Reconstructive surgery of the head and neck area is my common practice and is often a complicated surgical task. The head and neck area is highly compacted with functionally important anatomical structures, some of which are highly aesthetically related. Hence, every reconstructive procedure in this area, and especially in the face, requires specific consideration in order to restore functionality and to achieve a pleasing appearance.
Reconstructive Plastic Surgery from a Functional and Aesthetic Perspective
Reconstructive surgery of the head and neck area is my common practice and is often a complicated surgical task. The head and neck area is highly compacted with functionally important anatomical structures, some of which are highly aesthetically related. Hence, every reconstructive procedure in this area, and especially in the face, requires specific consideration in order to restore functionality and to achieve a pleasing appearance. Reconstructive breast surgery also requires diverse techniques to meet optimal patient requirement and esthetic result.
This leading principle is similarly applied in the treatment of tumors or trauma of the nose. The centrally located nose is a structure which imposes three dimensional reconstruction using diverse tissues such as skin, cartilage, and mucosa. Therefore, an aesthetically pleasing result depends on the resemblance of the texture and color of the tissues used, while arranged according to the aesthetic units composing the nose. Often, in order to achieve perfection, multiple operations are required following the first operation which establishes the foundation for a complete reconstruction.
In cases where the use of local tissues is not possible, distally located sources should be used. Such tissues can be transferred as grafts, as in the case of ear cartilage used to form the cartilaginous framework of the nose. In complex reconstructive cases, I frequently use the microsurgical technique to transfer missing tissues along with their supplying blood vessels connected to blood vessels near the defect, reconstituting its blood supply. The microsurgical technique has become a standard of care, used to successfully reconstruct large and complex defects in the head and neck area. Using this approach I can reconstruct structures, such as the lower jaw, by transferring the fibula bone from the leg with its blood vessels while adjusting it to the curvature of the lower jaw defect. Microsurgical techniques allow me to deal with different defects of the head and neck including the base of the skull, upper jaw, eye orbits, pharynx, larynx, esophagus, ears and in reconstructive breast surgery.
Microsurgery techniques have recently enabled a breakthrough in the treatment of cases where the defect was not amenable to reconstruction using tissues from the patient. This was achieved by a living donor, such as in the case of a dog bite where the nose and both lips were transferred.
Successful use of microsurgical techniques requires a highly skilled physician, with expertise in the implementation of specialized tools such as the operating microscope, as well as fine instruments specifically designed for such operations. Apart from in-depth surgical expertise, an adequate surgical plan is defined to achieve the ideal result while using the optimal sources and minimizing damage to the donor site. Mastering the anatomy of the head and neck along with the use of microsurgical techniques tailored for the specific defect has enabled me to deal successfully with various defects resulting from tumor ablation, trauma, or congenital anomaly.
Such unique expertise provides me with a balanced approach and improved operation success rates. Furthermore, it allows me to avoid inferior approaches and avoid surgery in high risk cases. The importance of cooperating with an experienced reconstructive surgeon is understood by surgeons from other disciplines who deal with diseases of the head and neck area including otolaryngologists, neurosurgeons and maxillofacial surgeons. The importance of preoperative consultation with an experienced reconstructive surgeon of the head and neck can not be over emphasized. My clinical practice in microsurgical techniques is also implemented in complicated cases of breast, upper and lower limbs, abdominal wall and more.
Aesthetic Surgery of the Face from a Reconstructive Perspective
Aesthetic surgery of the face has become a significant part of all aesthetic operations. The anti-aging trend as well as an increased rate of awareness has widely contributed to this rise amongst men and women alike. Amongst these surgeries is face lifting, a complicated operation, as well as aesthetic surgery of the eyelids, forehead, nose, and ears. It is common for me to conduct a combined surgery to these parts of the face.
A widespread motivation for aesthetic surgery of the face is aging, which is characterized by various stigmata. However, I also treat aesthetic deformities of congenital origin of the nose and ears. Aesthetic deformities caused by trauma accounts for another group of patients for whom I offer a tailored procedure inspired by my reconstructive principles and experience.
My approach to face lifting does not relate to formal techniques alone, but concentrates also on the specific need of every patient. Guidelines for treatment require a comprehensive reconstructive assessment and surgical implementation to achieve excellent results. Therefore, the restoring of tissue arrangement does not compensate volume loss, which is part of the aging process, and fat injection serves as an integral part of each face lifting surgery. The use of other fillers is combined for parts that are not directly addressed by the surgery, such as folds around the mouth or lips. My reconstructive approach to face lift surgery aims to conserve all the important tissues and to manipulate the SMAS tissue by elevating it using circular plication sutures. This approach produces a more youthful and natural result, both in the short term and for many years to follow. A tailored aesthetic surgery to the face enables a short scar face lift surgery when indicated. Raising the lateral side of the eyebrows is usually combined in cases of an operation of the upper eyelids and uses the same incision. This operative approach to the lower eyelids is done mostly via the conjunctiva, thus avoiding scarring on the skin.
Aesthetic surgery of the nose requires a concentration on functional perspectives to avoid post operative breathing problems. This principle is of utmost importance in achieving a natural look of the nose, as a result of non radical removal of cartilage and mucosa. In cases when preoperative breathing problems are present, meticulous assessment is required to achieve an optimal result.
I prefer an open approach to aesthetic surgery of the ears. This technique allows me to treat the deformed cartilage directly and accurately and restores the shape, while avoiding the use of internal fixation sutures.
My experience in reconstructive surgery of the head and neck area has provided me with an added value when treating such aesthetic cases. This is based on my acquired knowledge of the anatomy of the head and neck area, combined with my experience in complex head and neck cases.
