Plastic and reconstructive surgery

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was reviewed on June 20, 2022.

Cancer patients may have scars, defects or deformities, caused by their disease or surgical treatments, that may affect the way they feel about themselves. Reconstructive surgeons, also called plastic surgeons, are responsible for repairing, reconstructing or restoring physical defects caused by cancer or its treatment.

Reconstructive surgeons may perform skin, bone or tendon grafts, use implants to replace a muscle or a damaged body part, or transplant bone or tissue to replace an area has been removed. These procedures may help improve patients’ appearance, reduce scarring or disfigurement or repair injured body parts that may have been damaged. The surgeries may also help cancer patients regain their confidence, dignity and sense of self, especially after experiencing the impacts of breast cancer and head and neck cancer.

To help reduce symptoms and manage quality of life after surgery, we offer supportive care therapies, including pain management, nutrition therapy and oncology rehabilitation.

This article will cover:

Reconstructive microsurgery

With the aid of a high-magnification microscope, a plastic surgeon may be able to use a patient’s own tissue to reconstruct parts of the body affected by cancer. This is known as reconstructive microsurgery.

After isolating tissue from one part of the body on an artery and vein, surgeons completely detach the tissue and transfer it elsewhere in the patient’s body for reconstruction. Usually referred to as a “free flap,” this tissue may be composed of skin, fat, muscle or even bone, or a combination of these structures.

Free tissue transfer is accomplished with the aid of a microscope that allows magnification up to 50 times that of the naked eye. Using stitches finer than a single hair, surgeons are able to reconnect the tiny blood vessels from the free flap to recipient vessels in the area of the patient’s body affected by cancer. Because these blood vessels are very small, measuring 1-3 mm in diameter, the microscope enables surgeons to work with precision, and to help avoid complications such as clotting or kinking.

The process of using a patient’s own tissue with healthy blood flow helps promote healing, reduce scarring and create a more natural-appearing reconstruction. The technique also helps reduce damage to the area of the body (donor site) where tissue is removed, providing better surgical results, faster recovery and decreased rates of complications.

Head and neck cancer microsurgery

Plastic surgeons can reconstruct areas affected by head and neck cancer with reconstructive microsurgery. It may be possible to reconstruct the nose, tongue or throat using tissues from other areas of the body, such as the thigh, abdomen or forearm. The lower jawbone (mandible) may be reconstructed using the smaller bone from the lower leg (fibula). For patients with facial paralysis secondary to tumor removal, transfer of a small muscle from the inner thigh may be performed to restore a smile.

Oncoplastic breast conservation surgery

Oncoplastic breast conservation surgery adds an aesthetic approach to lumpectomy by reshaping or rebuilding the breast to maintain a natural look and feel. This type of surgery is intended to remove the cancer while preventing excessive scarring following surgery and radiation. Plastic surgery techniques such as breast lift, breast reduction or local flaps are commonly used in these types of operations. Surgery on the other breast may also be performed to create or improve symmetry. In addition to preserving a healthy physical appearance, oncoplastic breast conservation surgery may also help women heal emotionally after cancer surgery—restoring feelings of confidence, self-esteem and femininity.

Reconstructive microsurgery for breast cancer

Using a woman’s own tissue is a common approach for building a new breast. The reconstructed breast may look and feel more natural. One option is an operation called the deep inferior epigastric artery perforator (DIEP) flap for breast reconstruction. The procedure removes skin and fat from the lower abdomen while preserving the muscle. Women who undergo DIEP flap breast reconstruction may experience less pain and shorter recovery times than other techniques that do not preserve the muscle. By reducing damage to the donor site, abdominal wall integrity and strength may also be maintained.

Learn more about reconstructive microsurgery for breast cancer

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