Sara had a large congenital melanocytic nevus of her scalp and forehead. “After many years of searching and being examined by multiple surgeons who seemed to me, hesitant to do my surgery, I came across an article in the Chicago Tribune on Dr Bruce Bauer. It was my luck that a surgeon as talented and capable as Dr Dickie was working with Dr Bauer at the time and the rest is history.”
“As I got older I really became afraid that the nevus I had was going to turn cancerous, like I said I tried for years to find a surgeon that would attempt the type of surgery I needed but was not able to find anyone until Dr Dickie. It has completely changed my life in a positive way. Aesthetically I have been able to grow my hair long and actually have a hairline, something I never had before. Medically I’m thrilled that I can rest easy knowing I don’t have to worry about a large nevus turning deadly at some point in the future”
Tissue expansion is really the only way to tackle this reconstruction. Sara needed hair-bearing scalp and forehead skin and we needed to avoid pulling on the eyebrows and distorting the face.
Tissue expansion requires two or three surgeries. The first stage of surgery involves placing silicone balloons under the normal skin near the nevus, birthmark or defect. Then, over 8-14 weeks saline is added to the balloon through an injection port under the skin. As the expander fills the skin overlying the expander grows and stretches. When this is complete, the second stage of surgery is preformed. During this surgery the expanders are removed and the nevus, birthmark or scar is also removed. The expanded skin is moved into the place where the birthmark was.
“The biggest challenge for me came with the initial surgery which called for the placement of the expanders. I had some problems with pain management and nausea. This was all corrected for the second surgery. My main challenge during the expansion was managing some pain and discomfort in the injection port area. After the second surgery I did not experience any challenges.”
The benefits of tissue expansion are that a surgeon can replace like tissue with like tissue in color, thickness (the fat moves and expands along with the skin), texture and hair (scalp can be expanded); scars can be placed in optimal areas and directions to avoid distortion of anatomical structures, and the process can be repeated in cases when the nevus, birthmark or defect is especially large.
Sara had one round of tissue expansion with three expanders. She chose to work through the 12-week expansion. She shared with her coworkers her plan and experience. Expansion is a very safe method of reconstruction. Children as young as 6 months of age can undergo tissue expansion.
Following the removal of the expanders and the reconstruction. Sara pretty much looked normal. She had sutures that needed to be removed 2 weeks later. Her hair needed time to grow back around the incisions. Swelling and bruising corrected in 2-3 weeks. Today she is so happy with her choice to have her mole removed.
“All of my interactions with the staff and Doctors who assisted me were above my expectations”