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Reconstructive Surgery Tips

ACL Reconstruction - Know Procedure Of It!

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopedics, Fellowship, Depuy Joint Replacement
Orthopedic Doctor, Bhubaneswar
ACL Reconstruction - Know Procedure Of It!

The anterior cruciate ligament (acl) is a rope like connective tissue that gives support and stability to the knee, along with other related tissues. If you do not repair it, you can still perform many functions, and carry on with your life with little difficulty. However, surgery to correct the ligament tear is recommended if you do not want the injury to impede your sporting activities and want a 100% normal knee.

The acl reconstruction surgery can be performed in two ways, the arthroscopic method with incisions in the front and the new one which is more cosmetic and has lesser complications. Both of which you will find detailed below.

The latter is a wiser and more popular decision, and you will require a suitable surgeon well versed in the newer technique to perform the operation.

How is the surgery done?

Acl reconstruction surgery involves the following steps-

  1. The surgeon, after examination, makes sure whether you actually need to be operated on if you have approached in the early stages, a repair may be possible. This avoids the need for reconstructing a new ligament altogether.
  2. For an acl reconstruction the tissue, which will be inserted afresh in your body is extracted and prepared, either from your own body or from a donor’s body.
  3. A camera is affixed onto the surgical instrument, which makes your knee interiors visible to the surgeon during the operation.
  4. Anaesthesia is administered to you, and new tissue is inserted in place by passing it through a tunnel in your bone in a pioneering new technique, the tissue is derived from the back of your knee instead of the fron. This leaves minimal scars in your physical appearance on the front of your knee. This procedure is also not very invasive.

Surgeons are increasingly favouring acl reconstruction nowadays. The reasons for that are-

  • It helps patients who cannot do without their acls, like those engaged in competitive sports like football or mountain climbing.
  • It can help repair the chronic weakness of the knee and help people who have locomotive difficulties.
  • One can repair several ligaments including your acl if they are damaged at once, following an accident or fall.
  • To minimise tissue damage from surgery, the minimally invasive arthroscopic method is the way to go acl surgery including repairs are gaining in popularity, and those mentioned above are some of the reasons. The doctor will recommend this in case you have an injury like a vehicle crash, sports accident, or related trauma to the knee and surrounding regions.

Make sure you know your requirements and seek out a physician accordingly!

6082 people found this helpful

Skin Graft - Know Forms Of It!

M Ch. Plastic Surgery, MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Durg
Skin Graft - Know Forms Of It!

Skin graft is a form of a surgical procedure, which involves removal of the skin of a particular region of the body and transplanting it to a different body portion or to a separate individual. Grafting is usually recommended by the doctor if the patient has suffered from extreme burns or the protective layering of the skin of that particular region has been damaged because of extreme illness, bed sores sustained infection on the skin or repeated injuries. Grafting is also recommended as a procedure for nose and breast reconstruction surgeries. It is usually done with the help of local anaesthesia, making the procedure a less painful one.

There are two types of skin grafting procedures:
1. Split-level thickness grafts: The grafting in this procedure deals with the elimination of the epidermis and just a part of the dermis from the site of the healthy skin. These grafts are used to cover generally a large portion of the body. This form of grafting does not develop significantly with the other portions of the skin, so doctors recommend more split-level thickness grafts as the person ages. The grafts happen to be delicate, glossy and faded in comparison to the rest of the skin.

2. Full-thickness grafts: In this procedure, the grafting involves the subsequent removal of the blood vessels and the muscles along with the two skin layers from the donor site. This form of grafting is particularly useful in reconstructing small damages on the exposed portions of the body such as the face. This type adjusts well with the other portions of the skin and subsequently tends to merge with the rest of the skin.

Procedure
The procedure will begin with the implementation of intravenous therapy (IV) on your wrist or hand on the day of the surgery. This therapy helps the doctor to provide you with the necessary medicines and fluids at any point of the surgery. Just a few minutes before the operation, the doctor will inject general anaesthesia through IV. After removal of the skin, preferably from the unexposed portions of the body, such as thigh and buttocks in the case of a split-level thickness graft and the abdomen and the chest in case of a full-thickness graft, the healthy skin is transplanted at the damaged spot and is fixed by subsequent stitching and dressing. The donor site will also be covered by appropriate dressing to prevent any further infection. After the completion of the surgery, it is recommended to take a few days’ rest before getting on with your daily life routine.

992 people found this helpful

Craniofacial Surgery - Know The Causes & Risks Of It!

MBBS, MS - General Surgery, MCh - Plastic Surgery, FRCS, Fellowship In Cosmetic Surgery
Cosmetic/Plastic Surgeon, Noida
Craniofacial Surgery - Know The Causes & Risks Of It!

Craniofacial surgery is required when there are deformities or abnormalities present in the head or face area of the patient. Depending on the type of deformity, a craniofacial surgery is done to repair or reconstruct it.

The areas that come under a craniofacial surgeon's domain are the cranium (skull), the brain, the face, skin on the face, facial bones, and the nerves. For this reason, in order to conduct craniofacial surgery, a neurosurgeon and a cosmetic surgeon may often work together.

The time taken for completing a craniofacial surgery may vary between four hours and twelve hours.

Why do you need a craniofacial surgery?

There may be multiple reasons why a patient would require craniofacial surgery. These are:

  1. Tumors in the head or face region are one of the most common causes behind this type of surgery. The surgeries conducted to remove these tumors may sometimes lead to the formation of deformities in the region. Craniofacial surgery is conducted in order to correct them.
  2. This kind of surgery can also be used to correct abnormalities formed as a result of injuries or wounds on the face, the jaw or the head.
  3. Some patients may also undergo a craniofacial surgery in order to correct defects that they were born with. Such defects include Apert Syndrome (a syndrome characterized by the premature fusion of certain bones in the skull), cleft palate or cleft lip and craniosynotosis (premature fusion of certain bones in the skull).

Risks related to Craniofacial Surgery:

Certain risks are associated with this type of surgery. These are:

  1. Craniofacial surgery is conducted after putting the patient under general anesthesia. As a result of this, the patient may suffer from breathing problems, blood clots, infections and blood loss. He or she may also react to the medicine in an unwanted way.
  2. As a result of the surgery, the patient may also lose their bone grafts partly or wholly. He or she may go through cranial nerve dysfunction or damage in the brain. The formation of permanent scars is another possible risk of craniofacial surgery. Some patients, especially children who are of growing age, may need a follow-up surgery later on.
  3. Certain patients can face more risks as compared to other patients. These include patients who are malnourished, or suffer from other illnesses like lupus. Those that have suffered nerve damage in the past are likelier to develop complications. Smoking is also another risk factor.
2071 people found this helpful

Burn Reconstruction - Ways To Take Care Of It!

MCh, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery, Felloship In Microvascular Surgery & Hand Surgery
Cosmetic/Plastic Surgeon, Faridabad
Burn Reconstruction - Ways To Take Care Of It!

Burn surgery is very common these days. Burn surgery is usually done on people who suffer from major burns. Reconstructive burn surgery is usually required in the last stages when the initial burns have healed to a certain extent. Usually, reconstructive burn surgeries are done on patients who have suffered from huge accidents and have burnt their face, neck and hands to a great extent. Patients requiring this surgery usually become unrecognizable after an accident.

When is reconstructive burn surgery recommended? 

  1. If you have been involved in a household accident and the scars have not healed completely. Surgery might not totally heal the face, but it can improve your basic functions like breathing, smelling, seeing or tasting (if most of your senses are burnt and disfigured).
  2. Reconstructive burn surgery is also very useful for acid attack victims. Sometimes, burns are not only caused by fire, but it is also caused by chemicals and acidic substances which are worse and can completely burn and disfigure your face. When hydrochloric acid, nitric acid and sulfuric acid come in contact with your skin it seeps into the skin and burns off your nose, cartilage and sometimes even causes blindness. It disfigures your face completely, reconstructive burn surgery can do miracles, though it cannot bring back your previous features and skin texture, it does make you look more recognizable.
  3. After a burn, facial scarring occurs which leads to the loss of eyelids, hair, nose and lips. In this case burn surgery is required.

How to take care of yourself after a burn surgery?

  1. Regular stretching should be done, especially if the areas of your burn include your hands, legs, joints, etc. Do as much as activities as possible like getting dressed and grooming yourself. It will also make you more self-reliant and give you confidence.
  2. Depression is very common after burn surgery. A reconstructive burn surgery will not magically make you look the way you used to. A lot of sittings is required and remember, appearance and looks do not matter much. The wounds will fade away with time.
  3. Itching is also very common after a burn surgery. If this problem persists, you should consult your doctor for a moisturizer.
  4. Avoid sun exposure. Don’t go out in the sun, because the U.V rays are extremely harmful and can singe your already sensitive skin; you can also get skin cancer.
  5. Custom pressure garments should be worn to protect your skin.
1353 people found this helpful

Penetrating Keratoplasty - All About It!

MBBS, DNB - Ophthalmology, MS - Ophthalmology, Cornea Fellowship
Ophthalmologist, Mumbai
Penetrating Keratoplasty - All About It!

Ulcers and perforations of cornea are some very serious clinical conditions, which threaten vision rapidly and progressively, and disintegrate the eye globe. They need to be taken care of immediately to prevent irreparable damage to the eyes. In spite of the advanced medical research and practice, severe injuries, infections, and diseases of cornea can lead to serious corneal perforations, which require surgery necessarily as the ultimate solution.

Urgent reconstructive surgery might be necessary to avoid consecutive endophthalmitis, formation of synechiae (anterior and posterior), and secondary glaucoma to prevent spread of pathogens toward posterior pole of eye globe. This surgery is also performed to avoid other severe complications including inflammation. The approach of performing surgery to retain corneal integrity depends on localization, size, state of internal globe tissue, and depth and severity of corneal tissue damage. The state of inflammation and causative infection influences the choice and sequence of surgeries. Urgent Penetrating Keratoplasty, Total Penetrating Keratoplasty, and Corneal or Corneo Scleral Patch Graft, or combination of surgical approaches, also called ‘Keratoprosthesis’, which are performed only for end-stage, progressive corneal
pathology, or the last-chance medical treatment.

Ramon Castroviejo, in 1951, described Penetrating Keratoplasty as a method to replace a larger diseased cornea and sclera lying adjacent to it with donor tissue. The goal of Penetrating Keratoplasty is tectonic repair of large corneal perforations to restore the integrity of the eye globe and correcting or resolving many other conditions of the eye simultaneously.

When to Perform Penetrating Keratoplasty 
Penetrating Keratoplasty is performed for perforated cornea in the following cases:

● Corneal degenerations.
● Keratoconus and ectasias.
● Corneal dystrophies including Fuchs endothelial dystrophy.
● Viral keratitis.
● Noninfectious ulcerative keratitis.
● Post infectious keratitis.
● Microbial keratitis including Fungal and Bacterial keratitis.
● Chemical injuries.
● Congenital opacities.
● Refractive indications.
● Mechanical trauma.
● Regraft unrelated to allograft rejection.
● Regraft related to allograft rejection.

Surgical Procedure
Surgical procedure involves the following steps:

● Preparation of donor tissue is the first step. A corneal button slightly larger than the host corneal opening helps in reducing post-surgical excessive corneal flattening, reducing risk of secondary glaucoma, and enhancing closure of wound.
● Afterwards, host cornea is trephined; viscoelastic is filled into the anterior chamber followed by placement of donor tissue on the endothelial side down of recipient's eye.
● Cornea is then sutured in place, interruptedly or continuously. Interrupted sutures are preferred in inflamed, vascularized, or thinned corneas and in paediatric cases.
● Penetrating Keratoplasty might be performed in combination with cataract surgery, glaucoma surgery, retinal surgery. and secondary intraocular lens implantation.

Take Away 
Penetrating Keratoplasty is the true and last-chance medical treatment to treat large corneal perforations. It is the only ophthalmologic surgical procedure which restores ocular integrity, and at the same time takes care of infections, inflammations, and necrotic tissue. Such a holistic approach minimizes the risk of endophthalmitis and prevents the spread of disease to the globe of the eye. It also improves the probability
of graft survival and has a good potential to improve visual acuity. Penetrating Keratoplasty is an effective surgical process. However, it is always advisable to consult an experienced and skilled surgeon before opting for this method.

1650 people found this helpful

Reconstructive Surgery For Cleft Palate - Know More About It!

MCh - Plastic and Reconstructive Surgery, MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Hyderabad
Reconstructive Surgery For Cleft Palate - Know More About It!

A cleft palate and cleft lip are among the most common congenital birth defects. These conditions can occur individually or together and vary in severity and the side of the face affected. A cleft palate not only mars the beauty of a child, but can also lead to serious health problems associated with speech and food intake.

A cleft palate can be diagnosed in the 17th week of pregnancy with the help of an ultrasound. This condition develops when components of the upper lip and ceiling of the mouth fail to develop normally. A cleft palate can affect children of all races equally but an isolated cleft palate is more common amongst female babies than male babies.

In most cases, a cleft palate can be surgically reconstructed within the first year of a baby’s birth. This not only improves the child’s appearance, but also improves his or her ability to breath, eat, speak and hear. A cleft palate reconstruction surgery is performed under anaesthesia. To begin reconstructing the ceiling of the mouth, incisions are made on either side of the cleft. A specialised flap technique is used to reposition muscles and tissues in the palate so as to bridge the gap. This is then stitched close with removable or absorbable sutures.

Dressings or bandages may be placed over the sutures after surgery. It is essential to prevent your child from sucking his or her thumb or putting anything in the mouth that could hamper recovery. Pain medication may also be prescribed to help your child deal with the discomfort. Over the following few weeks, the swelling will subside and incisions will heal. It is also important to protect your child from sun exposure at this time to prevent the formation of jagged scars.

While a single surgery is often enough to repair a cleft palate, treatment for the same may continue into adolescence. Sometimes this can also extend into adulthood. In some cases, further plastic surgery may be required as the child grows to improve appearances and functioning of the palate.

803 people found this helpful

Hymen - Mind-Boggling Facts About It!

Diploma in Paediatrics, MBBS
Sexologist, Dehradun
Hymen - Mind-Boggling Facts About It!

Contrary to what most girls have been led to believe about the hymen being a flat tissue that covers the vagina and is ripped during penetrative sex, the truth is that hymen is a fringe of tissue around the vaginal opening. It is not an intact tissue draping across the vaginal wall because, without any outlet for the menstrual blood, girls would get periods only after they lose their virginity.

Here are a few mind-boggling facts about the hymen.

1. Just like labia, every woman's hymen varies in colour, size and shapes. 
2. It is elastic and stretchy in most cases. Vaginal delivery makes the hymen less visible by smoothening and stretching it.
3. Despite popular belief, the pain women experience when they have sex for the first time is not due to your hymen breaking but because your vaginal muscles are too tense and/or you're going at it too rough and fast without adequate lubrication.
4. Simple exercises such as walking, riding bicycles, doing splits as well as horseback riding may rip your hymen long before you have had intercourse. 
5. Hymens should not be perceived as the indicator of sexual activity because they are extremely stretchy and stay with you your entire life. Even sexually active people have hymens. 
6. If you do not resort to any sexual activity (including penetration during masturbation), the hymen returns to its default position in your vulva. 
7. Very few women have an imperforate hymen in which the opening is too small for penetration whether by tampons, fingers, sex toys or an erect penis. A simple surgery needs to be conducted in such a case where parts of the hymen are snipped away. 
8. There is a growth in hymenoplasty, also known as hymen reconstruction surgery, in the past few years because hymen is viewed as an indicator of virginity and there have been cases of annulment, public humiliation, torture and even death because they believe that the hymen is not intact due to sexual activity; therefore making hymenoplasty an effective solution. 
9. Although, not an indicator of the amount of sexual activities performed, one must seek immediate medical attention after being sexually assaulted because it can be examined to prove sexual abuse.
 

1675 people found this helpful

Hymnoplasty - Know Procedures Of It!

MBBS, MS - Obstetrics & Gynaecology, Fellowship in Minimal Access Surgery, Post Graduate Diploma in Sonography (Obstetric- Gynae), Fellowship In Assisted Reproductive Technology
Gynaecologist, Jaipur
Hymnoplasty - Know Procedures Of It!

Hymnoplasty is also known as hymen surgery. It is a surgical procedure where the hymen within the vagina is restored. The Hymen is a membrane covering the vaginal opening, which can be torn when a woman engages in coitus for the first time or it could be damaged due to other factors such as heavy lifting, exercise, cycling, swimming among many other activities. Hymnoplasty involves putting back the hymen’s torn edges to make it look like the hymen is intact.

Why do women want hymen reconstruction?
A woman would want a hymen reconstruction surgery for a number of reasons. They are:

  1. Religious reasons: In certain cultures, a woman’s hymen is inspected to make sure she has not engaged in coitus in the past. Virginity is valued highly is such places and if the woman is not a virgin, she may have to face social or even legal ramifications.
  2. In case of rape or sexual assault victims: In some cases, a rape victim may undergo this surgery to empower herself and feel mentally peaceful.
  3. Hymen related injuries: Certain factors like heavy exercise or sexual intercourse can cause rupture of the hymen which may cause bleeding, infections or other complications. A woman may want to rectify this with the help of this surgery.

The procedure
The entire surgical process lasts for about 45-60 minutes. The surgery is carried out in an outpatient setting under general anesthesia. The torn skin membranes are rejoined using dissolvable stiches so that scaring is minimal.

This procedure can be carried out in three ways
1. Joining the torn edges with stiches.
2. An artificial membrane is placed in the area whose function is to behave like an artificial hymen. This hymen however, does not have any blood supply, so a capsule that contains blood can be placed with it.
3. A flap is taken from the vaginal lining, which is used to create a functional hymen with proper blood supply.
4. You can return to your work in about 2-3 days after the surgery. However, the entire healing process takes around two months.

Risks
The procedure carries some risks that you should be aware of, they are –
1. Bleeding: Some bleeding is normal after the procedure, but any prolonged case of bleeding may indicate a complication.
2. InfectionLike all surgeries, you may have infections in the concerned area. The doctor may prescribe antibiotics to deal with these infections.
3. Narrowing of the vaginal opening: In some cases, the vaginal opening can become narrow after the procedure. This however, can be resolved without the need for any treatment as it may become wider on its own over time.

1398 people found this helpful

Facial Surgery - How To Prepare Yourself For It?

DNB (Plastic Surgery), DNB General Surgery, FCPS General Surgery, MBBS
Cosmetic/Plastic Surgeon, Pune
Facial Surgery - How To Prepare Yourself For It?

Facial surgery can be opted by people for a number of reasons, and these include being born with facial impairments like cleft lip, birthmark or other birth defects, the effects of aging, sun damage or other facial traumas that are noticeable on the face as well as a sense of general dissatisfaction with your facial features. Depending on these factors, facial plastic surgery can be divided into two categories - reconstructive and cosmetic.

Reconstructive plastic surgery is performed for correcting conditions that may be present from birth, including birthmarks on the face, cleft lip and palate, protruding ears and a crooked smile. Conditions resulting from accidents, traumas or burns are also corrected by this type of surgery.

Cosmetic facial plastic surgery is performed to enhance the visual appearance of facial structures and features which include facelifts, eye lifts, rhinoplasty, cheek and chin implants and liposuction.

If you are planning to get a facial surgery done, there are certain things you need to do to prepare yourself for it. These are:

1. Schedule a surgery when you are healthy

If you are planning for either of the surgeries, try to schedule it during a period of relatively good health. Your immune system will have the best chance towards a speedy recovery. Scheduling the surgery at the year-end is ideal when you can take a few days off with paid vacation time.

2. Get enough essential nutrients

Your diet, before and after the surgery should be rich in vitamin A, vitamin C, zinc, copper and selenium. They help the wound to heal quickly and in building your immunity, thereby reducing the chances of an infection. You can recover from more comprehensive procedures like tummy tuck, facelift or liposuction by including the requisite nutrients in your diet.

3. Protein intake

Calories and protein are the two most healing elements. Extra protein will help to build new tissue and blood vessels, repair injured tissue and increase production of cells that heal the wound. Choose high-quality protein sources like fish, poultry, beans, legumes and meat.

4. Stay hydrated

Consuming 6-8 glasses on the day prior to the surgery is very important to help cleanse and hydrate the body. Since fluid intake is reduced on the day of surgery, water intake is especially important prior to the surgery. To avoid complications during surgery, ensure that you do not drink anything after midnight the night prior to your surgery unless advised by your surgeon.

3798 people found this helpful

Hymenoplasty - Why Is It Required?

DNB (Obstetrics and Gynecology)
Gynaecologist, Thane
Hymenoplasty - Why Is It Required?

Hymenoplasty is also known as hymen surgery. It is a surgical procedure where the hymen within the vagina is restored. The Hymen is a membrane covering the vaginal opening, which can be torn when a woman engages in coitus for the first time or it could be damaged due to other factors such as heavy lifting, exercise, cycling, swimming among many other activities. Hymenoplasty involves putting back the hymen’s torn edges to make it look like the hymen is intact.

Why do women want hymen reconstruction?

A woman would want a hymen reconstruction surgery for a number of reasons. They are:

  1. Religious reasons: In certain cultures, a woman’s hymen is inspected to make sure she has not engaged in coitus in the past. Virginity is valued highly is such places and if the woman is not a virgin, she may have to face social or even legal ramifications.
  2. In case of rape or sexual assault victims: In some cases, a rape victim may undergo this surgery to empower herself and feel mentally peaceful.
  3. Hymen related injuries: Certain factors like heavy exercise or sexual intercourse can cause rupture of the hymen which may cause bleeding, infections or other complications. A woman may want to rectify this with the help of this surgery.

The procedure

The entire surgical process lasts for about 45-60 minutes. The surgery is carried out in an outpatient setting under general anesthesia. The torn skin membranes are rejoined using dissolvable stitches so that scaring is minimal.

This procedure can be carried out in three ways

1. Joining the torn edges with stitches.
2. An artificial membrane is placed in the area whose function is to behave as an artificial hymen. This hymen, however, does not have any blood supply, so a capsule that contains blood can be placed with it.
3. A flap is taken from the vaginal lining, which is used to create a functional hymen with proper blood supply.
4. You can return to your work in about 2-3 days after the surgery. However, the entire healing process takes around two months.

Risks

The procedure carries some risks that you should be aware of, they are –

1. Bleeding: Some bleeding is normal after the procedure, but any prolonged case of bleeding may indicate a complication.
2. InfectionLike all surgeries, you may have infections in the concerned area. The doctor may prescribe antibiotics to deal with these infections.
3. Narrowing of the vaginal opening: In some cases, the vaginal opening can become narrow after the procedure. This however, can be resolved without the need for any treatment as it may become wider on its own over time.

4300 people found this helpful
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