Any damage to the skin will leave behind some form of scar. Since the earliest days of plastic surgery, one of its primary concerns has been the minimization or even the elimination of those scars whenever possible, whether they are from previous injury or from necessary surgical practices. Scar revision is just one of the many cosmetic plastic surgery procedures that I perform at my Atlanta plastic surgery practice.
There are several different types of scars. The most minor types, which can include acne scars as well as scars resulting from minor injury, may present little more than a discoloration or irregularity on the skin’s surface. These subtle scars can often be cosmetically improved with non-surgical procedures, such as chemical peels or Sciton® laser skin resurfacing. Some scars, however, may be more extensive and require reconstructive surgery in order to repair. Thick clusters of scar tissue, or hypertropic scars, are often raised and significantly discolored, while keloids are even larger, often extending beyond the edges of the original wound, and can be painful or itchy. Both may require significant skin resurfacing, or chemical peels and, in some cases, it may be necessary to surgically remove the old scar entirely.
More serious scars, called contractures, occur when the skin and underlying tissue pull together during healing, restricting movement, frequently after an injury resulting in a large degree of tissue loss, such as a burn. The loss of tissue can result in a scar that is concave, or depressed into the skin. In these cases, injectable dermal fillers or fat transfer can be used to restore the area to a more natural-looking state, with results lasting from three months to several years. Frequently, restoring the cosmetic appearance of an area that has experienced this level of scarring requires a graft of skin taken from a healthy area or of a pharmaceutical tissue substitute. As an alternative to grafting, tissue expanders, like those used during breast reconstruction, can be used to stretch the existing skin gradually, creating an excess that can be moved to replace the scar tissue.
Similarly serious are the wounds that are left behind by Mohs micrographic surgery, an extremely precise method for surgically removing skin cancers. During the procedure, small layers of skin are removed, one at a time, under local anesthesia and immediately examined under the microscope. If cancer cells are seen, then another layer, or “level,” is removed and the process repeated. Once a level is removed that contains no more cancer cells, the surgery is complete. Although Mohs micrographic surgery does have an extremely high cure rate with good preservation of normal skin, it can leave behind large, unsightly wounds. Repairing or closing these wounds can require reconstructive plastic surgery procedures, like the use of a skin graft or transplant. I have achieved extremely satisfactory Mohs reconstruction results performing reconstructive plastic surgery after Mohs procedures.
If you are interested in a plastic surgery procedure that I perform, please contact my office to schedule a consultation today. Additionally, many reconstructive procedures may be covered by insurance, and Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, in order to assist you. Don’t forget to connect with me, Dr. Allyson Maske, on Facebook, Twitter, and Google+ for the latest plastic surgery news and updates.