Tracheostomy Scar Revision
Q: Dr. Eppley, I am interested in a tracheostomy scar revision for my wide and depressed neck scar. , In regards to tracheostomy revision using dermal fat graft…I am considering having this operation done, as I have a tracheotomy scar that has a dramatic upward retraction when swallowing or talking. I just don’t want to make it worse! Thank you for your time, I appreciate it. My questions are:
1. How many operational procedures are needed?
2. How long does it take to heal from the operation?
3. What is the size of the incision that is made on the neck scar?
4. In your experience, what (approximately) are the success rates?
5. What could go wrong with having this procedure done?
A: The concept of fixing any depressed scar with a combination of a dermal-fat graft and scar revision is not a new concept. By definition any depressed scar is always a combination of a wide scar and tissue deficiency issue. In answer to your questions about treating a depressed tracheostomy scar revision with a dermal-fat graft:
1) The goal is one operation to ideally fix the problem. In some cases a touchup of the outer scar may be needed.
2) Healing is quick and I would not say there is really much recovery to it. The neck scar area is small as well as the body donor site for the graft.
3) Usually the size of the neck scar is no wider than one’s excising neck scar.
4) I have not seen any dermal-fat graft failures to date.
5) Short of an infection (which I have not seen) or loss of the fat graft (which I have not seen), it is not a procedure where there is much to lose by doing it. It is just a question of how much better can the neck scar become.
Dr. Barry Eppley