Tracheostomies frequently consequent in unsightly neck scars. Their important neck location and the temporary indwelling breathing tube generally leaves a depressed neck scar after its removal. It often looks like a belly button with the skin turned inward. This is known as a tracheal tug although it is the lack of fundamental soft tissue that makes it look this way.
An undesired finding scar from a tracheostomy can experience improvement within months after a breathing tube has been removed if so desired. Historically, tracheostomy revisions have been done when the scar is more mature. (greater than six months after tube removal) It is not critical to wait this long however. The plastic surgery techniques used are not truly affected by how mature the tracheostomy scar is. And, for many patients, they would like to eliminate as soon as potential the corporeal and psychological marks of the sense of why the tracheostomy was there in the first place.
To get a good outcome from a tracheostomy scar revision, there are three basic concepts that must be achieved surgically. First, the turned in skin edges must be released from the deeper tissues and be wholly freed up. Secondly, this release creates a real tissue volume defect in the middle of the skin and the trachea which must be filled in. Lastly, end the skin must originate a fine line scar that lies in a horizontal direction along a natural neck skin fold. By far, filling in the lost tissue is the hardest one to achieve but it truly critical if one does not want the final consequent to have any indentation. Filling in the missing tissue can be done in a range of ways. If the tracheostomy scar is not that deep and fairly shallow, the surrounding skin edges can be used through a technique known as edge de-epithelization. The thinned skin edges are then turned down for a microscopic tissue fill and the full-thickness skin edges accomplished over it. For tracheostomy scars that are significantly indented, however, more volume is required. I prefer using dermal-fat grafts which can be quite thick if desired, up to 1 cm. A donor site is needed to harvest it and this will leave a scar elsewhere on the body. However, if one has a scar from a former surgery elsewhere that is from a suitable area that has some fat thickness, then this should strongly considered. Otherwise, allogeneic dermal grafts (from cadaver skin) can be used which is an off-the-shelf product.
Tracheostomy scar improvement is a fairly easy sick person procedure. All sutures are settled under the skin so there is none to remove. A fine line red scar will exist for awhile afterwards (months) but this will ultimately fade into a near invisible pencil line thin scar. Again the key to a victorious tracheostomy scar improvement is to wholly conclude the skin tethering to the trachea and replace any missing tissue.
Plastic Surgery:Plastic surgical operation revising of Tracheostomy Scars