Cosmetic Surgery, Plastic Surgery, Reconstructive Surgery in New York City: Dr. Elliott Rose: Burn Reconstruction

Burn injuries account for over 100,000 hospital admissions per year. The most common age groups are toddlers (age 2 through 4) and adolescents (age 17 through 25). Injuries to the head and neck account for approximately 50% of all burn injuries.

With the opening of many specialized burn centers for acute burn injuries, death rates from severe burns have dropped significantly. Survivors, however, are often left, not only with functional impairment (e.g., drooling, neck contracture, corneal exposure, nasal airway blockage, lip incompetence), but also with a grotesque facial appearance and distortion of facial expression. The recurrent question asked by most burn victims after survival is assured and acute vital life functions of breathing, eating and the five senses are satisfied is: "Doc, when am I going to look normal again?"

The focus of Dr. Rose's clinical experience over the past 20 years has been directed toward refinement of aesthetic appearance, as well as improvement of functional limitations in severely burned patients. Skin grafts are used by conventional plastic surgeons to replace burn-damaged skin. The grafted skin (only a few cell layers thick) often leaves a "patchwork," expressionless face. The skin texture is ropey, thickened and irregular, lacking facial animation. Dr. Elliott Rose, author of a major plastic surgery textbook, Aesthetic Facial Restoration (published by Lippincott-Raven in 1998), has refined the newest methods of burn reconstruction utilizing sophisticated computer imaging, the latest methods of microsurgical tissue transfers, intra-operative skin expanders, laser technology, and custom corrective make-up matches to achieve the most comlimentary surgical outcomes.

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Your initial consultation. At the time of your initial consultation, Dr. Rose will review your history, discuss your burn deformities, and design a comprehensive protocol of your treatment plan. A complete computerized facial analysis inspects facial features for balance, symmetry and functional distortions. Areas of disfiguring scar are defined and a video image of your more normal-appearing face is digitally recreated as a preview of the desired surgical changes. Dr. Rose uses these images as a “blueprint” for surgical reconstruction.

Since many of our patients are from out of town, Nancy Slifer, our patient coordinator, will assist you in hotel accommodations, travel arrangements, etc. As a courtesy, Dr. Rose will write a comprehensive letter to your insurance carrier describing the surgical plan and request pre-determination for medically necessary services. Linda Ossias, our practice administrator, handles administrative and insurance matters. We do not belong to Medicare, Medicaid, or any managed care plans, but we lobby for you to achieve maximal reimbursement for you from your insurance carrier as long as out of network coverage is available.

Your surgery. Major facial reconstructive surgery is performed at The Mount Sinai Medical Center in New York City—a “world class teaching hospital and “center of excellence” for restorative burn surgery. At surgery, thick scars, known as keloids, are removed and replaced microsurgically by patterned blocks of tissue harvested from inconspicuous donor sites (back, forearm, scalp, etc.) to fill the defect. Thick tendon-like tissue from the thigh is used like “internal suspenders” to support a more normal balance to the lips, cheeks, and nose. The tailored blocks of tissue, comprised of skin, fat and blood vessels, are inset like a “pieces of a puzzle” into the new facial unit (e.g., chin, neck, lip, cheek, etc.), and circulation is immediately restored by delicate attachment to the facial artery. The newly defined facial tissue is "sculpted" to look, feel and behave like a normal facial skin, with scars hidden in the shadows of the facial planes.

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In less complex cases, facial scarring can be eliminated or camouflage by the clever use of a variety of techniques including scar revision , internal slings, skin grafting, intra-operative tissue expanders, laser resurfacing. all with the goal of achieving the most aesthetically pleasing result.

Your Recovery. In most cases, you will resume normal activities within 2-4 weeks from your surgery date. After surgery, you will be taught cosmetic camouflage techniques by a skilled make-up artist to hide incisional sites and color imperfections. A flesh-colored concealer is custom blended as a foundation to blend facial tone properly (as in above photos). In some instances, medical tattooing is used to pigment facial features (e.g., lip eyebrow, beard).

What to Expect! Although disfiguring burn scars can not be "erased" in their entirety, generally significant improvement can be achieved in cosmetic appearance and functional activities of everyday life. While there are no absolute guarantees, Dr. Rose is confident that visible changes can be achieved in your case!

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PRE AND POSTOPERATIVE PHOTOS SELECTED FROM PATIENTS WHO HAVE GIVEN US PERMISSION FOR USAGE OR WHO ARE OTHERWISE UNIDENTIFIABLE. These photos do not warranty surgical outcome or results. A more complete photo gallery is available at consultation with Dr. Rose.