Reconstructive surgery is a type of plastic surgery. It is performed to reshape abnormal structures of the body to improve function and appearance. Reconstructive surgery is a different kind of plastic surgery than cosmetic surgery, which is performed to reshape normal structures of the body to improve a patient’s appearance and self-esteem.
The goals of reconstructive surgery are to reshape abnormal structures of the body, to improve function, and/or to allow a person to have a more normal appearance. Abnormal structures of the body that are corrected during reconstructive surgery may be the result of birth defects, developmental abnormalities, trauma or injury, infection, tumors, or disease. The three most commonly performed reconstructive surgeries in the United States are tumor ablation (removal) and reconstruction, hand surgery, and breast reconstruction.
Reconstructive surgery should not be performed on patients who are not healthy enough to withstand a surgical procedure performed under general anesthetic. People with severe diabetes, an autoimmune disorder such as AIDS, or a suppressed immune system should not undergo reconstructive surgery. This type of surgery is also contraindicated in patients with a history of excessive smoking, obesity, poor wound healing, abnormal scarring and/or a bleeding disorder. Women who are pregnant should not undergo reconstructive surgeries. Patients who have received recent irradiation treatments (generally within the last three to six months) should not undergo surgical procedures involving these tissues. Recently irradiated tissue is highly prone to infection and has poorer wound healing.
Microsurgical procedures are performed on parts of the body that are best visualized under a microscope. Examples of such structures are small blood vessels, nerves, and tubes. Microsurgery uses techniques that have been performed by surgeons since the early twentieth century, such as blood vessel repair and organ transplantation, but under conditions that make traditional vascular surgery difficult or impossible.
The first microvascular surgery, using a microscope to aid in the repair of blood vessels, was described by Jules Jacobson of the University of Vermont in 1960. The first successful replantation (reattachment of an amputated body part) was reported in 1964 by Harry Bunke. This replantation of a rabbit’s ear was significant because blood vessels smaller than 0.04 in (0.1 cm)—similar in size to the blood vessels found in a human hand—were successfully attached. Two years later, the successful replantation of a toe to the hand of a monkey was made possible using microsurgical techniques. Soon thereafter, microsurgery began being used in a number of clinical settings.