What Kind Of Results Can I Expect From A Tracheostomy Scar Revision?
Q: Dr. Eppley, I was born pre mature and have a bad tracheostomy scar that I really want improved. After reading your website I can see that you are a extremely talented surgeon with lost of practice in this area. I have attached two pictures, one where the neck is stretched and one where Im looking straight forward. Can you please tell me what is possible to do here, and what results I can expect?
A: What you have is a vertically oriented tracheostomy scar with a central depression. The best way to treat that type of trach scar would be total excision and contracture release, interpositional dermal-fat graft and linear or partial broken line skin closure. You most certainly should be able to substantially narrow the scar line and even out its contour with the surrounding unscarred skin. In short, there is a lot of room for improvement in your tracheostomy scar. The one negative to your trach scar is that it is vertically oriented, completely perpendicular to the natural horizontal relaxed skin tension lines of the neck. This natural anatomic violation will make any neck scar revision more prone to secondary widening than if the initial scar was horizontal in orientation.
Dr. Barry Eppley