The goals of reconstructive surgery differ from those of cosmetic surgery. Reconstructive surgery is performed on abnormal structures of the body, caused by birth defects, developmental abnormalities, trauma or injury, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance.

There are two basic categories of patients: those who have congenital deformities, otherwise known as birth defects, and those with developmental deformities, acquired as a result of accident, infection, disease, or in some cases, aging.

If you would like additional information about reconstructive procedures, please review the links below.

Reconstruction After Skin Cancer
Flap and Microsurgery
Head and Neck Cancer Reconstruction
Lower Extremity Reconstruction

Information provided by the American Society of Plastic Surgeons.



RECONSTRUCTION AFTER SKIN CANCER

Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each year-and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.

The different techniques used in treating skin cancers can be life saving, but they may leave a patient with less than pleasing cosmetic or functional results. Depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip.

Reconstructive techniques- ranging from a simple scar revision to a complex transfer of tissue flaps from elsewhere on the body-can often repair damaged tissue, rebuild body parts, and restore most patients to acceptable appearance and function.

Most skin cancers are removed surgically. The procedure may be a simple excision, which usually leaves a thin, barely visible scar. Or curettage and desiccation may be performed. In this procedure the cancer is scraped out with an electric current to control bleeding and kill any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks of the surgery are low.

If the cancer is large, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treat- ments for skin cancer include cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin), and Mohs surgery, a special procedure in which the cancer is shaved off one layer at a time. (Mohs surgery is performed only by specially trained physicians and often requires a reconstructive procedure as follow-up.)

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Information provided by the American Society of Plastic Surgeons


FLAP AND MICROSURGERY

Though success will largely depend on the extent of a patient's injury, flap surgery and microsurgery have vastly improved a plastic surgeon's ability to help a severely injured or disfigured patient. Using advanced techniques that often take many hours and may require the use of an operating microscope, plastic surgeons can now replant amputated fingers or transplant large sections of tissue, muscle or bone from one area of the body to another with the original blood supply in tact.

A flap is a section of living tissue that carries its own blood supply and is moved from one area of the body to another. Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support.

A local flap uses a piece of skin and underlying tissue that lie adjacent to the wound. The flap remains attached at one end so that it continues to be nourished by its original blood supply, and is repositioned over the wounded area.

A regional flap uses a section of tissue that is attached by a specific blood vessel. When the flap is lifted, it needs only a very narrow attachment to the original site to receive its nourishing blood supply from the tethered artery and vein.

A musculocutaneous flap, also called a muscle and skin flap, is used when the area to be covered needs more bulk and a more robust blood supply. Musculocutaneous flaps are often used in breast reconstruction to rebuild a breast after mastectomy. This type of flap remains "tethered" to its original blood supply.

In a bone/soft tissue flap, bone, along with the overlying skin, is transferred to the wounded area, carrying its own blood supply.

A microvascular free flap is a section of tissue and skin that is completely detached from its original site and reattached to its new site by hooking up all the tiny blood vessels.

Information provided by the American Society of Plastic Surgeons

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HEAD AND NECK CANCER RECONSTRUCTION

The current treatment in head and neck cancer is based on combined therapy, which includes surgery, radiation therapy, and chemotherapy. The Department of Plastic Surgery works in close coordination with our colleagues in the Department of Otolaryngology and the Department of Dermatology in order to offer the highest quality care to our patients, both in the removal of the cancer and its reconstruction. Successful reconstruction requires careful preoperative patient assessment and development of an individualized treatment plan. Important considerations include tumor stage and prognosis, patient age, sex, body habitus and functional status, available reconstructive donor sites, and the psychosocial make-up of the patient. Advances in the multidisciplinary treatment of these patients have led to improvements in the quality of life after cancer reconstruction.

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LOWER EXTREMITY RECONSTRUCTION

Severe lower extremity trauma can be a devastating injury, leading to significant functional consequences. Advances in surgical and microsurgical techniques have dramatically improved the treatment of complex limb injuries. Injuries such as complex open fractures, injuries involving loss of skin and soft tissue, and amputations can frequently be successfully reconstructed leading to functional outcomes.

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