Reconstructive plastic surgery. Reconstructive surgery and prosthetics

The goal of plastic surgery is to make parts of the body aesthetically attractive. However, in case of severe damage - trauma, burns, the task becomes more ambitious: it is necessary to recreate the original shape of the body and restore its functionality. This is what reconstructive plastic surgery does.

Features

Reconstructive surgery is a subtype of plastic surgery. It is distinguished by 3 main features:

1. nature of the operation– it is necessary to eliminate a defect that is not just disfiguring, but interfering normal operation organs. This category includes not only birth defects like a “cleft lip”, but also the consequences of burns, injuries, and serious illnesses. During surgery, sutures and scar tissue are not simply removed, but microsurgery of nerves and blood vessels is also performed in order to ensure the functionality of the restored area;
2. causes– traumatic effects and birth defects leading to partial or complete loss of ability to work. Massive damage to any tissue - muscle, skin, inevitably leads to lung dysfunction, of cardio-vascular system, kidney. In this case, plastic surgery not only restores the natural appearance, but also prevents the appearance of internal pathologies;
3. Another difference between reconstructive plastic surgery is active participation of specialists from various fields: dentists, otolaryngologists, ophthalmologists, gynecologists, orthopedists. This is due to the fact that with conventional rhinoplasty, for example, the surgeon does not need to restore the nasal septum, but when performing reconstructive operations it is necessary, first of all, to restore functionality.

Indications

Indications for operations are as follows:

• birth defects;
• deep burns – chemical, thermal, electrical, and frostbite – stage 3–4;
• malignant diseases;
• mechanical injuries - wounds, crushing of tissues, separation of body fragments - fingers, limbs, ears;
• consequences of operations - this includes the elimination of scars;
• the consequences of certain diseases - infectious and inflammatory, leading to the appearance of defects in organs and tissues;
• numerous benign formations on the skin - warts are classified as reconstructive plastic surgery;
• complications after childbirth or age-related changes leading to deformation of the uterus and perineum. For men, this category includes phalloplasty operations - restoration of the shape and length of the penis;
• sex reassignment surgery - and.

As a rule, reconstruction is carried out in several stages, since it affects too much bone and soft tissue. During the rehabilitation period, the patient remains under observation: before each next step it is important to achieve full recovery.

Unlike general plastic surgery, reconstructive plastic surgery in some cases is carried out free of charge.

Types of operations

By direction of impact

Reconstructive plastic surgery involves working not only with skin and muscle tissue, but also with mucous membranes, tendons, and bone tissue. Based on this feature, the following types of RP are distinguished:

• correction of skin defects– used to eliminate rough scars, extensive scars after chemical and thermal burns, postoperative sutures. This also includes removal benign formations, « spider veins", deep pigmentation and the like. As a rule, skin grafting is required to eliminate defects. It is preferable to use tissue from the patient himself: fragments are taken from an area that is invisible under clothing - the abdomen, buttocks, thighs;
• tendon reconstruction– carried out to restore completely or partially lost mobility: congenital underdevelopment of the tendon, contracture, traumatic impact. In case of severe damage, the tendon is replaced with artificial material;
• correction muscle defects – restoration of tissue in case of underdevelopment or loss as a result of injury. This also includes innervation muscle tissue and elimination of disturbances in the blood supply - in fact, microsurgery of blood vessels. The lack of tissue can be partially compensated by implants or;
• restoration of completely or partially lost organs– ears, fingers, chest, nose, as well as operations to eliminate unsuccessful plastic corrections and removal of stretch marks. Reconstruction requires donor tissue;
• correction of birth defects– asymmetry of hands and feet, fused fingers, cleft palate, cleft lip, missing ears, etc. This kind of intervention is considered to be the most complex; it requires whole line operations.

By localization

Another well-known classification is related to the area of ​​work. In many ways, it coincides with the types of conventional plastic surgery, but always involves the participation of specialists in the functionality of the organ being operated on:

• – change in the ocular shape and geometry of the eyelids. During reconstruction, a partially or completely lost eyelid is restored, and an uneven edge that leads to incomplete closure is corrected;
• – and, more precisely, that is, a correction in which the nasal septum. The operation is carried out under the supervision of an ENT doctor;
• – the position of the cartilage is corrected and the auricle is built up. At complete absence an ear implant is used;
• jaw correction– combines plastic surgery of the chin, lips, neck, and implies active cooperation with dentists. This category most often includes the correction of birth defects, such as cleft palate;
• – restoration of partially or completely lost mammary glands as a result of injury or surgery. Implants are almost always used;
• – removal of scars, postoperative sutures, burns and stretch marks in the abdominal area. Combined with excision of excess skin and fat;
• – correction of the walls of the vagina, uterus, plastic surgery of the labia majora and minora, etc.;
• – correction or restoration of the penis after surgery, injury or to eliminate birth defects. Includes recovery urethra if necessary, vascular surgery;
• – a complex operation aimed at restoring the biomechanical axis of the limb. Includes bone tissue augmentation, muscle implantation if necessary, and tendon replacement in case of irreversible damage. It is carried out in several stages and requires long-term resuscitation.

The video below will tell you about reconstructive plastic surgery:

What you need to know before RP

Reconstructive plastic surgery is used when there is no other solution to the problem. The possibilities in this area are not limitless, but in many cases surgery allows you to get rid of disability and return to a full life.

Contraindications

In general, reconstructive plastic surgery is not a life-saving operation. However, most types of correction are joint restoration, cartilage tissue and bone tissue, warns various pathologies internal organs, therefore, there are noticeably fewer restrictions in this area than with conventional plastic surgery.

These include:

• severe cardiovascular failure;
• oncological diseases;
• disorders of blood clotting - unfortunately, exclude surgical intervention;
• severe diabetes mellitus;
• autoimmune diseases - exceptions are possible, but require careful preliminary examination and consultation with specialists;
• severe damage to the liver and kidneys - operations are prohibited in cases where reconstructive plastic surgery is not aimed at correcting a negative operating factor;
• pregnancy and lactation – the need for surgery is determined by the benefit or risk to the fetus. Thus, correction of the nasal septum, if this causes hypoxia, is also resorted to during pregnancy.

Material for reconstruction

To restore body parts and organs, both artificial material and donor tissue from the patient are used. The second method is preferable as it minimizes the risk of rejection. However, in some cases it cannot be used.

Replenishment of missing muscle tissue, restoration of the cartilage and bone structure of the nose, angles of the jaw, and cheekbones are made from neutral organic materials. The most popular are silicone, medpora - polyethylene, and porous polytetrafluoroethylene. These materials do not cause allergies and are extremely rarely rejected.

The following are used as donor tissue implants:

• muscle tissue fragments- enough rare view operations;
• adipose tissue– used for mammoplasty, as well as for correcting curvature of the legs, replenishing missing muscle tissue during facial plastic surgery;
• bone and cartilage material– most often the source is the ribs, cartilage of the auricle;
• skin tissue– skin flaps are taken from areas hidden by clothing.

Features of the operation and rehabilitation

Reconstruction surgery is always more complex and difficult than conventional correction of body parts. Accordingly, preparation for it takes longer, and recovery is long and difficult.

The general reconstruction scheme is as follows:

• preliminary examination, laboratory examination, consultation with specialists - reconstruction is always associated with structural changes affecting the functionality of organs;
• extraction of biological material - bone tissue, cartilage, skin on the vascular pedicle. If a decision is made to use artificial implants, a suitable material is selected or the implant is made to order;
• surgery with transplantation of skin, cartilage, bones, implants;
• the period of adaptation of the transplanted tissue is a stage more important than the operation itself. The result of the reconstruction depends entirely on how well the tissue has taken root;
• rehabilitation – full or partial restoration of the functions of a damaged organ or part of the body.

In the vast majority of cases, reconstruction involves not one, but a whole series of operations. After each procedure, it is necessary to ensure tissue engraftment and fully restore function at this stage. Only then, in the absence of complications, is the next correction prescribed.

Reconstructive plastic surgery is a field of plastic surgery aimed not only at correcting an aesthetic defect, but also at restoring organs and body parts.

Reconstructive plastic surgery– one of the most necessary and sought-after departments of medicine. Sometimes, due to injuries received by a person or congenital characteristics of the body, a person’s face is far from aesthetic standards, causing him discomfort and rejection of his appearance.

In such cases, it is customary to seek help from plastic surgeons who are able to restore damaged soft fabrics and even individual organs. In addition, not only the appearance is restored, but also the natural anatomical functionality of organs and skin.

Types of plastic surgery

What is the difference between reconstructive and conventional plastic surgery? Reconstructive plastic surgery returns damaged organs to their functionality and can even partially or completely restore them if they are completely absent.

Alison Pontius

plastic surgeon

Facial reconstructive surgery includes various interventions that involve the restoration of a specific facial area. With their help, you can eliminate the consequences of burns, deformations, injuries, and also cope with congenital anomalies. I would like to note that often after surgery there is numbness for several weeks to several months. Because the nerves in the area become injured and then experience temporary neuropraxia (temporary loss of nerve conduction). This usually occurs over the next 6-12 weeks. This depends on the procedure being performed, sometimes much longer. If numbness is present more than a year, go to the doctor.

What and how to do with your body is a personal matter for each person. However, in some cases, a person needs to seek help from a surgeon who will restore damaged tissues, organs or correct a congenital defect.

Such a change will improve not only a person’s appearance, but also raise his self-esteem, and also eliminate psychological discomfort. Therefore, if you suffer from identical problems, we advise you to seek help from an appropriate specialist.

Multidisciplinary medical Center ViTerra in Belyaevo has been working for you since 2011. Heads the clinic Mostovoy Ilya Alexandrovich, urologist-andrologist, reflexologist, doctor ultrasound diagnostics, full member of the Professional Association of Andrologists of Russia, member of the European Association of Urology (EAU) and a number of other well-known medical societies.

The ViTerra Clinic in Belyaevo provides high-quality and affordable medical services to patients from Moscow, regions, near and far abroad. We cooperate with leading Russian and European educational institutions, we are the clinical base of a number of departments medical institute RUDN University

Our employees include doctors of all specialties, professors, doctors and candidates medical sciences, doctors of higher education qualification category, consultants from leading clinics in Moscow. Here you will be treated by specialized specialists and specialists. general practice, working on the most modern equipment. In addition, all our employees are simply caring people who are ready to help each of their patients.

Most services at the ViTerra medical center in Belyaevo are performed using disposable instruments. At the same time, the processing regime for equipment and tools fully complies with European standards, which eliminates even the slightest possibility of transmitting any infection. We provide medical services absolutely safe for every patient concerned about their health.

We provide highly accurate diagnostics and as soon as possible We carry out any types of analysis. ViTerra surgeons perform minimally invasive operations and manipulations using endoscopic equipment using safe anesthesia.

As supporters individual approach For each patient, we guarantee high-quality and extremely attentive attention to any problem that worries you. This means that by contacting the ViTerra clinic in Belyaevo, you are guaranteed to receive qualified advice from our specialists, your problem will be thoroughly studied, an accurate diagnosis will be made and all information will be given. necessary recommendations or effective and efficient treatment is prescribed.

Comfort for you, our patients, is one of the foundations of the philosophy of the ViTerra clinic in Belyaevo. Our medical center has free colorful shoe covers, a neat dressing room, coolers with cool drinking water own production, free coffee, sweets and chocolate. Spacious corridors with comfortable sofas and light music will allow you to relax and relieve stress before your appointment or while waiting for test results. And if you are caught in the rain at the clinic, you can use free umbrellas. In the toilet rooms, any visitor will always find everything they need for personal hygiene: hand cream, refreshing wipes and even perfume!

Getting to the ViTerra clinic is not only fast, but also very convenient: by car, metro or even on foot. And even in those cases when you don’t want to go to the doctor at all! :-) You can easily see this for yourself.

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Come to our multidisciplinary medical center for excellent health, strength and energy. Our doors are always open for you!

Plastic surgery can sometimes work real miracles - change facial features, erase age from it, make a figure perfect. Most modern plastic surgery, fortunately, is carried out precisely for aesthetic reasons, and not for medical reasons. But there are times when the body needs not improvement, but bringing it into line with generally accepted standards or simply functional state. And then reconstructive surgery comes to the rescue.

What it is

Reconstructive surgery is a special branch of plastic surgery, the name of which comes from the word “reconstruction” (restoration). The ultimate goal of the operation is in this case first of all is the maximum restoration of form and, if possible, natural functions individual parts bodies that have birth defects or have been damaged as a result of injury and surgery.

Reconstructive surgery can be performed for both medical and aesthetic reasons. For example, if the damaged septum of a previously broken nose makes it difficult to breathe normally, there is a medical need for surgery. And if a person is quite capable of breathing normally, but is no longer satisfied with his own appearance, then the operation is performed for aesthetic reasons.

Reconstructive surgery is often confused with conventional or restorative plastic surgery. This is fundamentally wrong. Distinctive feature it is that reconstructive surgery is always accompanied by skin or tissue transplantation (in most cases taken from the patient himself to reduce the risk of rejection) or the use of artificial implants.

Reconstructive surgery includes mammoplasty after a complete mastectomy. It allows you to form a new breast instead of the lost one, although it is not able to restore its natural functions.

Types and possibilities

All operations performed within the framework of reconstructive surgery can be relatively roughly divided into the following types:

And although the possibilities of reconstructive surgery are far from unlimited, in many cases it helps not only to correct serious shortcomings appearance, but even avoid disability and return to a normal lifestyle.

Contraindications and reviews

Unfortunately, in some cases, reconstructive surgery becomes impossible due to medical contraindications. First of all this:

Before setting a date for surgery, the doctor conducts a thorough examination and is sure to refer a series of laboratory tests. Almost always reconstructive plastic surgery requires the use of general anesthesia, and this is a serious burden even for a healthy body. Rehabilitation period ranges from several days to several weeks depending on the complexity of the operation. But the result is worth it.

IN modern medicine reconstructive plastic surgery used for the correction of functional disorders and for the correction cosmetic defects caused by the following reasons:

• - traumatic injuries such as fracture of the facial bones of the skull
• - burns
• - congenital anomalies: for example, cleft lip or cleft palate
• - developmental anomalies
• - infections or other diseases
• - deletion malignant neoplasms: for example, mastectomy for breast cancer

Target reconstructive plastic surgery- This is most often an improvement in organ function, but it can also be performed to obtain a visual effect that is as close to natural as possible. In most cases, this requires multi-stage operations.

The most common reconstructive plastic surgery operations.

The list of the most common reconstructive plastic surgeries includes:

• - breast reconstruction after mastectomy in women
• - correction of post-burn contractures
• - operations for cleft lip and palate (defects also called cleft lip And cleft palate),
• - ear reconstruction in case of congenital absence or underdevelopment of the auricle
• - suturing and correction of mucosal and skin defects after removal of tumors in the neck and head area.

In cases where the use of flaps from surrounding tissue is impossible or difficult, the development of microsurgery has allowed modern plastic surgeons to use flaps from other areas of the body. The flap contains skin tissue, muscle tissue, adipose tissue, bone tissue or a combination of several types of fabric. If a free flap is used, reconstructive surgery requires the use of microsurgical techniques with the application of sutures with a diameter of 1-2 mm to the arteries and veins.

Why is reconstructive surgery so popular?

The concepts of “reconstructive surgery” as well as “plastic surgery” are increasingly appearing in media headlines and on television. What do these concepts have in common and what are the fundamental differences? Few people really understand this, however, if you have determined for yourself the need for an operation of any kind, then you definitely need to know in detail what exactly is planned to be done to your body during any of these operations.

Reconstructive surgery.

Reconstructive surgery is characterized by procedures aimed at creating or restoring the shape and function of a body part or organ. Most often, the need for this type of operation arises as a result of congenital changes, as well as the consequences of previous injuries and operations. Reconstructive surgery is performed with the transfer of plastic material taken from the patient from another place, as well as with the implantation of tissues and organs of another person. It is also possible to carry out implantation using special devices which are implants.

Reconstructive surgery can be performed in any part of the human body; therefore, the operation can be performed by a surgeon of any specialty (plastic surgeon, gynecologist, urologist, ophthalmologist and others).

Plastic surgery has received a conditional division into aesthetic surgery and reconstructive surgery. In the process of aesthetic surgery, actions are taken to improve the shape of the face and body, taking into account the wishes of the patient. Reconstructive surgery involves actions to restore and improve appearance with improvement of functionality, carried out taking into account medical indications. The bulk of reconstructive operations are carried out in several stages. In principle, there is no clear distinction between the types of operations considered, because reconstructive operations almost everywhere involve the presence of elements of aesthetic operations. The same applies to aesthetic operations, in which the use of elements of reconstructive operations is almost always an integral part of the process.

Carrying out reconstructive plastic surgery on the face.

Another concept that includes various options Eyelid correction is blepharoplasty (or eyelid correction). Here it is possible to change the shape of the eyes and their shape, eliminating existing eyelid imperfections. This also includes age-related changes, which involve the removal of excess fatty tissue and skin in the lower and upper eyelids. In addition, the consequences of paralysis and previous injuries are also eliminated.

Carrying out reconstructive plastic surgery in the breast area.

Plastic surgery in this area is associated with both therapeutic and for cosmetic purposes. For example, birth defects chest(keeled or funnel-shaped breasts, etc.), or acquired defects (consequences of operations, injuries), require bone and musculoskeletal plastic surgery in the chest area. This will normalize the activity of the cardiovascular and respiratory systems, and will also make it possible to restore the correct contours of the body.

After removal of the mammary gland due to the presence of a malignant tumor, breast plastic surgery is also performed - mammoplasty, which promotes its complete restoration.

Carrying out reconstructive plastic surgery in the abdominal area.

Abdominoplasty (or abdominoplasty) involves reconstruction in the anterior abdominal wall associated with the removal of excess fat deposits, as well as restoration of normal appearance and improvement of skin tone. This procedure is one of the ways surgical intervention aimed at body correction. Abdominoplasty is necessary if the abdominal muscles and skin have been stretched, for example as a result of sharp decline weight or after childbirth. Abdominoplasty is also necessary as a result of extensive hernias or removal of tumors in the anterior abdominal wall.