Medsarticles. Medical Weblog

If you are considering reconstructive surgery, make sure you understand very clearly what can be achieved by it. Reconstructive surgery that surgeons are proud of is very disappointing for many patients. You are likely to be disappointed if you don’t find out beforehand exactly what sort of result you can expect, both in terms of appearance and of function. Ask to see ‘before’ and ‘after’ photos of patients who have had the proposed surgery. Remember that the appearance may be quite different when the part is being used or the position of the body is changed. For example, a reconstructed ‘lip’ that looks fine at rest may not move normally when you are talking. A reconstructed ‘breast’ that looks fine when the woman is clothed and standing up may look quite peculiar when she is naked and lying down. Ask exactly where you will be cut and how long the scars will be. For example, many patients asking about breast reconstruction are surprised to find that they will be left with a very long scar on their back. Often the normal breast is reduced in size to make it easier to match the reconstructed one. Ask about the function of the reconstructed part. For example, a reconstructed ‘breast’ and ‘nipple’ do not have the same sensitive nerve endings as a normal breast and nipple. Parts of them are likely to actually be numb or tingly. Obviously a reconstructed ‘breast’ cannot produce milk like a normal breast. Ask whether the reconstructed part will alter with time—can the tissues shrink, for example.

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