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What is reconstructive surgery?
Reconstructive surgery differs from cosmetic surgery in that it is something that is fixing
an issue that cannot not be fixed. It is estimated that over one million procedures will be
completed this year in an effort to cosmetically fix a defect of a child, or an elderly person
needing a physical adjustment. The primary purpose of this type of surgery is to normalize
an issue possibly caused by trauma, injury, tumors, diseases, or congenital abnormalities.
It is in an effort to improve a function or look, but it is meant to aid in the physical
and emotional outlook of the patient.
The idea behind this is to improve on an already existing perceived "deformity" - not to
perfect a look. There is no amount of surgery that can create perfection0 it is something
that is achieved through nature, and a healthy emotional well being.
This will give you a thorough background on the history of reconstructive surgery, and its
uses in modern day surgery. Always refer back to your surgeon for any questions you may have
in regard to possible options. Also, it is important to ask for information that may
specifically deal with the procedures you may be considering for yourself or your loved one.
There are several categories for patients involved in this type of surgery - those who have
congenital deformities or birth defects and those with deformities that have been acquired
by way of accidents, infection, disease, and in seldom cases due to aging.
Congenital abnormalities that are considerations for reconstructive surgery are birthmarks;
cleft-lip palate deformities; hand deformities such as syndactyly (webbed fingers), extra or
absent fingers; and abnormal breast development.
Acquired deformities are understood as burn wounds, growths, lacerations and aging problems.
There are innumerable cases where patients find a procedure commonly thought to be cosmetic
in some manner that may be performed to achieve a reconstructive goal. Blepharoplasty, for
example, can be used to correct drooping eyelid skin that blocks field of vision; it is not
viewed as a cosmetic procedure in this instance. There are situations where adults whose face
may have an asymmetrical look due to paralysis may use reconstructive surgery to get a
balancing facelift. The main purpose for these procedures is to restore function.
When large, sagging breasts are a problem - it may be a development of congenital deformity,
hormonal changes, or disease. Breast reduction is an option, and is considered a reconstructive
procedure. It can help a woman design the type of body that will work for her, breasts that
are at least in proportion to her body.
Reconstructive otoplasty (outer-ear surgery) is used to correct overly-large or deformed
ears, and primarily in children. Insurance is an issue with reconstructive surgery - many
policies will consider the cost of reconstructive surgery a covered expense when it is
deemed a necessity. It is important to check with the carrier to make sure that you will
be covered and possible limitations to that type of surgery.
It is important to remember that whenever surgery is an option to an issue - complication
are always an inherent part of the risk. Even when surgery is done by a qualified plastic
surgeon, complications may happen although they are infrequent and usually minor. However,
because everyone is unique people vary greatly in their anatomy and healing capability,
with the outcome always unpredictable.
When complications occur it is more than likely due to infection; excessive bleeding, such
as hematomas; significant bruising and wound-healing difficulties; or problems related to
the anesthetic and surgery.
There are several options one must be aware of when undergoing this type of procedure. With
that there are a number of factors that may increase the risk of complications in healing -
such as a patient who would be a higher risk if they are a smoker; one who may have a
connective-tissue disease; or has areas of damaged skin from radiation therapy. There are
an innumerable number of other potential issues, including decreased circulation in the
surgical area, HIV infection, or poor nutrition. There are a number of procedures that will
require that you take get off of all extra supplements, especially herbal supplements.
Surgery is decided upon with regards to size, nature and extent of the injury or deformity.
It will help determine what treatment you will undergo, as well as and how quickly the surgery
will be completed. Reconstructive surgery demands complex planning and those procedures be
done in stages.
It's not always possible to predict how growth surgery will affect the outcome desired,
depending upon the patient, follow up visits will be a big part of the healing process.
Everyone is unique in their healing process. Plastic surgeons cannot pinpoint an exact
healing date due to the nature of the surgery. They will be able to guide you to the next
level - and give you a good idea of when you will be able to go back to your normal way of life.
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What are some options in Reconstructive Surgery?
SKIN GRAFTS
Difficult to enclose wounds are treated with skin grafts. Healthy skin is taken carefully off
the body and grafted onto the site that requires the skin needed to aid in healing an open
wound. There are three types of skin grafts that surgeons frequently use.
A split-thickness skin graft is usually used in treating burn victims. According to where the
site that needs the skin is, the surgeon will match the skin from another part of the body,
taking into consideration color and texture. Matching the skin types is critical especially
when it is on a more obvious part of the body. The ability to virtually match the skin is
important in the emotional healing process as well.
Wounds that are deep and large tend to have the need for a full thickness graft. This is known
as such the skin that is grafted is grafted on all layers- usually this is needed when full
elasticity and movement are a necessity in healing the wound. In the final healing process
there may be an obvious scar, but this can be minimized as well in follow up treatment.
In skin cancer surgeries, a composite graft is used to heal with all layers of the skin;
including the underlying support, fat and cartilage are included from the donor site. There
may be a scar after healing in this process as well. It will very likely fade over time.
Tissue expansion is a procedure that helps the body to grow extra skin using a method that
streches the surrounding tissue. A device is put under the skin and filled with a saline
solution to encourage stretching and growing. It can be an involved process depending upon
how much is needed to stretch and grow.
This helps develop skin in the same area needed, so the minimal scarring and difference in
tissue color is not a worry. This process is virtually undetected once the procedure is
complete. The expander may create an unsightly bulge, making this an option that may be
undesirable for some patients.
Advances in surgery help surgeons work many of the most challenging patients in reconstructive
surgery. Depending upon the patient's injuries, the surgeon will use microsurgery or flap
surgery to work through the issues. In using these advanced techniques that may require
the use of robotic operating microscope, plastic surgeons now have the ability to replant
amputated fingers or transplant large sections of skeletal support, skin or even nerves
to another part of the body.
A flap is known as a section of living tissue that carries its own blood supply and is
moved from one area of the body to another. Flap surgery is known to rebuild form and
function to parts of the body that may have lost skin, fat, muscle movement, and/or
skeletal support.
Tumors, whether cancerous and benign, come in a wide variety of shapes, color, and
textures. The removal process depends largely upon the type of growth, what stage of
cancer it may be in, and its location on the body.
Skin cancers and growths are usually removed by excision and closed up, where the growth
is removed in its entirety with a scalpel, leaving a small thin scar. Surgery may be a
necessity if the cancer is large or spreading, using flaps to reconstruct the affected area.
If a defect is congenital or acquired, plastic surgeons can usually restore comfort,
mobility, and normal appearance to patients with hand problems. Defects that are acquired
over time include carpal tunnel and other painful conditions caused by pressure on the
nerves or benign cystic growth and scar contracture which may occur when a wound or burn
on the hand heals poorly, forming scar tissue that curls the fingers or restricts mobility.
Children born with syndactyly (webbed fingers) benefit from finger separation, where a
zig-zag-type incision separates the fingers and works with the tissue between them,
preventing any more growth deformities. If a child is afflicted with polydactyl (extra
fingers), correction is easily accomplished by simply removing the extra digits. Balancing
the structural support of the hand and stabilizing the remaining finger joints to ensure
the hand functions as normally as possible.
The most revolutionary process is that of laser technology. The laser's beauty is that it
has the ability to diminish imperfections or growths with minimal bleeding, bruising, and
scarring. The type of laser treatment you undergo largely depends upon your surgeons
suggestions, and how the procedure will work for you. Treatment methods may vary including
which type of laser and how the laser will appropriately correct the issue at hand.
The number of laser treatments that will be needed depends greatly upon the severity of
the defect. A child with a large scar may need up to ten laser treatments in trying to
achieve satisfactory results, whereas only one treatment may be needed to remove some
small spider veins on the face.
Lasers have a number of valuable uses, but a laser should not undermine traditional
surgery. For more traditional types of plastic surgery, the scalpel is still the proven
tool of choice.
Options vary greatly in the types of reconstructive surgeries out there. It is important
to discuss with your surgeon your realistic goals and hopes for the outcome of the
surgery. It is important to be able to communicate with your surgeon about your concerns,
and have them answered prior to deciding to go follow through with surgery. Research and
knowledge are your number one priorities in this case, to get the outcome you seek.
Many times reconstructive surgery happens when facial injuries, skin cancer, or a
poorly executed rhinoplasty has happened. It can be devastating to a patient's appearance
and self-confidence.
An unfortunate effect of rhinoplasty may be a surgery that fails to produce the desired
effect, and the patient may need to opt for a revision procedure. Revision rhinoplasty
requires a greater level of expertise and precision, due to the structure of the original
nose having changed. In some instances, there may be bone loss and minimal cartilage to
work with, with the added pressure of scar tissue being present. It is important to
choose a surgeon who has excellent experience in both reconstructive nasal surgery and
cosmetic rhinoplasty to ensure you get the best results.
With the nose being an important and delicate facial feature, reconstruction may be used
to correct problems, such as breathing difficulties or damage incurred through injury.
Nasal reconstruction rhinoplasty involves the reshaping of the nose through very discreet
incisions. Removing or repositioning bone and cartilage in the nose, breathing problems
can stabilize and reshaping can take place.
Your face is not the only place reconstructive surgery can take place. Yearly, the ozone
layer gets increasingly thinner and because this layer serves to protect our skin from
ultraviolet rays of the sun, its destruction ensure the rise of skin cancer. In fact, it
is estimated that half of Americans will develop skin cancer by the time they reach the
age of 65.
With skin cancer the good news is that if it is found and removed early enough, it has a
high rate of successful treatment. Once a cancerous area of skin has been found, its
stage of growth and type will be determined. Then, the area will be treated in one of
the following ways:
- Excision - removal of the area with a scalpel
- Cryosurgery - freezing of the cancerous cells
- Radiation therapy
- Topical Chemotherapy - application of drugs directly to the skin
- Mohs surgery - layer-by-layer removal of the cancerous lesion
Many people are unaware of that Mohs surgery is - it is one of the most effective ways
to remove skin cancer and reduce the chances of recurrence. In Mohs surgery, layers of
tissue are removed and examined under a microscope until all of the cancerous cells are
gone. Mohs surgery may leave an unsightly scar, but your surgeon will aid in correcting
this. Mohs surgery is often done on the face, and reconstructive surgery can be an
effective way of disguising scars and minimizing the damage left behind by the procedure.
Another non - facial reconstructive procedure is microtia. Microtia is a congenital
condition in which an infant is born is without external ears or with severe ear
deformities. Microtia may affect one or both ears with hearing also affected. The
fortunate part of the situation is that the problem can be improved through reconstructive
surgery. Surgery for microtia is a very intricate procedure that requires detailed
knowledge of both facial plastic surgery and otolaryngology.
Although all scars cannot be repaired to be invisible, your surgeon will be able to
aid in the minimization of reconstructive surgery scars. Always seek the advice of a
surgeon before making any plastic surgery decisions. It is important you are well
educated on the options and abilities that doctor's have- and what will be a realistic
expectation for you. You and your surgeon will be able to best determine that once you
have discussed your desires and expectations with them.
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Cosmetic/Plastic Surgery
