What is reconstructive surgery?

Reconstructive surgery is another type of plastic surgery. It aims to improve

function and to give a normal appearance to a part of the person’s body that has
been damaged.
Reconstructive surgery is all about repairing people and restoring function. It is
performed to repair and reshape bodily structures affected by birth defects,
developmental abnormalities, trauma/injuries, infections, tumours and disease.

Using a wide range of reconstructive techniques, plastic surgeons mend holes and
repair damage primarily through the transfer of tissue from one part of the body to
another. Their main aim is to restore the body, or the function of a specific part
of the body, to normal.

However, plastic surgeons carrying out reconstructive surgery also try to improve
and restore appearance. Wherever possible they attempt to minimise the visual
impact of the initial wound or defect, and the impact of the surgery itself.

Problems and conditions are treated with reconstructive surgery.

Reconstructive surgery is used to treat a wide range of conditions which fall into
the two following categories, congenital and acquired:

A. Congenital
Congenital conditions are those that are present at birth. Congenital conditions
that are treated with reconstructive surgery include:

•  Cleft lip and palate

Using local flaps and grafts, surgeons can repair the incompletely fused area of
the lip and palate.
•  Vascular anomalies, such as birthmarks
Surgical excision, combined with other treatment options, are available for the
treatment of arteriovenous malformations (AVM) and certain haemangiomas.
•  Prominent ears, constricted ears and microtia
Reconstructive surgery is used to correct all manner of ear defects; techniques
include otoplasty for prominent or constricted ears and ‘autogenous ear
reconstruction’ for the treatment of microtia.
•  Hypospadias
Soft tissue reconstruction is used to correct this defect of the urethra in baby
boys.
•  Craniofacial conditions
Reconstructive surgery is used to correct a wide range of cranial and facial
deformations, such as craniosynostosis.
•  Hand deformities
Plastic surgeons can also correct birth defects of the hand – e.g. where a child
has been born with too many or too few digits.

B. Acquired
Acquired conditions are those that develop or occur after birth. They can involve
disease and infection, or they can involve accident and injury. Acquired conditions
that are treated with reconstructive surgery include:

•  Cancer
Plastic surgeons spend a great deal of time operating on cancer patients.
Reconstructive surgery, mainly excision, closure and flap reconstruction, is used
to treat a range of cancer conditions, especially cancer of the skin, breast, head
and neck and sarcoma.
•  Trauma
Reconstructive surgical techniques are crucial in the treatment of trauma and
injury. These injuries most commonly involve the hand – in fact, 50% of the work
carried out in many plastic surgery units is concerned with hand trauma. The
treatment of open fractures of the lower limb is also common, as is surgery to
repair soft tissue injuries of the face.
•  Infection
Reconstructive surgery is used to remove dead tissue following severe infections
and to repair the surrounding area.
•  Burns
Plastic surgeons are the primary clinicians involved in the resuscitation, surgical
treatment and reconstruction of patients who have suffered burns.
•  Hand surgery
Plastic surgeons are involved in the management of a wide range of conditions that
affect the hand including nerve compression, paralysis, arthritis, ganglions.

COSMETIC SURGERY

Cosmetic surgery is a type of plastic surgery that aims to improve a person’s

appearance, but it should be approached with caution.Cosmetic surgery is an
extension of reconstructive surgery in which the main functional gain to be
expected is an improvement in appearance. 

Types and uses

A variety of aesthetic procedures is available for different parts of the body.

1 .Breast surgery

Breast augmentation, or enlargement, traditionally performed using saline or

silicone gel prosthetics, and now occasionally with fat grafting.

2. Liposuction

Liposuction, or suction-assisted lipectomy, uses thin cannulas, or hollow metal

tubes, to vacuum fat from various parts of the body, usually the abdomen, thighs,
buttocks, hips, backs of the arms, and neck. Liposuction may also be used for male
breast reduction.

3. Vulvovaginal surgery

Labiaplasty, labioplasty, labia minor reduction, or labial reduction involves

surgery of the labia majora or labia minora of the vulva, a part of the female
genitalia. 

4. Facial cosmetic surgery

Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age, the skin
becomes lax, and there may be drooping or hooding of the upper lids, and bags on
the lower lids. Eyelid surgery may be functional, cosmetic, or both

5. Body procedures

Abdominoplasty, or “tummy tuck” reshapes and firms the abdomen. Excess skin and fat
is removed from the middle and lower abdomen, with the aim of tightening the muscle
and fascia of the abdominal wall.
In rhinoplasty, also known as a “nose job,” the surgeon reshapes the patient’s nose
to improve the appearance and often breathing, too. It may involve reshaping the
tip and reducing the bony hump at the upper aspect of the nose.
It can be performed with small incisions that are well hidden, often inside the
nostrils. Surgeons do not recommend rhinoplasty until the patient is at least 15
years old, to allow for full growth of the cartilage and bone of the nose.

6. Facial cosmetic surgery

Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age, the skin
becomes lax, and there may be drooping or hooding of the upper lids, and bags on
the lower lids. Eyelid surgery may be functional, cosmetic, or both. It usually
involves removing or repositioning excess skin and fat, and the procedure may
reinforce surrounding muscles and tendons.

Surgery can change the shape of the face or tighten the skin.

A) In rhinoplasty, also known as a “nose job,” the surgeon reshapes the patient’s
nose to improve the appearance and often breathing, too. It may involve reshaping
the tip and reducing the bony hump at the upper aspect of the nose.

It can be performed with small incisions that are well hidden, often inside the
nostrils. Surgeons do not recommend rhinoplasty until the patient is at least 15
years old, to allow for full growth of the cartilage and bone of the nose.

B) Otoplasty, or ear surgery, treats prominent or misshapen ears by surgically

“pinning” the ear closer to the head with sutures, reshaping the cartilage, or
both.
One or both ears may be treated. It is most commonly performed in children after of
5 or 6 years as the ears have essentially reached adult size by that age.

C) Rhytidectomy, also known as a facelift, aims to surgically remove wrinkles and

tighten facial skin in order to achieve a more youthful appearance.
Typically, the incision is placed in front of and behind the ears, extending into
the hairline in the temple area. The skin is lifted off the deeper facial tissue,
redraped more tightly, and the excess skin is removed. The incisions are then
closed with sutures.
The deeper tissues of the face and neck may also be tightened. Blepharoplasty, or
eyelid surgery may be done at the same time.

D) A brow lift, browplasty, or forehead lift aims to remove signs of aging by

raising drooping eyebrows and removing forehead wrinkles, or worry lines. It is
often done alongside other cosmetic procedures to achieve a more harmonious facial
appearance.

E) Chin augmentation aims to make the chin more prominent and provide a better
balance of facial features. It may be done at the same time as rhinoplasty,
depending on the measurements taken before surgery. It can be performed with either
a prosthetic implant or through manipulation of the chin bone.

E) Malar, or cheek, augmentation can make the cheekbones more prominent. The

surgeon may place an implant at the top of the cheekbones.

7. - Peels, fillers, grafts, and laser treatment.

Less invasive treatments may include peels, fillers, injections, grafting, and
laser treatment.
1.- Chemical peels may help treat acne, pock marks, scars, or wrinkles. A number of
active agents may be used.
A light or superficial peel uses Alpha Hydroxy Acids (AHAs) such as glycolic,
lactic, or fruit acids to treat the outermost layers of the skin. The treatment is
not as deep as with some peels, so the recovery time is minimal.

2.- Botulinum toxin, or botox, is the brand name of a toxin produced by the
bacterium Clostridium botulinum (C. botulinum), first approved by the FDA in the
1980s for muscle spasm.
A range of cosmetic surgery procedures aim to improve appearance.
It is used to treat wrinkles and facial creases.
It acts by blocking the signal from nerves to the muscles that are injected. The
injected muscle can no longer contract, or tighten, as forcefully as before, and
this leads to a controlled relaxation of the muscles.

3.- Soft tissue fillers, or dermal fillers, are medical device implants approved by
the FDA for use in helping to create a smoother, fuller appearance in the face.
They can be used to treat nasolabial folds, cheeks, and lips, and to increase the
volume of the back of the hand.
They can also reduce wrinkles, lines and scars, and augment soft tissue contours.
They are not permanent, but they are degraded by the body, so repeat treatments may
be necessary to maintain the effect.

4. Fat injections and fat grafting have broad applications in cosmetic surgery.

The patient’s own fat is collected from one part of the body using liposuction, and
it is injected into areas requiring volume enhancement. It is usually applied to
the face, including the lips, the hands, and depressions in skin contour.

5. - Stem-cell enriched fat grafts have been trialed for reconstructive surgery,

with promising results, suggesting that the procedure is reliable, safe, and
effective. However, tumor growth may be an adverse effect, so further research is
needed before stem cells can become central to plastic and reconstructive surgery.

6.- Lasers and light-based facial treatment, also known as facial laser resurfacing
or laser skin treatment, can help reduce fine lines, wrinkles, and abnormal
pigmentation, such as sunspots. Treatment utilizes concentrated, pulsating beams of
light.

8. -Hair transplantation.

Surgery can return hair growth to those with hair loss.

Hair transplantation is a kind of cosmetic surgery ,can help renew hair growth.
Tiny hair follicle grafts are obtained from the back of the scalp, where hair tends
to be denser. It is then transplanted with minute incisions to the areas of the
scalp that are affected by hair loss.
Patients may need several sessions to achieve the desired results. After 6 weeks,
the transplanted hair will fall out, but about 3 months later, new hair will
appear.

Anyone who is considering cosmetic surgery should stop smoking or using any tobacco
products several months prior to any procedures, as they can interfere with wound
healing.