Before surgery, Juan sits down with Dr. Sanusi Umar to discuss the plan for removing extensive acne keloidalis nuchae (AKN) from the back of his head and neck. The conversation addresses a key concern: how to remove the affected tissue while accounting for the shape of the scalp and the position of his hairline.
Why Symmetry Matters in Juan’s Surgical Plan
Dr. U explains that the procedure involves more than removing the visible area. He wants the back of Juan’s head to look symmetrical, which means considering how much tissue must be removed on each side. He describes a substantial section of tissue that will be taken out as part of the planned operation.
For Juan, this discussion makes the extent of the planned removal clearer. It also shows why treatment for acne keloidalis in this case requires an individualized conversation about both the affected area and the anticipated appearance after surgery.
What Will Happen to His Hairline?
Dr. U then explains that the remaining scalp will be brought down, changing where Juan’s posterior hairline sits. Juan reacts with interest as he understands the proposed repositioning.
The plan also calls for cutting some of his hair, although Dr. U says the section on top that he calls the “mohawk” can remain. The conversation distinguishes hair that must be cut for the procedure from the hair expected to be preserved. After outlining these details, Dr. U asks to examine Juan himself.
A Serious Consultation With a Lighter Moment
The mood shifts when Dr. U puts on his headgear and jokes that the Bumpinator has come alive. Juan joins the humor by discussing what to call the lesion. After considering “Lumpy” and “Bumpy,” they settle on Bumpy.
Dr. U closes the exchange with a playful line: “Bumpy, your days are numbered.” The joke does not replace the surgical planning. Instead, it provides a brief, human moment within a consultation about extensive bumps on the back of the head and a significant proposed operation.
This chapter documents the discussion and examination before treatment. It does not show the operation or establish a surgical result.
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The Bumpinator | Episode 8, Chapter 5
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Medical Disclaimer
This article is for educational purposes only and does not provide medical advice. Treatment decisions depend on individual evaluation by a qualified clinician. Results are not guaranteed.
Further Reading
- https://dru.com/juan-acne-keloidalis-nuchae-chapter-00/
- Umar S, Khanna R. Papular acne keloidalis nuchae treatment success using follicular unit excision. JAAD Case Rep. 2023 Jul 25;39:96-100. doi: 10.1016/j.jdcr.2023.07.013. PMID: 37621307; PMCID: PMC10445098.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10904000/
