The purpose of reconstructive surgery is to restore function and form to damaged or misshapen parts of the face and body. The surgery can address problems stemming from any number of causes, including trauma, cancer, burns, congenital defects, malformations, infections, facial fractures, muscle and nerve damage.
At the Sorensen Clinic, we perform reconstructive surgery of both the face and body. However, we are specialists in reconstructive surgery of facial soft tissues, with the expertise not only to rectify tissue coverage and facial contours, but also to restore nerve and muscle function of the face.
Due to the varied nature of patients’ problems, there is no standardised reconstructive procedure for the face. Treatment requires in-depth analysis as well as a fully personalised surgical plan for each individual case.
Reconstructive techniques include:
● Skin grafts: A common procedure, skin grafting is the transfer of skin tissue from one part of the body to another in order to provide new skin cover for areas with defects.
● Flaps: To provide closure of any soft-tissue defect, a multitude of techniques, including the use of small or large local or regional flaps can facilitate the transposing of tissue excess into areas of tissue deficiency.
● Autografts: In cases where local tissue is absent, cartilage, facia, tendon, fat, dermis, muscle, nerve or bone can be harvested elsewhere on the body to provide the required building components for the reconstruction.
● Microsurgery: Reconstruction of missing tissue can be achieved by transferring a piece of living tissue to the reconstruction site and using microsurgery to re-establish its blood supply and nerve function.
The causes of scars include traumatic injury, infection, burn and surgery. Some scars are unattractive simply due to location, while others may affect facial expressions. Scars are permanent once formed, but surgically it is possible to alter scar lines and adjust the surrounding tissue to make the scar less visible. Many scars that appear large and unattractive at first may become less obvious with time.
Types of scars include: Hypertrophic scars, keloid scars, burn scars and normal scars. There are a variety of treatments including steroids, compression, surgical excision, fat grafting, or combined therapies which may be used depending on the nature of the scar.
Facial trauma reconstruction is the rectification of facial lacerations such as those commonly inflicted during motor vehicle accidents, incidents of violence, or from animal attacks. Appropriate treatment at the time of injury is the most effective way of preventing post-traumatic facial deformities. Although it may not be possible to completely restore pre-injury appearance, significant improvements can often be made in one or a series of reconstructive surgeries.
Basal cell carcinoma is the most common malignant or neoplastic tumour affecting the skin of the face, nose, eyelids and surrounding areas. It is typically a result of sun exposure, particularly in fair-skinned individuals or people who spend extended periods outdoors.
Other skin cancers include squamous cell carcinoma and malignant melanoma. Although most skin cancers can be removed surgically, treatment will depend on the type of cancer, its stage of growth and its location.
The facial nerve is responsible for the movement and control of muscle function in the face. Injury or dysfunction of the facial nerve may result in facial palsy. The facial paralysis, usually occurring on just one side of the face, can cause numerous problems of the eye, skin and muscles.
The primary therapeutic aim is always the restoration of nerve function. If for some reason this is not possible, healthy nerves and muscles can be transferred to the face, a procedure known as ‘facial reanimation’. A number of procedures targeting specific issues such as tightening of the oral commissure (mouth), brow lifts and eyelid surgeries offer temporary to long-lasting static improvement, either as stand-alone procedures or in combination.
Reduced eyelid functionality may have many causes, including traumatic lacerations, ptosis, eyelid cancer, facial palsy or previous surgery. The eyelids are delicate and complex structures that provide coverage and protection to the eye. They are also among the most important aesthetic components of the face, making restoration of appearance especially important.
Eyelids can be reconstructed with a wide variety of techniques; many functional eyelid problems may only require a minor adjustment, but occasionally complex multilayered reconstructions are required.