A few weeks earlier, a 12-year-old girl came to our OPD with her mother. Her complaint was a large, very rapidly growing tumour in her right breast, measuring 10 x 8 cm. Surprisingly, given its size, the pain was negligible. In fact, that lack of significant pain was the reason for her late presentation to us. When her mother first noticed the tumour two months earlier, it was very small. She ignored it at first and waited nearly six weeks, hoping it would disappear on its own. But when it grew large enough to compress the developing normal breast tissue and thin the overlying skin of the areola, her mother brought her to us for treatment.

On examination, we found a firm, very large, non-tender, oval mass within the little girl’s right breast. We investigated, and the radiological findings pointed to a benign, non-cancerous breast tumour. We suspected she was suffering from a giant juvenile fibroadenoma of the breast. Once we confirmed the diagnosis and reassured the patient’s mother about the necessity of surgery, we decided to move forward and planned the procedure.

When removing such a tumour, the goal is to achieve the objectives of treatment in the best interest of the patient. In this case, those objectives were particularly challenging to achieve. Let’s see why.

The first and most important objective was the complete removal of the tumour, without leaving any bits attached to the normal breast tissue, to prevent recurrence. The second objective seemed to contradict the first yet was just as important: to avoid injuring the normal breast tissue. Any injury to that tissue during removal could seriously affect the future development of the breast in a 12-year-old girl and lead to deformity.

The third objective may not seem relevant at such a young age, but ignoring it could leave the patient with permanent mental trauma: the scar of surgery. Let’s get into the story of how we achieved all three.

There is, of course, no substitute for qualified training, surgical skill, and proper planning. But the game changer for this surgery was the use of magnification. While its role cannot be overstated, achieving all three objectives also required several things:

• proper planning and preparation for surgery
• careful selection of the site for the incision
• gentle dissection of the tissues to separate the tumour
• avoiding injury to normal breast tissue by ensuring consistent haemostasis (stopping the bleeding)
• perfect closure of the tissues
• attentive post-operative care

First, we chose to make the incision in the crease below the breast, the inframammary crease, which becomes inconspicuous over time. Normally, our incision for a breast tumour is centred at the junction of the areola, the dark skin around the nipple, and the normal skin. This is called a periareolar incision. But as noted, the tumour was larger, at 10 x 8 cm, than the breast itself, so a periareolar incision would have been too small to deliver it. And extending the incision directly over the breast tissue and the tumour would have caused undesirable scarring and disfigurement. So we chose the most challenging, yet nearly scarless and safe, approach: from beneath the breast, in its natural crease.

In terms of scarring and patient satisfaction, this was without doubt the best approach for removing the tumour. But it was technically very challenging for the surgeon to reach such a large breast tumour from below and to do so using the 4X magnification needed to prevent injury to the normal breast tissue while ensuring the tumour was removed completely and intact.

Working with magnification in such a difficult scenario puts a tremendous load on the surgeon’s neck and back muscles. He is looking from below upwards, while constantly maintaining a distance of 45 cm from the magnifying loupes to the operative field, and all within a restricted circular field of vision barely 8 cm wide. In such an extreme situation, giving up the magnifying loupes would certainly have made the whole surgery easier for the surgeon. So why insist on magnification despite the tremendous strain on the back and neck muscles in such awkward working conditions? Simply to fulfil the first two objectives of surgery: to completely remove the tumour, and to avoid injuring the normal breast tissue.

Let us see how magnification helped us achieve both of these opposing objectives. Magnification in the range of 4X gives the surgeon as good a view as an operating microscope at the same magnification. This lets the surgeon clearly identify, isolate, and control the abnormal blood vessels around the tumour before they bleed and make the dissection messy. (Abnormal growth of blood vessels is the norm in large tumours anywhere in the body.) Magnification also helps the surgeon clearly see the definite, natural plane of separation between the tumour and the normal breast tissue, which is otherwise very flimsy and nearly invisible to the naked eye. On top of that, with magnification, separating the tumour from the normal breast tissue becomes a bloodless, seamless operation with no collateral damage. These advantages are exactly why we never even consider operating without magnifying loupes, even in extreme situations. It is the magnification, along with precise surgical skill, that helps us navigate such difficult and stormy situations.

In the end, we happily completed the surgery. We removed the tumour intact, without injuring the developing normal breast tissue, and with negligible blood loss, achieving an excellent, almost invisible scar hidden in the crease below the breast. What came as a happy surprise was the speed at which the compressed normal breast tissue resumed its growth. Within just six weeks after surgery, it had caught up to a growth comparable with the normal, unaffected breast.

Seeing the patient’s quality of life restored, with minimal scarring and excellent healing, brings us real satisfaction and makes us forget the challenges we faced during the surgery.

In fact, it is this feeling of pride and joy that drives a surgeon to keep pushing his boundaries and to keep doing better.

The post A Fast-Growing Breast Tumour in a 12-Year-Old Girl: How We Removed It Without a Visible Scar appeared first on Cutis.

In today’s world of social media, selfies, and mobile photography, children have become increasingly aware of their appearance and how others see them. Prominent ear (bat ear) is one such facial deformity where early and timely correction is extremely helpful for both the patient and the plastic surgeon.

Why Early Correction Matters

Prominent ear correction is done by placing sutures at precise, pre-marked points inside the ear cartilage. When these sutures are placed correctly, they mold the ear into a normal, desired shape. If the molded ear is protected with a bandage encircling both ears around the head for about 3 weeks after surgery, the new shape is usually retained for a lifetime.

Children have soft and pliable cartilage, which makes molding easier. As age increases, this pliability decreases, and it becomes more difficult for the plastic surgeon to place sutures and mold the ear. In adolescents and adults, the cartilage is more rigid and has a memory property, so even after correction it may unfold and return to its original shape.

In children below 10 years of age, recurrence after surgery is rare.

Prominent ear deformity is visible from birth but becomes a noticeable concern when the child starts going to school and begins comparing themselves with peers. Since hearing is usually normal in these children, parents may miss this subtle issue. Even today, many families visit a plastic surgeon only when the child becomes an adult—often around marriageable age—unaware that every birth defect has an ideal age for correction.

The same applies to prominent ear. When corrective surgery (otoplasty) is performed between 7 and 10 years of age, the results are most desirable and the chances of long-term retention of the corrected shape are highest.

Case Study: 8-Year-Old Girl with Prominent Ear Deformity

Recently, an 8-year-old girl visited us with her parents for correction of prominent ear deformity on both sides. Fortunately, she came at exactly the right time to receive maximum benefit from the operation. We planned simultaneous correction of both ears under general anesthesia.

The surgery was performed through an incision behind the ear (on the posteromedial surface), which is not visible in normal day-to-day life. The abnormal ear cartilage was dissected, molded into a normal shape, marked, and fixed with permanent stitches to retain the new contour. Each ear was corrected one after the other, ensuring symmetry on both sides.

The surgical incisions were carefully closed without disturbing the newly molded shape. A protective bandage was applied over both ears, encircling the head around the forehead. The patient was advised to keep this bandage on for at least 14 days after surgery.

This procedure does not leave any visible scar, and the results are striking and appreciated by all.

Conclusion

To achieve the best results in the treatment of prominent ear deformities or protruding ears, children should be treated at a young age, ideally prior to the age when the cartilage begins to harden and lose its flexibility. Surgical correction of the ears, performed at a young age, not only restores normal ear shape, but also helps to build a child’s self-esteem and confidence as they progress through their formative years in school and other social environments.

If you are a parent who is concerned about your child’s protruding ears, and wish to find out what the best surgical option and time for the surgery will be, you should contact Cutis Hospital in Ahmedabad. Parents should seek medical advice and information about when is the best time to pursue medical intervention for their child’s protruding ears. Early medical intervention will provide parents with the most accurate information regarding the treatment of their child’s ears, as well as help them achieve an optimal outcome based on the needs of their child.

Frequently Asked Questions

The post Case Study: Timely Correction of Prominent Ear (Bat Ear) Deformity in an 8-Year-Old Girl appeared first on Cutis.

This case of very large bilateral ear lobule keloid not only shows the difficulty and complexity of treatment of keloid, it also shows how important it is, to get treated by an experienced and expert plastic surgeon for such a complex problem. It also emphasizes the importance of long-term follow-up to get good results.

Keloid and cancer, both are 6 letter words. Though both are completely different from each other, I see some interesting similarity between them. Cancer is very difficult to cure (especially in advanced stages), same applies to keloid which has grown large over a period of time.

Cancer disfigures the person especially over the visible areas of the body, same applies to keloid when it happens on the chest or ear of a person. Repeated recurrences of cancer physically kill the patient, while repeated recurrences of keloid become frustrating and emotionally devastating experience for the patient akin to mental killing. But, the confined area of involvement of keloid without risk of death, unlike the cancer which spreads to other normal body parts and can lead to death draws the differentiation line between the two.

Having learnt this about the keloid, let us understand what it actually is. Before going directly to keloid, we need to understand normal wound healing and scar formation process.

We know that whenever there is any injury to our body, healing happens, and ultimately, the wound heals itself completely with the visible end result called scar. To us, healing after the injury and formation of a scar is apparently 7 to 10 days phenomena. But, below the apparently healed surface of a scar, biological processes of synthesis of newer collagen protein and degradation of old collagen protein continuously take place. Though both collagen synthesis and collagen degradation processes happen simultaneously, the whole cascade of events is so finely regulated by the nature, that we cannot perceive either of them.

At the end, after few weeks to few months of these finely regulated natural biological processes of collagen synthesis and collagen degradation comes to a halt and upon cessation of them, what we see on the surface is a soft, supple and acceptable scar as the end result.

In persons with tendency for keloid development, the fine balance between the collagen synthesis and collagen degradation is lost and the abnormal collagen bundles are produced by the body which are deposited one over the other in a haphazard manner.

Ultimately, what is seen on the surface of the skin is an ugly, undesirable, non-functional protuberance or many of them in clusters deposited over skin and projecting as scars what we call as keloid, instead of soft and supple normal scar which is level and harmonious with skin.

Real Patient Story: Bilateral Ear Keloid Removal Success

Recently, a lady of 26 years presented to us with large, unsightly keloid over both her ear lobules with constant pain and severe itching. She had undergone repair of both her ear lobule clefts by an unqualified person and with some non-documented technique of chemical cauterization in house hold setting before few months.

The size of both keloids and symptoms they caused were significant enough to warrant surgical intervention. Any surgical intervention for removal of keloid always poses unavoidable risk of recurrence.

We discussed our keloids treatment plan, follow up visits and possibility of recurrence of keloid after surgery with patient and her husband and decided to proceed with surgical removal of both ear lobule keloids under local anesthesia. Though keloid looks like just another swelling, removal (excision) of keloid is bit different from excision of other normal swellings like lipoma, sebaceous cyst or dermoid.

As we already discussed, keloid is literally made up of haphazardly arranged bundles of abnormal collagen. While removing large keloid from a very small area like ear lobule, it is imperative to preserve the shape of the lobule and at the same time, complete removal of keloid is also equally important.

We had to work meticulously to achieve both these goals for our patient. After complete removal of both lobule keloids, apparent wound healing and suture removal were complete within 8 days. However, we had strong doubt about the recurrence of keloid; so close and watchful follow up visits were scheduled. Our suspicion about recurrence was proved by appearance of induration (hardness) within the ear lobule scars of surgery after 4 weeks, which is a sign of early recurrence. We immediately treated both the scars with injection Triamcinolone acetonide (type of locally injectable steroid) under local anesthesia.

We were prepared to repeat the treatment session with injection Triamcinolone acetonide after 3 weeks, but to our surprise and good luck of the patient, both scars remained soft and supple and they remained so, since last 6 months. We hopefully believe, she will not develop keloid again. But, our close watch over recurrence of keloid is still on and we will not stop observing her till next 1 years, at least.

Conclusion

Though keloid is not a life-threatening condition, it causes constant irritation to the patient in the form of severe itching and pain. The psychological effect of ear lobule keloid on a person’s appearance and self-esteem cannot be underestimated. Timely detection, proper treatment by an experienced and qualified plastic surgeon and close follow-up after the surgery are the prerequisites to successful outcome.

If you or someone close to you is afflicted with recurring or persistent keloids, Cutis Hospital has specialized treatment with a patient-focused philosophy. Our expert Plastic surgeons and skilled staff are here to help you through each phase of your treatment process.

Book your consultation today!

The post Ear Lobule Keloid Case Study – Symptoms, Causes, and Treatment appeared first on Cutis.

But what if your nose had been changing for over 20 years—thickened, disfigured skin accumulating day by day, hiding the natural shape of your nose? What if you had lived with this growing deformity, accepting it as your fate with no hope for a cure? And then, one day, you discover someone with a similar condition who underwent a treatment and now looks normal—wouldn’t you chase that same possibility, regardless of your age?

Exactly. Age is never a barrier to the basic human desire of looking presentable. This is not about enhancing beauty; it’s about restoring normalcy to a severely distorted appearance. As plastic surgeons, we understand this desire—sometimes even more than the patient’s own family—and we always respect it.

With that in mind, I’d like to share a recent case where we treated a 62-year-old gentleman with rhinophyma.

Rhinophyma, often referred to as the “potato tumor” of the nose, is caused by overactive sebaceous (oil-producing) glands. These glands enlarge over time, making the nose appear bulky and misshapen. No medication can stop their growth. Without surgical intervention, the nose continues to distort, severely affecting the person’s facial appearance.

For plastic surgeons, rhinophyma surgery is fairly straightforward. We carefully shave off the excess tissue until we reach normal skin. The treated surface is then smoothed using either a carbon dioxide laser or radiofrequency cautery. The skin usually heals on its own within 2 to 3 weeks. During this healing phase, daily dressing changes are necessary.

The 62-year-old patient we treated had a moderately deformed nose and came from a tier-2 city, over 150 kilometers away from Ahmedabad. Just one month after surgery, his nose began to look nearly normal. When he visited his nearby village, his results caught the attention of a 75-year-old man with a more severe case of rhinophyma.

For this elderly man, the transformation he witnessed felt like a miracle. He had long believed there was no treatment for his condition. Encouraged by the results and supported by his family, he reached out to us. Within a few days, he came prepared with the necessary investigations and was ready for surgery—with a strong hope for a cure.

When we asked him if he would like us to remove other facial skin lesions—like tags, warts, and irregular patches—his response was simple: “Do whatever you think is right. I’m sure it will only make me look better.”

We proceeded with the surgery. We shaved the large rhinophyma and treated other superficial skin irregularities using radiofrequency ablation. He stayed at the hospital for two days and was discharged with clear instructions for aftercare and dressing changes.

When he came for a follow-up visit 1.5 months later, it was a moment of joy for both him and our team. His facial appearance had dramatically improved. But more than that, his entire body language had changed. Even his photos reflected the transformation.

Inspired by his journey, I felt compelled to write and share this story, because age should never limit someone’s chance to regain confidence and dignity through medical care.

Conclusion

This incredible saga of a patient who is 75 years of age is one that proves your age should not be a reason to stop you from regaining your confidence and well-being. At Cutis Hospital, our belief is everyone should feel great about themselves, independent of their age. It is our privilege to provide life altering changes in the form of plastic and cosmetic surgery to whoever needs it.

Having trouble with rhinophyma or any issue? Don’t wait.
Contact our experienced team at Cutis Hospital, Ahmedabad, for consultation and discover safe, effective plastic and cosmetic surgery procedures to restore appearance and confidence.

The post A Life-Changing Rhinophyma Surgery at 75 – Success Story appeared first on Cutis.

Completely unaware of the challenges on my way, the inauguration day was full of enthusiasm, optimism and joy for me. In fact, now I realize that it was my passion for plastic surgery awareness only which made me invite and call significant numbers of social and political leaders on the day of the inauguration. However, to invite the leaders and make a big show helps little, if any, to create awareness about plastic surgery. I learnt this fact over these 16 years.

Why Spreading Awareness Became My Mission

Why do I feel the need for plastic surgery awareness is so important? What should be done to create awareness about plastic surgery? Answers to these two basic questions define my 16-year journey at Cutis Hospital. Let us have a brief look at this journey.

Starting a little earlier than 2009. At the time of my admission to M.Ch. (plastic surgery course) in 2002, apart from popular operations of skin grafting and burns treatment, I did not know what else came under plastic surgery. As my 3-year rigorous training in plastic surgery (residency) progressed, I started getting fascinated by the varieties and possibilities of plastic surgery. The teaching of my respected and beloved teacher, the late Dr. Udayan Vyas, was instrumental in igniting my passion for burns and plastic surgery. But, when I passed my final university exams for plastic surgery in November 2005 and stepped out of the hostel and my 24/7 hospital accommodation, I realized that things were entirely different in the outside world for a plastic surgeon, no matter if he is a gold medalist, ethical, skillful, and caring for his patients. 

The Struggles of the Early Days

Though surprised, I accepted the then (and even still today) prevalent norm of freelancing plastic surgery practice. Soon, I started feeling exhausted and suffocated with this pattern of plastic surgery practice. A bit of financial exploitation was there, but during those days, financial exploitation was not a major concern for me. As a freshly passed super-specialist, I wanted to prove myself to the world, and for that, I needed more and more work. But, what was shocking for me were the repeated incidents where my identity as an operating plastic surgeon was purposefully kept hidden from the patients whom I operated on and I was prevented from giving them essential post-operative care and advice. During many such incidents, I was paid reasonable and even lucrative operation fees, but the very idea of hiding the identity of an operating plastic surgeon was not acceptable to me at any cost. It was preventing me from exercising my post-operative management skills and educating my operated patients and their family members during their follow-up visits, which is an integral part of excellent results. These were not the principles of patient care and management taught to me by my teachers, I said to myself. Then, what should I do to exercise the full potential of my knowledge and skill and complete patient care without any influence? Again, I asked myself. And the answer I received from within was “to create plastic surgery awareness.” So that I can utilize the best of my plastic surgery knowledge and skill for my patients and educate society about plastic surgery in an uninhibited way. 

A Defining Decision: Prioritizing My Core Expertise

After I started my plastic surgery practice at Cutis Hospital in 2009, I focused my attention on creating awareness for plastic surgery in the community. It is the reason, in spite of being trained by one of the earliest cosmetic surgeons (2008) in the city of Ahmedabad, I opted not to practice exclusive cosmetic surgery. Thus, I continued practicing liposuction, tummy tucks, breast surgeries, and hair transplants along with surgeries like hand injuries, reconstructive surgeries, facial injuries, burns, and congenital anomalies, which were my core expertise. In fact, around the year 2012, my hair transplant practice was developed so good that a few of my colleagues advised me to stop practicing everything other than hair transplants. They were right in their advice, I also believed. But, at the same time, my core plastic surgery practice also developed, and it demanded more attention and hard work, obviously. Now, I was to make a choice between a hair transplant and the rest of the plastic surgeries, which included core (basic) plastic surgery + cosmetic surgeries. It took almost 5 more years to execute my decision to quit my hair transplant practice completely and focus on the rest of all plastic surgeries. Though I am still doing hair transplants for smaller areas like mustaches, eyebrows, and isolated patches on beards, I avoid doing hair transplants for male pattern baldness. It was a bold decision, and I am happy about it. Although not doing hair transplants for male pattern baldness caused me financial losses, it helped me to spare time and focus on my core areas of expertise, especially hand injuries and diabetic foot infections. Today, 16 years after starting my hospital, we are doing the surgeries that are needed most by society, namely, hand injuries, diabetic foot infections, chronic non-healing wounds, burns, vascular malformation, congenital anomalies, and cosmetic surgeries like rhinoplasty and gynecomastia, which are really confidence-building surgeries. 

16 Years of Transforming Lives and Looking Ahead

The 16-year landmark has another significance in my career, such that I started my medical career as an M.B., B.S. student in 1993, and then after 16 years in 2009, I started my way of plastic surgery practice at Cutis Hospital. And now, in March 2025, I have completed another spell of 16 years at Cutis Hospital, doing the best possible efforts we could do for society. 

I am thankful to my teachers, Dr. Udayan Vyas sir, Dr. Santosh Raibagkar sir, Dr. Himanshu Vora sir; thousands of my patients, my family members, and friends; my staff; and numerous people without whom, it would not have been possible for me to contribute to society and I would not have dreamt what I am dreaming today for plastic surgery: “A state of the art Plastic Surgery Institute”.

The post 16 Years of Dedication: My Journey in Plastic Surgery at Cutis Hospital appeared first on Cutis.

Also, we’ll discover the origins of the term “plastic surgery” and address concerns about scarring and emergency procedures.

Accessibility and Cost

Myth: Plastic surgery is meant only for rich people.

Fact: If we look at the total number of people who seek plastic surgery treatment, low-income and middle-class people are much higher in number than rich and ultra-rich people. Plastic surgery can make a great difference in the lives of manual laborers, factory workers, and daily workers due to its superb reconstructive qualities.

Myth: Plastic surgery operations are very costly and they are possible only in big corporate hospitals.

Fact: Plastic surgery operations are much cheaper and more affordable compared to contemporary superspecialties like neurosurgery and cancer surgery. The majority of plastic surgery operations are possible in small nursing homes, and this is the best solution for the plastic surgery patient as it will provide personalized care, improve the results, and cut unnecessary expenses.

Insurance and Coverage

Myth: Plastic surgery is not reimbursed under mediclaim insurance.

Fact: The majority of plastic surgeries are reimbursed under mediclaim insurance. This includes surgeries for trauma (accidents), including hand injuries and facial injuries, burns, burn deformities, reconstructive surgery for cancer, diabetic foot infection, major infections of legs and feet, hand surgery, etc. Only surgeries for beautification (cosmetic surgery) and surgeries for birth defects (congenital problems) are not reimbursed under mediclaim insurance.

Scope of Plastic Surgery

Myth: Plastic surgery is only related to skin treatments and skin surgery.

Fact: Plastic surgery is a very vast field in which not only the skin but all the important structures beneath the skin, including muscles, tendons, blood vessels, nerves, and bones, are also treated. A plastic surgeon is trained to deal with transfers of different tissues of the body, coverage of various important structures, replenish extensive tissue losses, and restore functions of important body parts like eyelids, thumb, mouth, etc.

Myth: Most plastic surgeries are related only to skin replacement or skin transfer.

Fact: Yes, skin replacement or skin grafting (transfer) is one of the main basic operations of plastic surgery, but the complete spectrum of plastic surgery is much more than skin grafting and it includes many wonderful and life-changing operations. To understand the scope of plastic surgery, one needs to understand how the training of a plastic surgeon is different from other fields of medicine. After completion of post-graduation in M.S. – General surgery, one has to undergo rigorous three-year superspecialty residency training. These three years of residency training inculcate two of the most important qualities in a plastic surgeon; 1) patience, & 2) delicate tissue handling. Whether the student has imbibed these two essential qualities or not, is tested at the end of three-year training period by an examination. After clearing this final qualifying examination, one is conferred with the degree of M.Ch. – plastic surgeon in India. With the help of vast anatomical knowledge, patience during the operation, and delicate tissue handling, a plastic surgeon can handle complex situations of hand, face, leg, or other injuries.

Not only acute injuries, but a plastic surgeon has an excellent capacity to reconstruct lost/damaged tissues. Apart from injuries, infection of soft tissues (tissues other than bone) is another area of expertise of a plastic surgeon. Starting from a simple boil, or furuncle, to extensive infections of the leg, complex hand infections, diabetic foot infections, chronic nonresponsive infections like pilonidal sinus, congenital preauricular sinus, and many such complicated infections are surgically treated by the special approach of plastic surgery. After injury and infection come birth defects (congenital anomalies). Birth defects like cleft lip, cleft palate, various types of ear deformities (anotia, microtia, cryptotia prominent ear), nose deformities, jaw bone deformities, tongue tie, eyelid deformities like ptosis, developmental problems of the breast, various hand problems present since birth (syndactyly, polydactyly, thumb aplasia, radial club hand), birth problems of the lower limbs, vascular lesions like hemangiomas and malformations, birth problems of male and female external genitalia (hypospadias, epispadias, vaginal agenesis, imperforate hymen), and many such complex conditions are solved completely or up to the maximum possible extent by a plastic surgeon.

Reconstruction is a technique that is used by a plastic surgeon to solve multiple problems, as described above. Post-cancer removal defects, post-accident, post-burn, or post-massive infection defects are best covered by the reconstructive approach of plastic surgery. Microvascular surgery is one of the most important tools of a plastic surgeon, which he employs for reconstruction. Timely and precise application of microvascular surgery can save lives and limbs as well as enhance the beauty of reconstruction by many folds. Added to this, microvascular surgery saves patients from certain unavoidable difficulties associated with conventional reconstructive methods used by plastic surgeons.

Thus, a plastic surgeon can reconstruct a socket for eye, he can reconstruct the deformed or destroyed nose, can reconstruct the ear which is absent since birth or improvise the shape of deformed ear, can help the patient with droopy eyelid to elevate them, can reconstruct the jaw (from leg bone) removed during cancer surgery, can reconstruct the undeveloped breast or change the size and help patient in improving appearance of the breast, can reconstruct the amputated or absent thumb, can straighten the deformed hand and improve its function, can carefully remove the extremely dangerous vascular swellings and permanently cure the patient of them, can reconstruct the absent urethra with straightening of penis which is an essential requirement for a male child, help a girl with absent vaginal passage by reconstructing a vaginal passage from her own body tissues which is functional and save her marriage life, can help a diabetic patient to save his life by timely and radical debridement and save his limb with reconstruction, can solve a seemingly smaller yet very disturbing problem like ingrown toenail. The list can still go on. In short, plastic surgeries are much more than skin grafting or skin transfer.

Myth: Are plastic surgeons experts in using any special type of plastic? That is why they are called “plastic” surgeons.

Fact: No. To understand the meaning of plastic surgery, we need to know the origin of the word “plastic.” As many words in the English language are derived from ancient languages, the same is true with the word, plastic. In the Greek language, there was a word called “plastikos”, which meant capable of molding or changing shape. A surgical discipline that developed an inherent ability to change the shape of tissues and reconstruct something of vital importance to the body thus became known as plastic surgery.

Myth: It is possible to change one’s face completely by plastic surgery.

Fact: Plastic surgery can change disproportionate parts of the face like the nose, chin, cheekbones, etc. It can bring harmony in the proportions of different parts of the face and thus, plastic surgery can restore the aesthetic balance of the face. But, it is not possible to change any person’s face completely, as shown in movies.

Myth: Plastic surgery is a scarless surgery.

Fact: Any surgery on the human body always leaves scars. However, plastic surgery is falsely popular as scarless surgery because of its special ability to hide the scars. There are some obvious lines on our body called relaxed skin tension lines. These lines are present everywhere on the body, even at` sites where they are invisible. Surgical incisions made parallel to these lines have the least possibility of being conspicuous. Apart from the selection of incision lines, a plastic surgeon has excellent dissection and suturing skills in surgery. Because of all these abilities of a plastic surgeon, the incisions made by a plastic surgeon are least visible; to the extent they sometimes become invisible. That is the reason for the above-mentioned false belief.

Myth: In case of facial injury, anyone (including compounder or ward boy) can suture the wound. The resultant ugly scar after this emergency surgery can be erased by plastic surgery after a few weeks or months.

Fact: The first half of this sentence is true. Any person who has enough work experience can suture the wound in an emergency and help the patient. But, this hastily done emergency work can result in a bad and ugly scar that can never be erased by a plastic surgeon at a later date. Instead, the best thing to do is to get the wound sutured by a plastic surgeon in an emergency. Even if someone has sutured it inappropriately, reopening the stitches and revision suturing by a plastic surgeon, preferably within 48 hours of the injury, can produce miraculous results.

Do you still have any questions about plastic surgery? Call us at +91 97259 99526 to book a consultation with Dr. Chintan Patel (a plastic surgeon) to discuss how you might benefit from plastic and cosmetic surgery.

The post Myths and Facts About Plastic Surgery appeared first on Cutis.

Understanding the critical nature of his condition, the patient underwent a meticulous surgical procedure to release his multiple finger contractures. The surgery, performed under tourniquet control and with magnification to protect tiny nerves and blood vessels, involved using the patient’s own skin harvested from his thigh to cover the resultant defects. Post-surgery, the patient’s hand was carefully wrapped in a dressing and supported by a splint to ensure proper healing.

The post-operative care was thorough, following strict protocols alongside regular follow-up and physiotherapy sessions. These efforts were crucial in helping him regain full functionality of his hand, allowing him to flex and extend his fingers completely. The successful outcome of this surgery highlights the profound impact of timely and expert surgical intervention in treating severe burn injuries and restoring quality of life.

The successful surgical treatment of the young man’s post-burn hand deformity underscores the importance of expert care in burn recovery. Through meticulous surgery and dedicated aftercare, including physiotherapy, he regained the full functionality of his hand, highlighting the transformative potential of specialized medical intervention in overcoming complex burn injuries.

The post Post-burn hand deformity appeared first on Cutis.

In this case, we highlight a low flow vascular malformation in a 12-year-old boy’s left hand. The condition first became apparent when he was three years old, initially presenting as a small swelling over his wrist that would recede upon raising the arm. Over time, however, the swelling increased in size and permanence, no longer diminishing when the arm was lifted, and the skin over the affected area turned a dark bluish color. Surgical intervention was ideal when the swelling began to increase, but due to delays, the malformation had grown significantly by the time the child was brought to our facility, extending from his forearm to his wrist and palm, and impacting essential tendons, muscles, and nerves.

The surgical removal of the malformation was conducted with meticulous care under anesthesia. Utilizing a tourniquet to control bleeding and loupes for magnification, we navigated the complex network of vital structures to remove the malformation completely. This procedure demanded extreme precision and patience to ensure that all affected areas were addressed without compromising the child’s limb functionality.

Conclusion

The successful resolution of this challenging case underscores the importance of early detection and timely medical intervention in managing vascular malformations. While the surgery left a scar, it was a small price to pay for the complete eradication of the malformation and the preservation of normal function in the child’s hand, illustrating the potential for positive outcomes even in complex cases.

The post Vascular malformation of hand appeared first on Cutis.

Case Background: Krish’s Story

We will refer to the child as Krish. Like many kids his age, Krish is hyperactive and curious, always eager to touch and explore anything new. One day, he accidentally injured the back of his fourth (ring) finger on his right hand with a knife, causing a deep cut. Living in a remote village with no immediate access to medical facilities, his mother quickly applied a tight bandage to his injured finger. Fortunately, the deep wound healed over the next couple of weeks. However, after the wound had healed, Krish’s mother noticed that he was unable to lift the terminal joint of his injured ring finger.

When Krish was brought to Cutis Hospital, he was diagnosed with a zone 1 extensor tendon injury in his right ring finger. Zone 1 injuries are among the most challenging to repair, even when treated within 6-12 hours of injury. Krish, however, was brought to us on the 22nd day post-injury. This presented numerous challenges: an untreated 22-day-old injury, a difficult zone 1 extensor tendon injury, and a young, hyperactive, and uncooperative patient. Despite these odds, we decided to give it our best effort and attempt the repair.

The Surgical Approach

The scar from Krish’s injury was carefully reopened under anesthesia, using magnification. A minimal and gentle dissection was performed, and the damaged tendon ends were delicately repaired with fine suture material. At the end of the operation, a plaster of Paris splint was applied to immobilize and protect the operated finger and hand.

One of the significant postoperative challenges was keeping the splint in place for the mandatory 6-week period required after an extensor tendon repair. Krish, being a typical 5-year-old, managed to break the splint twice, and we had to reapply it both times. However, with perseverance, we managed to keep it on for the full duration.

Recovery and Outcome

After 6 weeks, the splint was removed, and Krish was asked to gently move his finger. To our delight, he did so without hesitation or fear of breaking the repair. Over the next 10 days, Krish’s finger regained nearly normal movements and functionality.

Achieving such an exceptional result in these circumstances was a combination of multiple factors: Krish’s young age, the initial sharp nature of the injury, the precise execution of the surgery, and a bit of good luck.

Conclusion

This case highlights the complexity and importance of timely and skilled intervention in tendon injuries, even when circumstances are less than ideal. Krish’s story serves as a testament to the effectiveness of expert surgical care, the resilience of young patients, and the potential for full recovery with the right approach. For parents and caregivers, it also underscores the importance of seeking specialized care as soon as possible, even if an injury seems to have healed on the surface. We are thrilled with Krish’s recovery, which demonstrates how a combination of skill, patience, and perseverance can overcome even the most challenging cases.

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The main challenge in treating Romberg’s disease is that a plastic surgeon cannot attempt to correct facial disfigurement until the disease has stopped progressing. Once the progression ceases, the deformity can be assessed, and a reconstructive plan can be developed. Traditionally, the soft tissue (muscles and fat) deficit was addressed using various types of tissue transferred from the patient’s own body, such as de-epithelialized skin, skin and fat, and different flaps. However, in recent years, autologous fat—fat harvested from the patient’s own body—has become a highly effective alternative for reconstructing soft tissue deficits in patients with Romberg’s disease.

Case Study: Autologous Fat Injection for Romberg’s Disease

Here we present the case of a 19-year-old patient diagnosed with Romberg’s disease. We waited for over a year until the disease had fully burned out. Once it stabilized, we planned the reconstruction using autologous fat injection. Under anesthesia, the patient’s fat was harvested from the abdominal wall. After a process of mechanical preparation, the fat was injected using a special cannula beneath the skin of the affected area on the face.

Immediately after the procedure, both sides of the patient’s face appeared symmetrical, with no visible sign of the previous deficit. However, it is important to note that over 50% of the injected fat typically gets reabsorbed by the body within the next 45 days, making it necessary to repeat the procedure 2-3 times. While the need for multiple sessions can be seen as a downside, this method is very safe and does not pose any long-term issues, even years down the line.

Apart from filling in the atrophied (shrunken) tissues, the injected fat also brings new blood supply to the overlying skin, which greatly improves the luster, texture, and color of the skin. This is a significant advantage because it enhances the patient’s self-confidence, making the overall outcome much more satisfying.

Conclusion

Autologous fat injection is a novel and effective approach to treating soft tissue deficits in patients with Romberg’s disease. While the procedure may require multiple sessions, it offers several advantages, including safety, improved skin texture, and natural-looking results. This treatment not only restores facial symmetry but also boosts the self-esteem of those affected. If you are dealing with Romberg’s disease and are seeking to restore facial harmony, autologous fat injection could be the solution you’ve been looking for.

If you are suffering from Romberg’s disease and want to enhance your facial harmony, please contact us at +91 97259 99526. for more details.

The post Autologous fat injection: A novel approach of treatment for Romberg’s disease appeared first on Cutis.