Reconstructive Plastic Surgery

What Is Reconstructive Plastic Surgery ?

Reconstructive plastic surgery is performed to correct facial and body abnormalities caused by birth defects, trauma, disease, or aging.

More than one million reconstructive plastic surgeries are performed each year in the US. Usually, the goal of reconstructive plastic surgery is to improve body function. However, reconstructive plastic surgery may also be performed to create a more normal appearance and improve self-esteem (this may also be called cosmetic surgery).

Who are candidates for reconstructive plastic surgery?

Generally, two types of patients have reconstructive plastic surgery, including the following:

  • Persons with congenital anomalies (including cleft lip, craniofacial anomalies, or hand deformities)

  • Persons with developmental deformities (including those due to an accident, infection, disease, or aging)

Preparation

Prepare for your surgery

The type of preparation necessary prior to surgery depends on the type of surgery to be performed and the type of anesthesia that will be administered. Plastic reconstructive surgery may require multiple procedures in several stages. Here are some considerations that you can discuss with your doctor / surgeon before performing the procedure:

  • Ask the surgeon to explain the benefits, risks and expectations of the procedure

  • Discuss the type of anesthesia to manage and what expected recovery time

  • Tell your doctor about any medications (without a prescription or prescription) that you are currently taking, as well as any previous procedures, history of chronic diseases, and / or allergies that you may have

  • Be sure to stop drinking and eating for the recommended time period before and / or after surgery

  • Be sure to follow any special instructions for bathing, shaving, or cleaning before surgery

  • Be sure to discuss any postoperative instructions that must be followed (for example, changing dressings, post-operative medications, and follow-up appointments).

  • Do not wear make-up on the day of surgery, including nail polish. Do not wear eye lenses on the day of surgery. Leave valuables and jewelry at home

  • Advise the medical staff of dentures or other prosthetic devices that you may wear

  • Be sure to arrange all insurance coverage before surgery, as many insurance companies do not cover many types of plastic surgery procedures (especially plastic procedures).

  • Make sure to arrange a home trip after the procedure

Surgical Techniques Used in Plastic Surgery

There are many different techniques used to perform cosmetic and reconstructive plastic surgery procedures, including the following:

Endoscopic Surgery

Endoscopic surgery is performed with an endoscope, a tubular probe that has a tiny camera and a bright light, which is inserted into a small incision. Images from the camera are transmitted back to a screen, which the surgeon watches while manipulating the endoscope inside the body. The endoscope is a device to assist the surgeon during surgical procedures. Instruments to actually perform the surgery are inserted through different incision.

Flap Surgery

Flap surgery involves transporting healthy, live tissue from one location of the body to another – often to areas that have lost skin, fat, muscle movement, and/or skeletal support. There are several different types of flap surgery methods that may be utilized, depending upon the location of the flap and the structures that need to be repaired. The types include the following:

  • Local flap – is located next to the wound; the skin remains attached at one end in order that the blood supply is left intact

  • Regional flap – uses a section of tissue that is attached by a specific blood vessel

  • Bone/soft tissue flap – this type of flap is often used when bone and the overlying skin are transported to a new location

  • Musculocutaneous flap (muscle and skin flap) – this type of flap is often used when the area to be covered needs more bulk and an increased blood supply. This type of flap is often used to rebuild a breast following a mastectomy

  • Microvascular free flap – involves detaching and reattaching skin and blood vessels from one site of the body to another site. Microsurgery is used to attach the blood vessels

Tissue Expansion

A tissue expansion is a surgical procedure that involves inserting a balloon-like device (called an expander) under the skin. The expander then slowly secretes liquid into the area to be repaired to actually stretch and expand the skin. This serves the function of “growing” extra skin to repair nearby lost or damaged skin

Laser Surgery

Lasers used in plastic surgery often provide for minimal bleeding, bruising, and scarring. There are many different types of lasers that may be utilized, depending upon the purpose and location of the surgery to be performed. Consult your physician/surgeon to determine if laser surgery, and which type, is most appropriate for you.

Skin Graft

A skin graft may be used to cover skin that has been damaged and/or is missing. This surgical procedure involves removing healthy portions of skin from one part of the body to restore normal appearance and/or function to another portion of the same body. The place where the skin is removed is called the donor site. There are three different types of skin grafts that may be utilized, depending upon the size and location of needed skin. These include the following:

  • Split-thickness skin graft :

  • Commonly used to treat burn wounds

  • Uses only the layers of skin closest to the surface

  • Donor location site will be chosen based on size, type, and pigment of skin needed

  • Full-thickness skin graft :

  • Used to treat deep and large wounds or scars

  • Used when maximum skin elasticity is needed

  • Uses all layers (not only the surface layer) of skin from the donor site

  • Composite skin graft :

  • Provides the repaired skin with the most underlying support

  • Involves lifting all layers of skin, fat, and sometimes the underlying cartilage from the donor site

Possible complications associated with reconstructive plastic surgery

Abnormal structures of the body may result from the following:

  • Trauma

  • Infection

  • Developmental abnormalities

  • Congenital (present at birth) anomalies

  • Disease

  • Tumors

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