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General Reconstruction








With flap surgery, tissue, sometimes including underlying fat and muscle, is taken from the back and tunneled to the front of the chest wall to support the reconstructed breast.



The transported tissue forms a flap to cover a breast implant, or it may provide enough bulk to form the breast mound without an implant.







Reconstructive Surgery: Procedures at a Glance

We bring back, refashion and restore to wholeness the features that nature gave but chance destroyed, not that they may be an advantage to the living soul, not as a mean artifice but as an alleviation of illness, not as becomes charlatans but as becomes good physicians and followers of the great Hippocrates. For though the original beauty is indeed restored . . . the end for which the physician is working is that the features should fulfill their offices according to nature's decree.

Gaspare Tagliacozzi, 1597

What is Reconstructive Surgery?




Although no amount of surgery can achieve perfection, modern treatment options allow plastic surgeons to achieve improvements in form and function that were thought to be impossible 10 years ago.


Who has Reconstructive Surgery?

Patients may be divided into two basic categories: those who have congenital deformities, otherwise known as birth defects, and those with developmental deformities, acquired as a result of accident, infection, disease, or aging.



Large, sagging breasts are one example of a deformity that develops as a result of genetics, hormonal changes, or disease. Breast reduction, or reduction mammaplasty, is the reconstructive procedure designed to give a woman smaller, more comfortable breasts in proportion with the rest of her body.

In another case, a young child might have reconstructive otoplasty (outer-ear surgery) to correct overly-large or deformed ears. Usually, health insurance policies will consider the cost of reconstructive surgery a covered expense. Check with your carrier to make sure you're covered and to see if there are any limitations on the type of surgery you're planning. Work with your doctor to get pre-authorization from the insurer for the procedure.

All Surgery Carries Some Uncertainty and Risk




Planning Your Surgery

In evaluating your condition, a plastic surgeon will be guided by a set of rules known as the reconstructive ladder. The least-complex types of treatments, such as simple wound closure, are at the lower part of the ladder. Any highly complex procedure-like microsurgery to reattach severed limbs-would occupy one of the ladder's highest rungs. A plastic surgeon will almost always begin at the bottom of the reconstructive ladder in deciding how to approach a patient's treatment, favoring the most direct, least-complex way of achieving the desired result.



Everyone heals at a different rate-and plastic surgeons cannot pinpoint an exact "back-to-normal" date following surgery. They can, however, give you a general idea of when you can expect to notice improvement.

Options in Wound Treatment


As you and your plastic surgeon form your surgical plan, it's important to have a clear understanding of what will happen during the procedure. Asking questions is key to making an informed decision.


Skin Grafts


There are three basic types of skin grafts.


Tissue Expansion



Advanced Wound Care: Flap Surgery & Microsurgery

Though success will largely depend on the extent of a patient's injury, flap surgery and microsurgery have vastly improved a plastic surgeon's ability to help a severely injured or disfigured patient. Using advanced techniques that often take many hours and may require the use of an operating microscope, plastic surgeons can now replant amputated fingers or transplant large sections of tissue, muscle or bone from one area of the body to another with the original blood supply in tact.


  • A musculocutaneous flap, also called a muscle and skin flap, is used when the area to be covered needs more bulk and a more robust blood supply. Musculocutaneous flaps are often used in breast reconstruction to rebuild a breast after mastectomy. This type of flap remains "tethered" to its original blood supply.

Other Reconstructive Procedures


Tumors, both cancerous and benign, vary widely in type, severity and recurrence. The removal method chosen will depend largely on the type of growth, what stage it's in, and its location on the body.


Hand Surgery



Laser Surgery

In the past decade, laser technology has revolutionized many areas of plastic surgery. The laser's allure comes from its ability to "blast" away or diminish imperfections or growths with minimum bleeding, bruising, and scarring.  Currently, there are many types of lasers available, with many more under development. Therefore, it's important to understand that not all lasers are alike.  If you're planning to have laser surgery, it's best to find a doctor who is well experienced with, and has access to, a variety of lasers.


The "pigment-blasting" laser family, the Q-switch ruby, the Q-switch YAG, and the alexandrite is a group of lasers that are effective in eliminating the black and blue pigments of tattoos, pigmented lesions and the brown patches and spots that often occur with aging. Though the removal of decorative tattoos is considered a cosmetic procedure, the removal of "traumatic tattoos" is a reconstructive process. Traumatic tattoos occur when material particles are forced under the skin through an accident such as an explosion or collision.



The argon laser is similar to the yellow pulsed-dye laser. The argon laser emits a blue-green light that is absorbed heavily by the color red. It is particularly effective in treating abnormalities that have a proliferation of blood vessels, such as blood blisters, "spider" blood vessels on the face, "strawberry" birthmarks, hemangiomas, and bulky vascular tumors.



Lasers have a number of valuable uses, but a laser should not be viewed as a "magic wand" that improves the results of any type of surgery. For traditional kinds of surgery and most plastic surgery, the scalpel is still the proven instrument of choice.

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