Reconstructive plastic surgery is much different than cosmetic plastic surgery. Cosmetic procedures are usually done to change or improve appearance. Reconstructive procedures are done for medical reasons.
Reconstructive surgeons repair severe wounds caused by accident, burn or other trauma. Wounds often are large, jagged or missing skin tissue. Surgeons also correct birth defects, such as cleft lip, and defects caused by disease. These are conditions that cause pain, loss of function or movement and disfigurement.
“Reconstructive procedures are more complex than cosmetic surgeries and take more time to heal,” says Salvatore Pacella, MD, a board-certified plastic surgeon and division head of plastic and reconstructive surgery at Scripps Clinic.
“The primary goal of reconstructive plastic surgeons is to help patients return their bodies to optimal form and function,” he says.
Health plans usually cover reconstructive procedures that are medically necessary. Most plans do not cover procedures done purely for cosmetic reasons.
Reconstructive surgery procedures often involve muscles, bones, nerves, tendons, ligaments and other tissues. Procedures are based on type and severity of the wound, including surgical wounds.
Skin grafts take tissue from one part of the body and suture it over the wound. They are often used for burn patients. Generally, skin is taken from an area that is typically hidden by clothing.
Recovery can range from three weeks to a couple of months, depending on the type of wound and skin graft.
Skin cancer removal and reconstructive procedures are often done in sequence. Mohs skin cancer surgery is effective for larger forms of skin cancer. Reconstructive surgery repairs the wound and improves the appearance of the skin cancer treatment area.
“Many times, a reconstructive plastic surgeon can manipulate soft tissue in a geometric way to close the wound. This solution is called a flap and is very common after Mohs Surgery,” Dr. Pacella says.
Microsurgery is used to repair nerves and blood vessels. It involves transplanting skin, muscle or bone from one area of the body to another. It is commonly done for breast reconstruction, jaw recreation and to improve movement and function of severely disabled extremities.
Deep inferior epigastric perforator (DIEP) is a type of breast reconstructive surgery, done to restore one or both breasts to a more natural shape and appearance. In a DIEP flap procedure, fat from the abdomen is used to reconstruct breast tissue after surgery to treat or prevent breast cancer.
In very large wounds, skin can be grown through a process called tissue expansion and used for replacement of damaged skin. It is often used in breast reconstruction.
A balloon expander gradually stretches the skin, and the extra tissue is used for the procedure. Tissue expansion requires patience as it can take a couple of months to complete.