Bodies under construction (Listín Diario)

As if it were a sculpture, plastic and reconstructive surgeons can mold, profile, reduce and bulge areas, reposition elements and even rebuild damaged areas of the human body.

Franklin Peña, plastic and reconstructive surgeon, says that although cosmetic surgery is very popular, it is only one of the two branches in which plastic surgery is divided. The second branch is composed of reconstructive surgery.

“Reconstructive surgery is special because we hear less about it. It consists in reconstructing the function that has been lost due to an accident, a trauma, a congenital malformation, a burn “, explains Peña. He adds that aesthetic surgery, on the other hand, has to do with beautifying the body, getting the beauty lost with the years, for pregnancies that sometimes play havoc or that which has not been had by nature.

Both branches are complementary and have as a common goal to help improve human appearance, an essential factor for healthy self-esteem.

HAND SURGERY

In the country, the most performed reconstructive surgery is to correct hand traumas, especially tendon injuries, common in machete attacks or knife violence. “In these cases it is almost always possible to recover both appearance and functionality,” explains Franklin Peña, plastic surgeon. It stands out that the faster the patient is operated in these cases, the better recovery will be.

Looking for the function
Reconstructive surgery seems the “ugly sister” of cosmetic surgery, however it is not so, and is often, in many cases, much more useful.

“We always hear that someone put on implants or had a liposculpture, but you hear little of the reconstructive work,” says plastic surgeon Franklin Peña.

He says that in the beginning of this medical specialty, wars played a fundamental role in its development. Before the mutilations and wounds in combat the doctors began to improvise trying to solve with what they had.

Instead, the popularity of cosmetic surgery has grown sponsored by the media and its promotion of desirable bodies, “a stereotype that is not really something divine, because who says that Barbie’s body is perfect? Nobody, but the media has been responsible for promoting it, from Hollywood with personalities like Pamela Anderson or Michael Jackson that are examples of plastic surgery excess, “explains Peña.

In the country, the most performed reconstructive surgery is the correction of hand trauma, specifically the tendon injury. These cases are delicate because of the importance of hands, with which most of us earn a living and we can stand on our own.

“In hospitals it is a very common case that the patient is given a machete in the forearm, the tendons are injured and the hand does not work. When those tendons are cut, the fingers do not move, but with a surgery of one hour the tendons are connected and at three weeks the patient has his hand working, perhaps not in one hundred percent, but in 90 or 95 percent. When the nerves are cut, you could lose 15 percent mobility or sensation, “explains the doctor.

An amputated finger can be relocated, “you only have to have a microscope and a hand surgeon. In the country we have three of these specialists, but there are few microscopes, “says Peña. If only the tip of the fingers is lost, it can not be relocated because the blood vessels are very thin and can not join. If it is half or the complete finger, the finger can be saved.

And also the hands: “We have had cases of hand amputation where everything can be reconnected and the patient recovers the function, maybe not total, but in 80 or 90%”, explains Peña.

In the face, the most risky reconstructive surgeries are practiced, since it is vital to recover the functionality, but above all the appearance. “I have had cases of patients with motor accidents where part or all of the face is detached and can be reconstructed by obtaining minimal or imperceptible scars. Without surgery, the patient would be disfigured, “says Peña.

The suture
Suturing is part of the tricks of plastic surgery. It is the first thing that a surgeon should know: make the scars inconspicuous, almost imperceptible.

“There are many people who have the idea that the wound will disappear. The wounds do not disappear, the scars are forever. The goal is to not see or see very little, “says the doctor.

To achieve this, a subcutaneous or intradermal suture is made, the thread goes under the skin. This prevents keloids from forming in the wound, although sometimes that thickening of the scar occurs.

“There are treatments for the keloid. The three basic ones are, first put a band of silicone on the wound to press it and prevent it from engorge. If the keloid still appears, the second step is to inject triancinolone, a steroid that causes the cells that close the wound, the fibroblasts, not to multiply. If it still does queloide, localized radiation is applied, “says the expert.

Burns
Another frequent reconstructive surgery in the country is burns. “It’s traumatic,” says Peña. He says that when a patient burns he will never be as he was before that second or third degree burn.

But you can recover some function. “When someone burns an arm it can not move because the scar makes a contracture. In surgery it is corrected using skin grafts, “says Peña. The function is recovered, so that the person can return to be productive, but the aesthetic is not restored.

There are cases of girls with severe torso burns who will not see normal growth of their breasts: “In the future it could be resolved with tissue expansions and the placement of implants that fill up little by little. It will have the shape of the breast, but with scars on the burned skin. ”

Cleft lip
Of the congenital malformations, the one that is most frequently treated is the cleft lip.

“A single surgery is not enough and neither can a surgeon do it alone, sometimes you also need a maxillofacial surgeon, orthodontist surgeons and speech therapists. But it depends on the case. ” The mild cases only present the lip open, but others have cleft palate, which is more complex. DO NOT LEAVE A LONG TIME

“The time that passes from birth, a trauma or a burn, until the time of surgery should be brief, the faster you operate better,” says Franklin Peña, plastic surgeon.

It is best to do it in the first hours. If a month goes by, only 50% of the functionality that could be recovered at the beginning will be achieved.

Peña emphasizes that, in plastic, aesthetic or reconstructive surgery, the patient must be attentive to the care indicated by their doctor and follow them to the letter and communication with the doctor must be maintained.

Peña says that the country has all the equipment and professionals capable of performing reconstructive surgery, but unfortunately not all people can access the procedures.