Plastic and
Reconstructive Surgery

Abdominal Wall Reconstruction

Reconstructive surgery can restore the integrity of the abdominal wall fascia, muscle or skin that has been adversely affected by trauma, tumors or hernia. Procedures may include using synthetic mesh, local sliding muscle and fascial flaps, or transferring vascularized tissue from another part of the body.

Thoracic Reconstruction

Many of the muscle flaps pioneered by Emory plastic surgeons can be used to cover and reconstruct chest wall defects following resection for cancer, wound healing problems or radiation damage.

Breast Reconstruction

Depending on the patient's overall health, breast reconstruction can either be part of the original mastectomy procedure or performed later.

Depending on the location and severity of the skin cancer, the consequences from surgery may range from small scarring to permanent changes in facial structures. In the latter case, the plastic surgeon can be an important member of the treatment team. Reconstructive techniques ranging from simple scar revision to the complex transfer of tissue flaps from elsewhere on the body can often repair damaged tissue, rebuild body parts, and restore acceptable appearance and function.

One of the more common procedures for combating skin cancer is MOH's surgery, in which cancerous skin is shaved away by a dermatological specialist. As each layer is removed, the surgical margins are checked for abnormal cells. Emory plastic surgeons are often involved in reconstructing any defects that occur as a result of such tumor removal in the facial area.

Facial Scars

While scars can't be completely removed, it is possible to modify them and restore bones to their normal position. Facial scars are often repaired with tiny sutures, leaving a thinner, less visible scar that can be made even more indistinguishable with dermabrasion or laser resurfacing.

Emory has been a consistent source of innovation, development, and refinement in the procedures and techniques of breast surgery and is one of the better known providers of minimally invasive techniques for breast reconstruction and augmentation in the country.

The reconstructive plastic surgeons at Emory Healthcare are able perform the following breast surgery procedures:

Breast Reconstruction

Depending on the patient's overall health, breast reconstruction can either be part of the original mastectomy procedure or performed later. It may also involve more than one operation, though follow-up procedures are often performed on an outpatient basis. Occasionally surgery is performed on the natural breast so that it will look similar to the reconstructed one.

Patients may undergo breast augmentation, or augmentation mammoplasty, to restore symmetry between the two breasts, to enlarge small breasts, or to correct breast volume reduction after pregnancy. Augmentation mammoplasty is done on an outpatient basis, usually under general anesthesia. An implant is placed through an incision made under the breast tissue or its muscle. The incision can be made under the breast, around the nipple, or under the arm. Implants available in various shapes. A breast lift may be done at the same time.

A breast lift, or mastopexy, removes loose skin, repositions the nipple, and re-shapes the breast. Since the procedure only removes the excess skin to maintain the natural size of the breast, it should not be confused with breast reduction. Mastopexy is typically an outpatient procedure performed under general anesthesia, though local anesthesia may be used in with a sedative depending on the size of the incision. The most common method applies an incision along the natural contour of the breast where excess skin will be removed. The nipple and areola are repositioned, the skin surrounding the areola is brought together to reshape the breast, and stitches are placed around the areola and the lower breast. For smaller lifts, the incisions are usually limited and result in a circular scar around the areola. Larger lifts can leave scars that either extend down the breast or that can be hidden in the crease under the breast. Mastopexy is commonly performed in conjunction with breast augmentation to increase breast firmness and size.

Breast Reduction

Women with large, heavy breasts often develop symptoms such as back, shoulder, and neck pain which can hamper their daily activities. Recurrent skin irritation, skeletal deformities, breathing problems, and headaches can also be caused by the weight of the breasts. Breast reduction, or reduction mammoplasty, can alleviate these symptoms while preserving breast shape by removing excess skin and breast tissue, repositioning the nipple, and shaping the breasts while generally preserving the patient's sensation and ability to breast-feed. Done under general anesthesia on an in-or-outpatient basis, the surgery removes fat, glandular tissue, and skin from the breasts while also reducing the size of the areola. Incisions are made around the pigmented nipple-areolar complex and extend vertically below the nipple and into the fold under the breast. The nipple-areolar complex is moved upward to the desired location, the incisions covered with a light dressing, and the breasts placed in a surgical bra that will hold them symmetrically during initial healing. Any discomfort generally subsides over time and can be controlled with oral medications. Scars usually fade in 6-18 months. Liposuction can further enhance the results.

Gynecomastia is enlargement of the male breast caused by side effects of certain medications, hormonal imbalance, or significant weight gain. The male breast reduction procedure removes fat and or glandular tissue from the breasts either by liposuction or direct excision through an incision below the nipple-areola. In extreme cases, excess skin is removed to produce a flatter, firmer chest.

When performing hand surgery and surgery of the wrist, forearm, elbow and shoulder, Emory plastic and reconstructive surgeons work to restore function as well as maximize cosmetic appearance applying such techniques as microsurgery. Post-procedure, division surgeons will refer patients to any necessary rehabilitative services.

Available reconstructive head and neck surgical procedures include:

Mandibular Reconstruction

This procedure restores oral function by transferring skin and bone from the leg, hip or back to the mandibular defect. The blood vessels are then reattached microscopically.

Intra-Oral Reconstruction

Following cancer resection, local muscle flaps from the patient's chest or back are often used to reconstruct oral defects of the tongue or floor of the mouth.

Esophageal Reconstruction

The esophagus is often reconstructed using a small portion of the intestine as a free tissue transfer to maintain a tube from the mouth to the stomach for feeding.

Cranial Reconstruction

Coverage of scalp defects often requires bony reconstruction of the skull and coverage with large local flaps or a free tissue transfer of muscle or omentum.