What Type Of Tracheostomy Scar Revision Do I Need?

Q: Dr. Eppley, I am interested in tracheostomy scar revision. I have already consulted some local plastic surgeons, but they are not expert with this kind of procedure. One of them told me I would have to go there twice or three times to have a reasonable repair conclusion. Actually, I am kind of afraid of it. I would like to receive an advice from you. Please, show me if it is possible to be removed! Would you perform a lipofilling procedure? Thank you!

A: Thank you for your inquiry and sending your pictures. You have a very deep tracheostomy scar deformity that goes well into the sternal notch area. This represents a severe loss of fat between the skin and trachea. I imagine that there is also a skin retraction deformity which occurs when you swallow. In my hands, I believe you can get a very good result in a single procedure using a dermal fat graft to fill the defect  and excising and closing the horizontal skin scar over it. Dermal-fat grafts survive very well in small defects like a depressed tracheostomy scar.This is a very straightforward and uncomplicated procedure that has a very minimal recovery.

Dr. Barry Eppley

Indianapolis, Indiana