Reconstructive and cosmetic surgery.pptx

Reconstructive and cosmetic surgery.pptx by DEEPIKA.R

1. Reconstructive and cosmetic surgery Presented by,Deepika . r, m.sc nursing ii year , con , mmc

2. Overview 3 The term "plastic surgery" originates from the Greek word "plastikos," which means to mold or shape.

3. introduction Fine Jewelry 4 The field of plastic surgery can be broken down into two main categories – Reconstructive procedures and Cosmetic procedures B o th are g e ner a lly co n s idered su b -sp e c ialties of Plastic surgery

4. categories 5 Co s metic Surgery Plastic Surgery Re c on struct i ve Surgery

5. R ECONSTRUCTIVE S URGERY- definition Fine Jewelry 6 Reconstructive surgery is all about repairing people and restoring function. It is performed to repair and reshape bodily structures affected by birth defects, developmental abnormalities, trauma/injuries, infections, tumors and disease.

6. E XAMPLES INCLUDE Fine Jewelry 7 Cleft lip and palate repair Breast re c onstruction follo w ing a l u mpe ctomy or mastectomy for breast cancer, Reconstructive surgery after burn injuries

7. WHO ALL DO RECONSTRUCTIVE SURGERY Plasticsurgeons , Maxillo- faciasurgeons and otolaryngologists Do reconstructive surgery on faces after trauma and to reconstruct the head and neck after cancer Other branches of surgery General surgery Gynecological surgery, Pediatric surgery Podiatric surgery

8. common feature To restore the anatomy or the function of the body part to normal Surgery represents a small but critical component of the comprehensive care of cancer patients.

9. INDICATIONS OF RECONSTRUCTIVE SURGERY

10. CONGENITAL CLEFT LIP AND CLEFT PALATE: Using local flaps and grafts, surgeons can repair the incompletely fused area of the lip and palate. VASCULAR ANAMALIES: Arter i o venous malfor m ations ( A VM) an d cert a i n haemangiomas Fine Jewelry 11

11. CONGENITAL Prominent ears, constricted ears and microtia Reconstructive surgery is used to correct all manner of ear defects; techniques include otoplasty for prominent or constricted ears and ‘autogenous ear reconstruction’ for the treatment of microtia. Fine Jewelry 12

12. CONGENITAL Hypospadias Soft tissue reconstruction is used to correct this defect of the urethra in baby boys. Craniofacial conditions Reconstructive surgery is used to correct a wide range of cranial and facial deformations, such as craniosynostosis Fine Jewelry 13

13. CONGENITAL 14

14. CONGENITAL Hand deformities Plastic surgeons can also correct birth defects of the hand – e.g. where a child has been born with too many or too few digits. Fine Jewelry 15

15. ACQUIRED Acquired conditions are those that develop or occur after birth. They can involve disease and infection, or they can involve accident and injury. Acqu i r e d co n d i t i ons that are tr e ated with reconstructive surgery include as follows . Fine Jewelry 16

16. ACQUIRED CANCER Reconstructive surgery, mainly excision, closure and flap reconstruction, is used to treat a range of cancer conditions, especially cancer of the skin, breast, head and neck and sarcoma Fine Jewelry 17

17. ACQUIRED TRAUMA Reconstructive surgical techniques are crucial in the treatment of trauma and injury. These injuries most commonly involve the hand – in fact, 50% of the work carried out in many plastic surgery units is concerned with hand trauma. The treatment of open fractures of the lower limb is also common, as is surgery to repair soft tissue injuries of the face. Fine Jewelry 18

18. ACQUIRED INFECTION Reconstructive surgery is used to remove dead tissue following severe infections and to repair the surrounding area. BURNS Plastic surgeons are the primary clinicians involved in the resuscitation, surgical treatment and reconstruction of patients who have suffered burns Fine Jewelry 19

19. TECHNIQUES TISSUE EXPANSION Tissue expansion is a procedure that enables the body to ‘grow’ extra skin by stretching surrounding tissue. A balloon-like device called an expander is inserted under the skin near the area to be repaired, and is then gradually filled with salt water, causing the skin to stretch and grow. The time involved in tissue expansion depends on the individual case and the size of the area to be repaired . Fine Jewelry 20

20. TECHNIQUES SKIN GRAFTS A skin graft involves taking a healthy patch of skin from one area of the body, known as the donor site, and using it to cover another area where skin is missing or damaged. The piece of skin that is moved is entirely disconnected, and requires blood vessels to grow into it when placed in the ‘recipient site Fine Jewelry 21

21. TECHNIQUES Fine Jewelry 22 There are three basic types of skin graft. These are: Split thickness skin graft, Full-thickness skin graft, Composite graft

22. Graft vs flap Fine Jewelry 23

23. TECHNIQUES FLAP SURGERY Flap reconstruction involves the transfer of a living piece of tissue from one part of the body to another, along with the blood vessel that keeps it alive. Unlike a skin graft, flaps carry their own blood supply, So can be used to repair more complex defects. Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and / Or skeletal support. Fine Jewelry 24

24. TECHNIQUES THREE MAIN TYPES OF FLAP 1.LOCAL FLAP Uses a piece of skin and underlying tissue that lie near to the wound. The flap remains attached at one end so that it continues to be nourished by its original blood supply and is repositioned over the wounded area. Fine Jewelry 25

25. TECHNIQUES 2.REGIONAL FLAP It uses a section of tissue that is attached by a specific blood vessel. When the flap is lifted, it needs only a very narrow attachment to the original site to receive its nourishing blood supply from the artery and vein. Fine Jewelry 26

26. TECHNIQUES REGIONAL FLAP This pictures shows muscle from the calf being transferred, keeping its blood supply intact to cover an open fracture below the knee. Fine Jewelry 27

27. TECHNIQUES 3.FREE FLAP/MICROSURGERY Free flap reconstruction also involves the transfer of living tissue from one part of the body to another, along with the blood vessel that keeps it alive. A free flap is a further modification of flap transfer where the flap is entirely disconnected from its original blood supply and then reconnected using microsurgery in the recipient site. Fine Jewelry 28

28. TECHNIQUES FREE FLAP/MICROSURGERY The patient has an open fracture of his right lower leg. A muscle is taken from his inner left thigh and transferred to his right leg. The blood vessels that keep this muscle alive are dissected out of his left thigh along with the flap, divided, and then joined up micro surgically to blood vessels in his right leg. Fine Jewelry 29

29. Types of flap Fine Jewelry 30

30. COMMON TYPES OF RECONSTRUCTIVE SURGERIES 31 Fine Jewelry BREAST RECONSTRUCTION SURGERY The goal of breast reconstruction is to reform or reshape one or both breasts after a mastectomy or lumpectomy. This reconstruction process can help a person find their self-confidence again and feel better during their cancer recovery Although many factors can help determine the most suitable type of breast reconstruction, there are three main options

31. BREAST RECONSTRUCTION SURGERY 32 Fine Jewelry There are three main options Implants or prosthetics : This type of surgery uses silicone or saline implants. Autologous or skin flap surgery: This method uses tissue from another part of the body. Combined: In some cases, a surgeon might use a combination of both techniques to create a more natural reconstruction of the breast or breast

32. 33 Fine Jewelry IMPLANTS FLAP SURGERIES

33. BREAST RECONSTRUCTION SURGERY IMPLANTS: When reconstructing a breast with implants, a surgeon will insert silicone or saline implants underneath the skin or muscle, in the place of the previous breast tissue. This is a two stage procedure . During the first stage, a surgeon places a tissue expander underneath the remaining breast skin, or pectoralis muscles. The expander serves as a temporary saline implant that gradually stretches the remaining tissue. After the person has fully healed following surgery, surgeon will inject sterile saline or salt water through the skin into the tissue expander on a weekly basis . This balloon gradually grows, stretching the overlaying skin and muscle until the breast reaches a size with which the person is comfortable. Fine Jewelry 34

34. IMPLANTS Fine Jewelry 35

35. IMPLANTS When the chest tissues heal and the surgeon has added enough saline to the tissue expander in preparation for the implants, they will perform the second procedure to insert the implants. The surgeon removes the tissue expanders and replaces them with either a silicone or saline implant . They will usually reopen the original scar. This often means that the procedure leaves no new scars on the chest. In some cases, a surgeon may place a permanent saline or silicone implant at the time of the mastectomy, without use of a tissue expander. Fine Jewelry 36

36. IMPLANTS Fine Jewelry 37

37. S KIN FLAP SURGERY With skin flap surgery, the surgeon takes tissue from another part of the body and moves it to the chest to rebuild the breast. The surgeon usually removes this tissue from the abdomen. However, it may come from other places on the body, including the buttock, back, or thigh. Two methods are available for this surgery: Free flap surgery Pedicle flap surgery Fine Jewelry 38

38. S KIN FLAP SURGERY FREE FLAP SURGERY In free flap surgery , a surgeon completely removes the tissue and the blood vessels that provide it with circulation for placement in the breast. Fine Jewelry 39

39. S KIN FLAP SURGERY PEDICLE FLAP SURGERY In pedicle flap surgery, a surgeon will not entirely remove the transplanted tissue from its blood vessels. Instead, the tissue remains attached to the body, and the surgeon usually rotates this into the chest to form the breast. A surgeon usually uses tissue from the abdomen or back for pedicle flap surgery. Fine Jewelry 40

40. RISK AND COMPLICATION Bleeding or blood clots Infection Potential complications with anesthesia Fluid buildup in the breast or at the donor site (for skin flap surgery) Extreme fatigue Slow or disrupted wound healing Tissue death, or necrosis, which may develop in the skin, fat, or tissue flap Fine Jewelry 41

41. RISK AND COMPLICATION Uneven breasts. Problems with the implant, such as movement , rupture, leakage, or scar tissue. Changes in breast or nipple sensation Need for more surgical procedures if complications occur Fine Jewelry 42

42. COMMON TYPES OF RECONSTRUCTIVE SURGERIES BREAST REDUCTION SURGERY: A l s o called redu c tion mammaplast y , breast reduction is a procedure that removes excess breast fat , tissue and skin to reach a breast size that’s more in proportion with the body. It can also be to relieve discomfort from overly large breasts. Men can also undergo breast reduction. Fine Jewelry 43

43. CLEFT LIP AND PALATE REPAIR Fine Jewelry 44

44. CLEFT LIP AND PALATE REPAIR S YMP T O M S Difficulty with feedings Difficulty swallowing, with potential for liquids or foods to come out the nose Nasal speaking voice Chronic ear infections Fine Jewelry 45

45. C AUSES Interaction of genetic and environmental factors A definite cause isn't discovered . R ISK FACTORS: Family history. Exposure to certain substances during pregnancy Having diabetes. Being obese during pregnancy COMPLICATION: Ear infections and hearing loss. Dental problems , Speech difficulties Fine Jewelry 46

46. T R E A TME N T The goals of treatment for cleft lip and cleft palate are to improve the child's ability to eat, speak and hear normally and to achieve a normal facial appearance Team of doctors and experts, including: Plastic Surgeons, ENT specialists, Pediatricians Pediatric dentists , Orthodontists, Nurses Auditory or hearing specialists Speech therapists Genetic counselors Social workers Psychologists Fine Jewelry 47

47. CLEFT LIP AND PALATE REPAIR-SURGERY SCHEDULE 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 Fine Jewelry 48

48. COMMON TYPES OF RECONSTRUCTIVE SURGERIES HAND AND FOOT SURGERY: Carpal tunnel syndrome, Rheumatoid arthritis and Dupuytren's contracture These surgeries can treat diseases that cause pain and impair strength, function and flexibility in the wrists and fingers. They can also correct some abnormalities that may have been present at birth. Foot surgeries may also be available for people affected by tumors, or by webbed or extra toes Fine Jewelry 49

49. HAND CONDITION Fine Jewelry 50

50. SCAR REVISION: This is a group of treatments that attempt to minimize the appearance of a scar and help it blend in more effectively with the surrounding skin. Treatments can range from mild, topical treatments and minimally invasive procedures to surgical revision. Know that while scars can be reduce they cannot be completely removed. Fine Jewelry 51 COMMON TYPES OF RECONSTRUCTIVE SURGERIES

51. ADVANTAGES AND DISADVANTAGES OF RECONSTRUCTIVE SURGERY Advantages of Reconstructive Surgery: It gives a normal look to the patient. A great effect on the patient's self esteem and will give her an emotional well being, Disadvantages of Reconstructive Surgery: costs involved Poor quality work ,which may require a new surgery to fix Fine Jewelry 52

52. Nurses role Fine Jewelry 53 ASSESSMENT OF SIGN & SYMPTOMS OF INFECTION AT THE SITE OF RECONSTRUCTION Fever of over 101F Feeling of overall malaise Green, cloudy (purulent) or malodorous drainage Increasing or continual pain from wound Redness around wound Swelling of wounded area Hot skin near wound Loss of function and movement

53. Nurses role 54 Fine Jewelry Assess color of flap: Dusky? Blue? Pink? Pale? Assess flap for changes in size and swelling: ASSESSING DRAIN STATUS: Jps are to be stripped Q2 hrs for 48 hrs to prevent clotting. Penroses are to be rolled q2 hrs for 48 hrs to express fluid out and prevent swelling. CHECKING CIRCULATION OF THE FLAP:

54. Nurses role 55 Drains:

55. TIPS TO REMEMBER AND THINGS TO REPORT TO PHYSICIAN The donor extremity site must be elevated at all times. Call physician immediately for and change in color, dopple sounds, or increased swelling/firmness at the related flap or donor site. Confirm that all flap patients have a blood thinner ordered to assist with perfusion to flap area. Fine Jewelry 56

56. C OSMETIC SURGERY 57 Fine Jewelry Cosmetic surgery is performed to enhance overall cosmetic appearance by reshaping and adjusting normal anatomy to make it visually more appealing. Unlike reconstructive surgery, cosmetic surgery is not considered medically necessary.

57. 58 Fine Jewelry

58. examples 59 Fine Jewelry Breast augmentation, Breastlift , Liposuction, Abdominoplasty (tummy tuck) and Facelift are popular examples of cosmetic surgery procedures

59. Types of Surgical procedures 60 Fine Jewelry Abdominoplasty (Tummy tuck) Blepharoplasty (Eyelid surgery) Phalloplasty (Penile liposuction) Mammoplasty – Breast augmentation (Breast implant) Reduction mammoplasty (Breast reduction) Mastopexy (Breast lift)

60. Types of Surgical procedures 61 Fine Jewelry Buttock augmentation (Butt implant) and Buttock lift Lip enhancement Rhinoplasty (Nose job) Otoplasty (Ear surgery/ Ear pinning)

61. Types of Surgical procedures 62 Fine Jewelry Rhytidectomy (Face lift) Neck lift Browplasty (Brow lift or Forehead lift) Midface lift (Cheek lift) Genioplasty (Chin implant) Cheek augmentation (Cheek implant)

62. Types of Surgical procedures 63 Fine Jewelry Brachioplasty (Arm lift) Liposuction (Suction lipectomy) Keloid removal Labiaplasty

63. Types of Non - surgical procedures 64 Fine Jewelry Muscle paralysis , such as injections of botulinum toxin (Botox) Dermal fillers Chemical peels Microdermabrasion Non-surgical laser and intense light treatments

64. Abdominoplasty 65 Fine Jewelry Abdominoplasty or tummy tuck is a type of cosmetic surgery used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. Indications - Patients with loose or sagging tissues after pregnancy and major weight loss

65. Abdominoplasty TYPES Complete abdominoplasty Partial abdominoplasty Extended abdominoplasty High lateral tension tummy tuck Floating abdominoplasty or FAB technique Circumferential abdominoplasty Fine Jewelry 66

66. Abdominoplasty-RISK Bleeding, Fluid accumulation, Poor wound healing, Skin loss, Anaesthesia complications, Skin discoloration, Asymmetry, Recurrent looseness of skin, Nerve damage, Suture rupture or visible scar. Fine Jewelry 67

67. Blepharoplasty Goal - Restoration of the correct functioning to the affected eyelids Blepharoplasty or eyelid surgery is the plastic surgery for correcting defects, deformities, and disfigurations of the eyelids and for modifying the eye region of the face. Excision and removal, or the repositioning (or both) of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues. Fine Jewelry 68

68. Breast augmentation Breast augmentation or augmentation mammoplasty are plastic surgery approaches used to increase the size, change the shape, and alter the texture of the breasts of a woman. Indication – Post - mastectomy breast reconstruction Repair of the chest wound consequent to the removal of a cancerous breast Correct congenital defects of the breast Fine Jewelry 69

69. Reduction mammoplasty Reduction mammoplasty is the plastic surgery for reducing the size of large breasts. Indications - Restoration of the bust that is proportionate to the woman's body, of the woman's self-image, and of her mental health. Contraindications – Lactating women or has recently ceased lactating If breasts contain unevaluated tissue masses If she is suffering a systemic illness Fine Jewelry 70

70. Mastopexy Mastopexy or breast lift is the procedure for raising sagging breasts upon the chest of the woman by correcting and modifying the size, contour, and elevation of the breasts. In surgical practice, mastopexy can be performed as a discrete breast-lift procedure, and as a subordinate surgery within a combined mastopexy - breast augmentation procedure. Fine Jewelry 71

71. Rhinoplasty Rhinoplasty or a nose job is a type of plastic surgery for correcting and reconstructing the form, restoring the functions of the nose. Indications – To resolve nasal trauma Congenital defect Failed primary rhinoplasty Fine Jewelry 72

72. Rhinoplasty The non-surgical rhinoplasty procedure modifies slight defects of the nose by means of subcutaneous injections of biologically inert fillers. Fine Jewelry 73

73. Otoplasty 74 Fine Jewelry Otoplasty denotes the surgical procedure for correcting the deformities and defects of the pinna. Indications - Reconstructing a defective, deformed, or absent external ear, consequent to congenital conditions and trauma.

74. Lip augmentation 75 Fine Jewelry Lip augmentation is a type of cosmetic surgery that aims to improve the appearance of the lips by increasing their fullness through enlargement.

75. 76 Fine Jewelry Lip reduction is a surgery which is done classically for reduction of lip volume. For macrocheilia or excessive prominent lip Side effects Drooling( due to improper closure of the mouth) Difficulty in speech LIP REDUCTION

76. Liposuction 77 Fine Jewelry Liposuction or lipoplasty is a cosmetic surgery that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere. Liposuction or lipoplasty is a cosmetic surgery that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere.

77. Liposuction 78 Fine Jewelry Side effects Bruising, swelling, varying sized scars, pain and numbness Complications – Allergic reaction to medications Infection Damage to the skin Skin necrosis (rare complication) Puncture of an internal organ Contour irregularities Thromboembolism

78. Bo t o x 79 Fine Jewelry Botox is a purified form of botulinum toxin A. They work by blocking the nerves that contract muscles, softening the appearance of wrinkles. Botulinum toxin injections block certain chemical signals from nerves, mostly signals that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that underlie and cause wrinkles, such as frown lines and forehead furrows. Other conditions are lazy eye, cervical dystonia, muscle contractures or chronic migraine.

79. 80 Fine Jewelry Botulinum toxin injections usually begin working a few days after treatment. Depending on the problem being treated, the effect may last for three to 12 months. To maintain the effect, regular follow-up injections should be done. Side effects includes headaches, bruising, pain at the site of injection, and, in fewer than 1% of cases, drooping eyelids or eyebrows that return to their natural position within a few months.

80. Chemical peel 81 A chemical peel is a technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin.

81. Chemical peel 82 Fine Jewelry Possible complications photosensitivity, prolonged erythema, pigmentary changes, skin atrophy, and textural changes. Types - Alpha hydroxy acid peels Beta hydroxy acid peels Jessner's peel Retinoic acid peel

82. Laser Treatment Laser in cosmetic surgery can reduce facial wrinkles, scars and blemishes. Laser treatment can improve minor facial flaws, such as: Fine lines or wrinkles around or under your eyes, forehead or mouth Scars from acne or chickenpox Aged or sun-damaged skin Warts Birthmarks such as linear epidermal nevi Enlarged oil glands on the nose 83

83. Hair transplant Common type of treatment nowadays Standard hair restoration method For severe hair fall patients –bald people Fine Jewelry 84

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