Reconstruction

The goal of breast reconstruction is to restore one or both breasts to near normal shape, appearance, symmetry, and size following mastectomy, lumpectomy, or other trauma. Breast reconstruction often involves several procedures performed in stages and can either begin at the time of mastectomy or be delayed until a later date.

Breast reconstruction generally falls into two categories: implant based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound. Flap reconstruction uses the patient's own tissue from another part of the body to form a new breast. There are a number of factors that should be taken into consideration when choosing which option is best:

• Type of mastectomy
• Cancer treatments
• Patient's body type

Labiaplasty is the surgical reduction of the labia minora, the inner lips of the vaginal lips, is an increasingly popular cosmetic surgery procedure. Women from their teens on often consider treatment for what can be an embarrassing condition – labia enlargement. The surgical goal is to reduce the size of a woman's labia minora and make them more symmetrical so they don't protrude or hang beyond the labia majora. Women often consider the surgery to avoid embarrassment, the stigma of labial enlargement that can be seen through clothing or observed in intimate situations, for comfort, and less commonly for chafing. In some circumstances, psychosocial and functional difficulties, as well as physical discomfort, are motivations for women to undergo the procedure. Labial enlargement may be due to hereditary congenital anomaly, due to aging, pregnancies or a variety of other causes.

The surgical procedure to reduce labia is done as an outpatient procedure and often takes less than one hour. There is minimal discomfort associated with it and the sutures that are used dissolve on their own. Following surgery, patients should avoid sexual encounters, significant physical exertion and exercise for approximately one month. The condition rarely recurs and is often lasts a lifetime.

Cancerous and other skin lesions can be surgically removed using specialized techniques to preserve your health and your appearance. Although no surgery is without scars, your plastic surgeon will make every effort to remove lesions without dramatically changing your appearance.

Depending on the size, type and location of the lesion, there are many ways to remove them and reconstruct your appearance if necessary.

Step 1—Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include local, intravenous sedation and general anesthesia. We will talk with you about the options and recommend the best choice for you.

Step 2—Removal

A small or contained lesion may be removed with excision - a simple surgical process to remove the lesion from the skin. Closure is most often performed in conjunction with excision.

Skin cancer can be like an iceberg. What is visible on the skin surface sometimes is only a small portion of the growth. Beneath the skin, the cancerous cells cover a much larger region and there are no defined borders. In these cases, a specialized technique called Mohs surgery may be recommended.

During this procedure, your plastic surgeon may order a frozen section. During this step, the cancerous lesion is removed and microscopically examined by a pathologist prior to wound closure to ensure all cancerous cells have been removed. The goal is to look for a clear margin - an area where the skin cancer has not spread. If clear margins are found, the resulting wound would be reconstructed. If clear margins are not present, more tissues may need to be removed until the entire region has a clear margin.

Step 3—Reconstruction
A lesion that is particularly large, is being removed with frozen sections or is likely to cause disfigurement may be reconstructed with a local flap. Healthy, adjacent tissue is repositioned over the wound. The suture line is positioned to follow the natural creases and curves of the face if possible, to minimize the obviousness of the resulting scar.

It may be beneficial to choose to treat your wound with a skin graft instead of a local flap. A skin graft is a thin bit of skin removed from one area of the body and relocated to the wound site.

Scar revision surgery will attempt to minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture.

Scars are visible signs that remain after a wound has healed. They are the unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be noticeable due to their size, shape or location; they can also be raised or depressed, and may differ in color or texture from the surrounding healthy tissue.

Your treatment options may vary based on the type and degree of scarring and can include:

• Simple topical treatments
• Minimally invasive procedures
• Surgical revision with advanced techniques in wound closure

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Scar revision can be performed on people of any age and is a good option for you if:

• You are bothered by a scar anywhere on your body
• You are physically healthy
• You do not smoke
• You have a positive outlook and realistic goals for your scar revision surgery
• You do not have active acne or other skin diseases in the area to be treated