Challenges of Neurofibroma Excision

Whether Type 1 or Type 2, neurofibromatosis produces complex tumors with specific abilities to induce changes to surrounding tissues and cause extensive bleeding. Therefore, simple excision to remove neurofibromas is frequently met with complications. It is important to note that neurofibromas do not behave as other soft tissue tumors. Their occurrence and growth is related to the release of specific hormones that can impact surrounding tissues and cellular processes. These hormones are known to soften fat and skin and lead to stretching of ligaments. This can cause drooping of tissues in areas involved with tumor, creating significant deformities. More concerning, hormones released by neurofibromas can result in the interruption of normal clotting, which can lead to extensive blood loss during surgery.

Massive buttock neurofibroma with overlying skin hyperpigmentation.

 

Dr. Panossian's Approach

Dr. Panossian’s experience in the removal of both simple and complex neurofibromas has led to the development of a careful and methodical surgical approach. Key factors include monitoring blood loss closely throughout surgery and employing various clotting agents to avoid excessive bleeding. In addition, drains are used occasionally for large excisions. Other surgical maneuvers are also necessary to avoid hematoma formation and infections. Dr. Panossian also knows when to vary the pace of surgery, something most surgeons neglect, in order to avoid these complications.

Surgical excision of forehead neurofibroma causing ptosis.

 

Reconstruction of Tissues

In addition, Dr. Panossian recognizes the deforming effects of neurofibromas on surrounding tissues. Fixing the deformities created requires an expert understanding of plastic surgery and reconstructive principles involving virtually every part of the human anatomy. Concepts of hiding incisions, cutting along natural wrinkle lines, and avoiding vital nerve structures are some of the most complex considerations necessary for a successful outcome. Dr. Panossian understands human anatomy with high precision and is a peripheral nerve expert, making him the ideal person to treat patients with neurofibromatosis.

Surgical excision of neurofibroma of arm with suturing.

Every treatment plan is individualized. Every aspect of the surgery is rehearsed ahead of time. Complications and bleeding are anticipated and handled to avoid excessive blood loss. Make sure the surgeon you choose has a deep understanding of these factors and the confidence to help deliver the very best results. Make an appointment with Dr. Panossian today to go over your options.

BEFORE AND AFTER GALLERY

Before and after photo of patient with neurofibroma after electrodesiccation of neck.

DR. PANOSSIAN APPEARS ON THE DOCTORS

DR. PANOSSIAN RECEIVES TOP AWARD FOR NEW TECHNIQUE

Best Paper Award for Andre Panossian, MD for top plastic surgery.

 

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