Surgical techniques used in plastic surgery

There are many different techniques used to perform cosmetic and reconstructive plastic surgery procedures, including the following:

• Endoscopic surgery Endoscopic surgery is performed with an endoscope, a tubular probe that has a tiny camera and a bright light, which is inserted into a small incision (a small cut in the skin). Images from the camera are transmitted back to a screen, which the surgeon watches while manipulating the endoscope inside the body. The endoscope is a device to assist the surgeon during surgical procedures. Instruments to actually perform the surgery are inserted through a different incision(s).

• Flap surgery Flap surgery involves moving healthy, live tissue from one location of the body to another - often to areas that have lost skin, fat, muscle movement, and/or skeletal support. There are several different types of flap surgery methods that may be used, depending on the location of the flap and the structures that need to be repaired. The types include the following:

  • Local flap - is located next to the wound; the skin remains attached at one end so that the blood supply is left intact.

  • Regional flap - uses a section of tissue that is attached by a specific blood vessel.

  • Bone/soft tissue flap - this type of flap is often used when bone and the overlying skin are moved to a new location.

  • Musculocutaneous flap (muscle and skin flap) - this type of flap is often used when the area to be covered needs more bulk and an increased blood supply. This type of flap is often used to rebuild a breast following a mastectomy.

  • Microvascular free flap - involves detaching and reattaching skin and blood vessels from one site of the body to another site. Microsurgery is used to attach the blood vessels.

• Laser technology Lasers used in plastic surgery often provide for minimal bleeding, bruising, and scarring. There are many different types of lasers that may be used, depending upon the purpose and location of the surgery to be performed. Consult your physician/surgeon to determine if laser surgery, and which type, is most appropriate for you.

• Skin grafts A skin graft may be used to cover skin that has been damaged and/or is missing. This surgical procedure involves removing healthy portions of skin from one part of the body to restore normal appearance and/or function to another part of the same body. The place where the skin is removed is called the donor site. There are three different types of skin grafts that may be used, depending on the size and location of needed skin. These include the following:

  • Split-thickness skin graft

    • Commonly used to treat burn wounds

    • Uses only the layers of skin closest to the surface

    • Donor location site will be chosen based on size, type, and pigment of skin needed

  • Full-thickness skin graft

    • Used to treat deep and large wounds or scars

    • Used when maximum skin elasticity is needed

    • Uses all layers (not only the surface layer) of skin from the donor site

• Tissue expansion A tissue expansion is a surgical procedure that involves inserting a balloon-like device (called an expander) under the skin. The expander is then slowly filled with liquid to actually stretch and expand the skin over time. This serves the function of "growing" extra skin to repair nearby lost or damaged skin.