Definition and Overview

Reconstructive surgery refers to a wide range of surgical procedures performed to restore the original appearance of certain body parts or their function. This is typically performed to correct a deformity caused by illness or trauma. A reconstructive surgery procedure is classified based on the body part that needs to be operated on.

Who Should Undergo and Expected Results

Patients who suffer from deformities or have body parts that have an abnormal appearance due to certain diseases, congenital abnormalities, or injury can undergo reconstructive surgery to restore not just the original appearance but also the function or mobility of the affected body parts. In most cases, reconstructive surgery improves the quality of the lives of the patients or gives paediatric patients a chance to live their lives normally.

However, not all reconstructive surgeries are medically necessary. There are cases where the patient requests for a reconstructive surgery to cosmetically enhance the appearance of a certain body part. Examples of these procedures include reconstructive liposuction or abdominoplasty.

Patients nowadays can expect very realistic results from reconstructive surgeries. The range and techniques used by surgeons are constantly improving; thanks to the continuous development of reconstructive aids and technologies. Some examples are barbed sutures, skin grafts, free flaps, implants, and the use of biomaterial implants that are more compatible with the body and can better assume the original roles of the body parts they are replacing. With these now in use, patients can expect their reconstructed body parts to look and function almost exactly the same way as their original body parts, with very mild differences in sensation and feel.

How Does the Procedure Work?

Reconstructive surgery is often performed based on the concept of a reconstructive ladder, which ranks different cases based on their complexity. The simplest surgeries are those that require only primary wound closure, while the more complex ones may require skin grafts and tissue expansion techniques.

The specific way that a procedure works depends on the type of reconstructive surgery being performed. The most common types include:

  • Skin cancer removal – The surgical procedure performed to treat skin cancer involves the removal of any abnormal skin growths to restore the skin’s normal appearance.

  • Cleft lip and palate surgery – This surgery is performed on young children who are born with congenital cleft lip and palate abnormalities. This is just one of many paediatric conditions that can be corrected through surgery shortly after birth.

  • Scar revision – Scar revision surgeries are performed to improve the appearance of surgical or traumatic scars to restore the normal appearance of the affected body parts. Patients must have balanced expectations when undergoing scar revision surgeries; this is because the result of the surgery depends on the size, location, and depth of the scar. Some scars are hard to mask completely, and the best that reconstructive surgery can do is to reduce their appearance so it they do not have a major effect on the body. Lighter and milder scars, on the other hand, are easier to treat.

  • Burns reconstruction – This type of reconstructive surgery is used to restore the skin’s appearance following injuries due to burns.

  • Breast reconstruction – A breast reconstruction surgery is a procedure that uses a combination of various plastic surgery techniques with the goal to restore the shape, appearance, and size of the breasts following a mastectomy. It is important for surgeons and patients to thoroughly discuss what a patient can expect from this procedure; in some cases, either the mastectomy or the reconstruction itself causes visible incision lines that are difficult to fully mask. Incision lines may also be left at the donor site, although these are usually confined only to body parts that are not often exposed. A breast reconstruction surgery may involve just one or both breasts.

  • Tissue transfers – A tissue transfer or tissue flap transplant is a reconstructive surgery procedure wherein parts of the body are restored to their original look and feel by transplanting tissue from the patient’s own body or a deceased donor. A tissue transfer is performed by removing tissue, such as skin, fat, muscle, nerve, and bone from another part of the body and moving it to the affected area. Attaching the nerves, arteries, and veins is part of the procedure.

Reconstructive surgeries can also be performed following facial and hand injuries as well as in the case of medical conditions that affect the jaw, head, and neck. These surgeries are performed by maxillofacial surgeons and otolaryngologists. The most common cause of the deformity is cancer or the growth of abnormal tumours.

Possible Complications and Risks

The list of possible complications and risks a patient faces following a reconstructive surgery differs depending on the specific type of procedure he underwent. For example, the common complications of breast reconstruction surgery have a lot to do with the implants used to restore the breasts’ appearance following a mastectomy. Saline breast implants surgeries have an overall risk rating of 27.6% with 25.8% of patients needing a second operation due to the deflation of the breast implant. There may also be problems with the symmetry of the original and reconstructed breast, as well as some contour or breast shape issues. Most patients also report an altered sensation. Breast implant patients also face the risk of seroma, or the accumulation of fluid around the implant, which can cause inflammation and swelling.

Other possible complications, which may affect not just breast reconstruction patients, include hypertrophic scarring, hematoma, wound separation, and infection.

References:

  • http://plastic.surgery.ucsf.edu/research.aspx
  • http://medicine.utah.edu/surgery/plastic_surgery/index.php
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