Reconstructive Surgery

Reconstructive surgery tries to restore the form and functions of the body and is different from cosmetic surgery though the procedures used may be similar. Sometimes accidents, burning, developmental problems, ageing may also result in loss or diminishing of functions of body parts, which can be restored by reconstructive surgery. It is not only plastic surgeons who perform this type of operations. Orthopedic surgeons may repair and restore the functions of hip, joints, tendons and the like. General surgeons, pediatricians, gynecologists can and do also perform similar operations which come under the name of reconstructive surgery.

The goals and the aims of reconstructive surgery differ from cosmetic surgery. The former is performed on abnormal structures of the body. Sometimes infection, disease, tumors, trauma or injury may also result in abnormality, which can be corrected to some extent by reconstructive surgery. The functions which had got impaired may be improved or brought to normal. More than one million reconstructive procedures are performed every year. This type of surgery can be performed on patients of any age. A small child with a birth problem may be cured by reconstructive surgery, a young person who has been a victim of an accident and has lost function of some part of his body, or an older person who has problems with his joints due to ageing, may all benefit from reconstructive surgery.

The patients are divided into two parts, one are those with congenital defects and the second are those with deformities due to accidents, ageing, disease, or infection. However one must realize that reconstructive surgery, like any other medical procedure is not foolproof and may have its own share of risks. Also the end result may not be as normal as one would like it to be. Still, medical science has progressed so much that reconstructive and plastic surgery is achieving near perfection and is able to achieve improvements and perfection in form, appearance and function which was thought to be impossible even just a decade back.

Some common birth defects which reconstructive surgery can improve are cleft lip and palate deformities, webbed fingers, extra or absent fingers and abnormal breast development. Others like pigmentation or blood vessel conglomeration like strawberry marks can be removed through lasers. Acquired deformities due to burn wounds, bone growths or tumors, and ageing can also be corrected and made functional. Some older people may have drooping eyelids which may be blocking their vision, and this can be improved using eyelid surgery. Women with ungainly or sagging breasts due to disease or hormonal changes resulting in physical problems may undergo mammaplasty or breast reduction, which will be more comfortable. Paralysis may affect the appearance, function and symmetry of a person’s face. Reconstructive procedures like a face lift for balancing purposes can help restore some function, at least, to such people.

Sometimes non-bony tissues like ligaments or muscles may get affected due to old age and lose their function gradually. The chronic loss of joint movement due to changes in these ligaments or muscles may result in contractures where the person finds it difficult to move the joints. The skin, underlying tissues, muscles, tendons, and ligaments may affect the joint areas. Scarring or lack of use may lead to contractures.

The external ear or the inner ear may also be affected by birth or injury and can be corrected using proper techniques. Ear reconstruction is quite a challenge for doctors but many have attempted and succeeded. Ear reconstruction demands precise technique along with artistic creativity. Microtia is a birth defect of the external ear where the auricle is severely deformed. Most doctors prefer to perform the reconstructive surgery of the ear when the patient is around 5 to 7 years of age.

When there is a burn, injury or an accident, the wounds caused may heal but a scar may remain behind which impairs the function of the body. Though most scars are flat and pale and disappear with time, there may be a few which are tough and inflexible. The natural collagen fibers are affected and the body has to be stimulated to create more, or else skin has to be developed in another part of the body and grafted to the area of injury and the place of the scar to correct it and restore the function. The body may not build the tissue exactly as it was before and hence the new scar tissue may have a different texture and appearance than the surrounding one. Skin grafts can be made using skin expanders, which are balloon like implants filled with saline water, which is gradually increased making the skin stretch and expand to required amounts. This skin can now be used as a skin graft for the affected parts of the body.

Traumatic injuries to the spinal cord, shoulders and nerves may result in the functions of the hands being impaired. Brachial plexus is the network of nerves coming from the spinal cord. It controls the hand movements. Any injury or disease or even childbirth may result in problems with the hands. This can be cured by reconstructive surgery. For most reconstructive procedures, skin grafts, tissue expansion, laser, flap surgery, microsurgery, incisions, and other such techniques may be used. The surgeon will check thoroughly and decide the form of procedure to be used. He will discus this with the patient and suggests medicines and certain stoppage of medicines like aspirin which prevent clotting of the blood. He may even tell the patient to stop smoking.

During the procedure, general or local anesthesia maybe given depending on the extent of corrective surgery to be done. After the operation, the wound may be closed using sutures and then the whole area may be bandaged and kept closed to prevent infection. There may be edema (swelling) or redness and soreness, or even some fluid or collection of blood in the area. Pain and discomfort can be minimized using painkillers. Every person is different and may take his or her own time to heal. There may be side effects but if the surgeon is immediately contacted, he may prescribe suitable medicines, exercises or movements, which may cure them. Complete healing with the body getting back to normalcy may take a few weeks or a few months. But the body functions and appearance will be better than before.