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Suggest Remedy For Edema Post Surgery

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Posted on Thu, 12 Nov 2015
Question: Hello,My question relates to a surgical procedure I had done 8 weeks ago.This procedure was performed by a vascular surgeon and involved the ligation of the frontal branch of the superficial temporal artery (approximately 6-8cm in length).I sought to have this procedure performed due to excessive prominence of this artery in times of heat and stress,etc.Therefore,this was a cosmetic procedure.I am a 39 year old male,5'11 in height,80kg,physically fit and a non-smoker.
My concern is that the wound site is quite bumpy and still highly visible almost as if the arterial branch was still present.My investigations have led me to believe that swelling should have subsided by now.I have been instructed by the surgeon to await a positive result and he was reluctant to see me for a follow up consultation.What can I expect with regard to the reduction in swelling?
doctor
Answered by Dr. Mukund Savaskar (5 hours later)
Brief Answer:
Post-ligation bumpy swelling of the Superficial temporal artery

Detailed Answer:
Post-ligation bumpy swelling of the Superficial temporal artery

Hi,Dear,Welcome for your query to HCM.
I read your query details and reviewed with current health concerns post-ligation of the STA(Superficial Temporal Artery)
The wound edema should have been resolved by now.But depending on the details of the procedure done while ligating the STA,the wound may take another 1-2 mths.
I would need more information to opine on-when bumpy wound site would resolve cosmetically.
Update Me more information on the details of the operative procedure -discharge notes-a scanned copy would do for the study of it.
Also I would need the current picture of the wound site to inspect and to guide you in next session.

Await above information soon, to reply in next session.
Welcome for any further query in this regard.

Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Mukund Savaskar (16 hours later)
Hello again,there are a number of incision marks along the trajectory of where the vessel was present but these are not what concern me.What I am hoping is that the bumpy appearance of the swelling dissipates in time.Can I expect this or will this be permanent?I do not have a transcript that I can forward which outlines the procedure but I was informed that the surgery would be 'said to be' a biopsy.
doctor
Answered by Dr. Mukund Savaskar (6 hours later)
Brief Answer:
Its just a Biopsy and a long way to go,to expect bumpy appearance dissipate

Detailed Answer:
Brief Ans-Its just a Biopsy and a long way to go,for You to expect bumpy appearance of STA to dissipate in time

Hi,Dear,thanks for the update.
How are YOU Dear?Hope you to be fine.
Read your updates and reviewed in context of your query.
Its a long way to go,for You to expect bumpy appearance of STA to dissipate in time.
This is because they have just planned a Biopsy procedure to study the Histo-pathology of the STA in your case.

As you accepted the multiple incision wounds and their wound site edema,which would take another 1-2 mths at the most to resolve.
Thanks again for Your inquisitive Query.

Keep Me updated on Your Progress,in time to come by a direct question to ME at HCM,so that I could keep you updated as per your expectations.

Do consult Me before undergoing any Specific procedure,so as to plan the best out of the available options for YOU.

Hope this simplified reply would satisfy you fully and would resolve the worry it created for you and your relative.

Welcome for any further query in this regard,which I would love to attend in next session.

IF you are satisfied with this reply,Will appreciate YOU, to write excellent service feedback comments,to help the needy patients like you at HCM services.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS(Thorasic)
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Mukund Savaskar (16 hours later)
I have a picture of the wound site to send.How can I attach this file?
doctor
Answered by Dr. Mukund Savaskar (6 hours later)
Brief Answer:
Thanks for the Updated picture of the wound site

Detailed Answer:
Hi,Dear,
I got the updates of the picture of your wound site.
But I did not get your query of- what you expect me to help you out?

I reviewed the picture,where I could see 2 fresh incisions along the frontal Branch of the STA.
There seems to be another old incision above the fresh 2 lower down.
Wound site seems ok and recovering well.No problem with the fresh wound site.
Remaining wound edema may vanish in another 2 weeks or so.
-But about the bumpy Right STA,I would need the old photograph updated from you,for comparative study of the STA on right side,to be reviewed in next session.
-Give me left sided view for comparative study with the Left STA.

Also I await for further query in this regard, which you might want to ask.

Hope this reply wound have explained more about the wound site to YOU.
If you need any more explanation,Welcome with further query in this regard.

IF you are satisfied with this reply,Will appreciate YOU, to write excellent service feedback comments,to help the needy patients like you at HCM services.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS(Thorasic)


Good Day!!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mukund Savaskar (2 days later)
This procedure was performed in one sitting.I understand that the incisions may scar.This does not concern me.My concern is that the swelling,bumpy appearance may remain permanently.Is this likely?It has diminished only slightly over the 8 weeks.
doctor
Answered by Dr. Mukund Savaskar (8 hours later)
Brief Answer:
Chance of STA swellings on left side after Biopsy/Under Investigation

Detailed Answer:
Ref My earlier reply-Its just a Biopsy and a long way to go,for You to expect bumpy appearance of STA to dissipate in time

Hi, Dear, Thanks for the extended query. Sorry for belated reply.
Was busy whole day with tight and hectic work schedules.

Dear as you very well know that you just underwent the biopsy for the ??????suspected GCA (Giant Cell of the STA-Superficial Temporal Artery), which is the main concern for your medical Team, who is to plan right treatment for you.
This-Biopsy which You underwent - is not the procedure which Guarantees you the removal of the Bumpy swellings of the STA left.

-Wait till biopsy HPR Report-
Now you have to wait till the Hisotpathological study reports come,as told by your Vascular Surgeon,who is attending you there.
Don't be panicky till then.
If your TAB report-(Temporal Artery Biopsy-Which is the accepted criteria) comes positive for GCA, line of treatment would be different. What your doctor is worried is for the cause of this Bumpy swelling, while he did this procedure.

-Your Query already Replied in My last reply-
I had already answered this question in My earlier Reply-by saying very clearly that -Its just a Biopsy and a long way to go,for You to expect bumpy appearance of STA to dissipate in time.

-Technical Details and Limitations of this Ligation and Biopsy Procedure-
While doing this Biopsy procedure-STA is ligated and part is excised and sent for TAB(Temporal Artery Biopsy).As the blood flow through the Superficial Temporal Artery is not completely blocked as the blood circulating through the supra-orbital Artery and other arteries in that area, with which STA forms a collateral circulation,the blood supply persists till the ligated parts.
***Thus this procedure is never done for Vanishing of the Bumpy Swellings of the STA in your case.You have been informed by your doctors by a informed consent ,which explains that the procedure is meant for the Biopsy of the STA.

-Point by Point Answer of Your query-
Besides the above explanation,I would still explain your exact query to Point by Point as follows-

Q-i-My concern is that the swelling,bumpy appearance may remain permanently.Is this likely?-
Yes,the bumpy appearance and swellings shall remain,as this procedure is meant for diagnostic Biopsy and not for the regression of STA bumpy swellings.
This is not possible technically also by this ligation of STA,as there is collarteral blood supply which would flow through these arteries.
-These lumps may regress if the collateral blood supply is of low pressure,which is a therotical possibility ,
and which could be evaluated after 2-3 half yearly follow ups later on,that is over a year,by which time the collateral circulation would be settled down.

-To what extent these lumps would reduce is THUS unpredictable to comment on.Its ONLY TIME which would Answer this question,as the procedure is only for diagnostic Biopsy of the STA-left.

Q-ii-It has diminished only slightly over the 8 weeks.-
The reason is the blood flow from the collateral arteries with which STA-is connected for the STAND BY SUPPLY -in case of the arterial blockage by the CLOTS.

I hope with this reply,you will get satisfied of your query and will be devoid of worries,which you had;regarding this emergency health issue,you had since this STA -Biopsy.


When in trouble for health issue Just contact Me,Before taking any further decision from time to time.

Hope this reply would help you to plan further treatment with your doctors and to recoup fast,by taking opportune steps of treating your health issues soon, as suggested.

Welcome with any further query in this regard,to be replied in next session.

Keep Me updated, to guide you property,as demanded and desired by you,anytime regarding your all the health issues.


Will appreciate YOU,to write your excellent review feedback comments of this service experience, to help the needy patient visitors like YOU, at HCM services.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist/ And Expert in Non-Curable-Diseases.
M.S.Genl-CVTS

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mukund Savaskar (1 hour later)
This procedure was performed for cosmetic purposes due to the appearance of the artery.It was not performed for GCA or any other medical purpose.It was performed by a vascular surgeon who told me i would be left with only flat 2mm x 2mm scars at the incision sites.Sadly,i am being told by you that this bumpy appearance is permanent.Is this correct?
doctor
Answered by Dr. Mukund Savaskar (1 hour later)
Brief Answer:
Chance of Left STA swellings to Vanish after Biopsy

Detailed Answer:
Brief-Chance of Left STA swellings to Vanish after Biopsy

HI,Dear,This reply is based fully on the facts told by YOU,as follows,that-

IN the Query-1-You Submit that-"This procedure was performed by a vascular surgeon and involved the ligation of the frontal branch of the superficial temporal artery."

Q-2- I do not have a transcript that I can forward which outlines the procedure but I was informed that the surgery would be 'said to be' a biopsy.

Here in 2nd Question,You categorically submit in your query -that the Procedure details are not with You,but You were informed that surgery would be"Said to be Biopsy" Procedure.

So on these facts that it was Biopsy-procedure-as was informed from your doctor,I gave My technical expert Opinion.

Dear,This ambiguity in your mind is due to the " Non-availability of the Script of the Discharge Card-which would have given ME the details of the Procedure available to You" ,which would have solved YOUR depressive feelings.

So let us discuss this topic after getting the Discharge Card details of the Procedure You underwent.That will solve the query and worry with it.

In the scenario where the First Hand written information about the procedure is not with you,I would suggest you to take up this discussion in educative way and not to make any final decision based on it,as the data given from you about the Procedure is ambiguous.
So DON'T WORRY TILL YOU GET THE SCRIPT OF THE OPERATIVE PROCEDURE FROM YOUR DOCTOR and Till the time You get the answer from YOUR OPERATING DOCTOR.
-in this regard you submitted in your first Q-i- as follows-that -"I have been instructed by the surgeon to await a positive result and he was reluctant to see me for a follow up consultation.What can I expect with regard to the reduction in swelling?"

So based on these scenarios of your submissions,it would be too early to opine in a FINAL WAY-until the wait is over /time is over ? about which YOUR OPERATING SURGEON ONLY-could TELL,and We have to RELY ON YOUR DOCTOR.
Hence I would suggest that You should wait, till the time your doctor has asked you to wait.
Till that time,(Which your Operating Surgeon could tell),DON'T WORRY ABOUT IT,and take this discussion as a technical educative discussion with assumed facts ,as you assumed and understood from the information given to YOU.

Hope this reply would explain you, the limitation of this discussion forum and the limitation of this technical discussion,which should be taken as a -ASSUMPTIVE DISCUSSION on the assumed facts as submitted from YOU.

I intended to explain the transparent facts what the established science says,and You should not get depressed and sad with this reply,as YOU should take this as educative discussion ONLY,based on your assumptive facts submitted as told in your query.

Hope this reply would resolve the worry YOU had,due to many assumptions and I would RELY on what your doctor has said to YOU.
HENCE And I would suggest YOU TO KEEP COOL till the TIME GOES BY.

Welcome with any further query in this regard,to be replied in next session.

Keep Me updated, to guide you property,as demanded and desired by you,anytime regarding your all the health issues.


Will appreciate YOU,to write your excellent review feedback comments of this service experience, to help the needy patient visitors like YOU, at HCM services.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist/ And Expert in Non-Curable-Diseases.
M.S.Genl-CVTS

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Mukund Savaskar (3 hours later)
Thankyou.I will ask one final question then close the discussion.I may have used the words 'ligation' and 'biopsy' wrongly.I assumed they were the procedure that took place.What i do know for certain is that the surgery involved removing by way off cutting out a significant length (over 8cm) of the frontal branch of the sta.I sought to have this done due to cosmetic reasons,not health factors.Does your previous information still apply?
doctor
Answered by Dr. Mukund Savaskar (8 hours later)
Brief Answer:
Yes, the Chance of Left STA swellings to Vanish after Biopsy is there!

Detailed Answer:
Brief Ans-Yes, the Chance of Left STA swellings to Vanish after Biopsy is there!(5th follow up Question replied)

Hi,Dear,thanks for your Cool Reply and Updates.
I can understand your anxiety and worries,regarding your cosmetic health concerns and the efforts you have done since last 1 yr.

If the operating Surgeon has removed 8 cm(or 3 inches)of STA,I would accept your contention- that the Biopsy procedure was involved with long excised Portion of left STA for the Cosmetic reasons.
-In that case, possibility of Cosmetic relief will definitely come after some time (may be in next 6-8 mths time)in the bumpy swelling region, but will take some time,than you expect.
-Usually the Biopsy procedure involves a small portion of the STA,for Histo-pathological studies.
-If your doctor has confirmed YOU to give cosmetic effect,DON'T WORRY AT ALL!!Time Can be predicted by your doctor,as he knows what and how much surgical excision of the peri-arterial tissue he has done to give that effect.

-So the answer to YOUR FINAL Question is -that You have chances of getting cosmetic effect.
IF no relief for cosmetic effect,do contact Me,after that by appointment at My mail YYYY@YYYY
I would try My best to help you out in that case.

Hope this reply would resolve the worry and anxiety YOU had.HENCE I would suggest YOU TO KEEP COOL till the TIME GOES BY.

Welcome with any further query in this regard,to be replied in next session.

Keep Me updated, to guide you property,as demanded and desired by you,anytime regarding all your health issues in time to come.

This has been a MARATHON CASE since last 5 days.
Hence I Will appreciate YOU,to write your excellent review feedback comments of this service experience, to help the needy patient visitors like YOU, at HCM services.

Wishing you fast recovery soon.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist/ And Expert in Non-Curable-Diseases.
M.S.Genl-CVTS
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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Suggest Remedy For Edema Post Surgery

Brief Answer: Post-ligation bumpy swelling of the Superficial temporal artery Detailed Answer: Post-ligation bumpy swelling of the Superficial temporal artery Hi,Dear,Welcome for your query to HCM. I read your query details and reviewed with current health concerns post-ligation of the STA(Superficial Temporal Artery) The wound edema should have been resolved by now.But depending on the details of the procedure done while ligating the STA,the wound may take another 1-2 mths. I would need more information to opine on-when bumpy wound site would resolve cosmetically. Update Me more information on the details of the operative procedure -discharge notes-a scanned copy would do for the study of it. Also I would need the current picture of the wound site to inspect and to guide you in next session. Await above information soon, to reply in next session. Welcome for any further query in this regard. Good Day!! Dr.Savaskar M.N. XXXXXXX Surgical Specialist M.S.Genl-CVTS