This review is for Dr James Chelnis, who is not currently a member of this site. I saw him at his office Manhattan Face and Eye in New York City. I came to Dr Chelnis for help with a scar on my temple, and after trying some other treatments, we ultimately decided to perform a scar excision to cut out the scar. The original scar was 1cm in length (Figure 1), and the area removed is approximated in Figure 2. The immediate result of the scar excision can be seen in Figure 3 (note the wound was closed under significant tension). A single 5-0 Vicryl suture was used for the deep layer and 6-0 nylon sutures were used superficially. However five days post-procedure, a complication arose as the wound began to dehisce (split open), where the tension on the skin is too large and the wound opens (Figure 14); note that in Figure 14, the tension on the superficial sutures was so large that they ripped through the skin. 7 days post-procedure, the wound dehisced further (Figure 4). To address the dehiscence, Dr Chelnis decided to extend the incision upward into the healthy skin above the scar, with the goal of reducing tension and suturing the wound together again (Figure 5). This action immediately increased the length of the scar. 5-0 PDO sutures were used in the deep layer and 5-0 nylon sutures were used superficially. The superficial stitches were removed a week later (Figure 13). Healing went smoothly for the next 70 days, until I encountered complications from stitch abscesses / spitting stitches. Stitch abscesses are extremely inflamed, pus-filled pustules. Stitch abscesses occur because the human body treats sutures as foreign bodies and will seek to eject them if they cannot be dissolved in time. PDO dissolves very slowly (6 months to complete absorption, compared to 70 days for Vicryl and 90 days for Monocryl sutures), and so they are very prone to spitting. The first stitch abscess occurred 70 days post-procedure and is pictured in Figure 6. Another suture abscess occurred a week later (Figure 7), and this one destroyed a whole column of skin, leaving a gaping hole (Figure 8). A third suture abscess occurred later (Figure 9), and this same location had a fourth suture abscess 3 weeks later (Figure 10), which only resolved when I squeezed out the suture knot. This last abscess occurred 110 days post-procedure. All of these suture abscesses have left me with new atrophic scars. The final scar can be seen in Figures 11 and 12. Figure 11 shows the area corresponding to the original scar (dotted green area) and the final scars after excision (dotted blue area). Figure 12 shows that the length of the final scar is around 1.9cm. Overall, my scar excision with Dr Chelnis has been a disappointing experience. Between the dehiscence and multiple stitch abscesses, my recovery ran into a number of complications, and the final scar is larger and more noticeable than the original scar. Even today, I am still very self-conscious about the final scar and will try to cover it up when going outside. It is further distressing that I may be stuck with these scars, since surgeons have told me that there’s not much laxity in the skin around the temples, and so another scar revision would be difficult. Dr Chelnis is very personable and has great bedside manners. The office and staff are also nice. But if I’m being objective about the cosmetic results of the scar revision, I have to say they’re pretty bad.
