Plastic Surgery | Chevy Chase, MD & Town Center, VA

Shervin Naderi, MD, FACS

Chevy Chase, MD

301-222-2020

Reston, VA

703-481-0002
Schedule Now
Questions & Answers / First, thanks in advance for taking the time to read this

First, thanks in advance for taking the time to read this in Virginia, Washington D.C. and Maryland

Greetings, Dr. Naderi,

First, thanks in advance for taking the time to read this. You are performing a public service with this forum.
I am a Caucasian woman in her early 50s, with fair, translucent facial skin. Three weeks ago I underwent a lower face/neck lift, and am very pleased with the result. However, I have a problem. Because I have *extremely* thin skin, the underlying work performed on my neck caused  one side of it to develop a burn-like lesion, about 1.5″ x .5″ in size. This week, my surgeon removed a large scab that had formed. He has instructed me to keep the wound covered with Bacitracin and a bandage at all times. He tells me the wound will take 2–3 weeks to heal.
I am very anxious that this lesion is not healing. It looks like a hollow depression with just ‘meat’ where skin should be growing. It’s still oozing clear fluid. I’ve noticed no improvement whatever since the scab was removed 5 days ago. I like my surgeon, but am afraid that he might be putting a rosy spin on things — and that, basically, I might need a skin graft in this area.
My question is, have you ever seen such a thing happen in your practice? Are my concerns justified? Any advice or opinion would be most welcome.
Sincerely,
Cass
p.s. If it would help, I could have my husband take a picture of the lesion.

Answer:

Hi Cass,

It sounds like the cautery that was done on the under surface of your skin flap during the surgery was too aggressive which has resulted in skin damage.  These problems should be extremely rare in any plastic surgeon’s practice and I am pleased to hear you are happy with your overall results.  It sounds like you have a good surgeon who made a slight over cautery.   What he is telling you to do now is correct.  Wounds such as this take weeks to heal.  The key is to keep them scab free and moist with antibiotic ointment.  Once it heals, it will take some attention to prevent a noticeable scar so you should continue to see your surgeon.  Once it heals, steroid creams, silicone topical scar treatment lotions and even Pulsed Dye Lasers may be needed.  Worse case scenario, he may need to cut out the scar and re-close it nicely.  However, all these issues are a matter of getting too far ahead.  First thing is first.  You have to let the area heal – under his supervision.  Once its healed you may not need anything further done or you may need one or more of the above treatments.  I hope this helps.  I wish you luck.

Specialization
Matters