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Hand Surgery

Hand surgery is a broad term that covers many different types of procedures. Plastic surgeons who perform hand surgery seek to restore hand and finger function. But hand surgeons also try to make the hand look as normal as possible, as well. Hand reconstructive surgery may be done for many reasons, including:

  1. Hand injuries
  2. Rheumatic diseases, such as osteoarthritis and rheumatoid arthritis, that change and damage the structures in the hand
  3. Degenerative changes to the structures in the hand
  4. Problems or defects of the hand that are present at birth, or congenital
  5. How long the condition is expected to last
  6. Infections of the hand

Hand surgery is the field of medicine that deals with problems of the hand, wrist, and forearm. Hand surgeons care for these problems with and without surgery. They are specially trained to operate when necessary. Many hand surgeons are also experts in diagnosing and caring for conditions of the elbow. Some hand surgeons treat only children, some treat only adults, and some treat both.

Types of hand surgery
Many different types of surgeries can be performed on the hand. It depends on the underlying cause of the problem. These procedures include:

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Ear Surgery

Otoplasty — also known as cosmetic ear surgery — is a procedure to change the shape, position or size of the ears.

You might choose to have otoplasty if you're bothered by how far your ears stick out from your head. You might also consider otoplasty if your ear or ears are misshapen due to an injury or birth defect. Otoplasty can be done at any age after the ears have reached their full size — usually after age 5 — through adulthood.

Why it's done ?
You might consider otoplasty if:
  1. Your ear or ears stick out too far from your head
  2. Your ears are large in proportion to your head
  3. You're dissatisfied with a previous ear surgery
Precautions

Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.


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Nose Surgery (Rhinoplasty)

Rhinoplasty or Nose Surgery, is a procedure designed to reshape or refine the nose & It can also help in selected nasal air flow problems. Rhinoplasty is truly a combination of art and science & a successful Rhinoplasty requires careful preoperative planning. Each part of the nose, including the dorsum (or “bridge” of the nose), the tip, the nostrils and their relationship and proportions to each other must be carefully analyzed. The effect that a manipulation of one part will have on the appearance of another must be predicted and calculated. His rhinoplasty technique revolves around balancing his patient’s proportions & overall shape that is perfect for each person’s unique characteristics.

Nose Surgery Patients commonly request for a change in
  1. Nose size, in relation to the other facial structures
  2. Nose width, at the bridge
  3. Nose profile, with visible humps or depressions on the bridge
  4. Nasal tip, that is large or bulbous, drooping or too upturned
  5. Nostrils that are large, wide or upturned
  6. Nasal asymmetry and deviation

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Breast Reconstruction

This procedure is designated for women after breast removal due to cancer or other conditions. The reconstruction can be performed during breast removal procedure, or after several months, even a year or afterwards. There are techniques to reconstruct a breast which is very similar to the natural one. – Breasts can be reconstructed with implants, expander and implant and with body tissues. After removal of breast, an expander is inserted under the skin and the chest muscles.

It has a special valve which can be filled from the outside. The implant is being filled gradually with a solution, until the skin has sufficiently expanded for the insertion of the implant. The breast can also be reconstructed with body tissue from areas with extra skin and fat, such as lower abdomen or back (latissimus dorsi muscle). It takes another 3-6 months until the breast has acquired its final shape, then the nipple can be reconstructed as well. Reconstruction results in significant improvement in social life and self esteem of women.

Reasons to have breast reconstruction
A woman might choose to have breast reconstruction for many reasons:
  1. To make her chest look balanced when she is wearing a bra or swimsuit
  2. To help make clothes fit better
  3. To permanently regain her breast shape
  4. So she won’t have to use a breast form that fits inside the bra (an external prosthesis)
  5. To feel better about her body

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Cleft Lip & Palate Surgery :

Cleft Lip

The goal of cleft lip surgery is to repair the separation of the lip. Cleft lip is typically repaired between 3 and 6 months of age. During those first few months, your child is monitored closely for adequate weight gain and nutrition, and to make sure that there are no issues relative to breathing while eating.

The plastic surgeon will make an incision on each side of the cleft from the lip to the nostril. The two sides of the lip are then sutured together, using tissue from the area to rearrange and close the lip as needed. In addition to closing the lip, cleft lip repair realigns the muscle of the upper lip to provide normal lip function and facilitate suckling.

After surgery for cleft lip:
  1. Your child may be irritable and feel mild pain.
  2. Your child may have to wear padded restraints on his elbows to prevent rubbing at the surgery site.
  3. Swelling, bruising and blood around stitch sites are normal. Stitches dissolve or will be removed in five to seven days.
  4. Scars will gradually fade but will not completely disappear.
  5. An intravenous (IV) catheter will be used to give your child fluids until he can drink adequately.

Cleft Palate

The goal of cleft palate surgery is to fix the roof of the mouth so that your child can eat and talk normally. Cleft palate repair is a more complicated surgery and has the best outcome when the child is slightly older and better able to tolerate the surgery, but before significant speech development occurs. Surgical repair of the palate generally occurs around 1 year of age, following the successful repair of cleft lip if present. In some cases, a second operation is needed.

After surgery for cleft palate:
  • Your child may experience more discomfort and pain with cleft palate repair than cleft lip repair.
  • Your child may have nasal congestion. This can be relieved with medication.
  • Your child may stay in the hospital for one to three days and will be given antibiotics to prevent infection.
  • Your child will have stitches on his palate. Stitches will dissolve after several days. If packing is placed on the palate, do not remove the packing until instructed.
  • There may be bloody drainage from the nose and mouth. It is also normal to have temporary swelling, bruising and blood at the surgery site.
  • An intravenous (IV) catheter will be used to help give your child fluids until he can drink adequately.

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Cranioplasty Surgery

Cranioplasty is the surgical repair of a bone defect in the skull resulting from a previous operation or injury. There are different kinds of cranioplasties, but most involve lifting the scalp and restoring the contour of the skull with the original skull piece or a custom contoured graft made from material such as:

  1. Titanium (plate or mesh).
  2. Synthetic bone substitute (in liquid form).
  3. Solid biomaterial (prefabricated customized implant to match the exact contour and shape of the skull).

Conventional cranioplasty methods, which have been used by neurosurgeons for more than 100 years, involve peeling back all five layers of the scalp to place the bone remnant or custom implant into the proper cranial location.

Why might a doctor recommend a cranioplasty?

Cranioplasty might be performed for any of the following reasons:
  • Protection: In certain places, a cranial defect can leave the brain vulnerable to damage.
  • Function: Cranioplasty may improve neurological function for some patients. In some instances, a customized cranial implant is designed ahead of time to help the surgeon obtain an ideal shape and outcome, as well as to house embedded neuro technologies.
  • Aesthetics: A noticeable skull defect can affect a patient’s appearance and confidence.
  • Headaches: Cranioplasty can reduce headaches due to previous surgery or injury.

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Vascular & Microvascular Surgery

Vascular disease is a group of diseases of the blood vessels (arteries and veins of the circulatory system) where there is a disorder and disruption in the blood flow that can lead to disability and even death. Vascular surgery is a surgical subspecialty which involves usage of minimal-invasive catheter procedures to treat the diseases of the vascular system, arteries, veins and lymphatic circulation. However, intracranial and coronary arteries are not included in vascular surgery.

Why Vascular Surgery Performed ?

The vascular system is the network of veins that move throughout the body. Vascular surgery specialist in India perform vascular surgery to treat the following conditions:

  1. Carotid Artery Disease : Carotid arteries are the arteries that carry the blood to the head and neck. When plaque builds up inside the carotid arteries, it may cause a stroke. To prevent stroke, vascular surgery is performed to treat the affected carotid artery.
  2. Aneurysms : It is the dilation of the blood vessel(s) which can lead to a rupture and ultimately result in death. Aneurysms can occur in any part of the body, but they are most common in brain, legs, spleen and aorta. It occurs when the wall of an artery weakens, causing an abnormally large bulge etc.

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Complex Limb Surgery

Limb lengthening is a process that gradually grows new bone. Limb lengthening is used to correct limb length discrepancies and congenital short statures, and is often performed in conjunction with limb deformity correction. There are a number of birth defects that result in limb length discrepancies and congenitally short limbs. Skeletal abnormalities and dysplasias can also be corrected via lengthening, as well as achondroplasia and other dwarfisms. Patients suffering from post-traumatic injuries may also undergo lengthening as part of their treatment.

How Does It Work ?

The limb lengthening process works by gradually growing new bone and soft tissues (skin, muscle, nerves, blood vessels, etc.). Bone and soft tissue regenerate when they are pulled apart at a very slow rate, a process known as distraction. The rate of distraction is typically one millimeter per day. Any faster and the bone may fail to form in the gap, muscles will become contracted, and nerves may become paralyzed; any slower and the bone will reform in the gap, a process known as premature consolidation, which halts the lengthening.

Lengthening is divided into two phases: distraction and consolidation. Lengthening happens during the distraction phase. After the desired length is obtained, the newly regenerated bone is still very weak. The hardening and calcification of this new bone is called the consolidation phase.


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Varicose Vein Surgery

What are Varicose Veins ?

Varicose veins are veins that become enlarged, bulgy or twisted, more likely in the leg or feet, but it could occur to any part of the body. They can be in blue, red or purple in colour. In the leg veins, there are valves that pump blood back towards the heart. Due to the increased pressure on the leg or feet, veins or the valves become varicose, don’t pump blood.

The situations get critical for those who have more standing hour’s jobs. Long-standing can lead to swelling, skin thickening, ulceration, and venous eczema. These are not life-threatening complications although, but sometimes it may be confused with deep vein thrombosis which can be life-threatening.

Varicose veins is a very common condition, it is estimated that about 6-7% of the entire population has some kind of varicose veins. That said, if we convert it to Indian demographics, about 84 million people will suffer from varicose veins. They can last for years or be lifelong.

Causes of a Varicose Veins?

It is usually hereditary. Approximately 70% of all patients with varicose veins have parents with a related condition. If either of your parents has or had these thick, bulgy veins you are more likely to develop them.

If you are working in a facility that requires long standing hours can root varicose veins. Also, pregnancy and obesity make you more vulnerable to varicose veins.

So men and women from different age groups can be affected by this condition. But women are more likely to develop varicose veins, because of hormonal changes during pregnancy, menopause, etc.

Symptoms of Varicose Veins ?

  • Pain
  • Fatigue
  • Itching over the veins
  • Burning
  • Swelling around ankle
  • Cramping in calves
  • Restlessness
  • Pigmentation
  • Dry thinned skin
  • Non-Healing Wounds
  • Numbness
  • Tingling
  • Throbbing
  • Ulcers

Surgery for Varicose Veins ?

These large swelling veins are caused by a blood clot which can be corrected through Lifestyle changes and wearing compression stockings. These remedies will relieve for some time, but it won’t offer you a permanent solution. So better to adopt the medical procedure to cure this problem of the root.


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AV Fistula Surgery

If you have been diagnosed with ESRD and require dialysis, you will need to have a dialysis access placed. An AV fistula is the type of dialysis access that is considered the best choice because it generally lasts longer and has fewer problems.

What is an AV fistula ?

An AV fistula is a surgical connection made between an artery and a vein, created by a vascular specialist. An AV fistula is typically located in your arm, however, if necessary it can be placed in the leg. With an AV fistula, blood flows from the artery directly into the vein, increasing the blood pressure and amount of blood flow through the vein. The increased flow and pressure causes the veins to enlarge. The enlarged veins will be capable of delivering the amount of blood flow necessary to provide an adequate hemodialysis treatment. AV fistulas are the preferred vascular access for long-term dialysis because they last longer than any other dialysis access types, are less prone to infection and clotting, and can be relied upon for predictable performance.

Advantages of an AV fistula

  • Remains functional longer than other forms of vascular access
  • No synthetic material implanted in your body
  • Provides the necessary blood flow needed for effective dialysis, which may help to decrease treatment time
  • Low risk of infection
  • Less prone to clotting than other dialysis access options
  • Created in an outpatient procedure under local anesthesia
  • Fast return to your daily activities

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Laser Surgery

Laser surgery is a type of surgery that uses special light beams instead of instruments for surgical procedures. LASER stands for "Light Amplification by the Stimulated Emission of Radiation." Lasers were first developed in 1960.

Newer laser modifications continue to have a large impact on medical and surgical practices. A large part of their impact has been seen in the treatment of various skin lesion and diseases.

How are lasers used during cancer surgery ?

Laser surgery is a type of surgery that uses special light beams instead of instruments, such as scapels, to perform surgical procedures. There are several different types of lasers, each with characteristics that perform specific functions during surgery. Laser light can be delivered either continuously or intermittently and can be used with fiber optics to treat areas of the body that are often difficult to access.

Types of Laser Usrgeries

There are many indications for the use of lasers in surgery. The following are some of the more common indications:

  • To remove tumors
  • To help prevent blood loss by sealing small blood vessels
  • To seal lymph vessels to help decrease swelling and decrease the spread of tumor cells
  • To treat some skin conditions, including to remove or improve warts, moles, tattoos, birthmarks, scars, and wrinkles