Plastic Surgery in Human Capital
Tuesday, October 22, 2013 | 0 comments
Reconstructive surgery is, in its broadest sense, the use of surgery to restore the form and function of the body, although maxillo-facial surgeons, plastic surgeons and otolaryngologists do reconstructive surgery on faces after trauma and to reconstruct the head and neck after cancer.
Reconstructive plastic surgeons use the concept of a reconstructive ladder to manage increasingly complex wounds. This ranges from very simple techniques such as primary closure and dressings to more complex skin grafts, tissue expansion and free flaps.
Doctors in China have grown an entire nose on a man's forehead. But as bizarre as the procedure might sound, plastic surgeons say such transplants are not anything new.
The case in China involved a 22-year-old man from Fuzhou who was involved in a car accident and suffered permanent damage to the cartilage in his nose through infection. Nine months ago, his doctors decided to re-construct a new nose on his forehead.
Such surgeries are not as odd as they might seem. The use of forehead skin to replace missing skin on the nose is actually pretty common, been around for a long time and used pretty frequently. Normally, it's only skin that's grown this way, using cartilage to form it into the right shape. But in this case, the middle structural area of the nose, as well as the nose lining, were grown on the man's face.
What's pretty unique about this case is that the surgeons chose to grow all three layers in the forehead prior to transferring the skin to the nose, where it's needed, This method allows blood vessels from the skin of the new nose to grow into the cartilage grafts that have been used to create the middle structure of the nose. That should help when it comes time to transplant the nose into its proper position. The main advantage is to make sure the entire structure has a good blood supply prior to stressing it with the move to the face.
The doctors will allow the nose to grow on the man's forehead for several months before they would attempt to transplant it. In order to ensure the structure still had a good blood supply, a component of the nose will remain attached to his forehead for a few weeks until the blood supply from the face nourishes it enough that you can disconnect it from the forehead. There is still multiple steps that the patient has to go through. If all goes well, the man should be able to maintain his sense of smell, since the smell receptors are pretty far up the nose.
EG: UCLA Operation Mend is a medical partnership established in October 2007 between Ronald Reagan UCLA Medical Center, Brooke Army Medical Center in San Antonio, Texas, and the V.A.-Greater Los Angeles Healthcare System that provides reconstructive surgery to U.S. military personnel that have been severely wounded during service in Iraq and Afghanistan. The project aims to serve as a model for other medical institutions interested in helping wounded service members.
