Plastic reconstructive and Plastic Surgery Department consists of plastic surgery, reconstructive surgery, laser and scarring treatment departments. Various regions of the body are reconstructed in plastic surgery and interventions. The aim of reconstructive surgery and interventions is to restructure deformed organs and tissues due to trauma, cancer, infection or congenital reasons and to make them regain their functionality. Some surgeries can be reconstructive as well as for aesthetical purposes. A removed breast due to cancer being lifted or lowered to be the same with the other breast would be a great example to this. Many non-surgical methods are used in plastic and reconstructive surgery in addition to the surgery to aid with the recovery. Laser techniques used for the treatment of capillary vessels, removal of unwanted hair or Botox, filling and lipid injections used in wrinkle treatments can be given as examples. Plastic and reconstructive surgery department, pays extra attention to the risk and gains as well as the expectations of the patients before interventional surgery options. All patients’ problems, expectations, treatment options, risks and results are different in plastic surgery. For this reason, Plastic, Reconstructive and Aesthetic Surgery department, interviews the physician of the patient to clarify all problems before surgery. Surgeries and Interventions Performed in Plastic, Reconstructive and Aesthetical Surgery Department: Liposuction Liposuction is the reshaping of the body by removing unwanted fats which are hard to lose by sucking them out. The patients who are not extremely overweight and still has elasticity in the regions of unwanted fat are the most appropriate candidates for this intervention. Liposuction is the most common plastic surgery intervention for both men and women. The most common regions for liposuction are belly, waist, ankles, arms, face, jaw and neck. It is also used in breast reduction for breast that are not sagging or breast enlargement for men (gynecomastia). The surgery lasts 1-3 hours and is done through 3 mm small incisions. It can be performed with anaesthesia, local anaesthesia or sedative medical support. Mostly staying at the hospital is not required, the average time to return to work is usually 1-2 weeks, and 3-4 weeks to heavy exercises. Main risks include temporary bloating and bruises, mostly temporary colour changes, bleeding, infection, asymmetrical skin and reduced sensitivity of senses, excessive liquid intake or loss as well as formation or an increase in embolism. It should be reminded that this is not a method for losing weight. Abdominoplasty It is the removal of hard to lose fat and skin around the abdomen, reshaping and tightening of the muscles. The most suitable candidates for this procedure are the patients who no longer has elasticity in their skin around the unwanted fat. This procedure is also very common after extreme weight loss. The loose and saggy excess skin around the abdomen, arms and legs of these patients are surgically removed to reshape the body. If there are other sagging areas around the body, it might require 2 to 3 sessions to fix all of them. Technically, abdominoplasty surgery is done by an incision below the bikini line to help the abdomen regain its tightness by removing excess fat and skin. Loose abdominal muscles of similar reasons are brought into middle line. This results in a bit of thinning around the waist. The surgery lasts for an average of 3 hours and is done with the help of general anaesthesia. The duration of hospital stay is usually 1 day. It takes 2 weeks to get back to work and 4-6 weeks to start heavy exercises. Face, Neck, Forehead and Eyebrow Lifts It is the procedure of removing the saggy and non-elastic skin around the face, neck and forehead areas, usually due to ageing. The most suitable candidates are people over middle age who has deep and saggy skin with wrinkles. Technically, the surgery is performed by removing the skin of the patient depending on their needs via small incisions. The areas of incision include behind and front of the ears, front and around of temples and scalp. Neck lift surgery is performed via a 2-3 cm incision below the jaw and is a relatively easy procedure which stretches the saggy front neck muscles to make it look young, it is usually very satisfactory. It uses general anaesthesia and usually lasts between 1-5 hours. Neck lift with jaw incisions can generally be performed via anaesthesia or local anaesthesia or even with sedative support. It can be performed with sedatives as well. A stay at the hospital is not necessary and it usually takes 2 weeks to return to work or daily life. Breast Enlargement It is the enlargement and reshaping of breasts by using various implants. Breast Enlargement intervention is also used in mild saggy breast treatment. Implants can be placed on top of the muscle via small incisions below the breast, near armpit and around the nipples. Implants are in two groups called silicone or normal saline and come in many shapes and sizes. The surgery lasts for 1-2 hours and performed with general anaesthesia or intravenous sedatives. There is no need to stay at the hospital and can return to daily life in 2-4 days. Sports and close contact physical activities are doable after 4 weeks. Breast Reduction It is the reduction of big or saggy breasts. This intervention especially aims to get rid of the pain around the neck, back and arms due to breasts being too big, therefore, it is an aesthetical as well as functional surgery. Breast Reduction can be performed in men with big breasts (gynecomasty) which cannot be treated with liposuction. Technically the excess breast tissue and skin is removed through an incision below the breast or around the nipples. The breast and the nipples are lifted and reshaped. The surgery lasts for an average of 3-4 hours and is done with the help of general anaesthesia. The duration of the hospital stay is usually 1 day. Sometimes staying at the hospital is not even necessary, resulting in a return to work in 2-3 weeks. Sports and close contact physical activities are doable after 6 weeks. Breast Lifts It is the lifting and reshaping of loose and saggy breasts by removing excess and loose skin. The most suitable patients for this intervention are people who have moderately sagging breasts. This intervention also includes reshaping the other breast to keep the symmetry if the other breast is removed due to cancer. A small incision underneath the breast is made to remove the excess skin and saggy tissue in order to lift the breast and then the breast and the nipple is reshaped. If it is desired to enlarge the breasts, an implant used during this surgery can both help lift the breast as well as make them bigger. The surgery lasts for 1-3 hours and performed with general anaesthesia or intravenous sedatives. There is no need to stay at the hospital and you can return to daily life in 7-10 days. Sports and close contact physical activities are doable after 4 weeks. Breast Reconstruction It is the reconstruction of the breast after being removed due to cancer (mastectomy). For this reason, the options and timing is always different for people. Reconstruction is done with the help of silicone, natural saline implants or using the natural tissue of the patients or maybe both. It can be performed during the mastectomy or delayed to another session as timing. Generally in the reconstructions which are performed by an implant, the skin of the removed breast is stretched with a stretching implant and then a silicone or natural saline implant is placed permanently. Another method of implant use is to place an implant filled with natural saline in the first surgery to place it in its place permanently after the skin is stretched. This method makes a second implant obsolete. Various skin and under skin tissues of the patient can be used in breast reconstruction surgeries. With this method, tissue from other areas of the body can be moved by pedicles or as a free flap via microsurgery into the field which would form the breast. This usually does not require an implant however, it forms a new scar on the patient. Usually 2-3 month after the initial surgery, another surgery is performed to bring the other breast to the same shape of the first breast. During this surgery or even 2-3 months after, a nipple can be constructed through surgery. The duration of the surgery is 2 hours for reconstruction surgeries with implants and 3-5 hours for flaps with general anaesthesia. The stay at the hospital is 1-2 days after implants and 3-5 days if the tissue of the patient is used. You can return to work in 1-2 days after implants and 3-4 weeks if your tissues were used. Rhinoplasty It is the reshaping of the nose depending on the needs of the patient. The aim of the intervention may change depending on the shape and desire of the results. The bridge of the nose can be lowered, large nostrils can be narrowed, and tip of the nose can be thinned out and raised. The angle of the nose can be changed as well. It can be performed with closed or open methods based on the needs of the patient and the type of intervention. During this procedure, septoplasty and conchal reduction procedures which allow easier breathing for patients who have difficulty breathing can be performed. The surgery lasts for an average of 1-2 hours and is done with the help of general anaesthesia. No staying is required. It is possible to return to work in 1-2 weeks, start heavy exercises in 2-3 weeks, and it is required to protect the nose from traumas and sun burns for 8 weeks. It can take up to 1 year for the nose to take on its final form. Blepharoplasty It is the removal of the upper and lower lid wrinkles, sagging and bagginess. This procedure helps the lids to look younger as well as fix the sight problems by fixing upper lids. With an incision right below the lower lid or the natural line on the upper lid the excess skin and bagginess is removed by removing excess lipid folliculus. The surgery lasts for 1-2 hours and performed with local anaesthesia or sedatives. No staying is required. It takes 1-2 weeks to get back to work and 3 weeks to start heavy exercises. Glasses may be used in 2-3 days and contact lenses in 2-3 weeks. Face Prostheses It is the reshaping of regions like the jaw, jaw tip and cheek bones via placing implants to increase fullness. The implants are placed upon the bone of the region via small incisions. The incisions are made on areas which are not visible such as inside the mouth, under and in the eye lid. The surgery lasts for 1-2 hours and is performed with general anaesthesia or intravenous sedatives. No staying is required. It is possible to start work within a week. It takes 2-4 weeks for the face to take on its normal appearance. Treatment of Wrinkles The wrinkles are treated differently depending on the facial expressions, depth and elasticity of the skin. Superficial and moderate depth wrinkles which form on their own without making facial expressions can be fixed by treating the top layers of the skin with chemical peeling, dermabrasion or laser. Retinoic acid, glycolic acid and solutions which include vitamins can be used to treat superficial wrinkles. Using fillings and fat tissue underneath the skin for moderately deep wrinkles which are apparent while resting. Botox injections which prevent muscles from moving can be used for wrinkles which appear during facial expressions. For deep wrinkles which appear when there is an elasticity problem of the skin can be fixed with surgical procedures such as face and neck lifts. Treatment of wrinkles can be done by using ambulatory care in the clinic. Face and neck lifts are performed in the operation theatres. Recovering period differs depending on the type and severity of the procedure between 1 hour and 3 months. The treatment methods for wrinkling are temporary and need to be reapplied occasionally depending on the method. Filling and Lipid Injections It is the fixing of reduced fullness of wrinkles, lips, face and top of the hand by readymade hyaluronic acid or fat tissue taken from the patient. Hyaluronic acid is a readymade substance. Fat can be taken from any area via 2-3 mm small incisions with an injector and can be placed within the same session with the help of local anaesthesia. The surgery lasts for an average of 10-60 minutes and is done with the help of local anaesthesia. No staying is required. You can return to your daily life almost immediately. It can take a couple of days for the swelling to go down. The procedure needs to be repeated every 12 months since hyaluronic acid can be absorbed by the body. Fat can also be absorbed (50% in a year) and it can be repeated when necessary. Botulinum (Botox) Injections It is the treatment of wrinkles formed by the facial expressions in the face and neck region by injection Botox. Botox injections are used to fix the horizontal lines in the forehead, vertical lines in the brows, nose and the muscle bands as seen on the neck. Botox can also be used for headaches and perspiration in the armpits and on the hands. The Botox solution is injected into the small muscles underneath the skin of the wrinkled area. The way Botox works is that it temporarily prevents the muscles which cause wrinkles from contracting. Botox starts working within the first 2 days of injection and becomes more effective in the next 10-14 days. The wrinkles are less apparent when they start appearing in 5-7 months. The procedure lasts for an average of 10-20 minutes and does not require anaesthesia. Botox injections are not applicable during pregnancy, nursing, infections in the area of injection, neurological diseases such as myasthenia gravis, aminoglycoside type antibiotics which end with “micin” users, rheumatoid arthritis patients who use penicillamine and patients who use cyclosporine which weakens the immune system and malaria medicine like chloroquine. Otoplasty It is the treatment of congenital flap-ear problem of the outer ear. It aims to get rid of the bad appearance of the ear as well as the psychological unrest of the child. It is most common between the ages of 6-14. It is easily applicable more advanced ages as well. All other structural problems can be treated with various otoplasty methods in all ages. The ear is brought near the head with a small incision behind the ear and the angling which causes the bad appearance. The surgery lasts for 1-2 hours and requires general or local anaesthesia depending on the patient. Mostly staying at the hospital is not required, the average time to return to work or school is usually 5-7 weeks, and 6-8 weeks to heavy exercises. The patients are required to wear a tennis head band for 3-4 weeks after surgery. Hand surgery Forming due to the nerves of the hand being pressured and damaged which causes pain and numbing, carpal tunnel syndrome, quervain syndrome which causes pain in wrists, cysts in hand and wrists called ganglion, trigger fingers, contractures in hands and fingers called dupuytren’s contractures, congenital finger structure problems, trauma and burn related defects, soft tissue lacerations like tendon, nerve, muscle, finger cuts and bone and soft tissue tumours etc., all fall under the category of plastic and reconstructive surgery. Hand surgery durations all differ. It can be performed with anaesthesia or local anaesthesia or sedative medical support. Brace needs to be used between 1-4 weeks after surgery. Skin cancers Skin cancers are the most common type of cancer. It appears on head, face and neck areas of the body as well as appear on 80% of the body which are exposed to sunlight. The most common skin cancers are basal cell cancer, squamous cell cancer and malignant melanoma including other types of skin cancer. Skin cancers are surgically treated and radiotherapy methods are used if necessary. The cancerous tissue is removed alongside of the healthy tissue surrounding it in skin cancer treatment. The boundaries of the cancerous tissue is dependent on the malignity of the cancer. The lack of tissue due to removal of the cancerous area is treated with different methods depending on the missing tissue and the region. Treating with stitches, skin grafts and skin transfers (flaps) are among the methods. Making it so that the treatment is in accordance with aesthetic rules especially head region is of utmost importance. Early diagnosis to determine whether the cancer infected the related lymphatic gland and radiological tests as well as biopsy methods for the treatment can be performed. The duration of the surgery is dependent on the type and the region of the cancer and can be performed both in the clinic and the operation theatre. Local anaesthesia, intravenous sedatives, medicine or general anaesthesia can be used. It takes 1-3 days to return to work and 1-3 weeks to start heavy exercises depending on the type of surgery. Scarring treatment It aims to nurture and treat the difficult to recover areas which may appear on any region of the body. Slow healing scars may cause psychological and social problems and damages as well as being medical problems. These types of scars appear on legs and feet due to diabetes, venous insufficiency and reduced arterial blood circulation; they may appear on any part of the body due to trauma, burns, long term bone infection-osteomyelitis, radiotherapy related soft tissue skin damage and long term pressure. Another reason for slow or non-healing scars are skin cancers. Accurate Diagnosis and treatment is very important in treating scars and a multi-disciplinary approach is required for success. The patient is evaluated by the specialist plastic and reconstructive surgeon about difficult scars. Vascular surgery, endocrinology, dermatology, infectious Diseases, nutritionist, physical therapy etc. can be consulted depending on the type and necessity of the scar. Incisions, skin grafts and flaps, muscle flaps and other surgical methods to treat vein insufficiency and various non-surgical methods such as medical dressings, scar stimulating medicine, antibiotics and vacuum closing is used. The patient is informed to prevent the scar from reappearing. The aim is to treat the patients in the most suitable way and help them return to their daily lives.
Plastic Surgery
