plastic surgery

Exploring the Art of Reconstructive Plastic Surgery Techniques

Art restoration requires extensive research, an understanding of chemistry and mastery of specialized tools. But it also calls for exemplary artistic talent.

Infrared imaging helps restorers view carbon-based drawings and older layers of paint. New technology is also helping them clean works without causing further damage. X-rays and CT scans show hidden details that may otherwise be obscured by dirt, varnish or other layers.

Artificial Implants

An artificial implant is used to replace or augment the function of tissue and skin damaged by disease, injury, trauma/injuries or congenital disorders. Examples include hip replacements that have a metal ball and socket to restore mobility, coronary stents to support the healing of blood vessels and intraocular lenses that reduce the need for glasses or contact lenses.

When medical implants are placed in the bone, a series of molecular and cellular events creates a strong bond called osseointegration between the implant and surrounding tissue. This process occurs when mesenchymal stem cells migrate to the implant’s surface, attach to a fibronectin framework and form an organic matrix that mineralizes as woven bone at the tissue-implant interface.

Plastic surgeons like Dr. Joel Aronowitz also use this technique to reconstruct defects resulting from surgical repairs or cancer treatments such as radiation therapy and chemotherapy. This is in addition to repairing lower limb injuries, treating open fractures and burns and reconstructing the face following traumatic facial injuries.

Tissue Expansion

A procedure that allows the body to ‘grow’ extra skin by stretching surrounding tissue. A balloon-like device called an expander is surgically placed under the skin to be repaired and then progressively filled with salt water, causing the skin to stretch and grow.

Large wounds, such as burns, can benefit from tissue expansion to promote the growth of healthy supplementary skin for replacement in the damaged area. This technique can also be used for other body areas, including ear and breast reconstruction after mastectomy.

Tissue expansion can produce excellent results when applied to regions of the face and neck, arms, hands or legs. However, using this technique in areas of the body with thicker skin, such as the back and torso, is usually impossible. Similarly, this method is unsuitable for smoking patients because smoking can delay healing.

Skin Grafts

Skin grafts are patches of healthy skin that help large wounds heal and improve the look of scars. They may cover a large area of damaged or missing skin, such as the nose or palm. They are also sometimes used to treat burns.

In a split-thickness skin graft, the top layer of the epidermis and some of the lower layers (the dermis) are removed from the donor site. The skin is then sewn to the wounded area of the body. This type of graft is often taken from the back of the neck, behind the ears, the chest or the upper arm.

In cell cultured epithelial autograft (CEA) procedures, skin cells are grown in sheets in a laboratory, and the person’s immune system does not recognize them as foreign. This type of graft is often less successful than a full-thickness skin graft. If the graft fails to connect with the blood supply, it can turn grey and require debridement surgery.

Scar Revision

Scar revision may improve the cosmetic appearance of a scar or help restore function to a part of your body restricted by the scar. Both surgical and non-surgical procedures can be used to do this, but surgery is usually the best option for large or severe scars, especially those that itch.

Reconstructive surgeons specializing in this field, like Joel Aronowitz MD, can use a skin graft to replace the scarred area or remove it altogether. They can also use Z-plasty or W-plasty, which involves cutting the scarred skin into a “Z” or “W” shape and securing it with stitches. These techniques will give that area more movement and make it less noticeable.

Injectable treatments like steroid injections can reduce the redness of hypertrophic or keloid scars and help flatten raised scars. It takes 12 to 18 months for new scars to mature and gain the tensile strength of normal skin. Your plastic surgeon will discuss your options and answer any questions you may have.