RECONSTRUCTIVE PLASTIC SURGERY

Plastic Reconstructive surgery

All kinds of facial injuries, whether they are facial injuries or facial bone fractures, are related to each other and deserve special care due to their enormous functional and aesthetic significance.

It is very important for the patient to seek for a plastic surgeon’s advice immediately, as the secret for the best reconstruction lies not in waiting too long but in beginning too soon. Be aware that your plastic surgeon’s goal is to minimize any scars as well as to repair any damage.

Scalp, calvarium and forehead reconstruction

The coalescence of several bones around the brain forms a protective covering known as the calvarium. This bony armor serves to absorb the blunt and sharp injuries and is itshelf protected by the overlying soft tissue of the scalp. In case of loss of this protective covering we may have desiccation of the calvarium and the development of infection and sequestration which can lead if not taken care in due time – to chronic wounds, denuded bones and dense scars. These prolonged intracranial complications can end up in scar carcinomas. Reconstructive efforts in this area must thus be made immediately.

Reconstruction of the Eyelids and Eyebrows and correction of ptosis of the eyelid

Reconstruction of the Eyelids and Eyebrows may be indicated after ablation due to trauma, tumor excision or burns. Once the decision is made for reconstruction, the method to be used will be chosen by your plastic surgeon based on a number of factors, including the size of the defect, if exposed bone is present, and if available local skin is available for flap coverage.

As far as the Correction of Ptosis of the Eyelid is concerned there is a great variety of techniques. However, your plastic surgeon after estimating the root of the problem and taking into account other previous problems will finally select the appropriate process with which the eyelid will be aesthetically corrected and it will require a good function

Reconstruction of the Ear

There is a great variety of reasons for which an ear requires reconstruction. There are also various techniques for its reconstruction. As every case is unique your plastic surgeon will select the most effective one which will bring recompensating results.

Nasal Reconstruction

Due to its central location on the face and its projection the nose is most vulnerable to severe injuries. Besides the nose is one of the most common sites of cutaneous malignancy, especially basal cell carcinoma. When it comes to its reconstruction there are various techniques which enable a plastic surgeon to achieve his goal; the nose should regain its good function and shape.

Thermal and Electrical Injuries

In these cases, the goal during the first 24 hours is to restore and maintain adequate tissue perfusion and oxygenation, avoid organ ischemia, and preserve heat-injured but viable soft tissue while minimizing any exogenous contribution to edema in non burned tissue.

Basal and Squamous Cell Carcinoma of the Skin

There is agreement that squamous cell carcinomas arising in skin damaged by sunlight do not metastize readily. Cancers that develop in scars or old burns or those that are produced by chemical carcinogens have a much higher rate of metastasis.

Therefore, it is absolutely essential the immediate excision of the lesion before they become more aggressive.

Malignant Melanoma

A continuous rise in cutaneous malignant melanoma over the years has led to early diagnosis and improved ability to assess the histologic and biologic attributes of this potentially lethal form of cutaneous cancer.

Wide surgical excision of the primary tumor is generally performed in all instances following the histopathologic diagnosis of melanoma. The goal is to remove any residual melanoma cells from the site and thus prevent local recurrence.

Once surgery is over the need for periodic follow-up is emphasized and excessive sun exposure is discouraged.

Pressure Sores

Avoidance of pressure is the guiding principle to the treatment and prevention of pressure sores. Management of pressure sores is one of the most difficult challenges of reconstructive plastic surgery.

Excision of the ulcer ad necrotic tissue with the underlying bursa is necessary prior to closure. The closure is done with regional rotation flaps.

Skin and Soft tissue Replacement in the Hand

When tissue loss in the hand prevents direct wound closure, adequate coverage usually requires either a skin graft or tissue flaps.

In cases where tumor is diagnosed, first it is excised and then closure follows up.