Monday, August 19, 2013

met with the plastic surgeon today.

Today we met with Dr. Jason Miller, a plastic surgeon in Omaha who also works at UNMC.  In the photo, he is with Charlotte because he is the doctor who performed the posterior vault reconstruction on her skull back in March.  He is a respected surgeon at Children's Hospital, the Med Center and the Aesthetic Surgery Center, so he was a logical choice for our consultation today.

We learned today that:
-the incision is still a little red and a little bumpy
-the size of the sutures used were a bit big for the face
-the bumps are scare tissue
-Mike should massage the bumpy scar tissue because it can disperse the collagen
-it may flatten out after a year and "it might be OK"
-an 'acceptable' scar is thin, flat and does not draw attention

The nurses and Dr. Miller were a bit surprised that Dr. Heibel chose the closure that he did (the large jagged "T") for an elliptical defect. Doctors are always very gracious and guarded with their comments about another doctor's work, but he did say "there are some things that could have been done differently" and "I personally wouldn't have put that big of suture on the face".  He also commented that "the hematoma (bleeding) was unfortunate".   These were my sentiments exactly, and somehow it was comforting to hear them.

Of course we couldn't help asking how he might have closed the 'eliptical defect' or quarter-sized hole in Mike's head after the cancer was extracted.  He drew a little diagram showing a 'cat eye' as one option and a rhomboid flap as another option... very interesting.  I think Mike felt a little better hearing that "the hallmark of a hematoma is exquisite pain".  Mike had happened to mention how painful it was when they had to unstitch and re-suture the area because of a bleeder.

Maybe the best part of the day is that we secured the names of three excellent MOHS certified dermatologists in Omaha - that don't hesitate to send cases to a skilled plastic surgeon for closure when needed. One of these men will be Mike's new dermatologist, and we are thankful for that.

Dr. David Watts
Dr. Anthony Griess
Dr. Scott Debates

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