Reconstructive plastic surgery is a branch of plastic surgery that focuses on restoring the form and function of body parts that may be affected by congenital deformities, developmental abnormalities, trauma, infection, tumors, or disease. Unlike cosmetic surgery, which is performed to enhance appearance, reconstructive surgery aims to repair or rebuild structures to improve functionality and appearance. 

Reconstructive surgery is used to treat many different diseases, ranging from conditions of the top of the head to the tip of the toe, and from newborn babies to the extremely elderly.

 

The main goals of reconstructive surgery are function restoration and human mending. It is done to fix and restructure body structures that have been impacted by illness, infections, tumors, trauma, aberrant development, and birth defects.

 

Plastic surgeons fill in gaps and fix damage mostly by moving tissue from one area of the body to another using a variety of reconstructive techniques. Their primary goal is to return the body, or a particular body part’s function, to normal.

What problems and conditions are treated with Reconstructive Surgery?

Breast Reconstruction:

This procedure is often performed after a mastectomy (removal of the breast) due to breast cancer. It aims to restore the breast’s appearance, shape, and symmetry.

Cleft Lip and Palate Repair:

Cleft lip and palate are congenital conditions where there is an opening or gap in the upper lip and/or the roof of the mouth. Reconstructive surgery is performed to close these gaps.

Hand Surgery:

Hand surgery may be needed for conditions such as congenital deformities, injuries, or carpal tunnel syndrome. Procedures aim to restore hand function and appearance.

Maxillofacial Surgery:

This includes a range of procedures to address facial trauma, congenital deformities, and abnormalities of the jaw, face, and skull.

Scar Revision:

Scar revision surgery aims to minimize the appearance of scars resulting from injuries, surgeries, or other traumas. Techniques may include excision, laser therapy, or tissue expansion.

Burn Reconstruction:

Following severe burns, reconstructive surgery may be necessary to restore functionality and improve the appearance of the affected area.

Skin Grafts and Flaps:

Skin grafts involve taking skin from one area of the body and transplanting it to another to cover a wound or defect. Flap surgery involves moving tissue along with its blood supply to reconstruct a damaged area.

Microsurgery:

Microsurgery involves using specialized instruments to repair small blood vessels and nerves. It is often used in procedures like free tissue transfer for complex reconstructions.

Ear Reconstruction (Otoplasty):

Ear reconstruction may be performed for congenital deformities or as a result of trauma. It aims to restore a natural-looking ear shape and position.

Abdominal Wall Reconstruction:

This procedure is often performed after trauma or surgery, such as in cases of hernia repair or abdominal wall defects.

Gender Confirmation Surgery (Gender Reassignment Surgery):

This involves surgical procedures to modify the physical characteristics to align with an individual’s gender identity.

Reconstruction after Skin Cancer Removal:

Following the removal of skin cancer, reconstructive surgery may be necessary to repair the affected area and minimize cosmetic impact.

It’s important to note that this list is not exhaustive, and reconstructive plastic surgery encompasses a wide range of procedures tailored to individual patient needs. The specific procedure recommended will depend on the nature of the condition or injury and the goals of the patient and surgeon. Surgeons in this field work closely with patients to address both the functional and aesthetic aspects of the reconstructive process.

What Techniques are used?

Reconstructive surgery involves various techniques to restore the form and function of body structures affected by congenital conditions, trauma, tumors, or disease. The choice of technique depends on the specific needs of the patient and the nature of the condition being addressed. Here are some common techniques used in reconstructive surgery:

Skin Grafting:

Skin grafts involve taking a piece of skin from one area of the body (donor site) and transplanting it to another area (recipient site). This technique is often used to cover wounds, burns, or areas where skin has been removed.

Flap Surgery:

Flap surgery involves moving a section of tissue, along with its blood supply, from one part of the body to another. This technique is useful for larger defects and is commonly employed in breast reconstruction, facial reconstruction, and complex wound closures.

Tissue Expansion:

Tissue expansion is a technique that involves stretching nearby tissue to provide extra skin for reconstructive purposes. A balloon-like device called a tissue expander is placed under the skin, and over time, it is gradually filled with saline to stretch the skin.

Microsurgery:

Microsurgery involves using specialized microscopes and precision instruments to perform surgery on small structures like blood vessels and nerves. It is commonly used in free flap procedures, where a segment of tissue with its blood supply is transferred to another site.

Cartilage Grafting:

Cartilage grafts may be used to reconstruct or augment structures such as the nose or ears. Cartilage can be harvested from the patient’s own body (autograft) or obtained from a donor source.

Bone Grafting:

Bone grafts involve taking bone from one area of the body and transplanting it to another to repair bone defects or enhance bone structure. This technique is often used in maxillofacial and orthopedic reconstruction.

Dermal Matrix or Tissue Substitute:

Dermal matrices are biomaterials that can be used as a substitute for skin or connective tissue. They provide support for tissue regeneration and can be used in various reconstructive procedures.

Nerve Grafting:

Nerve grafting involves the transplantation of nerve tissue to repair damaged or severed nerves. This technique is used to restore sensation and function.

Laser Therapy:

Laser therapy may be used for scar revision or to treat skin conditions. It can help improve the appearance of scars and promote skin regeneration.

Z-plasty and W-plasty:

These are surgical techniques used to reposition scars, particularly in cases where the scar interferes with function or aesthetics. They involve creating Z or W-shaped incisions to alter the direction of the scar.

Functional Reconstruction:

Functional reconstruction involves restoring not only the appearance but also the function of a particular structure. This can include restoring range of motion, strength, or sensory function.

Composite Tissue Transplantation:

In some advanced cases, composite tissue transplantation, such as hand or face transplantation, may be considered. This involves transplanting a combination of tissues (skin, muscle, bone, nerves) from a donor to a recipient.

These techniques are often used in combination, and the choice of method depends on factors such as the patient’s anatomy, the extent of the reconstruction needed, and the surgeon’s expertise. Reconstructive surgery aims to provide comprehensive and personalized solutions to address the unique challenges of each patient.