Burn reconstruction surgery isn’t for everyone. If you’re interested in reconstructive burn treatment, the first step is to book a consultation with one of our specialist plastic surgeons in Melbourne.

During this consultation you can discuss your goals and your expected outcome. Your surgeon will advise if your expectations are achievable and the long-term benefits of the procedure.

Remember, each individual is different, so your surgeon will determine the correct technique and treatment plan for your specific needs.

During your initial consultation the surgeon will:

• Ask you to provide a complete medical history. This will need to include details of any previous surgical procedure, past and present medical conditions and any medications or supplements you currently take.
• Conduct a physical examination.
• Advise the risks and complications associated with the burn reconstruction.

Scar revision can be undertaken in a number of ways. It may involve surgery to re-orient the scar to permit it to hide better by using existing nearby skin creases. Other times new skin may need to be imported by the use of skin grafts or flaps. In specific areas, stretching the surrounding skin using a technique called tissue expansion may allow for removal of contracted areas. These options will be discussed with you as part of your pre-operative planning.

Some specific techniques include:

Z-Plasty

In Z-plasty your surgeon will use a Z- shaped incision(s) to re-orient the direction of your scar or to break up the visible straight line of a scar to make it less obvious.

Skin grafts

Skin grafts are used when a significant amount of skin is necessary and there is not sufficient skin around the scar. Secondary burns reconstruction most commonly uses full thickness skin grafts from areas of natural laxity but thinner (Split thickness) skin grafts are still used in specific cases. Which method is used will depend on the location of the scarring and your needs.

Minor skin grafts can be done though outpatient surgery, but larger procedures using bigger grafts will need a longer stay.

Flaps

Tissue flaps are used to transfer tissue from an area of excess skin to the scarred area while preserving the blood supply to the tissue. This often leads to the best results, but is technically demanding and sufficient tissue is not always present at the site to permit flap reconstruction.

Tissue expansion

Tissue expansion can also be used for burn reconstruction. This technique involves the insertion of expandable medical devices that stretch the overlying skin as they are expanded through the injection of saline into a port on the implant. They can be particularly useful to stretch hair-bearing skin for scalp reconstruction and work best in younger, more elastic skin. Your surgeon will discuss this option with you if you have a suitable burn scar for management by tissue expansion.

There are several non-operative therapies to help improve burn scarring. These include scar massage, topical therapies and the application of pressure garments, fitted by occupational therapists.

These may be useful instead of surgery or to help following surgery.

After surgery the scar may look worse. It needs time to heal and mature.

We recommend avoiding sun exposure for a few months after your surgery. Scar tissue is more susceptible to sunburn and sun exposure can cause redness, delay healing and increase pigmentation of the scar.

If the scar is severe, you may require additional treatment over the following months.

Depending upon the severity of the original scarring, further treatment may be necessary in the following months.

We will give you specific advice regarding your individual post-operative recovery. They will advise:

• where you will go after your surgery
• what medication you will be given or prescribed
• what bandages and dressings you will need and when they’ll be removed
• if you require stitches, when they’ll be removed
• when you can get back to normal activity and exercise
• when to book your follow-up care.