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Home Surgical Procedures Reconstructive Otoplasty

The word “plastic” in “plastic surgery” is derived from the Greek word “plastiki”, or Latin “plasticus”, which is the art of sculpting, shaping, molding or modeling.

Even though aesthetic surgery is the most well known type of plastic surgery, most plastic surgery is not aesthetic. In fact the term “Plastic Surgery” includes other subspecialties namely reconstructive surgery, hand surgery, microsurgery, cranio-facial surgery and the treatment of burns.

Aesthetic Surgery is performed to enhance normal structures, in other words facial or body features patients are not happy with, towards some aesthetic ideal. Such operations do not only improve the appearance of these features but they also have a huge impact on the patients’ self esteem.

Reconstructive surgery, on the other hand, is performed to correct abnormal structures of the body in order to improve the function and appearance of any disfigurements such as those caused by burns, traumatic injuries, congenital and developmental abnormalities.

Hand surgery, as the name suggests, deals with acute injuries and chronic diseases of the hand and wrist, the correction of congenital malformations of the upper extremities and peripheral nerve problems.

Microsurgery is the term used for surgery requiring an operating microscope and is used for the reconstruction of missing tissue. This is done by transferring tissue to the reconstruction site from another area, in other words nerves, muscles, fingers and skin, and reconnecting it to a blood supply by suturing arteries and veins. Nerve suturing and brachial plexus repair is also part of this sub specialty.

Craniofacial Surgery revolves the treatment of congenital and post traumatic anomalies of the craniofacial skeleton and soft tissues.

Last but not least, the treatment of burns involves both the treatment immediately after a burn as well as correcting the damage which remains after the wounds have healed.

This side of plastic surgery is rather complicated and in many cases it requires extensive and round the clock infrastructure, including surgeons of various specializations, specially trained nurses, ICU and rehabilitation centers. Each case is unique and often requires the combination of a number of techniques or even multiple surgeries. It is, therefore, not possible to provide you with detailed information about each procedure. We will, however, present some indicative examples:

 

Scar Revision

Accidents, burns and even operations, can leave unsightly scars on patients which can be very distressing. Scarring is caused by poor healing and is, unfortunately, unpredictable as it depends on a number of reasons including the quality of the patient’s skin and its healing capacity.

Scar revision is the surgical removal or correction of scars. Healthy tissue is re-approximated in layers to favour a normal healing process which produces a more aesthetically pleasing scar.

This procedure is usually performed under local or regional anaesthesia as an ambulatory or day-case procedure.

 

Skin Tumors (benign and malign)

Many people are concerned about their skin tumors for aesthetic reasons, however, many are also worried because of the high incidence of skin cancer.

In addition to those which might be removed for aesthetic reasons, any skin tumor which itches, changes colour, bleeds, or expands should be looked at and eventually removed for biopsy.

Any benign skin tumor can be removed easily and effectively within a matter of minutes under local anesthesia on an out-patient basis.

On the other hand, malign skin tumors are usually removed under local anaesthesia with sedation as wider excisions are required and often skin grafts are necessary.

Benign skin tumors include skin tags, moles, papillomas, naevus, cherry angiomas, dermatofibroma, seboreeheic keratosis, actinic keratosis, sebaceous cysts, epidermoid cysts and lipomas. Malign skin tumors include melanomas, basal cell carcinomas, squamous cell carcinomas, Bowen’s disease, erythroplasia of queyrat, leukoplakia, verrucous carcinoma and keratoacanthomas.

 

Breast Reconstruction

Often women with breast cancer have to undergo a mastectomy operation which is the removal of the mammary gland and skin.

Breast reconstruction surgery is concerned with rebuilding the removed breast in order to restore their previous appearance.

This procedure can be done either together with mastectomy or three to six months after. The surgeon will use a silicon implant covered with muscle and skin, or even the patient’s own tissue, depending on the case.

In many cases the other breast also has to be operated on in order to achieve symmetry.

Breast reconstruction is always performed under general anaesthesia and requires a two day stay in the hospital.

 

Ectropion Eyelid Surgery

Eyelids are intended to protect the eyes, however, a variety of reasons including aging, excessive exposure to the sun, excess skin excision after blepharoplasty or post-traumatic causes can relax or retract the skin so that the lower eyelid no longer lies neatly against the eyeball. This condition is known as ectropion. The resulting exposure of the cornea of the eye to air causes drying which, in addition to discomfort, can also result in ulceration.

Ectropion can also affect the upper eyelids but this is not so common.

Plastic surgery can correct the position of the eyelids and the technique used will depend on the underlying cause. In most cases the surgeon re-suspends the eyelids with appropriate sutures in order to reposition them in place. In other cases a skin graft is required, which can be taken from the upper eyelid, behind the ear or even the upper inner arm.

Ectropion surgery is usually performed under local anaesthesia with sedation and the patient can return home a few hours after the operation.

 

Eyelid reconstruction

The most common causes of eyelid defects requiring surgical reconstruction are eyelid tumor removal and trauma.

The defects of the upper lid deserve special attention because it protects the eyeball and cornea. The reconstruction is aimed at restoring the lid continuity and its up and down movement.

The lower lid is much less mobile than the upper and the reconstructive operation aims at restoring anatomy, position and appearance.

Such procedures are usually day cases which take place under general anaesthesia although sometimes local anaesthesia with sedation is also used.

 

Lip Reconstruction

The lips are very important facial features both for aesthetic as well as for functional reasons as they affect our speech. Lip reconstruction may, therefore, be necessary after an accident, cancer or any other similar condition, to restore their appearance and function including eating, speaking and the ability to make facial expressions.

The surgeon will repair defects or distortions of the lips by transferring normal tissue into the affected area. This tissue includes muscle, mucosa and skin.

This procedure is performed under general anaesthesia and requires an overnight stay in hospital.

 

Alopecia

Scarring under the hair can leave patients with  bald patches known as alopecia. This can be unsightly and, as a result, seriously affect self esteem. Plastic surgery can solve this problem. The procedure involves excising the bald scar, creating flaps with hair of the right shape and size from non affected areas and attaching them to the affected area with fine stitches.

This operation can be performed under local anaesthesia with sedation or general anaesthesia depending on the size of the affected area and the patient’s preference. As with all operations under general anaesthesia an overnight stay in the hospital is required whereas in the case of local the patient can return home a few hours after the operation.

 

Reconstructive Rhinoplasty

Accidents, diseases or even operations can destroy a patients’ nose.

Plastic surgery can reconstruct a destroyed nose using tissue from the forehead which is given the right form and then moved to the right location.

This is usually done through a series of operations under general anaesthesia.

 

Reconstructive Otoplasty

Reconstructive otoplasty can correct the partial or total absence or loss of the ear through trauma, infection, tumor or congenital malformation.

The surgeon first constructs a new cartilage frame resembling that of the intact ear, inserts this prefabricated frame under the skin, and separates it from the head several months later in order to create the look of a normal ear.

 

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