical-grade; it’s manufactured in the USA by expert technical supervision. The Rejuveness is a non-invasive medical device that reduces hypertrophic and keloid scars resulting from surgical procedures, burns, and traumatic events.

Rejuveness smooth’s, softens, and flattens scars to restore them to a more normal color and texture. When the Rejuveness is used daily as directed, it has the potential to dramatically improve the appearance of the new and old scars. It has been clinically proven that the Rejuveness is effective in the management of hypertrophic and keloid scars and relieves the burning and itching that are characteristics of scarring disorders. It has also been shown to be a success in the prevention of hypertrophic and keloid scar when applied following surgical procedures.

The mechanism of action by which the product works involves the product’s high affinity for static electricity. Between the Rejuveness sheet and the surface area of the skin where the product is applied, an electrostatic field forms. The electrostatic pull over a prolonged period of time may be the critical factor in the successful reduction of hypertrophic and keloid scars and prevention of scarring disorders.

This submission is particularly to expand the indication for Rejuveness and further define instances in which Rejuveness may be used. We also propose to illustrate examples of surgeries where Rejuveness may have application, reference to surgical procedures. We also illustrate the point that Rejuveness has shown efficacy in the prevention of scarring disorders when applied following particular procedures. These singular surgeries are sited in attachment #7 pricing sheet examples and are outlined in the indications.