Plastic and Reconstructive Surgery

Reconstructive surgery covers many different procedures each with the common goal of reconstructing or forming a normal physical structure. Infants born with spina bifida or cleft palate may undergo reconstructive surgery to cover the spine or close the gap in the oral cavity, respectively. Patients that have had traumatic accidents with serious and multiple bone fractures may also have reconstructive surgery to restore function. Surgeons may perform reconstructive surgery on burn victims to cover areas of skin loss and repair heat sensitive structures such as cartilage that may have been deformed by heat or fire. Reconstructive surgery can also been electively performed on patients who simply want to improve their appearance although it is not often referred to “reconstructive surgery” when performed for subtle aesthetic reasons.

 

 

Surgeons that perform reconstructive surgery need to be extremely creative and resourceful as they attempt to make normal structures from damaged or missing skin, cartilage and bone. Often the plastic surgeon will harvest tissue from another place on the body and reshape it to provide structural support to the damaged of deficient area. For example, certain portions of the rib may be taken from the chest in order to reconstruct the nose. For surgery after burns, skin can be harvested from other places on the patient’s own body or donor (cadaver) tissue can be used. The surgeon needs to envision what the structure should look like and form it based on the best possible tissue available. The tissue has to have a reasonable blood supply or the reconstructed area will not survive. In other words, if the surgeon has an excellent piece of cartilage and muscle to use but the blood vessels cannot supply oxygen and nutrients in the new area, the tissue cannot be used. Also, the area from where the tissue is taken cannot be left without blood or covering either. If the tissue is taken from a donor, the patient may need to take immunosuppressant drugs so that the tissue is not rejected by the patient’s immune system.

 

Advancements in biomedical technology are making some of the work for reconstructive surgeons a little easier. Researchers are developing and perfecting artificial skin and cartilage to be used in reconstructive surgery. This means that the surgeon will not have to struggle to find suitable tissue, but can have a virtually unlimited supply that can be formed into the needed shape. With the lifting of many restrictions on stem cell research, this technology may be a new source for artificial tissue constructed directly from stem cells. Recent work has shown that a person’s own cells may be programmed to behave like stem cells and then perhaps reprogrammed to become the new tissue that is needed in the reconstructive surgery.

 

While these procedures are in part for cosmetic improvement for the patient, they also serve very real medical purposes and are likely to be covered by medical insurance. However, when it comes to health insurance plans, nothing can be assumed and every surgery, even reconstructive surgery should be discussed with the insurance company directly prior to the procedure. Since many reconstructive surgeries require more than one operation to achieve a lasting, favorable result, establishing who is responsible for the cost should be done as early as possible.