January 14, 2017 at 12:27 pm #4090
Hey there, 13 months ago I got in an atv accident, and my helmet didn’t cover my face and the atv ended up breaking my nose, and cutting/crushing my upper lip. I went to a highly rated plastic surgeon (who uses a bit more old school ways and no lasers) in Vancouver a couple weeks after, and he told me I lde have to wait a year before it healed.
So here I am wanting to get it fixed, I really want it to look the best as possible, not too worried about money, and am not sure what kind of plastic surgeon I should be looking for? I asked my family doctor if I should go with this old school guy, a newer technology surgeon or maybe one that generally does lip injections and is used to shaping lips all day but he said he wouldn’t know, so hopefully someone here can give me some insight? Thank youJanuary 14, 2017 at 1:39 pm #4091
Dr. Michael KreidsteinParticipant
Sorry for your grief!
Timing a revision is part of the art of plastic surgery. Some wounds will obviously benefit from revision immediately, whereas many may heal optimally without further surgery and should be allowed to heal fully before planning an intervention.
At 13 months, you should be very close to a final result, and the risks and benefits of a revision can now be estimated. Whether a ‘laser’, or one of many non-surgical devices and techniques will contribute to a better result should be a consideration, but these are just tools. Choose a surgeon based on their judgement, ability, and empathy for your needs, and let your surgeon choose the tools they need to do the job.January 16, 2017 at 9:35 am #4093
Dr. Benjamin GelfantParticipant
Wow, sounds like you went for a nasty tumble; I’m glad to hear you didn’t suffer even more serious injuries.
As Dr. Kreidstein has written, (without me having seen you in person) you are likely getting close to the scar now being “mature”, or more or less settled to its final appearance. I’m not a believer that any hi tech modality can speed that process up or alter it.
The question now becomes what might be done to improve the quality and visibility of the scar, and that depends on many subtle factors that make up the diagnosis of a particular scar ( the direction of, texture, colour, thickness, etc.). There are so many variables that go into the decision as to what if anything to do, including wait and see.
What makes a plastic surgeon the expert in wound management is the vast and wide experience with helping so many different kinds of wounds to heal ( burns, surgical infections, routine incisions, etc.) and in every conceivable site of the body. Once all these factors are evaluated a decision can be made what is the best solution, and sometimes this requires creative thinking.
I would suggest you start with a return visit to the plastic surgeon you already saw. He is in the best position to evaluate the way the wound is evolving, and from there whether to wait a little longer (4-6 months?) or whether something can or should be done now. If you are in doubt, seek another opinion.
Best wishes and be certain you are seeing a certified Plastic and Reconstructive surgeon.January 16, 2017 at 9:38 am #4094
Sorry to hear about your injury. Often the best plan is to wait up to 12 months after the initial repair before determining if additional treatment or surgical revision will be helpful. However, in some situations it is predictable that the final result will be suboptimal early in the healing process. Each wound is different.
In some cases, the scar may or may not be amenable to improvement with more surgery. There are a number of other modalities (some new and some old) that we consider using in my practice for patients with new scars. Intense Pulsed Light, Fractional Lasers, topical products, fillers to improve contours, botulinum toxin for muscle imbalances and what are called intra-lesional treatments. This decision making is where experience and credentials count most. Contact the office for a consultation if you are interested in another opinion.
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