Reconstructive Surgery - Medical specialists

Plastic surgery is almost as old as medicine itself. For example, reconstructive nose operations were being performed in India as far back as 1,200 years BC. To do this, a flap of tissue taken from the forehead was used as a transplant. The ancient Egyptians were also mastering such complex interventions, as mummy findings show. At the end of the 16th century an Italian doctor described a surgical technique which can be regarded as the basis of modern plastic surgery. The two world wars with their dramatic injuries drove forward progress in reconstructive surgery. Another milestone in this specialist field was the introduction of silicone implants in 1962.

Overview

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Reconstructive Surgery - Further information

Definition of reconstructive surgery

This specialist medical field addresses the reconstruction of tissue damaged as a result of accidents, the removal of tumors and injuries. This is why it is known as reconstructive surgery. Reconstructive surgery is closely linked with plastic and cosmetic surgery or occupies overlapping fields. Experienced surgeons work on rebuilding soft tissues and restoring more quality of life to their patients.

A sub-area which also requires very specific knowledge is hand surgery. The focus here is on the restoration of important body functions. The work is intensive and detailed and entails giving ligaments, muscles, tendons, bones and soft tissues the best form that they can possibly have to enable patients to use their arms and hands again.

What is the remit of a surgeon working in plastic reconstruction?

One frequent treatment is breast reconstruction. In addition to that, the specialist corrects scars, treats lymphedema (soft tissue swellings), reconstructs tissue after tumor removal, treats the aftereffects of accidents and burns and disordered wound healing. The removal of skin tumors also requires a major amount of ability and experience. Facial reconstruction also demands attention to the finer esthetic details. Surgeons in this field always work closely with dermatologists, anesthetists and radiologists. Edema (water retention) frequently occurs after tumors. In lymphedema, which cannot be treated with either compression therapy or medication or lymph drainage, surgery is recommended, for which the innovative surgical procedure of microsurgery is used.

Training as specialist for reconstructive surgery

Specialist doctors in plastic and cosmetic surgery will have first studied human medicine. After that, they have two years of further training in surgery. Finally, they follow a four-year course in plastic and cosmetic surgery. During the whole training period, they must continue to gain qualifications. Plastic and cosmetic surgery is constantly developing. This makes it essential for practitioners, even after successfully completing their specialist training and after years of practical experience, regularly to attend further training courses and keep in contact with other specialists.

Typical reconstructive surgery operations

A change to the body's silhouette in reconstructive surgery is not an 'optional service', as with some types of popular operations in cosmetic surgery. Doctors in this field aim to reconstruct as well as possible the person's natural appearance and restore basic bodily functions. The interventions can relieve patients a lot of stress. Reconstruction of both the form and function of the body after congenital or acquired diseases requires knowledge and finger-tip sensitivity. Often, microsurgery procedures are needed.

Reconstructive surgery is applied in the following fields:

  • to eliminate the effects of accidents
  • after burns
  • after nerve injuries
  • after tumor removal, especially skin cancer
  • in congenital malformations
  • for breast reconstruction
  • to treat scarring
  • to deal with deficiencies in soft parts
  • for bed sores
  • for diabetic feet

Breast reconstruction with free and non-native transplants

After breast removal as a result of cancer, breast reconstruction with the body's own tissue is an important task. Reconstructing a breast using silicone implants is an extremely complicated undertaking. This is why doctors use transplants made of skin, fat and muscle tissue - where possible. These are taken without cutting back the original blood supply. With free transplants, pieces of tissue are removed plus their connective blood vessels. Tissue for reconstruction generally comes from the broad back muscles or the transverse lower abdominal flap. The development of reconstruction techniques has made significant strides. They are used with the aim of including as little muscle tissue as possible in the transplant.

Plastic surgery requires special skills

For the demanding operations involved, doctors must master microsurgery techniques, which is contingent on a great deal of prior experience. Breast reconstruction surgery usually requires two surgical teams working in tandem, so that operation time is limited to 4-5 hours and no blood transfusions are needed.

Conclusion

Whether it is a matter of carefully sealing a wound, performing a skin transplant or re-implanting separated limbs, reconstructive surgery today can draw on many technical options. All microsurgery procedures are contingent on experience and thorough specialist knowledge, so that team work with colleagues from other specialist fields is absolutely essential.

Focus of treatment