Plastic-reconstructive measures are a basic foundation pillar in oro-maxillofacial surgery, and are correspondingly a focal point in our clinic, both in the treatment of patients as well as in research. Plastic-reconstructive surgery is carried out regularly within the framework of tumour surgery, the treatment of accidents, malformation surgery and after infections.
A great amount of attention is paid to the treatment of acquired facial defects with the reconstruction of important functions such as speech, chewing and swallowing. With visible and disfiguring defects however the patient’s main concern can be to regain an inconspicuous appearance. This exemplifies that the surgical techniques of aesthetic surgery, dealing with the correction of facial changes mainly due to age, are also incorporated in plastic reconstructive surgery.
The relocation and transplantation of tissue is the basis of plastic and reconstructive surgery. Skin, muscle, fascia, nerves, cartillage, bone and fat can be transplanted.
Another aspect of plastic reconstructive surgery to the face is taking into consideration skin tension lines, so that the resulting scarring heals unobtrusively and is later more or less invisible. Another important factor is the exact and tension free positioning of the wound edges, and stitches with non-traumatic and gentle sutures. Countless operations are carried out with magnifying glasses or using a surgical microscope.
With the face, functional and aesthetic reconstruction are of major importance. In cases of extended or difficult defects this can be achieved throughout autologic micro-surgical tissue transfer. Here tissue with its supplying blood vessels (arteries and veins) is removed from either the torso or the extremities and transplanted to the receptive area. The supplying vessels are attached to corresponding receptive vessels of the throat using a surgical microscope, so that the transplanted tissue is immediately supplied with blood and vital. There is no immunologic rejection reaction in this case, as the body’s own tissue is used. This is the main prerequisite for a successful recovery.
This varied range of reconstructive possiblities is especially beneficial to our tumour patients. Even if complete functional units have to be removed within the framework of resection, due to extensive and advanced malignant tumours, it is always our aim to rehabilitate the patient in one session as well as surgically possible. The outstanding importance of a tumour operation is the result of this approach. On the one hand, it is an opportunity to free the patient completely from his tumour, whereas on the other hand great dedication is required from the operating team when reconstructing lost tissue the best possible way, both functionally and aesthetically.
These microsurgical techniques are carried out annually over 100 times in our department. We have been organising national and international surgery courses on graft raising and microsurgical suture techniques regularly since 1992, substantiating our great expertise in this field. The so-called Perforans Flaps, miniature grafts first introduced in our field in 2003, are also carried out regularly.
The development and clinical introduction of a non-invasive monitoring procedure for microsurgical grafts, as well as further scientific work on perfusion and reduction of reperfusion damage have led to a success rate of over 95 % in micro-surgical tissue transfer.
Interested and/or affected patients should address themselves to the clinic during regular clinic hours (Langerstraße 3, 81675 München); Monday to Friday 8.30 – 11.30; private patients should report to the secretariat of Univ.-Prof. Dr. Dr. K.-D. Wolff). An individual consultation with correspondingly trained and experienced doctors and surgeons can then take place