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.
Please,
L
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
