An accident last year in August caused severe 2nd degree burn injuries to my wife (who is 30 years old) on 90% of her TBSA. She remained hospitalized for around 4 months during which she underwent several skin graft surgeries, most of which were for her arms, hands, shoulder, and legs. At the time of being discharged from the burn unit she developed calcification in both of her elbows which were operated on later (in around March and May of 2009) which have now restored her elbow movements almost to 90%. Also after being discharged from the burn unit she underwent physiotherapy for around a year and also used full body pressure garments as advised by the doctors.

Currently, she has the following main problems
1. She has developed a contracture under one of her legs at around the knee area because of which she not able to flex or bend her leg completely. Even though she is able to walk, it does create a hindrance and is at times painful as well.
2. Similar contractures have been developed around both of her shoulders and upper arms
3. And lastly the scarring on most of her body which is a lowering factor to her self esteem. The upper limbs are the worst effected part with scarring, even though other parts also have these scars of various degrees

My questions are as follows:
1. What are the options and treatments for the contractures and what are the expected outcomes of those treatment?
2. What are the possible treatments and procedures for the scars? Is it possible to minimize or remove scars through surgical or other medical procedures?
3. In your opinion, what would be durations for these procedures? Meaning, how many years should we expect would it take if we opt for these procedures?
4. What kind of expectations should we have for such procedures?

I would really appreciate your response and guidance.

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My scar, which is located on the left side angle of the mouth, is approx. 2.5cm. The scar was generated due a car accident when I was 15 years old, as doctors made stretches in the wounded area where its size was 1.3cm. I was looking for the treatment for this scar, though, in April 2007 I went for a facial surgery hospital in Kabul and they did their surgery, but its size changed to 1.8cm, due the poor quality of their surgery.

The latest surgery that have I made was about 7 to 8 months ago in one of the Afghan hospitals “Cure International”. However, this surgery has made my scar look thicker and bigger in size/shape. It might be cause of the reaction of usage (silk/nechrom) in the operation. We can refer also the reasons to a poor surgeon or it can be due the lowest equipment facilities at relevant hospital, although its clear we don’t have the latest technology in our hospitals for such treatment throughout Afghanistan…

I have attached the recent scar photo as well as the scar after the first surgery that I took in late 2007.

For your more information, we have been invited to participate on a Biosafety/Biosecurity event at Dubai and my flight has been confirmed from Jan 11 till mid Jan 2010, so I will be there available to discuss this with you from 11 Jan 09.

Your thoughts and guidance in relation to the best treatment for my face lift scar are highly appreciated before my arrival,

Thank you!

Have there been any advancements over the past few years in effective laser skin tightening for the body? I tried several rounds of Thermage with dismal results. I have lost a significant amount of weight, and am primarily concerned with the skin on my arms, above my knees, and upper stomach (I have already had a tummy tuck and thigh lift but still have loose skin).  -Helen P.

Laser treatments can erase fine lines, eliminate dark spots, remove hair and eradicate tattoos when used by a properly trained practitioner. Can lasers also dissolve fat? Dr. Jason Pozner has some surprising insights in this episode of Plastic Surgery Talk.

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A new gel for laser skin resurfacing helps reduces redness, allowing skin to look and feel better more quickly. The pretreatment gel contains vitamins, as well as additives that prevent bruising. The result, reports say, is a gel that desensitizes the skin and makes it less prone to the usual irritations. Read the full story

In the June 26, 2009 edition of Plastic Surgery News, learn about the growing trend of plastic surgery among teens, discover how Botox can affect incontinence, and find out how to avoid a common warm-weather danger you may not have considered. We’ll also boldly go to a place where doctors are using lasers to minimize bruising after surgery, and investigate a plastic surgery procedure for men that’s no joke.

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