When most people think about plastic surgery, they think about procedures such as lip injections, Botox, breast implants and other aesthetic or anti-aging procedures. They likely do not think about plastic surgery being used to restore form and function to the damaged skin and tissue of individuals who have suffered serious burns.
According to reports from the American Burn Association, 486,000 burns required medical treatment in the U.S. in 2016. Of this number, 16,000 required reconstructive plastic surgery to treat burn-related scarring, according to the American Society of Plastic Surgeons.
Scars from burns or other traumatic events often leave individuals with lifelong physical side effects such as chronic pain and itching.
Burn scars also often cause emotional side effects such as depression, anxiety, self-consciousness and embarrassment.
Reconstructive plastic surgery procedures used to treat burns include burn debridement, skin grafts and amputations, as well as secondary burn care, such as scar-revision treatment, skin-flap surgery and tissue expansion.
“Plastic surgery is useful for treating people who have suffered burns because plastic surgery as a medical discipline combines both aesthetic and reconstructive surgery approaches. Plastic surgeons have the training necessary to restore both form and function,” said Dr. Jack Peterson.
Peterson is a Topeka plastic surgeon who performs scar-revision treatments in addition to standard plastic surgery procedures such as breast augmentation, breast-lifts, face-lifts and liposuction.
“Plastic surgery is not just about cosmetics; it is also often about repairing damaged tissue,” Peterson said.
Damaged tissue can happen because of injuries such as burns or cuts, accidents and surgery. Plastic surgery is also used to repair deformed tissue caused by chromosomal mutations such as cleft palate.
“Many patients also visit plastic surgeons looking for solutions for acne scars,” Peterson said.
Plastic surgery approaches to treating burns and resulting scars include skin grafting, laser resurfacing, fat transfers and conventional surgery to minimize the size of scars.
The skin-grafting procedure is a conventional procedure for treating burns. During a skin graft, skin is removed from an unaffected area of the patient’s body to replace skin damaged by the burn. Although skin grafting is a standard approach to treating burns, it can result in skin scars and skin tightness that can prevent the patient from enjoying the full range of motion of the treated area.
“Using a skin graft can make the skin very tight and stiff, which means pain if patients try to move the affected area beyond what the skin will let it do. This can mean a lifetime of pain and frustration for many individuals,” Peterson said.
Laser therapy is a popular option to treat scars because it reduces the appearance of the scar and makes the stiff, scarred skin more pliable, which can give patients a greater range of motion. Laser therapy can also reduce inflammation, which means less pain for patients, Peterson said.
Fat transfer, also known as fat grafting, is also a relatively new technique gaining in popularity for burn scar treatment. During the fat-transfer procedure, fat is taken from another area of the patient’s body and injected into the skin and the nerves below. The benefits of the procedure include reduced pain and increased elasticity in the treated area.
The success rate for fat transfers is 80 percent for treating burn scars.
Other options for treating scars include steroid injections and dermal filler injections.
“There is no one-size-fits-all approach to scar revision. Every patient is different, and every scar is different and personal to each patient, so how it is handled is also personal to each patient,” Peterson said.
American Society of Plastic Surgeons. How Plastic Surgeons are Improving Quality of Life for Burn Patients. 4 February 2018.