Scar Revision & Keloid Treatment New Orleans
Dr. Velargo is sensitive to this and is highly skilled in scar revision surgery of the face and neck. “Surgical treatment” for deep scars and skin defects implies that incisions may be made to remove the existing scar or blemish. Each incision made into the skin, regardless of where it is placed, who makes it, for what purpose it is made, or whether it is deliberate or accidental, heals in the same manner as any other cut; that is, it produces scar tissue—nature’s method of healing. This simple fact is frequently forgotten or ignored by individuals who think that a plastic surgeon can make an incision and leave no visible scar and that he can, in fact, eliminate existing scars. In reality, Dr. Velargo’s goal is to replace an unsightly or disfiguring scar with a better scar, one which is narrower, more level, blends with the surrounding skin surface, and causes no contracture or pull on the surrounding structures; in short, one which is as inconspicuous as possible. The final appearance, however, is dependent on many factors, one of which is the patient’s own healing capability.
The passage of time is the best, the kindest, and, in the long run, the simplest treatment to give to any scar of recent origin since most will undergo spontaneous improvement if given enough time to do so, often 6 to 18 months. A decision regarding scar revision may be delayed until this time has elapsed. However, scars that cause distortion of normal structures (eyebrows, lips, eyelids, nostrils, etc.), those that spread widely or produce deformity by contraction, and “U” or “J” shaped scars may be repaired earlier because little or no improvement in the basic problem can be anticipated with the passage of time.
What Can A Scar Revision Accomplish?
A scar revision can correct scars that are:
- Wide
- Crossing natural creases or facial contour lines
- Elevated above the adjacent skin
- Depressed below the adjacent skin
- A different color from adjacent tissues
If any or all of these characteristics are present, improvement in any one of them should make the scar(s) less conspicuous. Correction of two or three of these factors can often result in dramatic improvement of the appearance (and sometimes function) of the scar(s).
What Happens During A Scar Revision?
Scar revision surgery is typically performed under local anesthesia in Dr. Velargo’s clinic procedure room. However, this surgery can be performed under a spectrum of anesthesia based on the patient’s health and comfort level. Dr. Velargo will spend time with you in consultation to ensure that every effort is made to reach your goals in a realistic manner. Dr. Velargo will analyze your scar and develop a unique plan for improvement.
When removing an existing scar or blemish by simple excision, Dr. Velargo makes every effort to place the line of incision as nearly as possible in or parallel to one of the normal crease lines of the face. Simple excision of the old scar with meticulous closure may be all that is required.
Sometimes it may be necessary to change the direction of a scar so that it will follow these lines – a technique known as a Z-plasty. Changing the direction of some scars is impossible and may require an additional technique of camouflage, such as W-plasty or geometric broken line closure.
Excision of large unsightly scars may require multiple operations over a period of time (e.g., serial excisions). Lastly, skin resurfacing procedures such as dermabrasion or laser therapy may be indicated to smooth out scars.
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Contact the New Orleans Center for Aesthetics and Plastic Surgery today to find out more about expert scar revision surgery.
Scar Revision FAQs in New Orleans
What Can I Expect During Recovery From A Scar Revision?​
Rhinoplasty is either performed using general anesthesia or a local anesthetic with IV sedation in a community-based outpatient surgery center. Dr. Velargo uses either a closed rhinoplasty or open rhinoplasty technique, depending on your case.
Most of the work is done through the nostrils from the inside of the nose (closed rhinoplasty). A closed rhinoplasty may need to be converted to an open rhinoplasty with a small incision made on the collumela below the nasal tip. With time, this incision becomes inconspicuous. Usually, a severely deformed nose or cases of revision rhinoplasty dictate an open approach to rhinoplasty. Dr. Velargo will counsel you on the approach necessary during your consultation.
A question often asked by patients contemplating rhinoplasty is: “Do you have to break my nose?” In Dr. Velargo’s surgical technique, he makes an incision into the nasal bones when they need to be repositioned, thereby eliminating the more antiquated technique of “breaking” the bones and resetting them. He feels this technique allows for better control of the operation and reduces the patient’s anxiety about having surgery. Incisions into the bone are necessary to narrow the nose or reconfigure the nasal structure after “hump” removal.
Excess bone and cartilage are removed from the bridge of the nose to remove “humps”. Dr. Velargo takes care not to remove too much, which could damage the nasal structure or create an unnatural scooped-out appearance. When the size of the nose is too large, excess bone and cartilage are removed as necessary.
How can we help you have an easy recovery?
As mentioned earlier, septoplasty is often performed in conjunction with rhinoplasty. This procedure involves removing the mucous membrane lining from the cartilaginous and bony septum. The deviated or “crooked” portions are identified and removed with care to preserve an adequate amount for nasal support and structure. The excised cartilage is saved for later use as cartilage grafts.
The mucous membranes are then reapproximated and sutured together, eliminating the need for deep nasal packing. This technique has been one of the greatest advances in nasal surgery, reducing much of the undesirable post-operative discomfort that packing has caused patients.
If the nose needs to be enhanced or strengthened, cartilage grafting will probably be used to build up that area. The cartilage can be taken from the septum, other parts inside of the nose, or from the ear. If Dr. Velargo thinks that ear cartilage will be necessary, he will discuss this with you in greater detail during your consultation. Rest assured that your ear will not look different after the operation, and the resulting scar will be inconspicuous. This technique is often used to support the tip, open the airway, strengthen the nostrils, or build up the bridge of the nose, among other things.
If it is necessary to make flaring or wide nostrils smaller, an incision can be made in the crease where the side of the nostril adjoins the upper lip and cheek. Because this is located in a natural body fold, the scar is practically invisible within a few weeks.
If simultaneous Endoscopic Balloon Sinuplasty to open the sinus passages is indicated, a small camera is inserted into the nose, and a balloon catheter is introduced into the main sinus openings. The sinus openings are dilated with the balloon, and the sinus cavities are cleaned and washed out.
Does insurance cover scar revisions?
If you are receiving septoplasty, functional rhinoplasty, or endoscopic balloon sinuplasty, some insurance plans cover that aspect of the procedure. Contact your insurance carrier for information. Note that cosmetic rhinoplasty is never covered by insurance plans, and even if your insurance covers a simultaneous septoplasty, functional rhinoplasty, or endoscopic balloon sinuplasty, a separate charge will be generated for the cosmetic component of your surgical plan.
Contact the New Orleans Center for Aesthetics and Plastic Surgery today to find out more about expert rhinoplasty.