Plastic surgery can be broken down into two main categories — reconstructive procedures and cosmetic procedures. Both are considered to be subspecialties of plastic surgery.
Reconstructive plastic surgery is performed to restore function and normal appearance. It can be necessary to correct deformities caused by birth defects, trauma, cancer, or other medical conditions.
As a board-certified plastic surgeon, Dr. Olack has extensive experience with reconstructive procedures. Here are four specific areas where he is called upon for these surgical skills.
Procedures we offer
Decubitus ulcers are commonly known as bed sores or pressure sores. These are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. People who are most at risk for developing these ulcers have medical conditions that limit their ability to change positions or cause them to spend most of their time in a bed or chair.
Decubitus ulcers are rated by stage. Stage 1 or 2 bed sores can be remedied by reducing pressure and friction by repositioning the person and using support surfaces. Cleaning and dressing the sores may be sufficient.
But when a patient develops stage 3 or 4 pressure sores, they are typically chronic and can be complex. These can require surgical intervention. For these procedures, Dr. Olack will likely use flap surgery, which involves taking a section of skin with an intact blood supply and placing it over the injured area. Flaps are excellent for healing pressure sores and for preventing complications such as site infections and wound recurrence.
Surgical reconstruction is often necessary after a traumatic event, such as a car crash or physical violence. This often involves facial trauma that requires reconstructive plastic surgery by Dr. Olack.
For most patients, this trauma is treated as soon as possible after the incident. Early surgery to stem the initial damage may also require later plastic surgery to further improve the patient’s appearance. With post-traumatic facial reconstruction Dr. Olack may be able to restore the patient’s facial features to a normal condition.
Virtually all of these facial procedures involve repairing the soft tissues using sutures. Microsurgery techniques may also be necessary (which may involve bringing in a specialist such as a neurosurgeon) to correct damaged facial nerves, salivary glands, and other structures.
Dr. Olack may need to repair facial bone structures after fracture. These surgeries often require plate-and-screw fixation devices to stabilize the bones so they can properly mesh and heal.
With lower extremity reconstruction, the goals are to restore limb function, cover vital structures, and restore appearance following traumatic injury, vascular or metabolic diseases, rheumatoid arthritis, and other causes. These surgeries can be grouped into three general locations: the tibia bone, the feet, and the knees.
Among the most commonly used surgical techniques employed by Dr. Olack are fasciocutaneous flaps, muscle flaps, tissue expansion, free tissue transfer, and microsurgery. These procedures may be straightforward and require simple closure where he makes an incision in the skin, reconstructs the wound as needed, and closes the incision. More complex cases may require the rearrangement of soft tissue to close over open skeletal tissue. For these cases, Dr. Olack may need to combine several techniques such as skin and/or bone grafting, and free tissue transfer.
After the removal of cancerous tissue, reconstruction is often necessary. For these procedures, Dr. Olack will work with the oncologist (cancer surgeon). Oncologic reconstruction typically uses tissue from one area of the body that is moved to the area where the cancerous tissue was removed. This is known as autologous reconstruction, meaning the tissue used comes from the patient’s own body.
When the tissue is taken and placed in the area being repaired, Dr. Olack will use tiny stitches to connect the tissue and blood vessels so that the tissue can attain the necessary blood supply to survive. If possible, the blood supply is moved along with the new tissue.
Other types of oncologic reconstruction surgeries include:
- Skin, tendon, and bone grafts — Healthy tissue is taken from another part of the body to the area needing repair.
- Local flap surgery — Dr. Olack uses tissue from a nearby area to cover the damaged area. This tissue will remain attached to its blood supply.
- Artificial implants — Implants are the most common form of breast reconstruction after a mastectomy to remove breast cancer. Implants may also be available for some other body parts.