Information about the procedure
Restoring form and function after injury — from soft tissues and scars to complex defects.
On this page
What it involves
Reconstruction after trauma restores what has been lost or deformed. It differs from aesthetic surgery in that the starting point is not normal anatomy but damaged anatomy.
The guiding principle is that function comes first. The first priority is to restore what the body needs to be able to do — close an eyelid, move a joint, cover a bone. Form comes after that.
Some reconstructions are planned in stages, several months apart. This is not a delay, but a way of working with mature tissues and a stable scar.
Types and approaches
Soft tissues
Repair of skin and subcutaneous defects with local flaps or skin grafts.
Revision of post-traumatic scars
Z-plasties and reorientation of scars that pull, restrict movement or distort the surrounding structures.
Facial reconstruction
Defects of the eyelids, nose, ears and lips require specific planning, because they affect both appearance and function.
Fat grafting for depressions
Grafting of your own fat into depressed scars that are tethered to the underlying tissue.
Multi-stage reconstruction
For extensive defects, the plan is divided into several operations performed at intervals, which gives a better final result.
Who it is suitable for
Suitable for
- A soft-tissue defect after trauma
- A scar that restricts movement of a joint
- Deformity of an eyelid, lip, nose or ear after injury
- A depressed scar, or one tethered to the underlying tissue
- An unsatisfactory result after primary wound management
- For elective correction — at least 6–12 months since the injury
Not suitable, or postponed, in cases of
- For elective correction — an immature scar less than 6–12 months old
- Active infection in the area
- Continued smoking when a flap or graft is planned
- Poor general health that has not been stabilised beforehand
- Unrealistic expectations that all traces of the injury will be erased
Preparation
- Assessment of the defect, the condition of the surrounding tissues and the blood supply
- Imaging if involvement of deeper structures is suspected
- For elective correction, waiting for the scar to mature
- Stopping smoking at least four weeks before surgery
- A clear discussion of the stages and the result that can realistically be achieved
How it is performed
Minor corrections are performed as day cases under local anaesthesia. Extensive reconstructions require general anaesthesia and a hospital stay.
The choice of method follows the principle of using the simplest solution that gives a good result. Not every reconstruction requires a complex technique.
The procedure takes from about 30 minutes to several hours.
Recovery
- The first 48 hoursSwelling and discomfort. If a flap has been used, its blood supply is monitored closely.
- The first weekRegular dressing changes. Movement is restricted after reconstruction around a joint.
- 2–6 weeksStitches are removed depending on the area. Rehabilitation begins if function is affected.
- 1–3 monthsThe tissues soften and active scar care begins.
- 6–24 monthsMaturation. In a multi-stage plan, the next stage is carried out — usually no earlier than 6 months.
Pain and discomfort
Discomfort depends entirely on the extent of surgery — from minimal after a small correction to considerable in the first few days after extensive reconstruction. Pain relief is planned in advance according to the type of operation.
Risks and complications
Every intervention carries risks. Listing them does not mean they are expected to occur — it allows you to make an informed decision.
- Partial or complete loss of a flap or graft
- Difference in colour and texture of the transferred tissue
- Recurrence of the contracture
- Infection
- Altered sensation
- Need for further corrective operations
- An unsatisfactory aesthetic result where defects are extensive
Results and longevity
The aim is restored function and an acceptable appearance — not the erasure of all traces of the injury.
With a multi-stage plan, the final result is assessed once the whole plan has been completed.
Where function is affected, rehabilitation is no less important than the operation itself. A well-performed reconstruction without subsequent rehabilitation gives an incomplete result.