Reconstructive Surgery

01. What is the role of Plastic Surgery in Cancer Management?

As a part of Cancer treatment, many times a body part is removed which may affect that organs’ function as well as appearance drastically. The main aim of plastic surgical treatment in such cases are to restore function and appearance of these body parts to a normal extent back. For example in oral cancers, when tumor part is removed without proper plastic surgery, swallowing, speech and facial appearance is affected to a major extent.

02. Which cancer affected body parts can be reconstructed with Plastic surgery?

  • Tongue
  • Buccal Mucosa
  • Jaw bone
  • Palate
  • Cervical Oesophagus
  • Lip
  • Breast
  • Chest and abdominal wall
  • Any bony defect

03. Which are such Plastic surgical procedures utilizable for cancer management?

  • Skin graft
  • Flap Surgery - pedicle and free flaps

04. What are the latest Plastic Surgical techniques used for cancer reconstruction ?

The most common and latest techniques utilizable for reconstruction of cancer area is called Free microvascular tissue transfer (free flap surgery). It’s a kind of tissue transplant like kidney and liver transplant surgery. The main difference is patients own body parts ,mainly skin, muscle or bone along with their supplying blood vessels are taken. These tissues are transferred to required site , fixed with stitches and their supplying blood vessels are joined with local available blood vessels under microscope with the help of finest sutures which are thinner than even human hairs.

05. Are these Free Flap surgeries safe ? Who can perform it ?

These surgeries should be done by experienced plastic surgeon who is trained specifically to perform such kind of complex procedures. In hands of such experienced plastic surgeons, these surgeries are quite safe.

06. What are the advantages of Free Flap surgery over conventional techniques?

  • Better and faster recovery
  • Better functional and cosmetic outcomes
  • Wider resections possible
  • Minimal donor site morbidities
  • Bony reconstruction possible, i.e. Jaw bone reconstruction is possible with leg bone(fibula bone)

07. From which part of body, Free flaps can be taken?

Free flaps can be taken from forearm, leg or thigh skin to reconstruct tongue and buccal mucosa. In jaw bone reconstruction, deficient bone is taken from leg bone(fibula).Part of small bowel(Jejunum) is utilized to reconstruct cervical oesophagus.

08. Can already operated head and neck cancer patients undergo corrective Reconstructive Cancer Surgery procedures ?

Those patients who have been already operated for head and neck cancers having facial disfigurement can be corrected later on with free flap surgeries or liposuction.

09. What is the aim of Breast Reconstruction?

As a part of treatment of breast cancer, when part or whole of the breast is removed, and if reconstruction is not done, a female patient would have lifelong psychological trauma, a trauma of having lost her breast or having deformed breast. Aim of plastic surgical technique is to establish self confidence, identity and femininity by reconstructing new breast with different plastic surgical techniques.

10. Which are the techniques available for Breast reconstruction?

  • In small and localized tumor, where breast conservative surgeries are employed, reconstruction is done with Latissimus dorsi flap(LD Flap) taken from back or in some cases local tissue is rearranged to restore the contour, which is called Breast Onco plastic Techniques
  • When the whole breast require reconstruction, Options are DIEAP flap (where patients own tissue from abdominal wall is used )and Implants. Long term outcomes are better with DIEAP flap

11. When patients can undergo such Reconstructive Cancer Surgery procedures?

Best results are achieved at the time of breast cancer removal surgery. But those patients who underwent mastectomy already in past, they can undergo Reconstructive Cancer Surgery procedure anytime safely.