Let’s be honest—ulcers are extremely difficult to deal with. Characterized by a sore or a break in the skin or mucuous membranes, ulcers may happen in any region of your body, be it internal or external. There are different kinds of ulcers, which include: 

• Skin Ulcers: These ulcers are open sores and also the topic of the discussion in the blog. These are sores caused due to persistent pressure, resulting in damage to the skin and tissues. Often affecting those with less mobility, these ulcers can be managed by a treatment known as flap reconstruction. 
• Peptic Ulcers: These occur on the stomach lining, esophagus or duodenum, which is the primary region of the small intestine. They are the consequence of an infection with the bacterium called Helicobacter pylori or regular use of non-steroidal anti-inflammatory drugs (NSAIDs). 
• Venous Leg Ulcers: These affect the lower region of the legs and are caused due to issues with the blood flow in the veins or venous insufficiency. 
• Arterial Ulcers: Less common than the other ulcers, these are caused because of insufficient blood flow in the arterial region. They are often associated with peripheral artery disease. 

All these ulcers, however, share common factors such as excessive pain, slow healing, and risk of complications. Since ulcer healing takes long and can impact heavily on healthcare costs and societal burdens, flap reconstruction is recommended.

What is Flap Reconstruction?

A surgical procedure performed to treat ulcers, especially diabetic foot and pressure ulcers, is called flap reconstruction. The procedure involves transferring a healthy, well-vascularized tissue, also known as a flap, from a donor site to the ulcer site. It is performed primarily to make sure there is enhanced coverage, necessary padding, and improved blood supply in comparison to skin grafts or natural healing. 

The goals of flap reconstructions in case of ulcers are: 

• To gain long-lasting and sustainable closure of the wound.
• To eliminate if there is any dead space and fill the cavities or gaps in the wound. 
• To compensate for the irregular blood supply and promote healing in that region.
• To prevent excessive pressure on the edges of the wound, which may cause the wound to open (dehiscence).
• To offer padding in extremely bony areas so there is no recurrence of ulcers.  
• To prevent further complications such as sepsis and fluid or protein loss and reduce the risk of infection in the bones, known as osteomyelitis. 
• To enhance physical appearance and bodily hygiene. 
• To prevent the possibility of chronic ulcers known as Marjorin ulcers. 

What are The Flaps Used in Ulcer Flap Reconstruction? 

Several factors, such as the location of the ulcer, its size and depth, and the overall wellbeing of the patient, come into play while deciding the flap. The common kinds of flaps are:

• Local Flaps: This technique includes harvesting tissue from a nearby area to fill the defect. These flaps frequently maintain their initial blood supply. Examples consist of rotation flaps, which are semicircular flaps turned around a pivot point; advancement flaps, in which tissue is shifted forward in a straight path (e.g., V-Y advancement flaps); and transposition flaps, which are rectangular flaps rotated over an intervening space (e.g., bilobed flap). 
• Regional Flaps: This involves harvesting tissue from a close vicinity, potentially encompassing deeper structures like muscle. These flaps rely on a particular blood vessel. Various kinds of regional flaps exist, such as muscle flaps that utilize muscle tissue (e.g., gluteus maximus flap for sacral ulcers), musculocutaneous flaps that consist of muscle along with surrounding skin and fat (e.g., latissimus dorsi flap), and fasciocutaneous flaps that incorporate fascia (a connective tissue layer) and the skin and fat above it. 
• Distant Flaps (Free Flaps): These involve harvesting tissue from a remote area of the body and necessitate microsurgery to reconnect the blood vessels at the site of the recipient. These flaps are utilized for intricate cases when local or regional flaps cannot be applied. They provide a remedy for major or challenging ulcers, facilitating reconstruction and recovery. 

The surgical procedure of flap reconstruction includes assessment and planning of the patient’s health, flap elevation, flap transfer and inset, donor site closure and drainage to stop collection of the fluids (hematoma or seroma). 

The postoperative care and healing in flap reconstruction of the ulcers consists of resting for long periods, taking care of the wounds by keeping them dry, regularly monitoring if the blood flow is regular and staying patient through the recovery. 

If you’re experiencing severe sores with tissue damage that seem non-healing and infectious, schedule an appointment with us today for prompt evaluation and treatment for your ulcers.

If you’re wondering what the sliding hinge-like structure in your jaw is, it is the temporomandibular jaw or TMJ. In simple terms, it is the connection between your jawbone and your skull. TMJ disorders are characterized by pain in the region of the jaw joint and the muscles controlling the movement of the joint. It is difficult to ascertain the exact cause of why TMJ occurs. The possibilities may include clenching of teeth, chewing gum, and biting nails. The disorders may also be caused by comorbidities such as fibromyalgia, osteoarthritis, and injury in the jaw. In some cases, bruxism, which is the act of clenching or grinding your teeth, may also cause TMJ disorders. 

Mostly, the person may experience the ache and discomfort of Temporomandibular Joint Disorders (TMJ) for a limited period. With treatments such as home care, and physical therapy for the jaw and mouth guard, one may manage their symptoms and get rid of the pain sooner. Surgery is also recommended if conservative treatments fail to help the patient. 

What Causes TMJ Disorders?

Essentially, the temporomandibular joint is a mixture of hinge action and sliding motions. The cartilage covers the different parts of bones working in the joint and has a tiny shock-absorbing disk between them. TMJ may occur due to the following factors: 

1. The cushion-like disc in your jaw joint may sometimes move out or wear down, which may result in pain and cause difficulty in moving your jaw properly.  
2. Injuries such as sprains or strains to the ligaments and soft tissues near the temporomandibular joint may lead to issues with TMJ.  
3. Arthritis can erode the cartilage in your jaw joint, resulting in pain, stiffness, and problems moving your jaw.  
4. If you face a direct hit or impact to your jaw, it may damage the joint and contribute to TMJ problems.  
5. Tensions or spasms in the muscles near your jaw may also cause pain and discomfort in TMJ disorders.  
6. In several cases, TMJ disorders may result from a combination of these factors, making it difficult to ascertain a single cause.

What are the Risk Factors of TMJ Disorders? 

Several factors may contribute to the risk of getting TMJ disorders. They consist of: 

• Various forms of arthritis, including rheumatoid arthritis and osteoarthritis.  
• Injury to the jaw.  
• Habits like chewing gum, biting nails, and grinding or clenching teeth (Bruxism) 
• Certain diseases that affect connective tissues.  
• Stress, PTSD, anxiety, or depression.  
• Conditions like fibromyalgia, ankylosing spondylitis, and sleep issues.  
• Smoking.

What are the Symptoms of Temporomandibular Joint Disorder? 

Symptoms of TMJ disorders may consist of:

• Discomfort or tenderness in the jaw.
• Discomfort in one or both temporomandibular joints.
• Dull pain in and around the ear.
• Difficulty chewing or pain during chewing.
• Dull facial pain.
• Locking of the joint, causing difficulty in opening or closing your mouth.
• Headaches.
• Pain in the neck.
• Pain in the eye.
• Tooth pain that arises with jaw tenderness.

TMJ disorders may also lead to a clicking sound or grating feeling when you open your mouth or chew. However, if there is no pain or restriction of movement associated with your jaw clicking, it is possible that treatment will not be necessary.

How Can Reconstructive Surgery Help in TMJ Disorders? 

Below are three suggestions on how reconstructive surgery can help in managing the pain and discomfort caused by TMJ disorder: 

1. Jaw Realignment: One of the biggest perks of reconstructive surgery is that it may assist in getting your jaw back in the same line. This further causes a reduction in pain and discomfort, making it easier for you to chew your foods and communicate without any issues.
2. Helps you Regain Confidence: Apart from the functional benefits, reconstructive surgery can enhance how you look. It provides you with a more balanced jawline, which may give you that confidence boost you’ve been looking for, making you feel great in your skin.
3. Multimodal Approach: In most cases, this surgery is only one part of the entire scheme of recovery. It may also use techniques such as physical therapy or braces, yielding you a comprehensive plan to take care of your TMJ issues.

It is important to discuss with your surgeon the risks and benefits of getting reconstructive surgery done for your TMJ disorder. Book an appointment today to feel better. 

When an unborn child’s upper lip and palate don’t close completely while the development occurs, the child ends up with a cleft lip or cleft palate. The affected area is the openings or splits in the upper lip, the roof of the mouth, also known as palate or both. This condition is extremely common, occurring on its own or together with other conditions. They are one of the most common birth defects and can be corrected with treatments and surgeries. After getting operated on by a series of surgeries, the cleft lip and cleft palate look as they did before and have minimal scarring in the end. 

What are the Symptoms of a Cleft Lip/Cleft Palate? 

At birth, a split (cleft) in the lip or palate is typically visible immediately. In a prenatal ultrasound, it could be discovered prior to delivery. Cleft palate and cleft lip can appear as follows:

• One or both sides of the face may be affected by a lip and palate split.
• A lip split that either starts as a tiny lip notch or spreads from the lip into the palate and upper gums before entering the nose’s base.
• The appearance of the face is unaffected by a split in the roof of the mouth.

It is less likely that a cleft only develops in the soft palate muscles, which are located behind the mouth and covered by the lining of the mouth. Healthcare professionals refer to this as a submucous cleft palate. This kind of cleft might not be noticeable at birth, and it might not be identified until later, when symptoms below start occurring:

• Having trouble eating.
• Speaking in a nasal tone.
• Constantly occurring infection of the ears.
• Having trouble swallowing, in rare cases. 
• Foods or liquids emerging from the nose.

What are the Causes of Cleft Lip or Cleft Palate? 

Cleft lip or cleft palate usually occurs when the tissues in the unborn baby’s face and mouth during healthy progression don’t get formed correctly. Generally, the tissues forming the lip and palate get together in the first few weeks of pregnancy. However, the babies with a cleft lip or cleft palate don’t have both the lip and palate together or have them only halfway there, which leads to an opening. The main cause of this is not known, as both genetics and environment play a role in a baby’s development. 

What are the Factors of a Cleft Lip and Cleft Palate? 

Many factors may cause a cleft lip and cleft palate in the child which may include:

• Babies having a family history of cleft lip or cleft palate may end up developing it. 
• Exposure to substances like tobacco, consuming alcohol, or taking specific medications may lead to the child developing a cleft lip or cleft palate. 
• Lack of vitamins in pregnancy, such as not having adequate amounts of folate in the body during the first trimester of pregnancy, may increase the chances of the unborn child developing a cleft lip or cleft palate. 
• Gender plays an important role as well, where men are more prone to developing a cleft lip than women. 
• Race or ethnicity also determines the likelihood of developing a cleft palate. People that are Native American or Asian heritage are more prone to developing a cleft palate than people with African American heritage. 

How to Treat a Cleft Lip or Cleft Palate? 

An important intervention for treating a cleft lip and palate is reconstructive, which is targeted towards restoring the regular functioning and appearance of the affected area. A cleft lip is a congenital condition where there is a split or opening in the upper lip, while a cleft palate consists of an opening in the roof of the mouth. These conditions may lead to issues in eating and speech and may even encounter dental and oral problems.

The treatment in reconstructive surgery usually occurs in stages:

Stage 1: First Surgery: This is generally performed when the child is around 3 to 6 months old for the cleft lip, which assists in enhancing the look and appearance of the lip, allowing feeding. 

Stage 2: The Repair: The cleft palate usually gets repaired between 9 and 18 months of age. This surgery includes closing the gap in the palate. This step is extremely important as it allows for the progression of normal speech.

Stage 3: Post-surgery: In this stage, the children may go for speech therapy and need follow-up care to monitor their improvement and development. The success of these surgeries significantly improves the overall quality of life for affected individuals, giving them a chance to lead more normal lives with enhanced speech and social meetings and conversations. 

All in all, reconstructive surgery for cleft lip and palate is an important aspect of multidisciplinary care that looks at both functional and aesthetic concerns.

Request an appointment today for more queries and personalized assistance. 

Overview of Facial Trauma:

Facial trauma is characterized by damage to bone or soft tissue to the face, which may be caused by motor vehicle accidents, assaults (such as gunshots), sports injuries, falls, exposure to chemicals, thermal burns, or animal bites. Since the human face has many bones, blood vessels, nerves, muscles, and sensory organs, it is a delicate part of the body. If neglected, facial trauma can potentially lead to permanent loss of function, including seeing, chewing, speaking, swallowing, and even disfigurement of the face in the worst-case scenario. Medical intervention led by emergency doctors and plastic and reconstructive surgeons could lessen the impact of permanent abnormalities. 

Traumatic Injury to the Face 

Facial trauma, depending on the kind of injury, can lead to severe bleeding, swelling, an inflamed and bruised face, and a distorted appearance of the facial features. 

Facial Fractures  

Facial fractures can affect any area of the face, leading to functional impairments or changes in appearance. Severe fractures in the facial bones may cause the leakage of cerebrospinal fluid surrounding the brain.

A fractured jaw can cause problems to a person’s ability to eat, chew, speak, and swallow. In addition to that, the teeth may be cracked or broken, calling for restorative dental procedures. 

Fractures in the midface (maxillary fractures) can include:  

– LeFort I fracture, which occurs horizontally above the teeth and below the nose (the alveolar ridge).  

– LeFort II fracture, which may involve one or both sides of the face. The fracture line extends from the lower edge of the eye socket across the bridge of the nose and downward through the cheekbone (zygomatic arch) into the upper jaw (maxilla) behind the back upper teeth.  

– LeFort III fracture, which creates a horizontal line across the back of the eye sockets and is often caused by a strong, downward impact to the head.  

An orbital bone fracture, or broken eye socket, may include:  

• Orbital rim fracture, which occurs at the thick outer edges of the eye socket bone.  
• Orbital floor fracture, sometimes referred to as a blowout fracture. This can happen when a direct impact to the face (like being struck by a baseball) leaves the outer rim of the eye socket intact but breaks the bone at the bottom of the eye socket, creating a hole. Orbital floor fractures can lead to symptoms such as a black eye, eye pain, and vision issues due to entrapment of nerves and muscles enabling the eye’s movement. 

Facial Soft Tissue Injury: 

The injuries to the face may include:

• Torn skin or scalp (facial laceration) raises the risk of bleeding, infection, and scarring.  
• Cuts and scrapes on the face.  
• Facial burns can be caused by heat, cold, or chemicals.  
• Eye injuries.  
• Nerve damage might affect sensation or a person’s ability to smile, blink, focus their eyes, swallow, bite, or chew.  
• A cut on the tongue can make it difficult for someone to eat, swallow, or talk.  
• Damage to salivary glands, which are over 100 in the face and help keep the mouth moist for eating and speaking.

Diagnosis of Facial Injuries:

Once the examination is done, imaging tests consisting of computed tomography or a CT scan are recommended to understand the extent of facial trauma. Since X-rays do not show the entire picture and MRIs don’t image the bones thoroughly, CT scans are used extensively by plastic and reconstructive surgeons. 

Benefits of Facial Trauma Treatment  

The benefits of treating facial trauma through plastic and reconstructive surgery are:  

• To restore normal facial functions that may have been impacted, including the ability to focus, blink, smile, chew, speak, and swallow.  
• To enhance the appearance of the face.

In conclusion, facial trauma can have a big impact on both how someone functions and how they look. Reconstructive surgery is extremely essential in helping people get back to normal by restoring facial functions and improving their appearance. This type of surgery not only helps with physical recovery but also boosts the overall quality of life for those who have experienced these injuries.

Breast Cancer begins as a growth of cells in your breast tissue. It is the most commonly reported cancer, after skin cancer. Breast cancer is not just restricted to women. Everyone has breast tissue as a part of their body, and everyone is equally susceptible to breast cancer. With the widespread support and awareness in the funding of breast cancer research, survival rates for breast cancer have been increasing. 

With the latest research of breast cancer being genetic and even hereditary, several individuals have chosen to get screened for their chances of developing breast cancer, and take preventive measures such as undergoing a double mastectomy. Some breast cancer patients find a lump in their breasts, and if it proves to be cancerous, they either have to undergo a mastectomy or a lumpectomy i.e., either surgically remove the affected breast or simply remove the lump. 

It’s normal to experience a sense of mourning or loss after a mastectomy, or a feeling of insecurity after a lumpectomy leaves a surgical defect on your breast. Many women find that having breast reconstruction surgery, or an oncoplastic reconstruction helps them deal with these intense feelings and move ahead. 

What is Breast Reconstruction?

Surgery to restore breasts following a mastectomy or lumpectomy is known as breast reconstruction. Reconstruction might occasionally require multiple procedures. There are numerous methods for reconstructing breasts. Some use saline or silicone breast implants. Alternative methods employ a flap of your own body (e.g., lower abdominal tissue). Breast reconstruction (sometimes known as immediate reconstruction) can occur immediately following breast cancer surgery. Alternatively, it may occur years or months later (delayed reconstruction). You might need surgery to rebuild both of your breasts. Alternatively, your surgeon may reshape one breast and reshape the other to match. Your doctor might suggest multiple procedures stretched out over time. 

After a mastectomy, some people decide to get breast reconstruction, but many others don’t. The choice to have breast reconstruction is highly personal.

What are the Types of Breast Reconstruction Surgery?

There are two most commonly known types of breast reconstruction surgeries after mastectomies.

• Flap Reconstruction

During flap reconstruction, your surgeon forms a breast using tissue taken from your body. Usually, the lower abdomen (belly) is where the tissue is taken from. However, it may also come from your back, bottom, or thigh. To build a new breast, your surgeon may extract muscle, fat, skin, and blood vessels from these areas of your body. Medical professionals refer to this tissue as a flap. Occasionally, a flap (pedicled flap) is moved through your body by a surgeon. In this manner, the flap keeps its blood flow. Alternatively, they might attach the free flap—which is separated from the blood supply—to the blood veins in your chest. 

Many types of flap reconstruction include DIEP flap, TRAM flap, LD flap, IGAP flap, PAP flap, TUG flap, and SIEP flap. Consult with your doctor and your surgeon to determine which is the best option for you. 

• Implant Reconstruction

Surgeons use saline or silicone implants to replicate breast tissue in implant reconstruction. Surgeons occasionally combine implant technology with your own body tissue. Mastectomy and implant reconstruction are possible procedures. Or you might decide to have this operation done following a mastectomy.

Your implant reconstruction can be under the chest muscle, above the chest muscle, or with a tissue expander. Consult your surgeon or your doctor to understand each method and determine what’s best for you.

What is Oncoplastic Reconstruction?

If you meet the criteria for a lumpectomy, oncoplastic reconstruction can be advantageous. You can find out if you qualify for breast conservation by speaking with your oncologic breast surgeon. On the other hand, radiation therapy will be necessary after a lumpectomy.

Surgeons performing oncoplastic reconstruction perform breast reduction or breast lift procedures concurrently with the lumpectomy. The breast form is improved and the defect left by the lumpectomy is filled up with a breast reduction or lift. For symmetry, the opposite breast will require a breast lift or reduction.

Determining What Type of Breast Reconstruction You Should Get

Your doctor and surgical team will recommend the surgery that suits you best based on certain criteria:

• Your age, overall health condition, and lifestyle
• The kind of mastectomy or lumpectomy you had and how much tissue is still left
• If you need additional chemotherapy for breast cancer
• History of surgeries that might affect the procedure
• Your goals and desired appearance

What Does Recovery Look Like?

Everybody’s post-operative recovery is unique. The length of your recovery relies on a few things. These consist of the kind of procedure you underwent and your general health. You must refrain from lifting, working out, and engaging in certain activities to allow your body to recuperate. When you can resume your favorite activities, discuss this with your provider.

Following breast reconstruction surgery, cancer may recur. See your doctor for routine examinations. You will require routine mammograms on the non-reconstructed breast to screen for malignancy.

Following a mastectomy or lumpectomy, breast reconstruction surgery can enhance one’s self-esteem and perception of their physique. Choosing to have breast reconstruction is a highly personal decision. Discuss the best procedure with your surgeon if you choose to have this surgery. Talk openly and honestly about your aspirations, way of life, and ideal look. You might require multiple surgeries spread out over a few months. During your recovery, adhere to the advice of your healthcare team. Call them as soon as you notice any acute pain or infection-related symptoms.