Plastic and reconstructive surgeries are terms that are used interchangeably and aim to treat body structures affected aesthetically or functionally by conditions such as congenital, developmental abnormalities, trauma, injury, infection, birth defects, tumour or disease. The surgeries are primarily done with the intention to enhance the functionality, while in some cases, it could also involve improving the physical appearance of the affected body structure. While technically the surgery aimed to enhance the functionality is known as reconstructive surgery, while the one used to improve the appearance of the body structure is categorised as plastic surgery. Though, both types of surgeries differ from cosmetic surgery, which is solely done to improvise physical appearance due to personal reasons or age. Reconstructive surgery procedures are the primary basis of all plastic surgeries, with the aim to improve the functionality and appearance of structures after congenital, acquired or traumatic problems.  

Who needs reconstructive plastic surgery?

Broadly, two types of people opt for reconstructive plastic surgery, including:

  • People who have birth defects such as cleft lip, facial anomalies, hand deformities, etc.
  • People who deformities caused because of accidents, infection, injury, tumour disease or increasing age. 

Types of Reconstructive Plastic Surgery

There are several types of reconstructive plastic surgery, which is done to improve functions and correct appearance. 

Brachial Plexus Repair: The brachial plexus is a complex network of nerves that monitors the movement and sensation of the arms and hands. This surgery is done to reconnect nerves or repair nerves by using high-powered microscopes and specialised instruments. The aim of the surgery is to restore control of the nerves lost due to trauma, age, weakness, injury, disease, cancer, etc.  

Breast Reconstruction: A surgery that involves reshaping or rebuilding the breasts that have been deformed or removed due to breast cancer or any other problem. The surgery involves using autologous tissue, prosthetics, etc. to reconstruct a natural-looking breast. 

Breast Augmentation and Reduction: A breast augmentation or reduction surgery is undertaken to increase or reduce the size of the breasts that are deformed genetically or due to certain disease or problem. The surgery can also change the shape of the breasts. Breast augmentation is considered by women who either feel that their breasts are small, disfigured, varied in size, or if the breasts have changed post-pregnancy. The surgery involves saline or silicone gel prosthetics.  

Breast reduction involves reducing the size and weight of heavy breasts, creating a more balanced breast contour in proportion to the body. 

Palatoplasty: This surgery is specialised to reconstruct the palate in a person with a cleft lip. 

Gynecomastia: This is a surgery to reduce the enlarged male breasts by removing excess fat and glandular tissue in order to provide a flatter, firmer and enhanced masculine contour to the chest. 

Hand Surgery: Hand surgery comprises of various sub-surgeries all of which mainly aim to restore the functionality of the hand and fingers, which could have been impacted due to injuries, trauma and rheumatic diseases – that change and damage the structure of the hand. This includes tendon and nerve repair, joint replacement, etc. 

Scar Revision: A type of surgery which is undertaken to improve the condition and appearance of the scars on any body part. This surgery also aims to restore any lost function, correct skin disfigurement, which can be a result of a wound, trauma, injury, accident, poor healing or an old surgery. This can further be categorised into:

  • Hypertrophic scars
  • Contractures
  • Facial scars

A speciality of the surgery known as Z-Plasty can be done to reposition the scar. 

Main Techniques of Plastic and Reconstructive Surgery

Some of the main techniques that are used to perform plastic and reconstructive surgeries include: 

Skin Grafting: This technique is used to take a healthy patch of skin from a body part and moving it, transplanting it to another area of the body whose skin cover could have been damaged due to reasons such as burn, injury, illness, etc. 

Tissue Expansion: A surgical procedure that enables the body to grow additional skin by stretching the surrounding tissue. In this surgery, an expander (a balloon-like device) is put under the skin near to the area that needs to be repaired; the area is then slowly filled with salt water to make the skin stretch and grow. 

Flap Surgery: This is a very common technique in plastic and reconstructive surgery in which a tissue is lifted from an area known as the donor site and is moved to a recipient area with intact blood supply. It is different from a flap surgery since the recipient has its own blood supply unlike in graft. 

Microsurgery: Microsurgery uses magnification and very tiny sutures to connect small arteries, veins and nerves in order to reinstate the blood or nerve supply to living tissue.

In all, plastic and reconstructive surgery is a boon for people with deformed and dysfunctional structures. However, it must be undertaken after careful consideration and consultation with the doctor. 

Complications of reconstructive plastic surgery

While the complications involved in a reconstructive plastic surgery depend on the type of surgery and the structure concerned; though some general complications involved are:

  • Infection
  • Bleeding
  • Bruising
  • Anaesthesia allergies
  • Blood clotting
  • Pain 

Risks Factors

Some people are at higher risk of facing complications during the surgery. These risks factors include:

  • Smoking
  • Connective-tissue damage
  • Exposure to radiation
  • Increased blood circulation at the concerned site
  • Compromised immune system
  • HIV Infection
  • Poor nutrition

Present health conditions play a very critical role in determining the complications of the surgery; hence, a detailed discussion with the doctor about the existing health problems such as heart disease, lung problem, diabetes, etc. – is necessary before deciding on the surgery.