Vitiligo is a chronic disease condition in which the skin loses its colour and results in white patches. These de-pigmented patches generally appear on the exposed body sites such as face, elbows, knees, hands and feet.
Vitiligo can either be treated with medication and creams and in few rare cases, it requires surgery. Phototherapy can also be done to treat the white patches on your body. Surgery is usually considered only in the condition when you have a stable vitiligo. Stable vitiligo is a condition where the depigmentation does not spread further to any other part of your body.
Goal of Vitiligo Surgery
The main goal of vitiligo surgery is to achieve complete re-pigmentation that will compliment your normal skin tone. All patients with vitiligo are not suitable for surgery; you need to consult your cosmetic surgeon before taking the decision of the surgical treatment.
The common factors that the cosmetic surgeon needs to consider in the patients are:
- The age of the patient
- Disease stability
- Size and location of the vitiligo patch
- The method selected for surgery
- Proposed donor site
Types of Vitiligo Surgery
The main aim of vitiligo surgery is to transfer the melanocytes from the normal skin to the affected area where vitiligo patches are present. Melanocytes are the pigment producing cells that are responsible for your skin tone.
The superficial layer of the affected skin is generally removed under local anaesthesia with different methods such as dermabrasion, cryotherapy, punch biopsy and laser therapy. Vitiligo surgery is categorised into two main types:
1. Tissue Grafting or Grafting of Melanocyte Rich Tissues
Tissue grafting is further classified into three categories:
- Miniature Punch Grafting (MPG)
Miniature Punch grafting is a common cosmetic surgical technique used in which a portion of the skin is punched out from the donor skin and placed on the vitiliginous skin. The donor site, in this case, will be buttock or thigh.
- Suction Blister Grafting
During suction blister grafting a negative pressure is applied to the pigmented donor site that promotes the formation of multiple blisters. It generally takes around 1.5-2.5 hrs for the development of blisters. The roof of the newly formed blisters are surgically removed and transplanted to the recipient site.
- Split Thickness Skin Grafting
Split thickness generally involves shaving off thin layers of skin from the donor site. Split thickness skin grafting covers a larger area and produces a uniform pigmentation.
2. Cellular Grafting or Grafting of Melanocytes
Cellular grafting is again categorised into two types:
- Autologous Non-Cultured Epidermal Cell Suspensions
During this procedure, the tissues are harvested from a donor site and are incubated with trypsin. Incubation is done with trypsin to separate the epidermis from the dermis.
After the separation of dermis and epidermis, the melanocytes are separated from the epidermis and made into a cell suspension that is transplanted to the recipient site. Through this method, large areas can be treated in a single session using a small donor graft.
- Cultured Melanocyte Suspensions
During this procedure, the tissue is harvested and incubated with trypsin. After the separation of epidermis and dermis, the melanocytes and keratinocytes are incubated in a medium that contains certain growth factors.
The cultured suspension is then transplanted to the recipient skin. To perform this procedure, you need a special laboratory for culturing and incubation.
White spots on skin are common in people of all groups. The skin white spots can either be treated through medication or surgery. For vitiligo treatment, you can consult the South Delhi cosmetic clinic. It is the best clinic for cosmetic surgery in Delhi. Dr. Surender Chawla is the best cosmetic surgeon in Delhi who can treat your white patches. The cosmetic surgery prices in Delhi are affordable and in most of the cases, positive results are reported.
