From the top of the head to the tip of the toe, and from newborn babies to the very elderly, reconstructive surgery is used to treat a wide range of conditions.
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.
Cosmetic surgery is an extension of reconstructive surgery in which the main functional gain to be expected is an improvement in appearance.
What 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:
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.
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.
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:
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.
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.
Reconstructive surgery is used to remove dead tissue following severe infections and to repair the surrounding area.
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 and Dupuytren’s Contracture
What techniques are used?
Plastic surgery is a technical specialty with the aim of achieving repair. The word ‘plastic’, which comes from the Greek ‘plastikos’, meaning to mold or shape, indicates that repair is generally brought about by moving tissues. In the UK, the number of practicing consultant plastic surgeons is increasing, as is the number of plastic surgery operations carried out each year. In this respect, plastic surgery is very much a ‘growth specialty’. It is also a discipline in which the scope and range of surgical expertise has improved dramatically in the last thirty years.