General Plastic Surgery – Skin, Scars, Wounds, etc – Designer Bodies

General Plastic Surgery - Skin, Scars, Wounds, etc

A skin lesion is an abnormal lump, bump, ulcer, wound or hyper / hypo pigmented area on the skin. It is an area of the skin which has changed appearance; the change may affect a small spot or an entire area. Benign skin lesions are those lesions which are not malignant (cancerous). Common skin lesions include moles, warts, corns and actinic keratosis, among others. Designer Bodies is best Skin Lesion Treatment in Mumbai.

Most skin lesions are benign though some, such as actinic keratosis and certain moles, can be develop into a skin cancer or already are a skin cancer. In general, any skin lesion which changes its behaviour (becomes itchy, etc), size, shape or appearance should be investigated.

Cysts

A Cyst is an enlarged, possibly infected sweat gland, sebaceous (Oil) gland or hair follicle in the skin. It occurs when the opening of its duct is blocked, either due to debris/dirt or thickened secretions. Sebaceous cysts can be left alone, but they grow slowly, over years, and may become cosmetically unacceptable or a physical discomfort. Often, they become infected and can lead to abscess formation. Removal is a simple procedure under Local Anaesthesia on an out-patient basis.

Lipomas

Lipomas are localized collections of fat under the skin. They may be solitary, or multiple, and may be isolated or a part of a systemic syndrome. There are different types of Lipomas, depending on the consistency of the tissues in the swelling. Solitary lipomas can grow to alarmingly large sizes, and though they are not dangerous, they may be removed by simple excision on an out-patient basis. Large solitary Lipomas, and even clusters of smaller lipomas may be reduced through tiny incisions (keyhole surgery) using Vaser Lipo.

Skin Tags

These are little outgrowths of skin that bulge at the end. They often occur at areas of the body that rub together, and need not be removed unless they become painful, irritated, bleed or become physical impediments. They are also often removed for cosmetic purposes.

Moles / Birthmarks

Moles are small pigmented marks on the skin, commonly called birthmarks or beauty spots. They can occur anywhere on the body, be flat or raised, smooth or rough, and some may contain hair. Most are dark brown or black, but some are flesh-coloured, red or yellow. They can change in appearance over time. Some can develop into cancer. Benign moles are generally small in size. A lot of moles appear in infancy or childhood, and grow in size proportionately to the child. Designer Bodies is best Skin Lesion Treatment in Mumbai.

Warts

Warts are benign skin growths caused by a viral infection referred to as human papilloma virus (HPV). They are notorious for recurring in adjacent areas, and being resistant to treatment.

Actinic Keratosis

Actinic keratosis occurs from too much sun exposure and damage, and appears as crusty bumps. It is usually seen in older patients, and on exposed areas. Actinic keratosis may be flesh-coloured, brown, pink or red. Affected areas may be inflamed, itch or bleed, and may progress into skin cancer.

Corns & Calluses

Corns and calluses are thick, hardened layers of skin that develop when your skin is exposed to unnatural friction and pressure. They most often develop on the feet and toes or hands and fingers. Corns and calluses may be unsightly and painful. They appear as a thick, rough area of skin, a hardened, raised bump, with tenderness or pain or flaky, dry and waxy skin. Pressure and friction from repetitive actions cause corns and calluses to develop and grow. Some causes include wearing tight-fitting shoes, not wearing socks, playing instruments or using hand tools, etc without gloves. Foot deformities, such as a bone spur, bunion or hammertoe can cause constant rubbing inside your shoe. Corns are smaller than calluses and have a hard centre surrounded by inflamed skin. Corns tend to develop on parts of your feet that don’t bear weight, such as the tops and sides of your toes and even between your toes. They can also be found in weight-bearing areas. Corns can be painful when pressed. Calluses are rarely painful. They usually develop on the soles of your feet, especially under the heels or balls of your feet, on your palms, or on your knees. Calluses vary in size and shape and are often larger than corns. If a corn or callus becomes very painful or inflamed, see your doctor. If you have diabetes or poor blood flow, consult your doctor because even a minor injury to your foot can lead to an infected wound.

TREATMENT

Treatment for corns and calluses usually involves avoiding the repetitive actions that caused them to develop. If a corn or callus persists or becomes painful, medical treatments can provide relief:

Trimming away excess skin. Your doctor can pare down thickened skin or trim a large corn with a scalpel, usually during an office visit.
Callus-removing medication. Your doctor may also apply a medicated dressing to the area.
Shoe inserts. If you have an underlying foot deformity, you may be prescribed custom-made padded shoe inserts to prevent recurring corns or calluses.
Surgery. In rare instances, your doctor may recommend surgery to correct the alignment of a bone causing friction.

Skin Cancers

Skin cancer is the most common form of cancer in non-pigmented skin, and the incidence is increasing faster than any other type of cancer. Persons with fair or freckled skin that does not tan are at increased risk. Dark hair and pigmented skin have a significantly lower incidence of skin cancers. Pigmented lesions that appear suspicious can be evaluated by using the “ABCD” rules: asymmetry, border irregularity, colour variation and diameter 6 mm or greater. Two other suspicious signs are more rapid growth than other lesions and the presence of a narrow pink halo around the lesion.

Types of skin cancer are:

BASAL CELL CARCINOMA

This is the least dangerous type of skin cancer because it tends to grow slowly and rarely spreads beyond its original site. However, if left untreated, it can grow deep beneath the skin and into the underlying tissue and bone, causing serious damage, particularly if it is located near the eye. Basal cell carcinoma may appear in many forms, often beginning as a small, pearly nodule.

SQUAMOUS CELL CARCINOMA

This is the next most common type of skin cancer and frequently appears on the lips, face or ears. It sometimes spreads to distant sites, including lymph nodes and internal organs, and can become life threatening if not treated. Squamous cell carcinoma may begin as a red, scaly patch, a group of crusted nodules, or a sore that doesn’t heal.

MALIGNANT MELANOMA

This is the least common type of skin cancer, but the most dangerous and life threatening. If discovered early enough, it can be completely cured. Malignant melanoma is usually heralded by a change in the size, shape or colour of an existing mole, or as a new growth on normal skin.

TREATMENT

Malignant lesions of the skin are common. Almost all skin cancers can be cured by early excision or destruction. A clinical diagnosis is made by considering the patient’s risk factors, the history of the lesion and its location, appearance and texture. The final diagnosis is made by pathologic examination of biopsy specimens.

How do you treat skin lesions?

The common procedures are:

Biopsy. The doctor cuts out or shaves a small part of the lesion.
Excision. The doctor cuts out the entire lesion and, often, some of the area around it
Cryosurgery. The doctor uses a very cold liquid or special tool to freeze and destroy skin cells.
Curettage
Electrocautery
Laser surgery.
Mohs micrographic surgery.
Radiation therapy and Topical Chemotherapy for Skin cancers.

Scars, Keloids and their management

What is a scar?

A Scar is the residual sign of healing of a wound or incision. Any break in the skin in a child or adult leaves a mark in the form of a scar. However, poor healing may cause the scars to become prominent, unsightly or even disfiguring. Even a wound that heals has a minimal scar. Scars may be visible due to their size, shape or location; they may be elevated or depressed, and may differ in colour or texture from the normal surroundings.

Discoloration or surface irregularities and other scars can be cosmetically improved by surgery or other treatments. These types of scars do not impair function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and surgical incisions.

Hypertrophic scars are thick clusters of scar tissue that develop directly at a wound site. They are often raised, red and/or uncomfortable and may become wider over time. They can be hyperpigmented (darker in colour) or hypopigmented (lighter in colour).

Keloids are larger than hypertrophic scars. They can be painful or itchy, and may also pucker. They extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but they develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.

Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.

TREATMENT

The type of scar you have will determine the techniques used to improve the scar.

Scar revision surgery attempts to minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture.

Your treatment options vary from simple topical treatments (creams, etc), Minimally invasive procedures, and Surgical Revision with advanced techniques in wound closure.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Skin grafting & Flap surgery

Skin grafting

Skin grafting is a type of tissue transfer involving the transplantation of skin from one area of the body to another, usually to cover a defect due to disease, trauma or surgery. The transplanted tissue is called a skin graft. Skin grafts are usually used for:

Extensive wounds or trauma
Burns
Areas of extensive skin loss due to certain severe infections such as necrotizing fasciitis
After Surgeries that require removal of areas of skin for treatment that are too large to close primarily.
To cover donor sites of flaps used to replace tissues in other areas.

Skin grafting serves two purposes: it can reduce the course of treatment needed (and time in the hospital), and it can improve the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy donor area, or a full thickness skin graft, which involves removing the entire thickness of skin away from the donor area.

FLAP SURGERY

Flap surgery is a piece of tissue that is still attached to the body by a major artery and vein or at its base. This piece of tissue with its attached blood supply is used in reconstructive surgery by being set into a recipient site. The flap may be comprised of skin, fatty tissue, muscle and bone from the donor site. This type of plastic surgery is typically used to repair defects left behind after traumatic injury, mastectomy and in facial reconstruction after skin cancer excision. There are as many types of flaps as there are types of injuries which might require the use of a flap. Flaps come from many different locations, and are used in many different ways to accomplish the desired result. However, flaps used for reconstructive plastic surgery can be broken down into two main categories.

LOCAL (PEDICLED) FLAP:

Tissue is freed from an adjacent area to cover the defect, yet remains attached to the body at its base and has blood vessels that enter into the flap from the donor site. The four major types of local flaps include the advancement flap (moves directly forward with no lateral movement), the rotation flap (rotates around a pivot point to be positioned into an adjacent defect), the transposition flap (moves laterally in relation to a pivot point to be positioned into an adjacent defect) and the interpolation flap. The interpolation flap is different from the others in that it rotates around a pivot point to be positioned into a nearby (but not adjacent) defect. The result is that a portion of the flap passes above or below a section of intact tissue, forming a sort of “skin bridge.” This type of flap is intended to be sectioned (separated) from the donor site in a subsequent procedure.

FREE FLAP:

Tissue from another area of the body is detached and transplanted to the recipient site and the blood supply is surgically reconnected to blood vessels adjacent to the wound.