Will my Vaser Lipo burn heal with minimal scarring? (Photo)

Question

Three months post op and I’ve been through hell. Waiting for this burn to shrink so I can have it stitched up. Dr doesn’t know yet if it will be best to stitch or graft. He’s making a decision this week. I'm not really liking the idea of graft but I want the best scar possible. What are your thoughts in this? It’s had me hospitalised twice with cellulitis for a week at a time. So it’s been a nasty journey.

W. John Bullis, MD · Answer

Thank you for your question and photos.  I am so sorry you are having to deal with this!  I'm sure it has been an ordeal.  For the record, this is highly unusual.  Do you know how it happened?  One of my friends (a plastic surgeon) had a Vaser liposuction patient who had a burn like this, because the handle from the Vaser had just come out of the sterilizer and was much hotter than anyone realized and they set it down on the patient for about 10-15 minutes.  That patient had to get skin grafting to close the burn.  Even something that isn't burning hot can cause a burn if it's left on the skin for a prolonged period of time.  From the looks of it, I would be leaning towards skin grafting, but it is difficult to tell how large it is.  If your doctor is not a plastic surgeon, then I would suggest getting a second opinion from a board certified plastic surgeon.  (I am NOT a board certified plastic surgeon, but I am a board certified cosmetic surgeon - see link below for more information on that, if you are interested.)  If you were my patient, I would send you to one of my plastic surgeon colleagues, as they are highly trained to repair these types of soft tissue defects using skin grafts and/or flaps.  Even if your surgeon is a plastic surgeon, it never hurts to get a second opinion.I am sure this has been a frustrating experience for you, but try to stay positive and get through it.  Complications can occur with any surgery, no matter how "simple."  One of my mentors used to say, "There's no such thing as 'simple surgery'."  Fortunately complications are rare, but as I tell my patients, the statistics we doctors cite regarding complications are based upon large populations of patients, which is why we can say "1 out of 10,000," for example.  However, when we are talking about you; one individual patient, the risk is either zero or 100%.  Complications like this can occur no matter how talented the surgeon.  Another saying we have in surgery is, "If a surgeon tells you s/he has never had a complication, they're either lying or they haven't done much surgery."  The point being, that the complication rate is never zero; there is always a statistical chance of a complication.  Both surgeons and patients should always keep that in mind when considering any surgery.Best of luck with this and please consider posting a follow up photo once everything is resolved - I would be very curious to know what you and your doctor decide and how it turns out.  I hope this was helpful in some way.

Karol A. Gutowski, MD, FACS · Answer

Based on the pictures, I would let it heal, then do a scar revision a year later. A skin graft will look bad and need to be cut out later. Closing it now may be possible but you may have healing problems.

Randy Dean, MD - Account Suspended · Answer

I am
sorry that you have experienced a complication of the vaser liposuction procedure.
 The cause of the defect can range from effects
of smoking, diabetes mellitus, vascular disease, infection, or may be due to the effect of direct thermal energy on normal tissue.  
At the
time your photographs were taken, I do not see significant infection, but
there is residual unhealthy tissue in the wound.. Treatment consists of
removal of the unhealthy tissue, followed by intensive wound care. One looks
for the development of granulation tissue, a beefy red vascular tissue, to
develop, after which time the wound will begin to shrink. Many wounds of this
size will seal over a span of 2-3 months. In our practice, we consider
application of a temporary skin graft over the granulations if the wound does
not seal within this time period (to eliminate the necessity for frequent wound care). This graft can be removed in stages at a later date. Some advocate the use of a suction apparatus
(wound vac) to accelerate the process of wound shrinkage. Various
enzymatic topical creams are available. Some advocate hyperbaric oxygen
treatments.
Each
plastic surgeon has his / her own wound care regimen based upon years of
experience. Follow the advice of your surgeon and maintain close followup care. After
the wound seals, and after the scars mature and the inflammation
subsides, one would then consider revisional surgery if necessary (usually
6-12 months). I am often surprised how well these scars heal on their own!
Best
wishes...

Will my Vaser Lipo burn heal with minimal scarring? (Photo)

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Will my Vaser Lipo burn heal with minimal scarring? (Photo)

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