Scars, Scar Revision, Scar Care, and Scar Reconstuction Plastic Surgery

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Scars and Reconstructive Surgery

Explore what others have to say about scars and reconstructive surgery with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Re: Please, can you help me? - Emotional Scars and Physical Scaring

Dear Dr. Bermant,

My name is L and I am fifteen-years-old from Maryland. In seventh grade, I fell into a deep depression and began to cut myself pretty much everywhere, but mainly my left arm. Today, three years later, I am a happy and healthy fifteen-year-old, however, the scars of my depression are still very clear and very obvious. It started with my doctor asking me what the scars were on my arm, then a few friends, and finally even a couple teachers, which in the end, resulted in me having to return to my physiatrists because people believed something was still wrong. Constantly I am either stared at or made fun of because of my scars. A boy once asked me if I was "to stupid to cut myself on the right side" in front of a lot of people.

Every morning when I wake up, I see the scars of my past, the deep slices in my arm, the word "WHY?" on the top of my hand, and it just makes me want to cry. Every stare, every comment about my previous depression, about my scars just makes me want to crawl up in a little ball again. Please, can you help me? I've tried the silicon sheets but they don't seem to work, and as much as I want some other kind of treatment, I don't feel that my family could even afford it. It there anything else that I can do? Please respond back Dr. Bermant.



Dr. Bermant responds:

This should not be construed as medical advice.

Scars do have a physical and emotional component. I would be awsome if scars could be erased completely. However, real plastic surgery does have limitations.

At your age, this is an issue that you need to discuss with your parents. If they agree, we are glad to help you explore your concerns during a consultation.

Scars need to be examined, seen and felt before advice can be offered about possible surgery. In some cases there ARE surgical options. Surgery does not erase scars, but replaces them with another scar. The question is always can the new scar be better than the old one. If the scar you have came from suboptimal wound healing or repair, scar revision surgery may have value.

My approach to scars includes:

skilled plastic surgery scar reconstruction
meticulous wound healing
monitored (adjusted for how the healing progresses) scar care

This require active patient participation and evaluation of progress in my office. People heal differently. Even with everything optimal, some scars just do not get beyond a certain point. Reasonable expectations are the key to a satisfactory outcome. Although we do not like them, scars are the way our body repairs itself.

I hope this information proves of some use. If my office can be of further assistance, please let us know. Jane is my office manager. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Scar Correction

Dear Dr. Bermant:

I am writing this letter because I've had an ugly scar on my forehead since I was about 8 years old that has made my life miserable and now that I'm 20 I want to get rid of it. So I would like you to give me an estimate on the cost of the procedure and if possible send me some before and after pictures of some of your other patient's along with any other additional information needed. My home address is:...Brooklyn, New York and my e-mail address is:(...)

Yours Truly,

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Scars are nature's way of healing wounds. No one can erase scars. Poor scars can be revised depending on the nature of the problem. An evaluation by a skilled board certified surgeon will be necessary to determine the nature of your problem. The surgeon must be told the history on how the original wound healed and or was treated. Chances for improvement are less if your original closure was done with skill and there were no complications (like an infection). Secondary healing (open wounds healing over time) can also lead to bigger scars.

Scars have both a static and dynamic component. It is one thing to look at a static picture and another to see the region in action. Dynamic scars can look much worse during animation. Other scars have color changes that may or may not be improved. Looking at pictures can therefore be deceiving.

Treatment may be as simple as a recommendation for camouflage cosmetic coverage. Surgical intervention may be the excision of the contour abnormality and layered closure. More extensive flap surgery may be recommended to rearrange tissue and change the direction of elements of the scar. Surgical price depends on how many centimeters (inches) the revision is and the type of revision (layered, complex, or flap).

Although we see patients from far away, you may want someone more local to you in N.Y. The American Society of Plastic and Reconstructive Surgeons can be reached by calling 1-800 635-0635. They will send some preliminary information and a list of board certified surgeons in your region. If you want further information from our office, please let us know how we can help.

Good luck,

Michael Bermant, MD

I have a scar as a result of hot water spillig on the left side of my face and the scar is not big but the color of some parts of the left side of my face is red. I know it's hard for you to say what can be done in this case without seeing me, but I still would like to hear from you if that could be improved.

Thank you for your time.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

A scar is the natural healing process of injured skin. Scars evolve over time and frequently start out red in color. Over the next several months, scars fade to a whiter color. Scars can sometimes be influenced during the acute healing stages but recommending any treatments cannot be done without proper examination.

Some scars mature to something unattractive with residual "red" components. Some reconstructive options may be of value, but again you need an evaluation before any recommendations. I recommend to my patients to wait for about 4-6 months after the injury before committing to surgical alternatives (for patients who have had normal healing from good surgical intervention). Any surgical intervention will also leave a scar, so that a risk benefit ratio must be presented to you.

Some "red" scars are really growths of blood vessels (hemangioma) and other options are available.

We have patients that come to see us from afar, however there are local board certified plastic surgeons in your area that may be more convenient. If we can be of service, please let us know. We can be reached at (804) 748-7737.

Michael Bermant, MD

Subj: Re: large pores on nose

Dear Dr Bermant:

I am only 20 years old but due to acne(that is now under control) and I guess genetics I have large pores on my nose, and inner cheeks and the condition is spreading. I was just wondering if perhaps laser dermabrasion or any other such method can be used now or in the future to help minimize the problem.

any thoughts on this would be appreciated

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Acne scars can be a real problem and vary from a superficial depression to a deep pit. Some patients also tend to scar more. The deformities that are more superficial can sometimes be improved by dermabrasion or laser treatments. Both try to control the damage to the skin in such a way that the body can resurface itself. The laser delivers its damaging effect with intense controlled light. The dermabrasion uses an abrading wheel.

Deeper pits do not do as well with either treatment but can be improved with scar excision (cutting it out) and or grafting (taking a plug of skin from one place and putting it in another. These plug grafts have a tendency to contract and form a small dome which can be improved by the laser or dermabrasion methods.

Each patients problems can be a combination of scars that will need a variety of treatments best planned with an evaluation and examination. Remember scars are never erased except on computers. In reality, we try to replace bad scars with ones that are less disfiguring. Since some acne patients scar more, having realistic expectations is essential for a happy outcome.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD



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