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Reconstructive surgery

WHAT IS RECONSTRUCTIVE PLASTIC SURGERY?
Injuries, disease, and birth defects can all lead to deformities that can be repaired with reconstructive plastic surgery.
Although surgery can restore form and function to improve your condition, it can’t fulfill unrealistic expectations. Your best results will occur when you work closely with your plastic surgeon to set realistic goals.
This page presents an overview of the indications and applications for the following reconstructive plastic surgery procedures:
Breast reconstruction
Breast reduction
• Cleft lip and palate repair
Ear surgery
• Tumor removal
Hand surgery
• Scar revision
• Skin cancer removal

BREAST RECONSTRUCTION
If you lost a breast or were disfigured by mastectomy, several surgical techniques can be used to reconstruct a new breast:
The flap technique forms a natural breast shape using donor sites that may include the abdomen, back, or buttocks.
Implants can create a new breast mound. Tissue expansion aids in the formation of new tissue.
Tissue expansion is used after mastectomy when not enough healthy tissue remains to cover and support the breast implant.
Nipple and areola reconstruction is achieved through additional grafting techniques and tattooing to provide areola (pigmented skin surrounding the nipple) color. Click here to learn more.

 

BREAST REDUCTION
Surgery can correct disproportionately large, sagging breasts through the removal of excess fat and tissue to create a smaller, better-positioned breast. Depending on the size and position of your breasts, incisions may include a keyhole pattern,
vertical pattern, or circular pattern. Excision techniques are recommended for removing glandular breast tissue or excess skin.
Liposuction is used when fatty tissue is the primary source of breast over-development. Incisions are commonly hidden at the areola, in the underarm area, or in the breast crease. Reduction in the size of an enlarged areola may also be performed.
Your breast reduction surgery may or may not be covered by insurance. Carefully review your policy to determine coverage. Click here to learn more.

 

CLEFT LIP AND CLEFT PALATE REPAIR
A cleft lip is an incomplete upper lip formation that appears as a separation on one or both sides.
A cleft palate is an incomplete formation of the upper palate's hard or soft parts inside the mouth. Both cleft lip and cleft palate are present at birth. These defects may cause impaired feeding, speech, dental development, and hearing and will
require surgical treatment by a team of specialists.
Cleft lip repairs are initially performed when a child is at least 10 weeks of age, 10 pounds in weight and has a hemoglobin (or blood count) of at least 10.
Cleft palate repairs are generally performed when a child is somewhat older, from six to 18 months of age.
Correction of a cleft lip or palate usually requires multiple procedures during a child’s growth and development. Intervention is recommended early because of other medical problems that can be associated with clefting.

 

EAR SURGERY
Surgical techniques create or increase an underdeveloped ear fold or reduce enlarged cartilage to create a more normal appearance. Conditions that can be treated include:
• Overly large ears – a rare condition called macrotia
• Protruding ears occurring on one or both sides in varying degrees – not associated with hearing loss. Click here to learn more.
• Underdeveloped or disfigured ears – a rare condition called microtia
In rare conditions like microtia, reconstruction requires staged surgical procedures to create a more normal external ear and improve hearing.
An individualized surgical plan is required for ear surgery to define goals and achieve desired results.

 

TUMOR REMOVAL
One of the most commonly performed reconstructive surgeries in the United States is tumor removal. Plastic surgeons can perform these procedures on benign or malignant tumors. Tumors can vary in size, structure, and severity.
Therefore, the methods for removal depend on a number of factors, including:
• Location
• Potential for recurrence
• Size
• Stage or development
• Type
Tumors can be benign or malignant in various sizes, so treatment depends on several factors. In small tumor removal, a surgeon will extract the tumor or the cancerous area with a scalpel and stitch up the wound or allow it to heal on its own. In cases of large tumors or spreading skin cancers, major invasive surgery is required, involving skin grafts or flaps to reconstruct the treated area. With the surgical removal of malignant tumors, there’s a risk of cancerous cells spreading to healthy areas of the body, a condition known as seeding.
There are two special techniques that may be used to help prevent seeding:
• Block resection: the entire specimen is removed as a single piece
• No-touch technique: the tumor is removed by handling only the healthy tissue that surrounds it; the tumor is never touched

 

HAND SURGERY
Plastic surgery can correct structural and functional irregularities and restore a more normal appearance of the hand and fingers. Conditions treated by hand surgery include:
• Abnormal nerves or blood vessels
• Carpal tunnel syndrome
• Dupuytren’s contracture
• Immobile tendons
• Traumatic injuries
• Missing digits
• Polydactyly (extra) finger
• Short or crooked fingers
• Syndactyly (webbed fingers).
 Click here to learn more about hand surgery.

 

SCAR REVISION
Excessive scar formation, which may cause restricted movement, can be repaired. Common scar formations include keloids, hypertrophic scars, and contracture. Scar revision includes:

Topical treatments such as gels, tapes, or external compression can help in wound closure and healing or reduce the ability of the skin to produce irregular pigment.
Injectable treatments are often used to fill depressed or concave scars.
Surface treatments such as dermabrasion, laser or light therapy, chemical peel solutions, or skin bleaching agents can improve scar appearance and texture.
Excision to remove, narrow, or change the direction of a scar.
Pharmaceutical tissue substitutes may be used if ample, healthy tissue is not present for the closure of a scar incision. Tissue may
be an alternative.


SKIN CANCER REMOVAL
A variety of techniques are used to remove and treat malignant lesions of the skin. Treatment of skin cancer with plastic surgery is designed to maximize cure rates and minimize any resulting disfigurement in appearance.
Simple excision of the cancer with a surrounding rim of normal skin and tissue treats small lesions, leaving a small, localized scar. Microscopic examination of the lesion during surgery assures complete excision of the cancerous tissue.
Larger lesions and those affecting underlying tissue and structures require more advanced treatment.
Reconstruction may use advanced flap techniques to repair the excision wound and restore a more normal appearance.
Additional treatments to improve cure rates include radiation therapy.

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