Scar Surgery - Chiang Mai

[iang]

Can anyone give any recommendations for a good & reputable plastic surgeon or hospital (doing plastic surgery) in Chiang Mai? My wife has a substantial vaccination scar on one arm. This is about 4 - 5 cm long / 2 -3 cm wide and raised in profile. Aside from making her self concious, it also itches constantly and apears to be growing! Clearly surgery is needed on the scar, which is going to (I imagine) require tissue replacement once the scar has been removed.

Not a pleasant thought! Has anyone had experince of this sort of thing and / or can make a recommendation as to a quality plastic surgeon - either at a private clinic or a reputable hospital in Chiang Mai?

[cathyy]

What type of vaccination scar is this? The only vaccination I know that leaves a scar is smallpox. The smallpox vaccination scar is indented, not raised. What your wife has sounds eerily to me like a skin cancer of some kind. It itches, it's growing, it's bigger than the eraser of a pencil in diameter...three of the top signs. Get her to a dermatologist NOW.

[iang]

Thanks Cathyy for your comments. You've got me worried now! I'm pretty certain it's a smallpox scar - I know that a normal scar is indented - have one myself.

She's had the scar for as long as he can remember however she says it has increased in size over the years. I've taken her on a couple of occasions to see a doctor and on one occasion to a hospital to have it examined.

The advise we've had so far is that it is a smallpox innoculation scar which as formed as a result of a combination of poor quality (or poor quality control of the) vaccine, together with a probable untreated secondary bacterial infection or abnormal reaction as a result of poor follow up screening. It's quite common here in Thailand and you see quite a lot of people with various degrees of similar raised red scarring.

A couple of years back, a doctor started a series of injections into the scar which was supped to help however aside from being very painful, resulted in the discolouration in the skin in the immediate area. As a result, the tratment was never completed. The hospital made reference to fibrous tissue & recommended surgery to remove it. We didn't have the confidence in the hospital to achieve this without further scarring and a resultant depression in the arm where the tissue would need to be removed, hence the call for referrals for a plastic surgeon or a recommended hospital & surgeon in Chiang Mai?

With what you've said though, I will certainly have this checked out too, just to be on the safe side & am most grateful for your advise and for anyone else's further input.

[cathyy]

Sounds like a keloid scar, then. Those are a pain. Ugly and very difficult to remove; the keloid tends to recur at the incision as it heals, but harmless.

[iang]

Thanks Cathyy. I've done some reading on the internet and that exactly what it is, a large and unattractive Keloid Scar! Thank you so much for this - at least I now know more about what we're dealing with! You seem to know what you're talking about!

The reading I've done hasn't been terribly encouraging - evidently in 50% of instances, keloid scars regrow / reform / reappear after surgery & sometimes the new scar can be worse / bigger than the one removed!

It's really hard to know where to go from here. There is a keloid sufferers forum & many on this speak of a Chinese herbal remedy available from Singapore www.thejamushop.com but I think I need to do more research first.

Any further input from you or others on this forum would be gratefully appreciated.

[ProThaiExpat]

I have consulted a plastic surgeon and a dermatologist at Rama 1 hospital in the last week and have concluded that Bangkok is the place to have any plastic surgery done,

I am impressed with the Yanee Hospital web site but Brumregard hospital is probably the best. Your talking about a outpatient proceedure, so a quick flight down and back would do it and when you are talking about this type of surgery, err in the direction of excellent care.

A keloid scar may wll be the problem, however, small pox vaccination scars are not keloid scars. Your wife may have developed a keloid formation after the injections.

One of the skills of a plast surgeon is the minimization of scars resulting from their work.

A keloid scard forming at the scene of a lacerationg, even when medical care was given, is not in the same league with a plastic surgeon's residual scar after surgery, especially when the purpose of the surgery was to remove the keloid.

Don't jump to any conclusions regarding your wife's ability to minimize the current condition through corrective surgery.

Go to Bangkok, consult with a dermantologist and a plastic surgeoon.

Laser treatment by dermatologists is far more advanced than it was only three years ago. After all, you are talking about a skin condition.

However, if surgical intervention is suggested, I would have a plastic man make the incision, not a dermatologist.

Since laser work results in the killing off of varying layers of dermis, keloid formation is far more likely than if the existing skin is excised and the healthy edges of the existing skin are drawn together and joined through stitching, as is done in a face lift. The age and skin tone of your wife will be important. If the skin on her arm is looser than on a young person, the "skin lift" may be far more viable.

Also, I have compared prices, and Rama 1 is not appreciatively cheaper than Yanee Hospital. In fact, I was quoted 75k for a chin lift, priced at 40k at Yanee.

I suspect you wont have to pay any more than 40k baht, and probably less for your wifes surger.

Good luck.

[iang]

Many thanks for your input ProThaiExpat. A good suggestion - we have to be in Bangkok in a few weeks time for business reasons anyway, so I can't imagine that after all this time, another few weeks wait would be an issue. Will make an appointment in advance.

Another consultation isn't going to hurt things and I'm a lot more educated on the problem than before, which should also be a help in asking the right questions!

[cathyy]

There's a new product on the market in the US for minimizing/reducing scars. It's like a band-aid, you just apply it to the scar. It's the same stuff plastic surgeons use to reduce scarring after surgery. It won't make a scar go away, but it will make it smaller and less noticeable, not so red and raised. You might want to look into that before having surgery. I don't know if it is supposed to work on keloid scars. Maybe I'll hunt it down on the Internet...

[farangene]

There's a new product on the market in the US for minimizing/reducing scars. It's like a band-aid, you just apply it to the scar.

That band-aid stuff is available in Bangkok. I saw it at a pharmacy on Sukhumvit near the Emporium. Thought it was expensive but dont recall the price. I know it is also available in hospitals so you might ask a doctor if you cant find it.

Maybe I am wrong but I thought it was for new scar tissue from recent operations, not old ones.