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-   Help and Resources for Hemangiomas (http://birthmark.org/board/forumdisplay.php?f=9)
-   -   Scar management (http://birthmark.org/board/showthread.php?t=3574)

mjwrw 10-30-2009 10:49 PM

Scar management
 
Hi everyone,
My daughter had a large hemangioma in the center of her forehead that was removed when she was 13 months old. Dr. Reinisch did an amazing job but it seems that as she is getting older her scar is becoming a bit more pronounced, or at least it seems, maybe it is just because she is bigger. I was wondering if anyone had any insight or advice into managing the scar as she gets older. I know there are products on the market such as Maderma that are touted to help with scarring but does anyone have any experience with this or any thoughts on it?
Any advice would be great. Thanks!!
Rory

missy 10-30-2009 10:55 PM

I have used Maderma on scars before and had success with it. With my kids, the scars they had are disappearing as they grow. My little one had a very bad scar over his eye, but you can't even see it now (4+ years)

Missy

CarrieChris 11-05-2009 01:58 AM

scars
 
I have found that scars tend to stretch out as the child grows. They lighten to a white color but my son has a scar that was about 1 inch when he was a baby and it is now about 2 inches long at 11 years old.

I have recently found a product called Scarprin that I am using on my daughters scars from her hemangioma surgeries on her cheek. It's a silicone gel and gets good reviews. I haven't been using it long enough to let you know how well it's working, but you could check that out. Silicone is supposed to be the best for scars.

Best of luck!
Carrie

Clare 11-07-2009 12:24 AM

rory,
my daughter also has a forehead H and we're scheduled for surgery dec 16, she will just be 12 months. if possible, i'd love to see pictures before and after to know what maybe to expect?? my email is claremclellan@gmail.com if that's sometihng you would do, or post here? thanks, and good luck with the scar.

Mkat 02-16-2010 07:17 PM

Scarring Post Surgery
 
Can anyone tell me of their experience with scarring after a hemangioma excision from the forehead? I'm curious about what to expect as the scar heals.
Thanks

3GirlsforMe 08-28-2010 04:55 AM

My daughter had a forehead hemangioma, removed at 8 months with Dr. Reinisch as well. Her scar also looked great at first, and as time progresses, is actually looking worse. She is 2 years post-op now. She has very prominent dog ears (points on either end of the scar) that I was never advised could potentially happen with this type of excision, to my disappointment. I am now seeking scar revision therapy with Dr. Nelson at UCI. I wish I had explored more laser treatment options at first and not gone with such a definitive treatment right out of the gate. As one of the moderators posted, Dr. Waner paraphrasing said, "surgeons like to cut, dermatologists prescribe meds, and laser surgeons do lasers". Doctors recommend what they know best, but it's not necessarily best for your child. You really have to weigh everything and go with your gut. I was strongly encouraged to excise her hamangioma as this option, I was told, was the best option for my daughter's size and location. I wrestle with the decision every day. Now that I am left with an undesirable scar and I see a lot of other people's success with lasers, I wish I had known about other doctors and experiences. I am hopeful that Dr. Nelson can improve her remaining scar.

CarrieChris 09-08-2010 01:31 PM

Scars..... Unfortunately, there will always be a scar if the little ones had surgery or if they had ulcerations. In time they change colors, lighten, stretch out, smoothe out on their own. BUT that isn't always enough. I know that it won't be enough for Bella's incisions since she has so many on the face. I think in her case it will be lasering that will help. I use the other products faithfully and things have been the same over the past year. They may have helped, definitely didn't hurt, but really not a miracle.
Carrie

mkrzarmomma2 09-09-2010 01:20 PM

My daughter had her ulcerated deep muscle hemangioma removed in May. Then you could not even see a scar. Now you can notice it a little more, but still not bad. Her plastic surgeon has encouraged use of mederma and biooil. We are lucky that hers is in a spot that is mostly hidden in a neck crease, but we still do not want major scarring for when she is older.

walkershane123 07-06-2011 12:19 PM

Remedies
 
As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. With this in mind, a scar management program has been adopted based on the modalities of wound support, hydration, and hastened maturity, all factors gleaned from scientific evidence published over the past 25 years. Tension on a scar in one axis will result in a stretched scar, probably initiated by neutrophils and their neutral proteases [18,26]. Tension on a scar from many directions or intermittently will result in a hypertrophic scar, possibly initiated by lymphocytes but definitely related to a prolongation of the inflammatory process, with increased fibroblast activity and overabundant extracellular matrix secretion [24,26]. The common initiating factor is the tension on the scar, and the critical element needed to counteract this tension is scar support. Clinical experience has shown us that the most reliable way to support a scar is by using microporous tape. Hydration is a second beneficial influence on scar control and is the basis of the use of silicone sheeting and gel [7,29,36]. Alpha Centella cream has two main components. The first is an extract from the plant Bulbine frutescens. This increases hydration under the tape by leaving a layer of fatty vesicles of glycoprotein on the skin surface. This also has antibacterial properties. The second component is the principal terpenoids extracted from the Centella asiatica plant. These include asiatic acid, madecassic acid, and asiaticoside. Centella asiatica has been documented to aid wound healing in a large number of scientific reports [5,12,21,22,33,34,40]. The most beneficial effect appears to be the stimulation of maturation of the scar by the production of type I collagen [4,19] and the resulting decrease in the inflammatory reaction and myofibroblast production. Thus these components have been incorporated into the formulation of a scar management program. This publication reviews much of the available literature relating to scar management and describes the formulation and use of a scar management program based on this information.

mjwrw 07-15-2011 09:18 PM

Hi again
 
I have clearly not logged into this discussion forum in a very long time. I am very sorry to those of you who posed questions to me and I did not get back to you.
Also, I am in no way disappointed in the results of the surgery Dr. Reinisch performed on our daughter. I think he did an amazing job and was a wonderful doctor to work with. Our daughter had a very large hemangioma and I cannot expect it to be completely erased. I am grateful to those of you who posed some new ideas for the scar management--thank you. Overall, my daughter is beautiful and we never even get questions about her scar unless I mention it. This stands in stark contrast to the horrible things people used to say to us before her surgery.
I will post some before and after pictures in a separate post (I can't seem to figure out howto do it on the iPad!) Louise was 13 months old at the time of surgery and she just turned 5 last month. It is truly amazing how something that used to absorb my thoughts and worries is very rarely on my radar these days at all--hence my reason fo rnot logging in recently!
Thank you so much for all of your thoughts. I will try to be better at logging on and hope to help some others who arpeggio where I was several years ago. Good luck to all of you!


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