Post-cancer breast reconstruction
Breast reconstruction for patients who have undergone or are scheduled for mastectomy as part of cancer treatment. May be performed immediately (at the same operation as the cancer surgery) or delayed (after completion of adjuvant therapy). Selection depends on cancer type, adjuvant treatment plan, and patient preference.
Suitable for
- Patients who have undergone or are scheduled for mastectomy
- A preference for reconstruction with implants or autologous tissue
- Significant asymmetry after unilateral mastectomy
Technique
Two main pathways. (1) Implant-based: placement of a tissue expander followed by exchange to a permanent implant. (2) Autologous tissue: flap-based reconstruction using DIEP, TRAM, or latissimus dorsi tissue. Selection depends on body habitus, prior scars, and the broader treatment plan.
- Coordination
- Close coordination with oncology and radiation oncology
- Inpatient stay
- 2–5 nights inpatient depending on technique
Reconstruction after skin cancer excision
Reconstruction of skin defects following excision of skin cancer (BCC, SCC, melanoma). The objective is restoration of function and appearance while preserving oncologic clearance as the highest priority.
Suitable for
- Patients after excision of facial, scalp, or sun-exposed skin cancers
- Large defects requiring flap, graft, or tissue expansion techniques
Technique
Selection depends on defect size and location: primary closure, local flaps, regional flaps, or skin grafting. In some cases, staged tissue expansion is required.
- Coordination
- Coordinated with dermatologic oncology or surgical oncology
- Inpatient stay
- Variable
Burn reconstruction
Reconstructive surgery for patients past the acute phase of burn injury. The goals are scar contracture release, restoration of motion, and improvement of appearance. This is a multi-stage process spanning months to years.
Suitable for
- Scar contracture limiting motion
- Hypertrophic or thick burn scars affecting function or appearance
- Tissue loss requiring soft-tissue restoration
Technique
Scar release and revision using specialized techniques (Z-plasty, W-plasty); skin grafting; local and regional flaps; tissue expansion; laser adjunct in selected cases.
- Coordination
- Typically staged 6–12 months apart
- Inpatient stay
- Variable per stage
Congenital deformity reconstruction
Reconstruction of common congenital surface anomalies: prominent or underdeveloped ears, minor facial anomalies, syndactyly, and other structural surface variations. Complex deformities (cleft lip and palate, large craniofacial deformities) are referred to specialized centers.
Suitable for
- Children over six years old with prominent ears or simple syndactyly
- Adults seeking correction of minor congenital findings
- Coordination with pediatrics when relevant
Technique
Diagnosis-specific; individualized planning per case
- Coordination
- Coordination with pediatrics, genetics, or psychology where indicated
- Inpatient stay
- Variable
Trauma reconstruction
Reconstruction of the face, hand, or other regions following major trauma (motor-vehicle injury, occupational injury). May include facial bone, soft tissue, peripheral nerve, and scar reconstruction.
Suitable for
- Facial post-traumatic deformities requiring structural restoration
- Large scars after emergency closure requiring revision
- Tissue loss requiring grafting or flap coverage
Technique
Planning follows comprehensive evaluation; commonly multi-stage; multidisciplinary
- Coordination
- Coordinated with orthopedic trauma, maxillofacial, and neurology services
- Inpatient stay
- Variable