A plastic surgeon has spent years mastering techniques to place scars in the most desirable location. Nevertheless there are certain areas of the body such as the back and chest which produce more severe scarring regardless of the technique used for reconstruction and closure. A keloid is an overgrown or hyperplastic scar. In some patients keloids can grow from 10 to 50 times the size of the original scar. Treatment of keloids is a difficult task although various treatment modalities are available with varying results.
Skin grafting is used when it is the best way of closing a wound or defect.
A qualified plastic surgeon has years of training to allow good judgement in deciding the best way of reconstructing a defect. A skin graft may appear to have poor color match and texture compared to the native skin, however with careful selection of a skin graft donor site these problems may be minimized. The word pedicle means that the blood supply to the flap is never divided. When the blood supply is completely divided and reattached this is called a free flap, and requires specialized skill in microvascular surgery. Rhinoplasty reshapes the nose usually to improve appearance however it may also be required to relieve breathing problems.