Vitiligo surgery

Get the color you want

Our clinic is providing all possible treatment modalities for treatment of of vitiligo. When other modalities don’t produce color in skin, surgeries for white spots are like a hope and part of our services since beginning.

What are Vitiligo surgery treatments?

The surgery involves extracting skin from places where pigmentation is normal and transplanting it on depigmented skin. Surgery has been seen effective in 90%-95% cases. The surgical modalities include

• Tissue grafting
• Cellular grafting

A. Tissue grafting: Following techniques can be used:

1. Punch grafting: In this technique grafts are punched put (1-2mm in diameter) from the pigmented skin (called as donor sites), usually from thighs, buttocks, posterior ear, upper arm. Then sockets are created in the area of depigmented skin (called as donor area), and these grafts are replaced in these sockets. Post operatively dressings are placed on the operated sites. Usually in 7-10 days the grafts are taken up by the recipient skin, and patient is now treated with phototherapy topical steroid for even spread of pigment.

Advantages:This method is fairly inexpensive and effective for all areas except angle of mouth and nipples. This technique is also effective in areas like fingers, toes palms, and soles which are otherwise difficult to treat.

Disadvantages:This technique is not suitable if large areas are involved.

2. Suction blister epidermal grafting: In this technique, very thin grafts (consisting of epidermis only) are harnessed from the donor area by applying a prolonged suction pressure which leads to a physiological split at dermo epidermal junction. These grafts are then applied on the recipient site after abrading it. The graft typically falls of within 7-10 days.

Advantages:As the grafts are very thin, it gives excellent cosmetic results. Chances of scarring are minimal both at donor and recipient sites.

Disadvantages:It is a time-consuming process as the grafts take time to separate, thus large areas can also not be treated.

3. Split thickness grafting:In this technique, the grafts consists of epidermis with a portion of dermis. Local anaesthesia is required for small areas and for large areas patient may require general anaesthesia. The split thickness graft is transplanted on abraded skin on recipient site, further secured by pressure and immobilization.

Advantages: is a good technique to treat large areas in short span of time.

Disadvantages:This technique requires lot of skill and expertise. There is a probability of donor site scarring and colour mismatch and undesirable pigmentary changes on recipient site.

B. Cellular grafting: Following techniques are available:

1. Non-cultured melanocyte grafting:This technique involves taking a biopsy sample from the recipient skin, which is then immersed in trypsin solution to separate epidermis from dermis. This is followed by obtaining the cellular suspension of melanocytes which is then transplanted on abraded on recipient site.

Advantages:This method is suitable for treating fairly large areas.

Disadvantages:This method requires high level of expertise, and equipped laboratory.

2. Transplantation of cultured autologous melanocytes:This technique involves culturing melanocytes in vitro (outside body, in a culture medium in laboratory). The culture growth takes 15-30 days, after which the isolated melanocytes in suspension are transplanted on abraded donor area.

Advantages:This technique can treat unlimited body areas. In cases where more than 30 % of body is involved, this technique is useful.
Disadvantages: This technique is quite expensive and requires elaborate tissue culture laboratory setup.

3. Autologous cultured epithelial grafts:In this technique, an epidermal sheet is obtained through cell culture. This takes few weeks to grow. This epidermal sheet is then attached on a petrolatum gauze and applied on recipient site and dressing is done.

Advantages:Large areas of skin can be treated.

Disadvantages:Its expensive and requires skill and equipment.

Patient selection

Who are candidates of vitiligo surgery?

• When a patient has undergone medical therapy and light therapy, but the results aren’t satisfactory.
• In the adult patients where the vitiligo has been stable for 1 year (no development of new patches or current patches have not expanded).

Who are not so good candidates for surgery?

• Unstable disease
• Children
• Patients who forms scars and keloid easily or have such history.

What are important things before vitiligo surgery

Detailed consultation with Dr. Sunil Kothiwala

Examination of all white spots

If number of lesions are multiple , Selection of lesions to be covered in surgical treatment

Surgery time : Patient should enough time to stay at clinic. Punch grafting takes 1-2 hours, suction blister grafting takes 5-6 hours and cellular grafting surgery takes 2-3 hours.

Blood investigation as doctor suggest

Good healthy meal before coming to clinic

Written Consent

Photography

What should I expect post -surgery?

• You may have to rest and miss work for some days.
• Depending on the technique used, you may have to come for follow-up visits for changing the dressing or reviewing the graft status.
• Phototherapy and medical therapy may still be required for 2-3 months to achieve optimal results.

What are the possible side effects of surgery?

• Infections.
• Graft colour mismatch.
• Graft rejection.
• Scarring at donor site
• Persistent vitiligo

These side effects can be greatly minimized by election of right technique and surgical expertise.

Why Dr. Kothiwala SkinEva Clinic is best clinic for vitiligo surgery treatment in Jaipur?

Detailed authentic consultation with AIIMS trained best dermatologist in Jaipur Dr Sunil Kothiwala

Clear explanation about advantage and disadvantage of every type of vitiligo surgery with display of before after results images of surgery treatment of vitligo

Dr Sunil Kothiwala is postgraduate from AIIMS Delhi, where vitiligo surgeries are done in huge number and he has done more than 200 vitiligo surgeries. So he is providing services as per AIIMS protocols for vitiligo surgery treatment in Jaipur.

Post surgery there is requirement of phototherapy and our clinic is equipped with both phototherapy and world’s best Alma Excimer laser.

For more information on Vitiligo surgery or to inquire about other services please contact us at 7726938335