AESTHETIC & FUNCTIONAL IMPROVEMENTS
Scar Revision
Scaring is a normal part of healing, and for many of us, they're a fact of life. However, the size, depth and position of scarring can have a detrimental impact on both our confidence and even our bodily functions. Where scars are problematic, medical and surgical techniques can be employed to minimise these scars and reduce the impact they have on us emotionally and physically.
It's important to note that scars can't be entirely removed; however, utilising the latest medical and surgical techniques means they can be repositioned, minimised and greatly improved in respect of their aesthetics.
Mr Florian Bast's expertise as both an ENT surgeon and a facial plastics expert positions him to address many types of scars across the face to improve their form and provide a much-needed boost to those who seek his expertise.
TYPES AND APPROACH TO MANAGEMENT
What are scars?
Scars can form in many tissue types, but visible scars appear on the skin. A scar can form when the skin is damaged through disease, injury or surgery. Its development is a product of your physiology, genetics and the method of injury. This latter point is crucial because scars from sharp injuries, where the skin can be closely reapproximated tend to form far cleaner scars than those resulting from blunt force or inflammatory (disease) damage. Surgery can help with many types of scars, but those from injury, disease or trauma are often good candidates for review.
In addition to surgery, many methods exist to address scars, including steroid injections, silicone gel, pressure dressings, light therapy and even tattoos.
Keloid Scarring
These scars form when the body's repair mechanisms go into overdrive. The result is an ever-evolving scar that raises above the skin, often producing a bulge of connective tissue. These scars can be pink or red; they can also be painful. Predisposition to keloid scarring is often genetic, and having darker skin can increase the risks of developing one following injury. Keloids have a high reoccurrence rate, but options are available to treat them; some are non-surgical, reducing the risk of reoccurrence.
Hypertrophic Scarring
Much like keloid scars, hypertrophic scars result from an overproduction of collagen; however, their formation does not extend beyond the boundary of the wound. These types of scars are typically bright in appearance and can form in areas where the skin is under tension or following burns. They present less of a challenge than keloid scars to treat, and numerous options exist to address them.
Sunken Scars
Sunken, pitted, and ice-pick are all names to describe the scars that form following injury whereby a depression in the skin is left. They're typical of severe acne breakouts and certain viruses such as chicken pox. They result from a loss of fat cells at the site of the injury.
Contracture Scaring
Contracture scars are a serious complication of a previously healed scar; they are sometimes seen following burn injuries or where wide areas of skin are lost or damaged. They result in the ends of the scar coming together, often bringing underlying soft tissue structures with it. This can profoundly impact the mobility of the structures beneath the skin, such as muscle. These scars should be evaluated to understand options for cosmetic and functional improvements of the affected regions.
Interested in discussing Scar Revision Surgery with Mr Florian Bast?
KEEPING YOU INFORMED
Discharge Advice
Blepharoplasty is the surgery to remove excess upper or lower eyelid skin (dermatochalasis). Dermatochalasis is caused by loss of elasticity of the skin, leading to ‘baggy eyes’. The most common form can start from around age 40 and can affect any ethnicity or gender. Dermatochalasis may cause upper lid droopiness, which could then lead to blocking of your visual field and aesthetic impairment.
Your eye will be bruised and inflamed for one to two weeks after surgery. We advise you to rest and keep your head propped up with pillows when you are lying down for the first few days after surgery.
To decrease swelling during the first two to three days, we suggest using ice packs or a bag of frozen peas hourly for 10-15 minutes on the operated eyelid.
Do not wear contact lenses for two weeks to avoid irritation of the eye.
Wearing dark glasses when you are outside may reduce your sensitivity to sunlight, wind, and other irritants.
You can start driving and go back to work once the swelling has gone down and your vision is clear.
Further check ups
You will be seen two weeks after the surgery for removal of the stitches and if appropriate, advised to continue the chloramphenicol ointment four times a day for a few more days.
Possible minor complications
Bruising and inflammation are common after the operation, which should clear up one to two weeks after the surgery.
Rarely, the operated area can become infected. If this happens, you may need further treatment with antibiotics.
Scarring may occur after surgery, but this will usually be hidden under the crease of your upper eyelid.
Overall, the results of this type of surgery are usually successful. Nonetheless, with ageing further loss of elasticity may occur and sometimes further surgery may be needed to achieve the best result. However, the skin excess may not be as much as it was before the first surgery.
Serious complications can include orbital haemorrhage (ranging from 1 in 2,000 to 1 in 25,000) and diplopia (double vision). However, it is important to keep in mind that these serious complications are rare.
