Davinci Plastic Surgery is a specialized practice in Washington, D.C. The clinic focuses on aesthetic and reconstructive plastic surgery. Key areas include facial rejuvenation, breast reconstruction, and body contouring. The office surgical suite has 10 exam rooms and two operating rooms. Both operating rooms hold AAAHC accreditation for outpatient safety.
Dr. Steven Davison and Dr. Ximena Pinell lead the medical team. Dr. Davison is triple board-certified in plastic and facial surgery. He has authored over 100 clinical papers. Dr. Pinell is double board-certified and trained at Emory University. The team uses Vectra 3D imaging for surgical planning. They also apply the Keller Funnel no-touch technique for breast safety.
The practice treats a diverse group of international patients. Virtual consultations are available via FaceTime and Skype. The surgeons perform complex revisions for rhinoplasty and breast procedures. Non-surgical options include BOTOX and the full range of Juvéderm fillers. Most surgical patients return to work within one week.
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Dr. Steven Davison and Dr. Ximena Pinell lead the medical team. Dr. Davison is triple board-certified in plastic and facial surgery. He has authored over 100 clinical papers. Dr. Pinell is double board-certified and trained at Emory University. The team uses Vectra 3D imaging for surgical planning. They also apply the Keller Funnel no-touch technique for breast safety.
The practice treats a diverse group of international patients. Virtual consultations are available via FaceTime and Skype. The surgeons perform complex revisions for rhinoplasty and breast procedures. Non-surgical options include BOTOX and the full range of Juvéderm fillers. Most surgical patients return to work within one week.
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في المرحلة 0 والمرحلة الأولى من الورم الميلانيني ، قد تكون إزالة الورم الأولي هي الإجراء الوحيد الضروري للشفاء التام.الأنواع الرئيسية للعمليات التي يتم إجراؤها لعلاج سرطان الجلد:
الاستئصال الواسع (الاستئصال) يتضمن إزالة التكوين مع بعض الأنسجة السليمة حول الحواف. يتم استئصال الورم بمشرط تحت التخدير الموضعي ، مما يجعل المسافة البادئة 0.5-2 سم. يعتمد حجم الهامش الجراحي على سمك (إنبات) الورم الميلانيني في عمق الجلد.
بعد إزالة التكوين ، يتم وضع خياطة.
سمك التكوين | الحافة الجراحية |
0.5 سم | |
أقل من 1 مم | 1 سم |
من 2 إلى 4 مم | 2 سم |
أكثر من 4 مم | 2 سم |
إذا تم العثور على خلايا خبيثة في العقدة الليمفاوية الحارسة ، يتم إجراء تشريح العقدة الليمفاوية (استئصال العقد الليمفاوية ) - إزالة العقد الليمفاوية المصابة.
عملية موس هي إزالة التكوين على مراحل ، في طبقات. يتم فحص كل طبقة يتم إزالتها أثناء العملية تحت المجهر للكشف عن الخلايا السرطانية. تتم إزالة الطبقة التالية طالما توجد خلايا سرطانية بداخلها. هذا النهج لطيف ويسمح لك بإزالة الورم والحفاظ على صحة الجلد قدر الإمكان.
يمكن استخدام جراحة موس لآفات الوجه ، حيث يمكن أن يترك الاستئصال الواسع عيبًا تجميليًا غير مرغوب فيه. يوصي العديد من الأطباء بإجراء جراحة موس فقط لسرطانات الجلد غير الميلانينية .مع تلف الأطراف والإنبات العميق للورم ، يمكن إجراء البتر. في محاولة للحفاظ على أكبر قدر ممكن من الأنسجة ، يقدم الأطباء أيضًا العلاج الإشعاعي والعلاج الكيميائي الموضعي (نضح الأطراف المعزولة) كبدائل.
في المراحل 0 و 1 ، تكون الطريقة الرئيسية للعلاج هي الاستئصال الواسع.
في المرحلة الثانية ، يتم استئصال الورم أيضًا ، ومع ذلك ، تكون خزعة العقدة الليمفاوية الحارسة إلزامية ، وفي حالة تلفها ، يتم إجراء استئصال العقد اللمفية.
في المرحلة الثالثة من الورم الميلانيني ، يتم إجراء استئصال واسع وإزالة العقد الليمفاوية التي وجدت فيها الخلايا الخبيثة والعلاج الدوائي.
في المرحلة الرابعة (الأخيرة) ، تتم إزالة الورم الرئيسي كلما أمكن ذلك. لعلاج النقائل ، العلاج الدوائي و / أو الإشعاع إلزامي.
لتسريع التئام جرح ما بعد الجراحة ، من الضروري اتباع توصيات أخصائي بدقة:
الوذمة اللمفية هي تورم وتورم في الأطراف ناتج عن ركود اللمف أثناء الاستئصال الجراحي للغدد الليمفاوية.
أعراض الوذمة اللمفية هي:
يمكن أن تتطور الوذمة اللمفية مباشرة بعد تشريح العقدة الليمفاوية ، وبعد فترة طويلة. راقب بعناية حالة الجسم وأبلغ الطبيب بأي تغيرات!
اليوم الأول - الوصول
اليوم 2 - ما قبل العملية
اليوم الثالث - الجراحة
اليوم 4-7 - بعد العملية
الأسبوع 1-2 - إعادة التأهيل
الأسبوع 3-6 - إعادة التأهيل
يرجى ملاحظة أن هذه الجداول الزمنية قد تختلف تبعًا لمعدلات التعافي الفردية ومدى تعقيد الجراحة.
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Extensive reconstruction or sentinel node biopsy may need a day-case or overnight stay; not included."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":4,"unit":"weeks","qualifier":"Simple closure; avoid wound-stretching strenuous activity until healing confirmed. Longer on trunk, back, joints, or after reconstruction."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"Time for scar maturation after wide local excision; oncologic outcome is determined by pathology and surveillance, not by this timeframe."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"After simple closure once suture removal and wound check are done; later after graft or flap."},"follow_up_visits":[{"purpose":"suture_removal","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Typically 7-14 days; longer over joints or on the lower limb."}},{"purpose":"result_review","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"Review of excision margin pathology and discussion of staging and further management."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":180,"unit":"days","qualifier":"First surveillance skin and lymph node examination; subsequent schedule depends on stage."}}],"indications":["Biopsy-proven primary melanoma needing wide excision with Breslow-based margins","Re-excision after diagnostic excisional biopsy with positive or inadequate margins"],"main_risks":["Bleeding or hematoma","Wound infection","Wound dehiscence or delayed healing, especially on the lower limb","Visible, widened or hypertrophic scar","Numbness or sensory nerve injury","Incomplete excision requiring re-excision"],"pain":"Local anesthetic injection causes brief stinging; afterwards mild to moderate soreness for a few days, usually managed with simple analgesics.","preparation":["Review of biopsy pathology and clinical staging as indicated","Marking of the biopsy scar and planned excision margins","Medical history review including bleeding tendency and allergies","Perioperative medication instructions given by the surgical team","Arrange wound care; companion if walking or driving affected"],"recovery_timeline":[{"phase":"Day 0-3","description":"Dressing in place; mild pain and swelling. Rest and elevate the area if on a limb.","restrictions":["Keep dressing dry","Avoid strenuous activity and stretching the wound"]},{"phase":"Days 7-14","description":"Suture removal or wound check; pathology review of margins.","restrictions":["Avoid heavy lifting or strain on the wound until cleared"]},{"phase":"Weeks 2-4","description":"Wound healing; gradual return to normal activity and exercise.","restrictions":["Avoid vigorous activity involving the area until healed"]},{"phase":"Months 3-12","description":"Scar maturation with sun protection and ongoing skin surveillance.","restrictions":["Protect scar from sun exposure"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Functional recovery after simple-closure excision; longer after graft, flap or lower-limb surgery. Nodal surgery excluded."},"result_longevity":"The excision scar is permanent once matured. Cure depends on tumor stage, not time; lifelong skin surveillance is advised because of recurrence and new melanoma risk.","revision_rate_pct":{"min":2,"max":8,"unit":"percent","qualifier":"Re-excision for positive margins or later scar revision, or return to theatre for wound complications."},"scars":"Linear scar from elliptical excision, about three times as long as wide; size depends on tumor thickness and margin. Grafts or flaps leave larger scars. Scars mature over 6-12 months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single excision visit; follow-up not counted. Sentinel node biopsy is additional, outside base scope."},"stages":[{"code":"wide_local_excision","label":"Wide local excision of the primary melanoma site with closure","after":{"min":14,"max":56,"unit":"days","qualifier":"Usually 2-8 weeks after diagnostic biopsy."}}],"qualifier":"Excision-only base protocol; reconstruction and nodal surgery are not included."},"success":{"metric":"Local recurrence-free after wide local excision","value":97,"unit":"percent","horizon":"5 years","population":"Adults with primary localized cutaneous melanoma (in situ or thin to intermediate thickness)","evidence_status":"limited"},"techniques":[{"name":"Wide local excision with primary closure","suits_whom":"Most primary melanomas, with margins set by Breslow thickness (generally 0.5-2 cm).","recovery":"Sutures removed in about 1-2 weeks; return to light activity in days."},{"name":"Wide local excision with skin graft or local flap reconstruction","suits_whom":"Larger defects or sites (face, acral, lower limb) where direct closure is not feasible.","recovery":"Longer healing and activity restriction; may require a longer stay."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Primary closure under local anesthesia. Sentinel biopsy, reconstruction and nodal surgery excluded and take longer."},"initial_assessment_documents":["Biopsy histopathology report with Breslow thickness","Dermoscopy or clinical photos of the lesion site","Pathology slides or digital slide scan (if available)","Ultrasound or CT reports (if available)","Previous skin cancer or melanoma treatment records"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single excision; stay 10-14 days covers suture removal and margin pathology review. Second trip only for surveillance or further staging."}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=united-states/city=washington/procedure=hirurgiya-melanomu/"}],"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"illnessesByOperation":[{"id":53,"alias":"melanoma","name":"سرطان الجلد"}],"rendersOffersList":false}