Plastic and Reconstructive Surgery: Skin Disorders & Procedures
Large noticeable scars may become less visible over time and some scars can be treated
with steroids to relieve symptoms such as tenderness and itching. For these reasons,
many plastic surgeons recommend waiting a year or more before undergoing scar revision.
Our UF plastic surgeons will discuss the possible methods of treating your scar,
the risks and benefits involved and the possible outcomes. Because insurance doesn’t
usually cover cosmetic procedures, it is important to check with your insurance
carrier prior to scheduling a consultation. However, if a scar revision is performed
to minimize scarring from an injury or to improve ability to function, the procedure
may be partially covered by insurance.
The surgeons of UF Health Plastic Surgery at Jacksonville treat the following scars:
Keloid scars are described as thick, puckered, itchy clusters of
scar tissue that grows beyond the edges of a wound or incision. Often red or darker
in color than the surrounding skin, keloids appear after a wound has healed and
form when the body continues to produce collagen, a tough, fibrous protein.
Keloids can be treated by injecting a steroid medication directly into the scar
tissue to reduce redness, itching, and burning. In some cases, this may also shrink
the scar. If steroid treatment does not reach the desired outcome, the scar tissue
can be cut out and the wound closed with stitches. This is generally an outpatient
procedure performed under local anesthesia. Because keloids have a tendency to recur,
repeated procedures may be required every few years.
Hypertrophic scars are similar to keloids because they are thick,
red and raised. Hypertrophic scars remain within the boundaries of the original
wound or incision, while keloids spread beyond. They often improve on their own
over time or with the help of steroid applications or injections.
Hypertrophic scars can often be improved surgically. The procedure involves removing
excess scar tissue and repositioning the incision so that it heals in a less visible
pattern. Depending on the scars location, this surgery may be done under local or
general anesthesia. Steroid injections may be administered during surgery and at
intervals for up to two years afterward to prevent the scar from reforming.
Contractures develop when the loss of a large area of skin forms
a scar that pulls the edges of the skin together. This contraction process is often
caused by burns or other significant injuries. Contractures may affect adjacent
muscles and tendons which causes the restriction of normal movement.
Correcting a contracture usually involves cutting out the scar and replacing it
with a skin graft or a flap. In some cases, if the contracture has existed for some
time, physical therapy may be necessary after surgery to restore full function.
Facial scars, whether hypertrophic or not, are frequently considered
a cosmetic problem. There are several ways to make a facial scar less obvious. Often
it is simply cut out and closed with tiny stitches, leaving a thinner, smaller scar.
If the scar lies across the natural skin creases, it may be repositioned to run
parallel to these lines, making it less noticeable.
Some facial scars can be softened using a technique called dermabrasion, a controlled
scraping of the top layers of the skin using a hand-held, high-speed rotary wheel.
Although it won’t completely erase a scar, dermabrasion leaves a smoother surface
to the skin.
With any kind of scar revision, the degree of improvement depends on the size and
direction of your scar, the nature and quality of your skin, and how well you care
for the wound after the operation. Some scars appear worse following surgery and
final results may not be apparent for a year or more.
Skin cancer is the most common type of cancer and is defined as the abnormal growth
of cells in the skin. It is almost always cured when it is found early and treated.
If you notice changes in your skin or an abnormal lesion develops, it is important
to consult your physician as soon as possible.
Most skin cancers are of the nonmelanoma type which is usually caused by too much
sun exposure and by using tanning beds or sunlamps. Skin cancer usually appears
as a growth that changes in color, shape, or size. This can be a sore that does
not heal or a change in a preexisting mole.
There are two types of nonmelanoma skin cancer that are treated by UF Health Plastic
Surgery at Jacksonville:
Basal cell carcinoma usually affects areas that get the most sun
– the head, neck, back, chest, or shoulders. The nose is the most common site. Signs
of basal cell carcinoma can include skin changes such as a firm, pearly bump with
tiny blood vessels in a spider-like appearance; red, tender, flat spot that bleeds
easily; small, fleshy bump with a smooth, pearly appearance, often with a depressed
center; scar-like patch of skin, especially on the face, that is firm to the touch;
a bump that itches, bleeds, crusts over, and then repeats the cycle and has not
healed in 3 weeks; or change in the size, shape, or color of a wart or mole.
Squamous cell carcinoma usually affects the face, head, or neck.
Signs of squamous cell carcinoma include any persistent, firm, red bump on sun-exposed
skin; patch of skin that feels scaly, bleeds, or develops a crust; a skin growth
that looks like a wart; or a sore that does not heal or an area of thickened skin
on the lower lip, especially if you smoke or use chewing tobacco or your lips are
often exposed to the sun and wind.
The most common treatment for nonmelanoma skin cancers is to numb the skin and cut
out the cancer. The procedure is done while the patient is awake. A sample of the
growth is then sent to a lab to see if it contains cancer cells, this process is
called a biopsy. If it does, then the appropriate treatment is administered to remove
all of the cancer. After treatment, you will need regular checkups, because having
skin cancer once means you are more likely to get it again.
In addition to treating nonmelanoma skin cancers, our UF surgeons also treat the
most serious form of skin cancer known as melanoma.
Melanoma can affect the skin only or, if not found and treated
early, it can spread to the organs and bones. Spending too much time in the sun
is a key factor in developing melanoma, which causes normal skin cells to grow out
of control and attack the tissues around them.
The most important sign of melanoma is any change in the shape, size or color of
a mole or other skin growth, such as a birthmark. Melanomas can be found anywhere
on your body; however, most of the time, they are discovered on the upper back in
both men and women and on the legs of women.
Melanoma looks like a flat, brown or black mole that has uneven edges and is usually
in an irregular or asymmetrical shape. Unlike a normal mole or mark, a melanoma
can change color, be lumpy or rounded, or become crusty, ooze, or bleed.
Melanoma is diagnosed when a biopsy reveals cancer cells are present. At that point,
more tests are run to determine how far the cancer has spread and the appropriate
treatment necessary. The most common treatment is surgery to remove the melanoma.
If the cancer has not spread to other parts of the body, that is all the treatment
needed for early-stage melanomas. For late-stage melanomas, cancerous lymph nodes
may need to be removed.
Related: UF Health Cancer Center at Jacksonville