What Type Of Trach Scar Revision Do I Need?

Q: Dr. Eppley, I am interested in trach scar revision. I have a very ugly scar from a tracheotomy tube and am interested in knowing what my options are in terms of eliminating or reducing the appearance. The tube was removed mid-September of 2014. My doctors suggested waiting some months for everything to heal before considering any cosmetic surgery.There may also be some internal scarring, which seems to be inhibiting normal swallowing somewhat. What type of trach scar revision do you recommend?

A: Tracheostomy scars can be reduced/improved in appearance but never completely eliminated. Given that you are six months from the tube being removed, the treatment of the trach scar could be done any time in my opinion. The only reason to wait any longer, in any type of scar revision, is if one thought that more time had a chance to make it improve enough that surgery should not be needed. Because most tracheostomy scars are depressed, I prefer the use of  a small dermal fat graft to fill the defect at the same time as revision of the skin scar. This can also release the tether that is often seen when swallowing. This converts a round depressed scar into a flat linear scar.

Dr. Barry Eppley

Indianapolis, Indiana