reconstructive cosmetic surgeries

1. Plastic reconstructive
cosmetic surgeries

3. Plastic surgery
• AESTHETIC{cosmetic}
• RECONSTRUCTIVE

4. Cosmetic surgeries
 Improvisation of physical features that already in normal range

5. FACIAL RESURFACING
 CHEMICAL FACE PEELING
Application of chemical mixture to the face for the superficial destruction of epidermis
and the upper layers of the dermis to treat fine wrinkles, keratoses and the pigment
problem.

6. DERMABRATION

8. Process of sanding the surface layers of skin of
cheeks and forehead with an electric rotating brush
to smooth out pitting and surface blemishes
Used for deep scars and depressed acne
Surface is then covered with antibiotic ointment and
gauze

9. Dermal fillers
 Defects by aging , photodamage, trauma or scarification.
 Filling small wrinkles or depressed blemishes with autologous fat, collagen,
hyaluronic acid, hyla form
Contraindication: autoimmune disorders

12. Botulinum injection
 Botulinum toxin type A [botox] injection provide a temporary improvement of the
moderate to severe frown lines between eyebrows
 Small doses are injected in to affected muscles and block the release of
acetylcholine.
 Paralyzation of the muscle will be last for 120 days
 Side effects:
Headache, RTI, flue syndrome, blepharoptosis

13. Laser resurfacing

14.  ablative or non-ablative lasers.
 ablative lasers include carbon dioxide or Erbium.
 Carbon dioxide laser resurfacing procedures are used to eliminate scars, warts, and
deep wrinkles.
 Erbium is used for fading finer lines and wrinkles and superficial skin issues. Both
these types of lasers help to remove outside layers of the skin.
 Non-ablative lasers don’t remove skin layers, and these comprise pulsed light,
pulsed-dye lasers, and fractional lasers.
 This type is beneficial for treating skin conditions like rosacea, spider veins, and
acne breakouts.

15.  Creates a shallow burn injury to the skin.
 Antiviral agents are used before treatment
benefits risks
Reduce fine lines and wrinkles
Treat brown spot, redness and
discoloration,
Tighten skin and encourage
collagen production
Improve acne scars
Decrease size of enlarged scars
Burn from heat
Scarring
Changes in skin pigmentation
Swelling itching crusting, soreness
Bacterial, viral or fungal infections

16. RHYTIDECTOMY[FACE LIFT]

17. Removal of wrinkled skin from forehead, around the
eyes and mouth
Incisions are made from the temple along the ear
and out in to the hair bearing scalp behind the ear
Excess facial skin is undermined and pulled back
towards the ear

19. Complications
Hematomas[smokepre existing htn]
Increased drainage and changes in facial sensation

20. BHLEPHAROPLASTY

21. Surgical removal of the excess skin and periorbital fat from
the upper or lower eyelid
Wide elliptical incisions are made on the upper lid
The excised wedge of excess tissue is lifted off and
herniated fat is removed

22.  Lower lid blepharoplasty is placed 1/8 inch below the edge of eyelid

23. RHINOPLASTY
SURGICAL CORRECTION OF THE NASAL DEFORMITIES
Incision are made inside the nose to reshape dorsum, ala, or
internal cartilage
The incision
Rhinoplasty is performed either using a closed procedure,
where incisions are hidden inside the nose, or an open
procedure, where an incision is made across the columella
Through these incisions, the skin that covers the nasal bones
and cartilages is gently raised, allowing access to reshape the
structure of the nose.

24. Reshaping the nose structure
An overly large nose may be reduced by removing
bone or cartilage. Sometimes surgery of the nose
may require the addition of cartilage grafts.
[the septum, the partition in the middle of the nose,
the ear or rarely a section of rib cartilage can be used.]
Correcting a deviated septum
If the septum is deviated, it can be straightened and
the projections inside the nose reduced to improve
breathing.

25. Closing the incision
Once the underlying structure of the nose is sculpted
to the desired shape, nasal skin and tissue is re
draped and incisions are closed.
the results
For a few days, splints and gauze packing may
support the nose as it begins to heal.

27. BODY CONTOURING SURGERIES
 by eliminating the fat, tightening the skin, and reshaping several body areas.

28. Body contouring, or body sculpting, is a medical or
surgical procedure that aims to reshape an area of
the body.
• Get rid of extra skin.
• Eliminate excess fat.
• Reshape or contour the area.

29.  Nonsurgical body contouring is called lipolysis.
• Cryolipolysis uses very cold temperatures to destroy fat cells (for example,
CoolSculpting.
• Injection lipolysis involves putting deoxycholic acid into the body to target fat cells.
• Laser lipolysis uses lasers to destroy fat cells
• Radiofrequency lipolysis uses ultrasound waves and heat to target fat cells

30. LIPECTOMY
LIPOSUCTION
TO aspirate fatty tissues from areas of the body resistant to diet
and exercise, to contour flaps and remove lipomas.

32.  Before the procedure
Before your liposuction procedure, the surgeon may mark circles and lines on the areas
areas of your body to be treated
Tumescent liposuction. This is the most common type of
liposuction. The surgeon injects a sterile solution — a
mixture of salt water, which aids fat removal, lidocaine
and epinephrine that causes the blood vessels to constrict
— into the area that's being treated. The fluid mixture
causes the affected area to swell and stiffen.

33. The surgeon then makes small cuts into your skin
and inserts a thin tube called a cannula under your
skin. The cannula is connected to a vacuum that
suctions fat and fluids from your body.

34.  Ultrasound-assisted liposuction (UAL).
This type of liposuction is sometimes used in conjunction
with traditional liposuction. During UAL, the surgeon inserts
a metal rod that emits ultrasonic energy under your skin.
This ruptures the fat-cell walls and breaks down the fat for
easier removal.

35.  Laser-assisted liposuction (LAL). This technique uses high-intensity
laser light to break down fat for removal. During LAL, the
surgeon inserts a laser fiber through a small incision in the
skin and emulsifies fat deposits.

36.  Power-assisted liposuction (PAL). This type of liposuction uses a cannula
that moves in a rapid back-and-forth motion. This vibration
allows the surgeon to pull out tough fat more easily and faster.
PAL may sometimes cause less pain and swelling and can allow
the surgeon to remove fat with more precision.

37. After the procedure
the surgeon may leave your incisions open and place
temporary drains to promote fluid drainage.
need to wear tight compression garments, which help
reduce swelling, for a few weeks.

38. ABDOMINOPLASTY
a cosmetic surgical procedure to improve the shape and
appearance of the abdomen
Removal of excess abdominal fat and skin and the repair and
tightening of separated abdominal muscles.
An incision made on the lower abdomen and the tissue is
undermined to the costal margin.
The excess skin and fatty tissues are excised and recontoured
The umbilical stalk is detached and then reattached once the
overlying skin Is in proper position

39. • Complete abdominoplasty: The incision is made at the bikini line, at
about the same level as your pubic hair. surgeon will then
manipulate and shape the skin and muscle .
• An incision around navel also made with this procedure,
Drainage tubes may or may not be placed under your skin.

40. • Partial or mini-abdominoplasty:
• Mini-abdominoplasties are done with shorter incisions
and are often performed on people who have less excess
skin.
• skin will be separated between the line of incision and
your belly button. This procedure generally takes one to
two hours.

41. Circumferential abdominoplasty:
This surgery includes the back area.
you may have either liposuction of the back or
circumferential abdominoplasty.
The procedure allows for the removal of both skin and fat
from the hip and back areas, which improves the shape of
your body from all sides.

43. • Scarring.
• Hematoma (bleeding).
• Infection.
• Seroma (accumulation of fluid).
• Poor wound healing.
• Blood clots.
• Numbness or other changes in sensation
 Other complications include:
• Fat necrosis (death of fatty tissue located deep in the skin).
• Wound separation.
• Asymmetry ).

44. PANNICULECTOMY
A panniculectomy is a surgical procedure to remove the pannus —
the excess skin and tissue from the lower abdomen.
• a horizontal cut from one hipbone to the next
• in some cases, a vertical cut extending to the pubic bone
The length of the cuts depends on how much skin needs to be
removed. Through the incisions, the surgeon will remove excess
fat and skin. The remaining skin and tissues are then pulled
together and closed with stitches, and the incision areas are taped.

46. Mammoplasty –
Breast augmentation (or "breast enlargement" )Augmentation of
the breasts.
This can involve either saline or silicone gel prosthetics.
- Breast reduction: Removal of skin and glandular tissue.
Indicated to reduce back and shoulder pain or for psychological
benefit in women with macromastia. –
- Breast lift (Mastopexy): Lifting or reshaping of breasts to
make them less saggy, often after weight loss (after a
pregnancy, for example). It involves removal of breast skin as
opposed to glandular tissue.

47. Buttock Augmentation (or "butt augmentation" or
"butt implants"):
.This procedure can be performed by using silicone
implants or fat grafting and transfer from other areas of
the body
Chin augmentation: Augmentation of the chin with an
implant (e.g. silicone) or by sliding genioplasty of the
jawbone..

48. prosthesis

49. Application of various body and face cosmetic
prostheses
The amount of incision will vary depending on the type of
prosthesis and its placement area, and sutures that are
absorbed by the body are often used for sutures.
To remove facial wrinkles or fill in facial organs such as
cheeks and chin, prosthesis is often done by injection of
silicone material, injection is done with small syringes and
in most cases their place will not be visible.

50. Who are cosmetic prostheses suitable for?
• natural or congenital defects in various areas such as the
chest or face and buttocks.
• A person who has had to have part or all of her breast
removed due to breast cancer
• For people with congenital or genetic defects, for
example in cases of small and flat buttocks or asymmetry
of the breasts, When low bone growth causes a defect in
the face, such as when the chin or cheekbones are not
well developed and small.

51. CHIN PROSTHESIS
People who have lost the shape of their chin in a natural
accident or car accident, or who have lost the beauty of
their chin due to mouth and jaw problems, can use
special chin prostheses.
Genioplasty or chin surgery is a type of cosmetic
treatment and operation that is performed to bring the
chin and jaw forward as well as to enlarge the small
jaws.
There are many types of chin prostheses available that
are made from a variety of materials, including silicone
or other materials.

53. LIP PROSTHESIS
Lip augmentation using a lip prosthesis or gel injection in
the lips makes the lips look plump and prominent, and
this improves the overall appearance of the face.
Those with thin lips, in particular, can benefit from the
benefits of lip prosthesis with gel injections.

54. NOSE PROSTHESIS
By having a prosthesis at the top and bottom of the “protrusion” on
the nose (nasal hump), a flat nose can be easily achieved and its
defect eliminated. In addition, by injecting the gel around the tip of
the nose, it can be customized.
.This method can be used to lift the tip of the nose, remove medium
nasal humps, eliminate imperfections and indentations of the nose,
and correct the shape of the nose.

55. • MATERIALS USED
• The first group is the silicone prosthesis, main advantages of
installing a silicone prosthesis is its cheapness, softness and
very easy removal.
• The second group of prostheses are made of Gortex. These
prostheses are dense foam and have pores in which the
surrounding tissue can penetrate. Because they have little
flexibility, a larger incision must be made to place them, and
more pressure is applied to the muscles and nerves around
them.
• The third group is Medpour-Purks prostheses, which have hard
bone tissue and many pores. Therefore, the surrounding tissue
penetrates them to a large extent.

57. Flaps and skin graft

58. Traumatic injury management
Sharp and blunt trauma can include lacerations, deep
abrasions and tears of the skin and fat layers. Deeper soft
tissue injuries to the muscles can also occur, as well as
injuries to tendons, blood vessels and nerves.

59. • Facial deformities
• Craniofacial deformities
• Extremity injuries
• Complex wounds, including burns

61. Common reconstructive surgical procedures are for:
 Breast reconstruction
 Face injury
 Contracture surgery for burns
 Hand and finger injury
 Cleft lip and palate
 Injuries to limbs.
 Craniofacial defects
 Pressure sores
 Hand anomalies
 Spinal cord defects
 Congenital cardiac defects repair

62. PRINCIPLES
Removal of excess tissue in the area needed.
Timing of reconstructive surgery should be
individualized.
Early reconstruction does not retard or influence further
treatment or adversely affect predicted survival.
The extent of reconstruction depends on the type of
surgery done.
Flaps are mostly taken from back or abdomen

63. procedure
Flap techniques reposition a woman's own tissue to create
or cover the breast mound
A TRAM flap uses donor muscle, fat and skin from a
woman's lower abdomen to reconstruct the breast.
The flap may either remain attached to the original
blood supply and be tunneled up through the chest
wall, or be completely detached, and formed into a
breast mound.

64. In DIEP flap or SIEA flap techniques, which use
only skin and fat to the chest from the
abdomen.

65. A latissimus dorsi flap uses muscle, fat and skin from
the back tunneled to the mastectomy site and remains
attached to its donor site, leaving blood supply intact.

66. Tissue expansion stretches healthy skin to provide
coverage for a breast implant
For women who do not require breast radiation
implant-based reconstruction is an option.
Reconstruction with tissue expansion allows an easier
recovery than flap procedures

68. Surgical placement of a breast implant creates a
breast mound
A breast implant can be an addition or alternative to
flap techniques.
 Surgeons may also use an implant as a temporary
placeholder.
 Saline and silicone implants are available for
reconstruction.

70. Reconstructing a nipple and areola, breast revision
techniques
Techniques usually involve folding skin to create the
shape of a nipple followed by tattooing. Three-
dimensional nipple-areolar tattooing may be used alone
to create the appearance of a realistic nipple with the
illusion of projection

71. Oncoplastic reconstruction after lumpectomy
use the techniques of breast reduction or breast lift at the
same time as the lumpectomy.
The breast reduction or breast lift helps to fill in the defect
created by the lumpectomy and improves the breast shape.

72.  Complications
Blood clots.
Breasts that are a different size or shape
Bruising or scarring around the reconstructed
• Fat necrosis. Death of the transplanted tissue after flap
surgery.
• Problems with the implants (for implant
• Weakness, pain or sensitivity at the donor site after a
reconstruction procedure.
• breast implant-associated anaplastic large cell

74. Cleft lip and palate are the common birth defects
This type of surgery deigned to correct the
abnormal development and restore more normal
appearance.
These are the openings or splits in the upper lip,
the roof of the mouth or both.
These result when facial structures that are
developing in an unborn baby don’t close
completely

75. Difficulty with feedings
Difficulty swallowing, with potential for liquids or foods to
come out the nose
Nasal speaking voice
Chronic ear infections

76. complications
Cleft lip repair — within the first 3 to 6 months of age Cleft palate repair — by the
age of 12 months, or earlier if possible Follow-up surgeries — between age 2 and
late teen years Surgery can significantly improve your child's appearance, quality of
life, and ability to eat, breathe and talk. Possible risks of surgery include bleeding,
infection, poor healing, widening or elevation of scars, and temporary or permanent
damage to nerves, blood vessels or other structures.