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Reconstructive surgery helps patients of all ages and types. The goals of reconstructive surgery differ from those of cosmetic surgery. Reconstructive surgery is performed on abnormal structures of the body, caused by birth defects, developmental abnormalities, trauma, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Cosmetic surgery is performed to reshape normal structures of the body to improve the patient's appearance and self-esteem. Although no amount of surgery can achieve "perfection," modern treatment options allow maxillofacial surgeons to achieve improvements in form and function thought impossible just a few years ago.

This will give you a basic understanding of some commonly used techniques in reconstructive surgery. It won't answer all of your questions, since each problem is unique and a great deal depends on your individual circumstances. Please be sure to ask your doctor to explain anything you don't understand. Also, ask for information that specifically details the procedure you are considering for yourself or your child.

Who has reconstructive surgery?

There are two basic categories of patients: those who have congenital deformities, otherwise known as birth defects, and those with acquired deformities, received as a result of accident, infection, disease, or in some cases, aging.

Some common examples of congenital abnormalities are birthmarks, craniofacial deformities or syndromes, cleft-lip and palate deformities, or dentofacial deformities.

Wounds from trauma, growths, and aging deformities are considered acquired deformities. In some cases, patients may find that a procedure commonly thought to be aesthetic in nature may be performed to achieve a reconstructive goal. For example, some older adults with redundant or drooping eyelid skin blocking their field of vision might have eyelid surgery; or a person with misalignment of his or her jaws or facial bones may need orthognathic reconstructive surgery to reconstruct this misalignment or asymmetry.

In addition, patients with partial facial paralysis from stroke, accident, etc., may need a facelift to better match or reconstruct a normal symmetric facial appearance. Often patients with severe degenerative temporomandibular joint disease need full replacement and prosthetic reconstruction of their temporomandibular joint. The end result is not only to restore appearance, but more importantly to restore normal function. In another case, a young child might have reconstructive otoplasty (outer-ear surgery) to correct overly large or deformed ears.

As with any surgery, complications can occur. These may include infection; excessive bleeding, such as hematomas (pooling of blood beneath the skin); significant bruising and wound-healing difficulties; and problems related to anesthesia and surgery. There are a number of factors that may increase the risk of complications in healing. In general, a patient is considered to be a higher risk if he or she is a smoker; has a connective-tissue disease; has areas of damaged skin from radiation therapy; has decreased circulation to the surgical area; has HIV or an impaired immune system; or has poor nutrition. If you regularly take aspirin or some other medication that affects blood clotting, it's likely that you'll be asked to stop a week or two before surgery. In addition, patients who are diabetic should be well controlled before, during, and after surgery to minimize infection and maximize healing.

Planning your surgery

The size, nature and extent of the injury or deformity will determine what treatment option is chosen and how quickly the surgery will be performed. Reconstructive surgery frequently demands complex planning and may require a number of procedures done in stages.
Because it's not always possible to predict how growth will affect outcome, a growing child may have to plan for regular follow-up visits on a long-term basis to allow additional surgery as the child matures. Everyone heals at a different rate-and surgeons cannot pinpoint an exact "back-to-normal" date following surgery. They can, however, give you a general idea of when you can expect to notice improvement.
Although facial reconstructive surgery is performed by a competent and well-trained maxillofacial surgeon, complications do occur and are usually very minor. Nevertheless, all patients present different problems, anatomy, and reconstructive needs. Patients should keep in mind that reconstructive surgery is not an exact science; however, should complications arise, your surgeon is well aware of the problem and will work with you to reach a satisfactory result.

Usually, health insurance policies will consider the cost of reconstructive surgery a covered expense. Check with your carrier to make sure you're covered and to see if there are any limitations on the type of surgery you're planning. Work with your doctor to get pre-authorization from the insurer for the procedure.