Dr. Ma Plastic and Cosmetic surgery logoDr. Ma Plastic and Cosmetic surgery

Multiple Excision Nasal Dorsum Scar Removal

Homepage Star of February 2014
[ Author:Fushun Ma | Time:2014-05-13 21:56:13 |  Font Size: [Large Medium Small]
Tags: multiple excision, scar removal, nasal scar

We all know that facial scar has great influence on people's appearance, but there are still no way to eliminate it completely without any trace, even to make the scar on the face smaller is a challenge to the plastic surgeons. Skin in different areas of the face has different thickness and color. And the facial skin is also obviously different from the skin in the other parts of the body in pigment and texture. The common repair procedure of facial skin defect such as skin graft, skin flap transfer or skin tissue expansion definitely leave unwanted side effect of discoloration or supplemental incision scars. In this case the modified essential plastic surgery technique of multiple excision is utilized to treat the refractory nasal dorsum scar.

The scar of this beauty was in the middle of the nasal bridge, a prominent position on face, covering more than half of the nasal bridge. This scar was formed after free skin graft following a congenital pigmentary lesion removal on the nose.  Although no obvious hyperplasia and contracture, the scar was still difficult to conceal by means of make up because of the discoloration and thickness change of the scared skin. At this location skin tissue expander and local flap transfer are not suitable. And it was not a good choice to do free skin graft again in improving appearance, on top of that this girl had lost confidence on free skin graft.

Multiple Excision Nasal Dorsum Scar Removal
Three years after the first nasal dorsum scar excision surgery.

Multiple Excision Nasal Dorsum Scar Removal2
One year after the second excision surgery

 Multiple Excision Nasal Dorsum Scar Removal3
One year after the third excision surgery

Multiple Excision Nasal Dorsum Scar Removal4
 One year after the fourth excision surgery

When we finish reading these comparison pictures we may wonder how a simple plastic surgery technique could really mend the defect on the face thus improve the appearance of a person, yet the patient's compliance counts in the repeated surgeries year after year. Every time when Dr. ma review those pictures and enjoy the changes after each resection surgery he always admires the achievement of such a simple plastic surgery and also the endure this girl has made in pursuing the goal of eliminating the scar.  May she is blessed to be more and more beautiful every year.

The multiple excision technique is a commonly used basic surgical technique in plastic surgery. Its advantage includes easy to learn, minimal traumatic. The disadvantage is that it is not suitable to treat large scars that cover big area, and also not good  for round or nearly round scars in shape. If the scar is too spread it may take too many times to get it removed. Or if the scan is round in shape cat ear deformity may happen at the ends of the incision line after multiple excision and stitching, same thing as when we try to suture the cloth after cut a round hole on it. However these shortcomings are relative, which can be avoided by some special treatments and careful surgical planning. So this technique can also be cautiously applied to scars covering big area and round in shape by more and more surgeons nowadays.

In this case, the suture was easier at the first excision, because the skin had not yet been taut. In the second surgery closure of the surgical wound was also relatively easy, as the interval to the first surgery was three years long. The intervals to the previous surgery of the last  two operations were only around one year, so the wound closure was not as easy at the last two surgeries. Dr. Ma had to close it by means of mobilizing the surrounding tissue such as expanding the scope of dissection, using multiple layer dissection technique and tension release suturing technique in different directions. Even so due to tightness of the forced closure, the nasal dorsum and the tip of the nose seemed to be depressed and squeezed in the photos.

The mechanism of multiple excision scar removal is simple . It pulls the surrounding tissue toward the suture line by applying forced stitches when closing the wound. The surrounding normal skin and subcutaneous tissue then can be stretched loose over time ready for another session of excision. This skin expanding technique has a similar mechanism to the skin and soft tissue expander technique . May the beauty can actively observe the post surgery care protocol to expand the normal skin more efficiently, so her residual scar can be removed sooner.

Story Beyond the Photo

This girl is pretty and hard worker. She had a pigmentation problem at the dorsum of her nose during her childhood. She went for a excision surgery for the removal of the pigment skin and free skin graft was utilized to cover the wound in a local hospital. After that permanent scar was left on the receipt site of the graft. The first time she saw Dr. Ma was when she came for treating a secreting refractory fistula inside the area of the dorsum scar. Dr. Ma did the removal surgery for that fistula without any mark, so her mom encouraged her to do the scar removal surgery also by Dr. Ma. She started the first surgery in the year of 2006 and the following surgeries are at 2009, 2010 and 2011 respectively. Since the first surgery every time when Dr. Ma was about to forget her she showed up for a another surgery, so Dr. Ma got used to meet her periodically. When she didn't show up for more than three year since the last surgery in 2011, Dr. Ma called her and at that time she told Dr. me her story and agreed to post her photos on the web.

[Next]Mandible Bone and Mandible Angl.. [Previous]Parted Lips and Sticking Out Te..
Related Pages
New Pages
Hot Pages