Teplica David, Cooney Emmett, Srock Jamey, Sayers Michael
The 803 Foundation, Chicago, Ill.
Section of Plastic and Reconstructive Surgery, Department of Surgery, The University of Chicago, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2022 Jul 7;10(7):e4408. doi: 10.1097/GOX.0000000000004408. eCollection 2022 Jul.
Cosmetic outcomes are among patients' top concerns when discussing treatment options for facial nevi. Benign lesions of the face often enlarge with time, and many patients seek care to minimize the perceived deformity. Complete excision remains the frontline treatment for facial lesions, but a choice must be made between the deformity from the lesion itself and scar deformity incurred from its removal. Traditional elliptical excision results in a linear scar that is often conspicuous, while alternatives to surgical excision seek to minimize scarring but possess their own disadvantages. We report a new application for nevus reduction (subtotal or near-total excision) to diminish deformity from the lesion itself while minimizing scar visibility with a novel "irregularly irregular stellate incision" approach.
Incisions are made in a stellate pattern with irregularly irregular borders circumscribed within the lesion. Therefore, the scar is restricted to the lesion surface, while a reduction in area and projection off the skin surface can be tailored to fit the patient's wishes for any benign skin feature.
This technique has been employed with hundreds of facial lesions, with two representative cases shown. No significant complications have been observed and the method has been used on a wide variety of sizes and types of lesions.
The technique presented meets the need for minimal scarring when reducing benign lesions of the face. The method is applicable to a wide range of presentations and can also function as a method to biopsy lesions, should there be concerns about pathology.
在讨论面部痣的治疗方案时，美容效果是患者最关心的问题之一。面部的良性病变通常会随着时间而增大，许多患者寻求治疗以尽量减少可察觉到的畸形。完整切除仍然是面部病变的一线治疗方法，但必须在病变本身造成的畸形和切除病变所导致的瘢痕畸形之间做出选择。传统的椭圆形切除会产生一条往往很明显的线性瘢痕，而手术切除的替代方法试图将瘢痕最小化，但也有其自身的缺点。我们报告了一种用于痣缩小（次全或近全切除）的新方法，通过一种新颖的“不规则星状切口”方法，在减少病变本身畸形的同时，将瘢痕的可见度降至最低。
以星状模式进行切口，切口边界不规则且限定在病变范围内。因此，瘢痕被限制在病变表面，同时可以根据患者对任何良性皮肤特征的期望来调整面积缩小和皮肤表面突出度的降低。
该技术已应用于数百例面部病变，展示了两个典型病例。未观察到明显并发症，该方法已用于各种大小和类型的病变。
所介绍的技术满足了减少面部良性病变时对最小瘢痕形成的需求。该方法适用于多种表现形式，并且如果对病理情况存在疑虑，也可作为一种活检病变的方法。
