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DEFECTS
& TREATMENT-
VARIOUS DEFECTS &
PLASTIC SURGERY TREATMENT AT A GLANCE
RECOSTRUCTIVE PLASTIC SURGERY ..
BIRTH
DEFECTS
CLEFT LIP & CLEFT
PALATE
One of the commonest birth defects or congenital deformity
involves paring or cleft of the upper lip on either or both sides. The
floor of the nose and the hard or the soft palate may also have cleft to
varying extent.
The corrective surgery is done in stages starting around three months of
age depending upon the general physical condition of the baby.
Results of the surgery: General
looks of the patient are improved to a great extent after the lip
continuity is restored. Surgery of the palate helps to improve symptoms
like regurgitation of food & liquids from nose and development of
speech.
CRANIO-FACIAL DEFECTS
The child is born with several defects involving the bony
framework and the soft tissues of the skull and face. There may be a
single defect or combination of several deformities. Some such defects
are: crouzon’s disease, Apert’s syndrome, craniofacial microsomia,
mandibulofacial dysostosis etc.
The surgery is done by plastic surgeons especially trained for
cranio-maxillo-facial surgery and involves multispeciality inter
disciplinary approach. Several sessions at varying intervals may be
required. Timings of the surgery depend upon nature of the defect and
condition of the patient.
Results of the surgery: Brings about
very good changes in the overall appearance.
PTOSIS OR DROOPING
EYELIDS
One or both upper eyelids may be drooping to varying extent
since birth. The condition may also be acquired following injury or
other disease process. The child is unable to lift the affected upper
eyelid and has to raise the neck to view around. The corrective surgery
is done before school going age or when the patient reports.
Results of the surgery: In most of
the cases a near normal looks can be achieved.
DEFECTS OF THE EARS
One or both ears may have varying defects. The ear may be
absent, rudimentary, cup shaped, too large, fan shaped, crumpled or bat
ear shaped. There may be extra appendages, tubercles or missing or large
ear lobule. Such defects are present alone or in association with other
defects of skull and face.
Single or multistage surgeries are required to correct the deformity.
Results of the surgery: Some of the
defects can be totally removed while others show varying degree of
improvement.
HAND & FINGER
ANOMALIES
The individual is born with extra finger or thumb or one or
two extra digits (polydactyly). There may be missing or fused fingers
(syndactyly). Finger may show abnormal bending at normal joints. The
size of the finger or toes may enlarge several times more than adjoining
digits (macrodactyly). Sometimes deep grooves are present on the digits.
All such cases are operated early in life.
Results of the surgery: Generally
good.
GENITAL DEFORMITIES
The commonest genital defect in males is abnormal opening of
the external urinary meatus or hole. This is termed as hypospadias or
epispadias depending whether the opening is on the under surface or over
the penis. Hypospadias i.e. opening under and short of the normal tip is
mostly associated with curvature or bending of the penis. The child
passes urine in the downward and backward direction. The external
opening may be small and constricted. The size of the penis may also be
small. Absent vagina in female child also requires plastic surgery.
Plastic surgery is done around three to five yeas of age for
hypospadias. Single or multistage procedures are done. Reconstruction of
vagina is undertaken at or near puberty.
Results of the surgery: The surgery
helps to straighten the penis making it sexually functional and the
abnormal opening is restored at or near the tip. Vaginal reconstruction
helps to restore the female identity.
BIRTH MARKS
Black or hyperpigmented large moles or nevus are present any
where on the body. These may be hairy when they are termed as hairy
nevus. There can be red or pigmentary lesions that are either raised or
flush with the skin surface. These are abnormal lesions arising from
blood vessels and are called haemangiomas.
The surgery is mainly done for cosmetic purpose or if the lesion is
growing and causing some problem.
Results of the surgery: most hairy
nevi and other lesions are removed and replaced by skin grafts or skin
flaps. Treatment with Laser also helps in vascular lesions. The results
depend upon type of lesion but generally are good.
SPINAL CANAL DEFECTS
Due to this defect the child has swelling or protrusion
anywhere along the spine. This protrusion incorporates spinal chord
coverings and cerebrospianal fluid and varying amount of nerve tissue.
Depending upon the contents it is termed as meningocoele,
meningomyelocoele or encphalocoele if brain tissue is also incorporated.
Sometimes there is no protrusion but a tuft of hair at the back.
Results of the surgery: The surgery
is done early and is aimed at closing the defect in the spinal canal.
The results depend on the nature of the defect. Any hairy patch can be
removed effectively by skin grafting.
ACCIDENTAL
INJURIES
FACE INJURIES
All the wounds or cuts involving the forehead, eye brows,
eyelids, cheek region, nose, ears, lips etc. are best treated by plastic
surgery. All fractures involving the facial bones like forehead, orbits,
nose, zygoma (cheekbones), upper jaw and the lower jaw or the mandible
are treated by special techniques of plastic surgery i.e. maxillo-facial
surgery.
Results of plastic surgery: Any
injury resulting in skin loss or deformity if treated primarily by a
plastic surgeon results in a much better and finer recovery. It avoids
later complications and future surgeries.
HAND & FINGER
INJURIES
Simple household cuts to hand and fingers. Finger tip
injuries, injuries to the tendons, nerves, blood vessels and skin loss.
Industrial crushing injuries associated with fractures of the bones,
severe skin damage or a totally mangled hand require plastic surgery
intervention.
Results of the surgery: Primary
intervention by a plastic surgeon enables immediate skin and soft tissue
coverage and repair of all-important structures. This helps to salvage
the damaged fingers or the hand. The main aim is to restore an
functioning hand.
INJURIES TO THE LIMBS
Injury to the upper or the lower limbs especially when
associated with loss of skin and soft tissue coverings with or without
bony fractures require attention of plastic surgeons.
Results of the surgery: Skin
coverage in severe limb trauma can save the limbs from possible
amputation. The bone surgeon can perform immediate fixing procedures
after plastic surgeon can assure soft tissue coverage to the exposed
bone.
AMPUTATIONS
Total or partial amputations of fingers, hand, arm etc. due to
any accidental injury require reimplantation surgery.
Results of the surgery:
Microneurovascular reanastmosis or reunion if done immediately or within
a few hours can restore the severed part.
BURNS
Acute or fresh burns from direct flames, hot liquids, acids,
electricity flash etc. require urgent care. In some instances skin cover
is required within a few days to prevent life threatening complications.
During the course of healing after burnt skin or slough has been removed
urgent skin cover can prevent bad contractures and ugly scar formations.
Some patients report very late with extensive scars and functional
deformities. All such cases require one or several plastic surgery
procedures to correct the defects.
Results of the surgery: Plastic
surgery for burns is not only life saving at times but prevents several
complications. Aesthetics of the burnt part is improved.
Lost functions like normal movements of any part which are vital for
daily chores are effectively restored. The inactive depressed burnt
victim can be brought back to society mainstream by plastic surgery
procedures.
SCARS
Accidental injuries, burns or previous surgery can result in
unsightly scars. Such deep or hyperpigmented scars when present on the
visible areas can be socially embarrassing. Scar revision surgery is
done for such cases.
Results of the surgery: Marked
improvement in the looks of the scar is achieved after most scar
revision surgeries. The scars are made much finer, their direction
changed suitably to make them less or least noticeable. The scars
however can never be eliminated.
PRESSURE
SORES
Prolonged pressure on a particular skin region results in the
breakdown and wound or ulcer formation. Such chronic ulcers are commonly
seen in spine injuries when the patient is unable to move on his own.
Areas of bony prominence like lower back (Sacrum, ischium), upper outer
thigh region (trochanter), etc. are involved. Reconstructive plastic
surgery by skin grafting or skin flaps is done.
Results of the surgery: Surgery is
done to remove all the dead tissues and resurface the raw area with good
quality skin cover. Majority of ulcers heal after the surgery.
Recurrence of lesion is there if effective measures are not taken to
prevent prolonged presure.

COSMETIC PLASTIC SURGERY .
AGEING
DEFECTS
Wrinkles on the face and forehead a natural sequel of old age
could be disturbing to many individuals. Some persons may have premature
wrinkling giving them a very aged look. Deep frown lines, drooping
eyebrow, drooping upper eyelids, crowfoot lines at the outer side of
eyes, bagginess of the lower eyelids wrinkles around the mouth and lips,
jowls, hanging cheeks, double chin, neck bands, and wrinkled neck can
all lead to psychological and personality changes apart from taking away
an individual’s young looks.
Conventional cosmetic surgery or laser assisted skin resurfacing helps
to improve or eliminate all above-mentioned defects
Results of the surgery: Face-lift or
Rhytidectomy along with Forehead lift can take care for most of the
wrinkles. Eyelid surgery or Blepharoplasty can relieve the tired looks
due to drooping & baggy eyelids. Liposuction can markedly improve
the double chin. Most of these procedures last for about five to ten
years and in the immediate postoperative period the person looks
rejuvenated and younger.
NOSE
JOB
Nose, the most prominent part of the body draws
everyone's attention.Alteration in shape of the nose or rhinoplasty is
thus the most important and frequently asked for procedure in cosmetic
surgery. a large nose with a hump, depressed nose, long or short nose,
irregular or crooked nose, nose with broad or bulbous tip and post
injury defect or deviated nose are common problems.Plastic surgery for
correction of these defects is usually a day surgery procedure done
under local anesthesia.
Results of the surgery: Rhinoplasty
or nose reshaping surgery is both most demanding and rewarding surgery.
If the patient knows what results to expect and the surgeon experienced
enough to explain the actual changes that can be brought about the
results are highly satisfying and encouraging. The operating surgeon and
the patient must discuss and analyse the importance of altered body
image following this surgery.
OBESITY
Some individuals may be generally obese and overweight while
others have localized fat deposits deforming the normal body contours.
Pot belly, loose hanging abdomen, hanging upper arms, hip rolls, love
handles, altered waist line, heavy and drooping buttocks, fat deposits
on the sides of the thighs etc. are common problems for which people
seek help of plastic surgery.
Results of the surgery:
Dermalipectomy or removal of the loose extra skin flaps with underlying
fat and suction assisted lipectomy (liposuction) can restore the body
contours. This surgery gives promising results.
BALDNESS
Premature loss of the scalp hair may be hereditary or
associated with some illness. Many individuals also contest Balding due
to old age.
Plastic surgery is done to restore the missing hair by transplanting
one’s own hair taken from back of the scalp. Several new techniques
have evolved in the field of hair transplant.
Results of the surgery: The
transplanted hair grows normally and the stigma of being called a bald
person is over. The transplanted hairs however lack the thick density,
as the donor area at the back is not sufficient to cover the entire
head.
BREAST
DEFECTS
Some young males can have abnormal enlargement of their breast
tissue(gynaecomastia). In females, small sized breasts, unequal breasts
or very heavy breasts and post pregnancy ptosis can be a matter of
concern. Removal of breast in the event of cancer surgery can be a great
mental trauma. Plastic surgery helps all such cases.
Results of the surgery: In male
gynaecomasia entire abnormal breast tissue can be removed. In females,
breast reduction brings a great relief to those with heavy breasts.
Breast enlargement is commonly done with implants and good cosmetic
results are achieved. Mastopexy corrects the drooping pendulous breasts.
Surgically removed breasts are reconstructed by various methods.
WHITE
OR HYPOPIGMENTARY DEFECTS (VITILIGO)
A vitiligo patch especially on the exposed parts is a matter
of great concern more so in dark races of Asian origin. Some localized
patches that do not show any changes over a long period of time are
treated by plastic surgery.
Results of the surgery: The stable
white patches are removed and replaced by normal looking skin grafts. On
large areas, superficial abrasion and pigment cell transfer brings about
good cosmetic results.
ALTERATIONS OF EXTERNAL
FEATURES
Some individuals may ask for alterations in their facial
features such as; changing the thickness of lips, reducing or raising
the cheek bones, reducing or enlarging the size of the chin, reducing
the wide angles of mandible, pushback of protruding upper jaw and teeth.
Some Orientals may ask for upper eyelid fold and elimination of
epicanthal skin folds of the eyes. Creation of artificial dimples is yet
another demand of some individuals.
Results of the surgery: Cosmetic
plastic surgery enables to meet all above mentioned goals to a large
extent. 
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