Leana Teston, MBBS(Hons), FRACS

Thanks for your question.

It would definitely be wise to wait until you have finished breastfeeding for any surgery, especially that related to the labia. The hormones in your system when you are breastfeeding will affect the labia and vaginal secretions. It is best to wait for nature to heal the perineum after childbirth as much as possible before considering surgery. 

One thing to consider is that anaesthetics and medications (ie antibiotics) that are given to you during surgery and after surgery can affect the taste of the breast milk to the baby, and the baby may reject the breastfeeding. 

Hope this helps answer your questions. 

Regards,

Dr Leana Teston

Thank you for your question. I am sorry that you have had to go through a complication like this. 

It appears that too much skin has been removed, resulting in the pulling of the remaining skin. I am not sure why skin grafting is not an option for you, as this may well be required. Multiple flaps may help with z-plasties. Tissue expansion on the inner thighs could be a possibility, although it would certainly be difficult to put up with while expansion is proceeding, and depending on the thickness of your skin in that area, it is possible that the tissue expanders may work their way through the scar. The expansion would have to be done very slowly. This is the only way that does not involve taking skin from somewhere else, whether it be a skin graft or a skin flap. 


You definitely need to have something done to improve the quality of your life, so I hope this answer helps. 

Regards,

Dr Leana Teston

Given that it is 3 years post MOHS surgery, the scar has had plenty of time to settle adequately. The only way to correct the 'bump' would be to have a different flap used to remove the pale area and the indentation. It looks like the original flap may have only partly survived, hence the depressed and pale area. It is also possible to have laser to reduce the redness, the pale area could also be tattooed with skin colour.

I would strongly advise against filler under the scar on the nose, as there have been cases of blindness reported from filler injected into the nose where it has blocked arteries to the eye. I also do not think fat grafting would be suitable either. 

I hope this answer helps.

It is unusual for dissolving sutures to take 9 months to dissolve. For the otoplasty procedures that I perform, I use dissolving sutures in the cartilage, which is deep beneath the skin, and do not show on the surface. These should be dissolved by 6 months. In the skin behind the ear, where the incision has been made, I use sutures that are removed by 2 weeks post-op. 

Some surgeons use dissolving sutures in the skin and these show on the surface and as they dissolve, can produce more inflammation in the scar. For skin surface level sutures, I prefer to use a non-dissolving nylon suture that produces very little reaction and therefore a better scar. In my technique, the skin sutures do not hold the correction of the ear in place and are only used to close the skin. 

If the dissolving sutures are visible, or palpable in the skin, then they certainly can be removed earlier than 6-9 months. I would suggest 1 month. If these sutures are irritating you, I would suggest you ask your surgeon to remove them.