When Is Surgery Considered?
Vitiligo surgery is not the first line of treatment. It's considered when:
- Vitiligo has been stable for at least 6–12 months (no new patches, no spreading)
- Topical treatment and phototherapy have been tried but patches
remain
- Patches are in areas with poor blood supply (lips, fingertips, bony areas) where medical treatment is
less effective
- The patient has realistic expectations about outcomes
Surgical Techniques
Suction Blister Grafting
- Suction is applied to normal pigmented skin to create small blisters
- The thin blister roof (containing melanocytes) is carefully removed
- This tissue is placed on the depigmented patch (prepared by dermabrasion or laser)
- Best for: Small to medium patches, especially on face and neck
- Advantage: No scarring at donor site, good colour match
Melanocyte-Keratinocyte Transfer (MKTP)
- A small piece of normal skin is taken and processed to create a melanocyte suspension
- The suspension is applied to the prepared depigmented area
- Best for: Larger areas of stable vitiligo
- Advantage: Can cover larger areas from a small donor site
Punch Grafting
- Small punches of pigmented skin are transferred to corresponding holes in the depigmented area
- Best for: Small, localized patches
- Limitation: Can have a cobblestone appearance if not done precisely
What to Expect
- Procedure time: 1–3 hours depending on area size
- Anaesthesia: Local anaesthesia
- Recovery: 1–2 weeks for initial healing; pigmentation develops over 3–6 months
- Success rate: 70–90% repigmentation in carefully selected patients
- Post-surgery: Phototherapy sessions may be needed to enhance pigmentation spread
Who Is Not a Candidate
- Active, spreading vitiligo (unstable disease)
- Koebner phenomenon positive (new patches at injury sites)
- Keloid-forming tendency
- Unrealistic expectations of 100% perfect colour match