Plastic and Reconstructive Surgery: Reconstructive Surgery

Abdominal Wall Reconstruction

Often times after multiple abdominal procedures, patients are left with unsightly scars, chronic/poor healing wounds, chronic pain, and hernias. These patients may benefit from plastic surgery intervention to perform scar revision, panniculectomy or other reconstructive procedures to correct these deformities.

Breast Reconstruction

This procedure involves reconstruction of a breast that has been removed due to cancer or other disease. Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all. Types of breast reconstruction offered by the University of Florida Plastic Surgery Institute of Jacksonville include tissue expander/implant reconstruction, and autologous tissue reconstruction (using your own tissue) including latissimus dorsi myocutaneous flap, and rectus abdominus (TRAM) myocutaneous flap.

Decubitus Ulcer Surgery

Decubitus ulcers are wounds that develop usually when patients have a loss or decreased level of sensation that prevents them from feeling when they have been sitting or lying in one position too long. A wound, also known as a bed sore, starts out superficial but becomes deeper as time goes by and can involve skin, subcutaneous tissue (fat), and even bone. These wounds can be treated by modification of lifestyle including obtaining a specialty bed at home which redistributes pressure so that a patient is not putting pressure on the same area all the time, and improving nutrition. Often times, patients may need more aggressive surgical intervention by the time they are referred to a plastic surgeon (skin graft, muscle flap coverage of the wound). In some instances, these patients and their wounds are poorly cared for and need a procedure to remove dead tissue, which can be performed by a general surgeon.

Panniculectomy

Typically for obese patients, panniculectomy involves removal of skin and fat below the umbilicus (navel or bellybutton) to improve hygiene, help with yeast-type rashes, poor mobility, etc. NO tightening of the “muscles” (fascia) is performed. Typically these patients are observed in the hospital for 1-5 days, depending on their other medical problems. The procedure takes 3-5 hours. Drains are placed at the time of surgery, which may remain in place for up to a month (depending on the drainage which is often related to the amount of tissue removed).

Split- and Full-Thickness Skin Grafts

Skin grafts require harvesting skin (the epidermis and a small amount of dermis) from one part of the body (often the thigh) to cover a wound that would take much longer to heal on its own without a skin graft. These grafts are used for the closure of acute and chronic soft tissue wounds, provided bone and tendon is not exposed.