Reconstructive Surgery is the basis
of Plastic Surgery. It is from the methods developed to repair defects caused
by injury, surgery, acquired and genetic defects that the principles of aesthetic
cosmetic surgery were born.
INJURY:
From fractured facial bones to noses bitten off by the
neighborhood dog, many techniques and technologies are available to the
plastic surgeon. The methods include simple scar revisions (including
the most common procedure of this category: split earlobes) and closed
reduction (alignment) of fractured bones to complex rearrangement of skin,
muscle, cartilage and bone, and to fixation with metal plates and screws and
implantation of artificial supporting substances. The possibilities are
endless, and the topic too large to cover in this web page.
POST SURGICAL DEFECTS:
Skin cancers represent a multitude of challenges for the
reconstructive surgeon. On the one hand, it is important to remove a
comfortable margin of normal tissue when removing a cancer, on the other, form
and function remain important to the patient. Knowledge of the
aesthetics of the face is balanced with knowledge of function in
reconstructions. Many of the defects that Dr. Blum must repair in his
practice are complex and extensive. He works closely with Moh's surgeons
in Sacramento, fixing the defects caused by their exacting, but sometimes
remarkably deforming, procedures. A large Moh's defect from the exact
and complete removal of a nasal cancer is illustrated below.
 
MOH'S DEFECT
REPAIRED WITH COMBINATION FOREHEAD AND CHEEK FLAP
GENETIC AND ACQUIRED DEFECTS:
This also represents a large category of topics. Cleft
palate and hare lip patients present with associated deformities.
Although Dr Blum does not do the primary surgeries for these problems, the
cosmetic and functional defects related to the nose are dealt with.
Hemi-facial atrophy (marked asymmetry between the two sides of the face)
can be treated with a variety of techniques.
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