Scars are common and vary from mild to severe. They are the natural result of healing of injury which can be as a result of infection, trauma, burns or other causes. When scars are severe it can lead to cosmetic and functional problems. These, in turn, can cause psychological impairment of the affected individual. Even though it is impossible to completely eliminate scars, it is possible to improve them.

The various procedures for improvement of scars range from less invasive techniques to surgical correction. Each of these procedure has certain advantages and disadvantages compared to others. So a technique that may be effective in a certain type of scar may not have a similar benefit in another. It is seldom one approach suits all. Less invasive techniques include dermabrasion, peels, and LASERS.  These are useful for mostly superficial scars. Superficial scars do not involve all the layers of skin. 

Type of scars amenable to surgical procedures
Such type of scars would include the following
1. Deep scars  
2. Contractures (scars with distortion of surrounding structures)

Deep scars involve most of the layers of skin. In some cases,  scars can draw attention due to their orientation across the natural skin creases (lines). 
Contractures occur due to the progressive contraction of scar tissue. Across mobile areas like joints, these contractures can limit the movement. For example, a burn contracture across the fingers can reduce the function of the hand. During surgical correction, these contractures are first removed and the resulting wound is covered with a graft or flap such that free movement is possible across the joints. 

Treatment options for surgical correction of scars 
The goal of plastic surgery would be an improvement in appearance and function. This is brought about by redistribution of tissues. The most commonly applied techniques include, 

Scar revision: During scar revision the scar is removed and neighboring tissues are brought together. Stretched out scars can be narrowed down with an approximation of dermis. A straight line scar can be broken down for a more pleasing outcome. In mild contractures, Z-plasty and Y-V plasty can be used for scar lengthening and functional relief. Most of these cases are carried out as outpatient procedures and patients can return home soon afterward. 

Serial excision: Sometimes it may not be possible to remove an entire scar and close the wound by approximation of the neighboring tissues. In such situations, it may be possible to remove the scar in stages. This is commonly adopted for removal of burn scars and naevi. 

Split thickness skin grafts: This is indicated when large areas need to be covered after a release of extensive contractures. Skin grafts are obtained from the top layers of skin and transferred for coverage of wounds. An advantage is the ability to cover large wounds in a single stage. The release of burn contractures and coverage with split thickness skin grafts result in a dramatic improvement of function. Skin grafts are usually obtained from lower extremity. The donor site heals by itself. 

Full thickness skin grafts: The full thickness of skin is used to cover the wounds following removal of the scar. These are cosmetically superior compared to split thickness skin grafts. Full-thickness grafts are limited by the limited availability.  The donor site can usually be managed with straight line closure. 

Flaps: Flap surgery involves recruitment of neighboring or distant tissue with its blood supply for coverage of the wounds. They have the advantage of mobilization of tissues with similar texture and appearance. 

Tissue expanders: These are inflatable devices placed under the skin and adjacent to a scar. Once the operated site heals, these expanders are gradually inflated with saline. Over a period of time, this leads to stretching of the overlying skin. Once an adequate expansion is achieved the expanders are removed and the redundant skin is used to cover the wound after removal of the scar. Tissue expanders are useful in coverage of large areas with tissues similar to the native tissue. 

Timing to undergo plastic surgery for scar improvement
It is advisable to undertake surgery once the scar has matured. This can take more than a year. During this time, the scar tends to become soft and supple. An exception to this would be cases with contractures causing significant impairment of function. For example, a scar of the neck which prevents the patient from carrying out daily activities needs early release and coverage. Patients should be in good health at the time of any elective surgery. 

Recovery following scar revision 
Most of the procedures are outpatient or short stay procedures. Depending upon the location and extent of the procedure, anesthesia can be local or general anesthesia. Patients need to follow up regularly after surgery. Use of silicone sheet, splints, and pressure garments form a part of the post-operative management. 

Benefits of undergoing surgical scar revision 
These would include, 
1. Improvement in appearance and function.
2. Improved confidence and self-esteem. 

​To learn more about scars, click here. 

Understanding Burn First Aid: A Critical Guide

Burns can happen unexpectedly, and knowing how to respond quickly and effectively can make a significant difference in the outcome. At Amicus Clinic, we believe in empowering our community with essential first aid knowledge. Here's a detailed explanation of the steps to take when dealing with burns:

1. Stop the Burning Process:
The first and most crucial step is to eliminate the source of the burn. If clothing is on fire, remember the "stop, drop, and roll" technique. This helps smother the flames quickly and effectively.

2. Cool the Affected Area:
Immediately after stopping the burn, cooling the area is vital. Use cool (not cold) running water for up to 20 minutes. This helps to dissipate the heat and minimize tissue damage. Avoid using ice, as it can cause further harm to the burned skin.

3. Protect the Burn:
Once cooled, cover the burn with a clean, dry cloth or sterile non-stick bandage. This helps prevent infection and protects the sensitive burned area from further irritation.

4. Seek Professional Medical Care:
Even if the burn seems minor, it's crucial to get it evaluated by a medical professional. Burns can be deceptive, and proper assessment ensures appropriate treatment.

Remember, these steps are for initial first aid. The severity of burns can vary greatly, and professional medical evaluation is always recommended. At Amicus Clinic, we're equipped to provide expert care for burn injuries, from assessment to advanced treatments and reconstructive procedures if necessary.

For more information on burn care or to consult with our specialists, visit www.amicusclinic.in. Your safety and well-being are our top priorities.

Stay informed, stay safe, and remember – in case of severe burns, always call emergency services immediately.

What are keloids?
They are prominent scars which grow beyond the boundaries of the original wound. They can follow trauma, infection, burns or any other type of injury. 

What are the symptoms of keloids?
They are commonly associated with the following,
1. Pain
2. Itching
3. Cosmetic deformity

What causes keloids?
The exact reasons are not known. It has been found to occur in all types of skin. It is less common among elderly. A tendency for keloid scarring is known to run in families. 

What are the most common sites of keloids?
These include,
1. Ear lobes
2. Chest
3. Back
4. Jawline

What are the treatment options for keloids?
Large keloids are more difficult to treat when compared to smaller ones. The treatment options include,
1. Intralesional injection of steroids: These have to be repeated at regular intervals for improvement in appearance and texture. 
2. Silicone sheet application: Silicone sheets have to be applied for prolonged periods. 
3. Pressure garment: These can be applied with the help of a custom made garment. 
4. Radiotherapy
5. Intralesional injection of 5 fluorouracil
6. Surgery 

The combination of more than one modality of treatment is advised in case of large keloids. Surgery is useful for debulking ( reducing the size ) a keloid. It has to be followed up with another modality like intralesional injections or use of pressure garment. 

What is the role of prevention?
The possibility of keloid formation following surgery should be borne in mind in persons with a tendency for keloid formation. Measures such as the use of silicone sheet and pressure garment are advised early in the post operative period. 

To learn more about other types of scars, click here.Scar revision

A dimple is considered as cute by many. In some cultures, it is regarded a sign of good luck and prosperity. It results from a difference in the insertion of a cheek muscle into the overlying cheek skin. It can be found on one or both sides of a cheek. In case one does not have a dimple, it is possible to get one with the help of a short plastic surgery procedure. After the small surgery, the individual can soon return home.
Creating a dimple begins with a consultation when the patient and doctor together decide on the location of the dimple. Once the position has been marked the doctor anesthetizes the site by injection of a local anesthetic. An incision is placed inside the cheek and a small bit of tissue is removed between the skin and the muscle. A dissolving stitch is used to tether the dermis of the cheek to the underlying muscle. The incision inside the mouth is closed with dissolving stitches. Medications are prescribed for the discomfort which may last for a few days. Antibiotics are advised for five days.
Initially, the dimple is seen at rest. As the suture dissolves, the dimple becomes evident only during a smile. During this period scar tissue that forms between the cheek and the muscle is responsible for the dimpling. It is not possible to precisely control the depth of a dimple due to the presence of multiple factors that affect wound healing. In some cases, the dimple may be shallow and can be made deeper with the help of a revision procedure. It is difficult to undo a dimple once it has been created. This should be borne in mind before undertaking the procedure.

Discover Youthful Radiance with Amicus Clinic's Anti-Aging Treatments

At Amicus Clinic, we understand that aging is a natural process, but that doesn't mean you can't look and feel your best at any age. Our comprehensive range of anti-aging treatments for the face is designed to rejuvenate your appearance and boost your confidence.

We offer both surgical and non-surgical options to cater to your individual needs and preferences:

Surgical Treatments:
1. Brow Lift: Elevate drooping eyebrows for a more alert and youthful look.
2. Blepharoplasty: Rejuvenate tired-looking eyes by addressing excess skin and fat in the eyelids.
3. Face and Neck Lift: Tighten sagging skin and reduce signs of aging in the lower face and neck area.
4. Fat Transfer: Restore volume to sunken areas using your own fat for a natural-looking enhancement.

Non-Surgical Treatments:
1. Filler Injections: Restore volume and contour to various areas of the face for a more youthful appearance.
2. Creams: Topical treatments to improve skin texture and address specific skin concerns.
3. Resurfacing Procedures: Revitalize your skin's surface for a smoother, more radiant complexion.

Our experienced team at Amicus Clinic will work with you to create a personalized treatment plan that addresses your unique concerns and goals. Whether you're looking for subtle enhancements or more dramatic results, we have the expertise to help you achieve the refreshed, youthful look you desire.

Visit www.amicusclinic.in or contact us today to schedule a consultation and take the first step towards a more youthful you. Let Amicus Clinic be your partner in turning back the clock and embracing your timeless beauty.

Proper Scar Management: Your Path to Optimal Healing

At Amicus Clinic, we understand that scars are often an unavoidable part of surgery or injury. However, with proper care, you can significantly improve their appearance and promote healthier healing. Our expert-recommended scar management tips are designed to help you achieve the best possible outcome:

1. Sun Protection: Shielding your scar from harmful UV rays is crucial. Sun exposure can darken scars and slow the healing process. Use protective clothing or accessories when outdoors.

2. Gentle Massage: Regular, gentle massage of the scar area can improve circulation, reduce tightness, and help break down scar tissue. Start only after your wound has fully closed and with your doctor's approval.

3. Sunscreen Application: Even with protective clothing, applying a broad-spectrum sunscreen with at least SPF 15 is essential. This extra layer of protection helps prevent hyperpigmentation and promotes even healing.

These simple yet effective techniques can make a significant difference in your scar's appearance over time. Remember, consistency is key in scar management. Incorporate these practices into your daily routine for the best results.

For personalized advice or advanced scar treatments, we invite you to consult with our experienced team at Amicus Clinic. Our state-of-the-art facilities in Trivandrum offer comprehensive care to address your specific needs and concerns.

Visit www.amicusclinic.in to learn more about our services or to schedule a consultation. Let us help you on your journey to confident, healthy skin.

Blepharoplasty is the surgery of the eyelids. Depending on which lid is being treated it is referred to as upper or lower lid blepharoplasty. It is one of the more commonly performed cosmetic  procedures of the face. 

Our eyes are considered to be the most important aesthetic units of our face. They are considered as  windows to our soul probably because they easily reflect our level of alertness, mood, and sense of well-being. The eyes are also subject to early signs of aging. These changes reveal as extra folds of skin in the upper lid which in some advanced cases can hamper our visual fields. This may be accompanied by loss of definition of the area immediately below eyebrows. The lateral corners of eyes may shift downwards giving rise to a tired appearance. Lower lid undergoes changes as a result of the loss of support of eyelid tissues. They may shift downwards with more display of the white  below cornea. There may be baggy swellings of lower lid as a result of protrusion of fat around the eyes. The lower eyelid appears lengthened with an abrupt demarcation between lower lid and cheek. The youthful 'blending' of lower lid and cheek is lost with age.

Blepharoplasty benefits those with aging changes of the eyelids. It is also undertaken for those who need an alteration of their prominent epicanthal folds. It can also be undertaken for individuals who desire an extra fold in the upper lid.

Evaluation for blepharoplasty begins with a preoperative consultation when a patient indicates her concerns to the physician. Patients should come prepared to reveal details of the previous treatment of the eyes (for example, LASIK, use of contact lens) and systemic illnesses. The physician suggests treatment options based on changes present in the eyelids and neighboring structures. A consultation with an ophthalmologist is also arranged.  The patient is advised to stop all forms of herbal supplements and blood thinners for two weeks before the scheduled procedure. Isolated blepharoplasty of the upper lid is usually carried out under local anesthesia with sedation. More extensive procedures involving the lower lid may necessitate general anesthesia for the comfort of the patient. The choice of anesthesia is decided in consultation with the anesthetist. Patient recovery is usually rapid and she can return home the same day or the next. Sutures are pulled out by the end of the first week. Swelling starts to subside after the first 36 hours. If the surgery involved a number of steps, the swelling may take longer to subside. Patients are usually presentable at the end of second to the third week. 

When properly executed, blepharoplasty is one of the most gratifying procedures in cosmetic surgery. It gives rise to alert and youthful looking eyes. 

To learn more about other facial plastic surgery procedures, click here. 

The procedures are categorized into three main areas:

1. SKIN: This section includes non-invasive treatments such as Botox, Filler, Scar treatment, and Removal of Moles/Swellings.
2. FACE: A wide range of facial procedures are listed, including Blepharoplasty (Eyelid correction), Rhinoplasty (Nose job), Otoplasty (Prominent ear correction), Lip reduction and enlargement, Creation of dimple, Genioplasty (Chin correction), and Face and neck rejuvenation.
3. BODY: This category covers various body contouring and enhancement procedures, such as Breast Augmentation, Reduction and Lift, Gynecomastia correction (Male breast enlargement), Liposuction, Tummy tuck (Abdominoplasty), and Female genital rejuvenation.

Beauty may not be skin deep. But it is worthwhile having beautiful skin. These tips can help one look youthful and vibrant. So, what are they?

 1. Sun protection: 
Sunlight is good for the body. It helps one to get vitamin D. But too much of exposure can damage skin. It can cause photodamage with early onset of wrinkles and sagging of skin. 
One should use protective clothing and shades. Sunscreen should be a part of daily skin care. It should not be limited to trips to the beach. Sunscreen must be applied 15 to 30 minutes before exposure to the sun. It must be reapplied in case an individual is under intense sunlight for a prolonged duration or else if it gets removed.

 2. Do not smoke:
Smoking reduces blood supply to the skin. There is a narrowing of small blood vessels which deliver nutrients. It also impairs the quality of components, like collagen and elastin fibers, which make up our skin. 

 3. Eat healthy diet: 
Nutrition obtained from a healthy diet helps in repair and rebuilding of skin. Food should contain fresh fruits, vegetables, and whole grains.

 4. Regular exercise:
Research has shown that exercise helps in reducing signs of aging in individuals who start exercising late in life. It also helps one retain a youthful skin as we grow older. The exact mechanism by which exercise contributes to youthful skin is not yet clear.

 5. Gentle cleansing of skin:
Prolonged bath with harsh soaps depletes the skin of essential oils. Use of mild cleansing agents is recommended. Moisturizers are good for skin. Especially, for individuals with dry skin.

About scars:

Scars are extremely common. Often they are minor and quite inconspicuous. But sometimes they can be a reason for considerable distress. Scars result from a perfectly normal process of wound healing. Wounds could be as a result of trauma, burns, acne or many other causes.

Scars are composed of tissue which have different properties when compared to the native tissue it replaces. This leads to an alteration in appearance and function. Severe scars can end up with impaired function of the affected part. 

What determines the extent and severity of scarring?

It depends on the severity of the injury. The wounds which are deep and take longer to heal usually end up as bigger scars. It also depends on an inherent scarring tendency of an individual. Some of us tend to get prominent scars with trivial trauma. Keloids are scars which grow beyond the boundaries of the original wound. Elderly tend to get better scars than younger individuals.

Can anything be done for better scars?

During wound healing steps taken to expedite the process helps. If a wound takes a long time to heal, the resultant scar tends to be more severe. Scars are living tissues which undergo remodeling. This leads to a change in dimension as well as appearance over time. A scar once formed can be modified with various surgical and nonsurgical methods. Various activities like massage, occlusion, use of pressure garment and application of silicone sheet help in obtaining more favorable scars.

What is the role of injections in scars?

Various agents like steroids are indicated in individuals with hypertrophic scars. Persons with hypertrophic scars have red and raised scars. Steroids act by modifying the remodeling of scars. These injections are often repeated at regular intervals.
Platelet-rich plasma ( PRP) is a platelet concentrate obtained from autologous blood used in the treatment of acne and burn scars. They help by locally providing growth factors.

What is the role of surgery in treating scars?

The indications are either cosmetic or functional. Treatment options depend on the type of scars. Different factors are taken into account like pigmentation, contour abnormality, the presence of contracture and orientation of a scar in relation to neighboring landmarks. Various surgical treatments include scar revision, dermabrasion, excision and coverage with graft or flap.

What can be expected with scar revision procedures?

Better scars. When properly planned and executed they lead to a more pleasing appearance. Scars can not be totally eliminated. But it is usually possible to make them less noticeable.

When can a scar be operated?

Once the scars are mature and supple. But if there are significant functional problems, the patient may be advised to undergo an early correction. This is decided on a case to case basis.