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Skin Grafting

Skin grafting

What is a skin graft?

A skin graft consists of skin taken from another part of the body and applied to the site where skin is missing. This might follow surgical removal of a skin cancer or a burn. A skin graft is thus a skin transplant. Skin grafts are performed by surgeons (including plastic surgeons) and by some dermatologists.

Why do you need a skin graft?

A skin graft is required when the area that has been cut out is too big to sew the edges together directly. The skin graft covers the wound and attaches itself to the cells beneath. If you didn't apply a skin graft, the area would be an open wound and take much longer to heal.

What is involved in having a skin graft?

Your dermatologist will explain to you why the skin lesion needs excision and why a skin graft is required. He or she will explain the procedure involved. You may be asked to sign a consent form indicating that you agree to and understand the procedure. Tell your doctor if you are taking any medication (particularly aspirin or warfarin, which could make you bleed more), or if you have any allergies or medical conditions. Remember to tell your doctor if you take any herbal remedies as a number of these can also lead to abnormal bleeding.

The area to be excised is marked with a coloured pen. Local anaesthetic will then be injected which will sting briefly. The dermatologist will then cut around and under the lesion with a scalpel and sharp scissors so that it is completely removed (excision biopsy). The lesion will be microscopically examined by a pathologist.

There may be some bleeding in the area from where the lesion has been removed. The doctor may coagulate the blood vessels with diathermy. This can make a hissing sound and a burning smell.

The dermatologist will measure the area of the wound to know what size to make the skin graft. A piece of skin will be shaved or cut from another part of your body (e.g. leg or arm) that is large enough to cover the wound. When possible, skin of similar thickness and colour will be selected.

The piece of skin (the graft) will be applied to the wound and secured in place with stitches. A special non stick dressing will be applied over the skin graft.

Usually this dressing is left in place for a few days until you see the dermatologist or nurse again. Make sure you have received instructions on how to care for the wound and when to get the stitches out.

Will I have a scar?

It is impossible to cut the skin without scarring in some way, so some sort of scar is inevitable. Scarring depends on what sort of skin graft has been applied and the size of the graft. Your dermatologist will try to excise the lesion and apply the skin graft carefully, to keep scarring to a minimum. He or she will explain to you what the scar is likely to look like although this can be hard to predict for certain.

You will have two scars, the scar where the skin graft has been applied and the scar from where the skin graft was taken.

Some people have an abnormal response to skin healing resulting in larger scars than usual (keloid or hypertrophic scarring).

What are the types of skin grafts?

Split skin grafts
This type of skin graft is taken by shaving the surface layers (epidermis and dermis) of the skin with a large knife called a dermatome. The shaved piece of skin is then applied to the wound. This type of skin graft is often taken from the leg. A split skin graft is often used after excision of a lesion on the lower leg.

Full thickness skin grafts
This type of skin graft is taken by removing all the layers of the skin with a scalpel (a Wolfe graft). It is done in a similar way to skin excision. The piece of skin is cut into the correct shape, then applied to the wound. This type of skin graft is often taken from the arm, neck or behind the ear. It is often used after excisions on the hand or face.

How do I look after the wound following skin grafting?

You will have two wounds, the site of the original lesion and the site where the skin graft was taken from.

Your wounds may be tender for an hour or two after the excision when the effect of the local anaesthetic wears off.

Skin grafts are very fragile and great care must be taken when looking after them. Leave the dressing in place as advised by your dermatologist. Avoid strenuous exertion and stretching of the area until the stitches are removed and for some time afterwards.

If there is any bleeding, press on the wound firmly with a folded towel without looking at it for 20 minutes. If it is still bleeding after this time, seek medical attention. Do not rub the area as this may disturb the graft.

Keep the wounds dry until your dermatologist advises that you can wash them. If the wounds become red or very painful, consult your dermatologist: they could be infected.

Does the skin graft always take?

Sometimes the skin graft doesn't stick to the wound underneath and falls off. This usually happens within the first two weeks after the procedure. It can happen for a variety of reasons including bleeding underneath the graft and wound infection. If this happens, your dermatologist will inform you what further treatment is required. It is quite normal for the graft to appear black and crusted on the surface when the dressings are removed. This does not necessarily mean it has failed

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Our goal at NYC Dermatology is to be the Tiffanys of Skin
Care. I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results. We also support our patients with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy is simple…Experience Counts and Quality Matters. Please allow me to solve your skin problems.  After all, at NYC Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.”
 
Best Regards,
 
Dr. Rothfeld
 
 
 

Botox

Wrinkles and Frown Lines


Years of squinting and frowning can leave deep wrinkles that form between the eyebrows and may extend to the bridge of the nose. Wrinkles and frown lines also may appear across the forehead and at the corners of the eyes ("crow's feet"). Dermatologists can quickly and safely inject botulinum toxin during an office visit to diminish these wrinkles and lines that create an angry or sad look and detract from a pleasant facial appearance.

What is botulinum toxin?

Botulinum toxin type A and botulinum toxin type B are purified substances, derived from a bacteria, that block muscular nerve signals. Injecting very small amounts into specific facial muscles blocks the muscle's impulse. This temporarily weakens the muscle and diminishes the unwanted lines.

Botulinum toxin has been used since 1980 to treat many muscle disorders such as lazy eye and uncontrolled blinking. It was pioneered by dermatologic surgeons for cosmetic use in 1987.

Botulinum toxin type A is specifically indicated for the lines between the eyebrows, and it also can be effectively used for "off-label" indications in other facial areas.

Once the muscle is weakened and relaxed, it cannot contract. Since there is no way to make the undesirable facial expression, the lines gradually smooth out from disuse, and new creases are prevented from forming. Other muscles such as those needed to raise the eyebrows are not affected, so a natural expression is maintained. For optimal results, botulinum toxin therapy may be used in combination with other cosmetic skin procedures such as chemical peels, laser resurfacing, and dermal fillers. Combination therapy also can help prevent the formation of new lines and wrinkles. Botulinum toxin is less useful for the smile lines around the mouth because muscle action in this area is needed for important functions such as eating and talking.

Botulinum Toxin Therapy

Before treatment, the dermatologist obtains the patient's medical history, including any medications taken. Treatment involves injecting very small amounts of botulinum toxin directly into the underlying facial muscles to relax them. A tiny needle is used; the procedure is well tolerated and takes just a few minutes with no "down time" or prolonged recovery period.

Botulinum toxin takes effect about 3 to 7 days after treatment. The improvement generally lasts about 3 to 4 months; the effect gradually fades as muscle action returns. Patients require re-injection at various intervals. With repeated treatments, atrophy (thinning) of the muscle may occur. This usually produces longer-lasting results.

Treatment Areas

Vertical lines between the eyebrows and on the bridge of the nose

  • Squint lines (crow's feet) at the corners of the eyes
  • Horizontal lines on the forehead
  • Muscle bands visible on the neck, commonly known as "turkey neck"

Are there any side effects?

Side effects are generally minimal, temporary, and typically relate to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Makeup may be applied after the treatment, but care should be taken to avoid pressing or massaging the area for several hours. A temporary headache is not uncommon after injections in the forehead area, especially after the first treatment. In rare instances, patients may develop weakness of the neighboring muscles leading to a temporary droopy brow or eyelid. All of these possible effects are mild, reversible, and self-limiting.

Other Applications

Hyperhidrosis (excessive sweating) can be treated with injections of a highly diluted form of botulinum toxin which is superficially injected directly into the underarm skin, skin on the palms of the hands, or on the soles of the feet. This weakens the action of the skin's sweat glands which are responsible for excessive perspiration. A single treatment session can provide months of relief, and injections can be repeated when the excessive perspiration returns. Twitching muscles also can be treated by injecting botulinum toxin into the appropriate muscle.

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At NYC Dermatology, our goal is to provide compassionate, medically-sound patient care. We respect the trust our patients and referring physicians place in our opinions.

  We provide a complete range of dermatology services including the most advanced treatment for skin cancer,  the most up-to-date treatment for acne, psoriasis, eczema and work related skin conditions.

We also offer many cosmetic services to reduce the effects of aging on the skin, including Botox, chemical peels,  laser treatment to remove facial veins, sclerotherapy to remove spider veins on the legs, dermal fillers, cosmetic excisions and repair, and hair removal.

Trained in Dermatology, NYC Dermatolgy by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding  Dermatologist in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist, Dr. Rothfeld  in Manhattan treats the most difficult cases until the problem clears.  Dr. Rothfeld, a Board Certified Dermatologist at NYC Dermatology in Manhattan, New York is caring, detailed, and meticulous and will never give up until the problem is cleared.  Dr. Rothfeld, a board certified dermatologist in nyc who practices Dermatology in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous and will not give up until the condition resolves.  Dr. Rothfeld is recognized as one of the best Dermatologists in NYC by the entertainment industry.

NYC Dermatology is under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist.
To enhance every aspect of your skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures..

NYC Dermatology by Board Certified  Dermatologist Dr. Gary Rothfeld  is a board certified NYC  Dermatologist with a  New York City office in Manhattan, New York  providing expert skin care, dermatology, and cosmetic dermatology services.

A board certified dermatologist in NYC specializing in dermatology and dermatologic surgery including state-of-the-art cosmetic surgical procedures, Dr. Gary Rothfeld  is known for his attention to body symmetry and his dedication to meeting patients’ personal goals. His specialties include full body liposuction using the tumescent technique, facial fat transplantation, Botulinum injection into facial lines and laser resurfacing. NYC dermatology  specializes in chemical peels, vein injections, laser, restylane, Perlane, Botox injections, JUvederm, non-surgical facelifts, collagen implantation and treatment of skin cancer.
 
As an expert in the field of dermatology and cosmetic dermatologic surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high profile national magazines.
Our goal at the manhattan office of Board Certified  Derrmatologist , Dr. Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology and Cosmetic Surgery Center in Manhattan, New York.  Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board Certified  Dermatologist at NYC Dermatology who has treated many patients in the  entertainment industry.
   Schedule an appointment at our office which provides top of the line  expert skin care, dermatology, cosmetic dermatology services, and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media  office and   including different offers and many more. We offer a variety of services from Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for a consultation.   Beauty Is Forever!  and Dr. Rothfeld  at NYC Dermatologist has over 20 years of experience with his beauty tips. 
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During your office consultation  and examination you will be provided with a detailed plan of the treatments that will benefit you most.  NYC Laser Center NYC Dermatology top laser dermatology center offering skin care, dermatolgy,cosmetic dermatology services, and laser treatments for sun damaged skin, acne, acne scars, rosacea, pigmentation, laser hair removal, broken blood vessels, as well as superficial and deep wrinkles. We offer patients in Manhattan,  services including general dermatology, wrinkle fillers such as Restylane®, Captique,  Perlane,Cosmoderm and Cosmoplast, Radiance® (radiesse) and Sculptra. We also offer Botox®, Cosmelan, Velasmooth, Fotofacial, Titan laser, Refirme, and the Fractionated Resurfacing laser. in the treatment of acne, rosacea, skin cancer and  surgery.  Dr. Rothfeld has taught numerous other physicians on the proper use of Botox®, medical hair transplants, and lasers in  the country.   Acne Photodynamic Treatment - Botox® - Botox® for Hyperhidrosis - Cellulite - Cool Laser  - Cosmelan Depigmentation Treatment - Glycolic Acid Peel - Fat Transfer - Fotofacial / IPL Fractionated Resurfacing Laser - Hair Loss - Laser Hair Removal - Liposuction -  - Surgery - Minimal Scar Technique -  Photodynamic Rejuvenation Radiance® - Restylane® - Sclerotherapy - Sculptra - Smoothbeam - Stretch Marks - SunFX - TCA Peel - Tattoo Removal - Titan Laser Facelift - V-beam Laser Treatments - Velasmooth Our cosmetic surgeon includes Dermatologist  Dr. Gary Rothfeld Board Certified Dermatologist  at NYC Dermatology.  Our NYC dermatologist offers advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer our services to Manhattan , Brooklyn, Bronx, Queens locations through our Manhattan office in NYC

Open 7 Days A Week — Se Habla Español


NYC Dermatology - Manhattan Dermatology - Skin Institute of New York - Skin Cancer Doctor- NYC Cosmetic Dermatology-  Cosmetic Dermatological Surgery - New York City - Board Certified Dermatologist

Manhattan Office 

 Dr. Gary Rothfeld
NYC Dermatology - Board Certified Dermatologist - New York, NY
30 E. 60th St. Ste. 805
Manhattan, New York 10022
212.644.9494
1.800.BLEMISH
  

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