Treatments
Minor Surgery
Minor Surgical Procedures
Minor surgical procedures are defined as a set of procedures in which short surgical techniques are applied on superficial tissues, usually with local anesthesia, and minimal complications, that usually do not require postoperative resuscitation and need minimal equipment, many of which are used on a daily basis, and can be easily and safely performed in a short amount of time during clinic visit.
Labiaplasty
Also known as vaginal rejuvenation, labiaplasty is a plastic surgery procedure that involves modifying the labia minora (inner lips), and/or the labia majora (outer lips).
A labiaplasty is most often performed on the labia minora, the folds closest to the clitoris, to create a ‘tucked in’ appearance.
There are two main types of procedures to address the labia minora: edge resection and wedge resection. Both of which are usually done under anesthesia.
Edge resection involves trimming the “excess” protruding edges of the labia, the way you’d trim your hair during a haircut, for instance.
Wedge resection maintains the original labial edges by cutting wedge-shaped slivers of skin out of the center of the labia minora, bringing the remaining skin together with dissolvable sutures.
Procedures to address the labia majora typically go one of two ways:
- cutting out tissue or using liposuction on labia that are longer or fuller than desired
- injecting fat or other filler material to plump labia that aren’t as full as desired
excision
The removal of tissue from the body using a scalpel (a sharp knife), laser, or other cutting tool. A surgical excision is usually done to remove a lump or other suspicious growth. Some normal tissue around the lump is usually removed at the same time.
subcision
Subcision is an incisionless surgical technique. It can be used to improve the appearance of:
- depressed scars
- wrinkles
- cellulite
Although subscision is most often used to treat acne scars, it may also help reduce scars caused by other conditions, like:
- chicken pox
- wounds
- surgery
With this procedure, a healthcare practitioner inserts a hypodermic needle into your skin directly beneath the scar. The needle is used to loosen and break the fibers that connect the scar to the tissue underneath it.
This process not only helps to lift a depressed scar, it also triggers the release of collagen at the site of the needle insertion.
Both the lifting of the scar and the release of collagen can help diminish the appearance of the scar.
This procedure is usually repeated three to six times with at least 4 weeks in between each treatment.
scar revision
A scar revision is a procedure done on a scar to alter the appearance of the scar. The revision may improve the cosmetic appearance of the scar, restore function to a part of the body that may have been restricted by the scar, or improve an itchy scar. It is important to remember that scars cannot be completely removed.
What are the different types of scars and scar treatments?
There are many different types of scars, including the following:
Keloid scars and scar tissue removal
These are thick, rounded, irregular clusters of scar tissue that grow at the site of a wound on the skin, but beyond the edges of the borders of the wound. They often appear red or darker in color, as compared to the surrounding normal skin. Keloids are formed from skin cells and connective tissue (fibroblasts) that begin multiplying to repair the damage. These scars may appear anywhere on the body, but more commonly on the face, neck, ears, chest, or shoulders. They occur more often in darker-skinned people. Keloid scars may occur up to one year after the original trauma to the skin.
Treatment for keloid scars varies. There is no one simple cure for keloid scar removal. Recurrence after treatment is common. Treatment may include the following:
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Steroid injections. Steroids are injected directly into the keloid scar tissue to help decrease the itching, redness, and burning sensations that these scars may produce. Sometimes, the injections help to actually decrease the size of the scar.
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Cryotherapy. Cryotherapy involves the scar being “frozen” off by a medication. This treatment is often effective in conjunction with steroid injections for keloid scars.
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Pressure therapy. Pressure therapy involves a type of pressure appliance worn over the area of the keloid scar. These may be worn day and night for up to 4 to 6 months.
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Surgery. If the keloid scar is not responsive to nonsurgical management options, surgery may be done. One type of surgery directly removes the scar formation with an incision, and stitches are placed to help close the wound. Sometimes, skin grafts are used to help close the wound. This involves replacing or attaching skin to an area that is missing skin. Skin grafts are done by taking a piece of healthy skin from another area of the body (called the donor site) and attaching it to the needed area.
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Another option for keloid scar treatment is laser surgery. Scars may be treated with a variety of different lasers, depending on the underlying cause of the scar. Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for keloid scars is done in conjunction with other treatments, including injections of steroids, use of special dressings, and the use of bandages. Multiple treatments may be required, regardless of the initial type of therapy.
Radiation therapy
Radiation treatment is often used in conjunction with surgery to decrease the risk of recurrence of a keloid scar.
Hypertrophic scars
Hypertrophic scars are similar to keloid scars; however, their growth is confined within the boundaries of the original skin defect. These scars may also appear red, and are usually thick and elevated. Hypertrophic scars usually start to develop within weeks after the injury to the skin. Hypertrophic scars may improve naturally, although this process may take up to a year or more.
In treating hypertrophic scars, steroids may be the first line of therapy with this type of scar, although there is not one simple cure. Steroids may be given as an injection or by direct application. These scars may also be removed surgically. Often, steroid injections are used along with the surgery and may continue up to 2 years after the surgery to help maximize healing and decrease the chance of the scar returning.
Contractures
Contractures are an abnormal occurrence that happens when a large area of skin is damaged and lost, resulting in a scar. The scar formation pulls the edges of the skin together, causing a tight area of skin. This can also occur as scars heal. The decrease in the size of the skin can then affect the muscles, joints, and tendons, causing a decrease in movement. There are many different surgical treatment options for contractures. Some of which may include the following:
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Skin graft or skin flap for contractures. Skin grafts or skin flaps are done after the scar tissue is removed. Skin grafts involve replacing or attaching skin to a part of the body that is missing skin. Skin grafts are performed by taking a piece of healthy skin from another area of the body (called the donor site) and attaching it to the needed area. Skin flaps are similar to skin grafts, where a part of the skin is taken from another area, but with the skin flaps, the skin that is retrieved has its own blood supply. The section of skin used includes the underlying blood vessels, fat, and muscles. Flaps may be used when that area that is missing the skin does not have a good supply of blood because of the location or because of damage to the vessels.
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Tissue expansion for contractures. Tissue expansion is a newer technique being used for scar treatment, and involves a process that increases the amount of existing tissue available for reconstructive purposes. This procedure is often used in addition to the flap surgery.
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