AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2300 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Organizations belong to ASAPS (American Society for Aesthetic Plastic Surgery); ASPS (American Society of Plastic Surgeons); ACS (American College of Surgeons); Clinical Assistant Professor of Plastic Surgery at the Albert Einstein College of Medicine in New York
Question QUESTION: Dear Dr Engler,
About a week ago I got into a small motorcycle accident that left me with a rough puncture like wound on my upper shin area about 1/4 or more inches wide and a little less deep. I did not realize that it was that bad until I really looked close some days after the accident (and after it started to blow up with infection) I went to the hospital in Thailand today..where they cleaned the wound and put on bandages..they said that I should have gotten stiches but that now it is too late...I am afraid that I will have scarring or even worse a small divot or recession in my leg..Is there any way that I can stitch it together after a week to prevent scarring ...what can I do now to best help it..?
Thanks in advance...Evan
ANSWER: Hi Evan,
What they told you is basically correct; a week is, in fact, not a good time to try to put in stitches. The tissues have retracted a bit and are swollen, and trying to pull things together may compromise tissues that would otherwise heal reasonably well.
You may wind up with a wider scar or depression, but the larger concern is to make sure that you do not have any bone exposed. There is very little skin and soft tissue coverage in the area that was injured and so, not surprisinvly, injuries in that region are more likely to lead to exposed or damaged bone than in other regions.
We can assume that the Emergency Room did a pretty good job but I would advise you to be seen by a plastic surgeon as soon as possible just to make sure there isn't a deeper injury. You can get a recommendation through the hospital or via surgery.org or plasticsurgery.org. The potential scarring or deformity are much less of a concern than infection spreading to the bone. And even if they've put you on antibiotics, which hopefully they have (if not make sure they do) you have to be sure that you don't have a deeper injury that risks becoming apparent, in a more substantial manner, at a later date. You should have this looked at by a specialist ASAP.
I hope that this helsp, and good luck,
Dr. E
www.bodysculpture.com
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QUESTION: Thank you Dr. E for addressing my questions. I will go to see a specialist tomorrow. As a follow up, can plastic surgery be done now ? (it sounds like it cant) and if there is a depression later, can plastic surgery improve that? ...How long do I have to wait to look into that process...? At present it looks like a bullet hole (ach!!)
Evan
Answer Hi Evan,
It's hard for me to tell but you may have to wait several months for it to heal, at which point things can often be done to improve the appearance of a defect such as you're describing. A lot, of course, depends on exactly how bad it is once it's healed, other medical issues, etc., and to have those answered you'll have to speak with the specialist.
