Reconstructive Surgery

Childhood isn’t always just a time for play and learning. Occasionally, it’s a time for medical concerns too. If your child has a birth defect (like a cleft palate), vascular malformation, or a worrisome birthmark, we can help. And if your child has suffered a burn, bite, or other trauma that’s left a scar, we can help with that as well. Our team has extensive experience performing a range of pediatric reconstructive surgery procedures.

What types of birth defects can be treated with surgery? While cleft lip/palate is by far the most common birth defect, occurring in 1 of every 750 US births, other congenital defects include malformations of the ear, hand, and even breast. Many birth defects can indicate underlying conditions that can be far more serious.

How old must a child be to undergo surgery? Repairing a cleft lip can start soon after birth, although surgeons usually wait until a patient weighs 10 pounds and is 10 weeks old. Cleft palate surgery can take place as soon as 10 months. Every case is different, however, and our specialists would recommend the optimal timeline.

How are birthmarks, skin lesions, and hemangiomas treated? Although some are benign, other birthmarks, lesions, and hemangiomas can be serious, depending on their location and the involvement of other organs. Consultation with other specialists can help determine the best course of treatment, which could involve laser treatment or surgery.

How are traumatic injuries, burns, and animal bites treated? Emergency room or primary care physician treatment is often sufficient for minor injuries, burns, or bites. More severe cases should be evaluated by a plastic surgeon like Dr. Holzman because of their potential for disfigurement as well as their impact on functioning.

It is important to have a board-certified plastic surgeon treat children, so they feel confident about their looks after surgery.

Skin cancer is the most often seen form of cancer in the US. Basal cell carcinoma and squamous cell carcinoma are the two most usual types and are very curable. The third most common type is also the most serious. It’s called melanoma. Most of these skin cancers are caused by exposure to ultraviolet (UV) light such as that from the sun or tanning beds.

What is basal cell carcinoma and how is it treated? Basal cell carcinoma is a slow-growing form of skin cancer that most often appears on parts of the body that are frequently exposed to the sun, like the face or top of the head. It rarely spreads, and can be treated by surgery, cryotherapy, topical medication, light therapy, or sometimes radiation.

What is squamous cell carcinoma and how is it treated? Squamous cell carcinoma grows faster than basal cell carcinoma. Its earliest symptom may be a growing bump with a rough, scaly surface and flat reddish patches. Squamous cell carcinoma sometimes spreads to other parts of the body. It’s treated by surgery, cryotherapy, topical medication, light therapy, or sometimes radiation. Radiation is used especially when the cancer has spread to the lymph nodes or internal organs.

What is melanoma and how is it treated? The most serious type of skin cancer is melanoma. Many times, the first sign of melanoma is a change in the size, shape, color, or feel of a mole. You may notice a blackish area on the mole, or you may notice a new mole, often abnormal-looking. For all melanomas, the first treatment is surgery. Patients may also receive other treatments like chemotherapy and radiation.

Mastectomy (surgical removal of one or both breasts) can often remove much or all breast cancer tissue. The procedure can have profound effects on a woman’s self-image, however. Women may choose to have the breast reconstructed, in order to restore the breast mound to its previous size and shape. There are several ways to do this.

What options do I have for breast reconstruction surgery? You can choose to receive either saline or silicone implants, or you can use tissue from another part of your body (often the lower abdomen). Your doctors will help you decide which reconstruction method is best for you. Factors include future radiation treatment needed (if any), age, general health, and recovery time.

Can I get reconstruction done at the same time as my mastectomy? It depends. Reconstruction surgery can be either immediate or delayed. In some cases, the chest is “prepared” with tissue expanders that are slowly inflated over the course of many months in order to stretch the skin. Most reconstructions performed today are immediate reconstructions.

What is the breast reconstruction recovery like? After breast reconstruction surgery, gauze or bandages will be applied to your incisions. You may also need to wear an elastic bandage or support bra to reduce swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess fluid, and you may have a pain pump to reduce the need for narcotics.
Our team of experts will give you instructions on how to care for your surgical site(s) following surgery, what medicines to take, and what specific things to look for at the surgical site or in your general health. You’ll continue to heal for several weeks as swelling decreases and breast shape and position improve. Keep following your instructions and attend follow-up visits as scheduled.

Is breast reconstruction surgery covered by health insurance? In most cases, yes. The Women’s Health and Cancer Rights Act (WHCRA), enacted in 1999, requires group health plans, HMOs, and insurance plans that offer mastectomy coverage to pay for reconstructive surgery as well. However, it’s a good idea to check with your individual plan. Medicare is exempted from this law, as are many religious-sponsored health plans.

Will breast reconstruction surgery make my cancer more likely to come back or make it harder to detect if it does? Studies have not shown that having breast reconstruction surgery makes it more likely that breast cancer will return. In addition, studies haven’t shown that breast reconstruction surgery makes it more difficult to detect cancer on mammogram, although special procedures may be used.