It's estimated that plastic surgeons perform over one million reconstructive procedures each year. Reconstructive surgery helps patients of all ages and types - whether it's a child with a birth defect, a young adult injured in an accident, or an older adult with a problem caused by aging.
Breast reconstruction surgery in Glendora & Los Angeles area can be approached using any one of a number of different methods for recreating the breast, including the transverse rectus abdominal muscle (TRAM), or latissimus dorsi flap techniques; and artificial implants and expanders. The common aim among these procedures is to reconstruct the breast, usually after one or both breasts have been removed during breast cancer treatment.
Flaps used in breast reconstruction consist of fat, skin, blood vessels, and muscle from the abdomen (TRAM), back (LD) and serve as the tissue used to recreate the breast. The flap can be designed as either a pedicle flap, which means that it is attached to its original blood supply.
Artificial implants are made of a silicone rubber shell filled with sterile saline or silicone gel. They may be selected over a flap procedure because they are less expensive and require less surgical time. Various techniques are used to place these implants. An expander can be used to expand the skin after the mastectomy until it gets to a size that is appropriate for the patient. Patients who are recommended for flap surgery may have already tried implants, or they may have an opposite breast that is difficult to match with an implant.
Women who undergo breast reconstruction have usually received a mastectomy or other procedure for breast cancer. Alternatively, they may have experienced trauma to the breast or suffered an abnormality during breast development.
Breast reconstruction surgery may take place as an immediate reconstruction (IR) that is combined with the mastectomy, or delayed reconstruction (DR). Dr. Sattler will sit down with you to review your options and recommend a course of action that best suits your needs. To give you an idea about how breast reconstruction can be conducted, let’s focus on the TRAM flap technique. In this procedure, plastic surgeon Dr. Sattler in Glendora & Los Angeles area will relocate abdominal tissue to the breast for reconstruction. The TRAM procedure is conducted in a hospital setting under general anesthesia and lasts between 4-6 hours. Using a pedicled TRAM flap, the skin and fat are left attached to the lower portion of one rectus abdominus muscle, which are then tunneled under the chest wall to reconstruct the new breast. Breast implants can be used to help fill out the breast as desired. Again, Dr. Sattler will discuss your goals and expectations so that your needs can be met in a manner that is also supportive of your health.
In most cases, 4-5 days of hospitalization is required following a flap breast reconstruction procedure. Many patients require between 6 weeks to 2 months before they are able to resume normal activities, though the recovery process varies from individual to individual. For women receiving implants only, recovery time can be as little as 1 to 2 weeks. Dr. Sattler is board certified in plastic and reconstructive surgery by the American Board of Plastic Surgery practicing in LA County. Please contact our office in Glendora from nearby Arcadia or Azusa if you are interested in learning more about breast reconstruction in the San Gabriel Valley area.
When an individual undergoes hand surgery he or she may be treated with any number of surgical techniques including grafting or flap surgery. Hand surgeries are designed to treat limited function caused by traumatic injuries, syndromes such as carpal tunnel, or congenital defects like syndactyly (two or more fingers are fused together). The hand is incredibly complex, its function essential, and the corresponding variety of injuries and defects, enormous. Hand surgeries are, therefore, highly specialized and intricate. During hand surgery, the surgeon works to restore form and function by treating injuries to tendons, nerves, blood vessels, and joints, as well as fractured bones, burns, and cuts. Dr. Jon Sattler performs hand surgery, along with a wide variety of reconstructive surgery procedures in the San Gabriel Valley.
Reasons for seeking a plastic surgeon's assistance for hand injuries and defects include:
Trauma to the hand/Hand injury
The procedure that your plastic surgeon recommends will depend on the condition for which you seek help. Some procedures, especially reconstructive procedures to address trauma, may require advanced microsurgery, skin flaps or tissue grafts. If you suffer from carpal tunnel syndrome, your surgery will focus on releasing the tissue that presses the median nerve, and builds pressure inside the carpal tunnel, a passageway through the wrist. Open release surgery conducted in an outpatient setting using local and MAC (standby) anesthesia. During open release surgery, the surgeon makes an incision in the wrist in order to access the carpal ligament. The ligament is then cut in order to enlarge the carpal tunnel.
Most patients experience mild to severe pain following surgery. To help manage this discomfort, your plastic surgeon may prescribe pain medication, and antibiotics. Special dressings may be applied to reduce swelling. With carpal tunnel release, as well as other hand surgeries, rehabilitation is imperative to regaining movement and strength, and should be expected as a part of your aftercare program. Heat or massage therapy may be recommended as part of a continued pain maintenance program. Please contact our plastic surgery practice in LA County if you have any questions about hand surgery. Dr. Sattler will be happy to set up a consultation with you so that you can receive information about the benefits and risks involved. Our office is conveniently located to better serve residents in Glendora, San Dimas, Rancho Cucamonga and throughout Southern California.
Skin cancer is prevalent among individuals who are repeatedly exposed to ultraviolet radiation (UV), and skin cancer surgery is one of the most common procedures performed by board certified plastic surgeons. The facts are unmistakable our skin is sensitive to UV radiation, and we put ourselves at risk each time we step outdoors without sunscreen or other adequate protection. Of the non-melanoma skin cancers, basal cell carcinoma (BCC) is by far the most common; it usually develops slowly in the basal cells of the deepest epidermal layer, rarely metastasizing. If BCC is neglected, it can cause significant destruction and disfigurement to the skin. The next most common non-melanoma skin cancer after BCC is squamous cell carcinoma (SCC). Like BCC, SCC is slow-growing, but it develops in the squamous cells of the top layer of the epidermal. Though unlikely, squamous cell carcinomas can metastasize and even cause death. Individuals with a previous diagnosis of BCC are at higher risk for contracting SCC. Other factors that put individuals at greater risk for developing skin cancer include:
Chemical carcinogens exposure
Fair skin, blond or red hair, light-colored eyes
If you have received a diagnosis of skin cancer that has been confirmed by biopsy, you may want to make an appointment with Dr. Sattler to discuss your options for treatment. Surgical approaches to skin cancer treatment include curettage, surgical excision, radiation therapy, or cryotherapy. During curretage, the surgeon scrapes away the cancer with a tool called a curette, then applies electricity with an electrocautery needle to destroy any remaining cancer cells. If the surgical excision approach is selected, your surgeon will first numb the area to be treated with local anesthesia. Using a scalpel, he will then remove the tumor along with a surrounding border of normal skin. The excised tissue is sent to the laboratory for microscopic examination to verify that all the malignant cells have been removed. During cryotherapy, liquid nitrogen is applied to the cancerous tissue, which freezes and destroys it. The procedure may be repeated during the same session to ensure total destruction of the malignant cells. Radiation therapy is generally only used for cancer that has spread to organs, lymph nodes, or tumors that are surgically untreatable. X–ray beams are directed at the tumor, a procedure that must be repeated several times each week for a few weeks.
Aftercare varies considerably with skin cancer treatment, depending on a number of factors which technique was used, how extensively the cancer had spread, as well as factors specific to the patient like general health, age, and medical history. Other surgical approaches to skin cancer require varying degrees and types of care. Your surgeon may also schedule follow-up visits with you so that he can monitor your recovery. To learn more about skin cancer surgery and treatment in LA County, contact our plastic surgeon's office in Glendora, CA located near Arcadia and Azusa. Dr. Jon Sattler is board certified in plastic and reconstructive surgery by the American Board of Plastic Surgery.
Tissue expansion is a surgical technique that serves as an important component to reconstruction efforts like breast reconstruction, cleft lips, burns, and hair replacement surgery. When there is a shortage of tissue to complete a reconstructive procedure, tissue expansion is used to assist the body in producing new soft tissue. During the procedure, a deflated balloon-like device is inserted under the skin. Over the next days to weeks, the balloon fills with saline, an action that slowly stretches the skin, causing it to grow. When the skin has grown sufficiently, the balloon device is removed, and the skin is used to complete the reconstructive procedure.
As noted, tissue expansion is used when there is an inadequacy of soft tissue required to complete a reconstructive procedure. Some of the advantages of using tissue expansion in surgical reconstruction are that it:
Produces tissue with near-perfect match in color and texture
Results in minimal donor site morbidity and scarring
May be used on various body parts
Can provide tissue with sensory function or appendage attributes
Considered superior to other methods used to reconstruct or repair damaged skin
Your tissue expansion procedure will take place in an outpatient surgical facility and will last between 1-2 hours. Either local or general anesthesia may be used, depending on the extent of the procedure. The plastic surgeon will first make a small incision near the area being treated, then insert the silicone balloon expander just beneath the skin. The expander comprises a tiny tube and self-sealing valve that allows the surgeon to gradually fill the expander with saline solution; the valve is usually left just beneath the skin surface. Follow-up visits will be scheduled so that, once the incision heals, your surgeon can inject the expander with additional saline. During this process, the skin over the expander stretches as the expander enlarges. Once the skin has stretched enough to complete the reconstruction procedure, your surgeon will remove the expander in a second operation, then resume reconstruction surgery using the new tissue.
Recovery from tissue expansion procedure varies drastically depending on an array of factors such as the extent of the symptoms precipitating reconstructive surgery, and your general health. Most patients continue their normal routines while the expander is in place, and can resume these activities within a week following surgery. To learn more about the benefits, costs or possible side effects of tissue expansion surgery in the San Gabriel Valley, contact Dr. Sattler for a personal complimentary consultation. He is conveniently located in Glendora in LA County to serve residents throughout Southern California.
Male breast reduction surgery, also known as gynecomastia correction, is designed to reduce excess breast tissue in males using liposuction and surgical excision. The term comes from "gyne," meaning woman and "mastia," meaning breast. Other suitable names for the condition may be "hypermastia" or "macromastia." By removing excess fat and tissue, the patient can realize a flatter, more masculine chest contour. Dr. Jon Sattler offers male breast reduction at his plastic surgery practice in Glendora, along with a wide variety of procedures for surgical body contouring.
Before and After Male Breast Reduction in Glendora, CA
Men who suffer from excess breast tissue — a combination of fat and glandular tissue — may be candidates for breast reduction surgery. Along with excess breast tissue, these men can experience sensitivity or tenderness in the area. This combination of symptoms may be diagnosed as gynecomastia. The cause of gynecomastia is not known, but many physicians believe it is a hormonal problem, and is often connected to drug use and lifestyle. Gynecomastia occurs in both adolescents and adults. For children ages 14-15, the occurrence of male breast enlargement may be as high as 65%, tapering off to just under 8% by age 17. Men may also experience hypermastia between ages 50-70. Possible causes include impaired liver function, testosterone deficiency, and use of estrogen-containing medications or anabolic steroids. Other medications that are believed to possibly lead to gynecomastia may include marijuana, zantac, tagemet and nizoral. Men who seek cosmetic surgery for this problem are often embarrassed that they have the disorder and sometimes even too embarrassed to deal with it.
Dr. Sattler may ask that you undergo a medical examination prior to surgery in order to get a thorough look at factors that may be causing your condition. An MRI or mammogram may also be requested so that the surgeon can inspect the composition of the breast tissue. The surgery itself lasts approximately 2 hours, and will be conducted under general anesthesia for large removal, local for minor removal. If the procedure is targeted mostly at removing glandular tissue, the surgeon may use exclusively surgical excision when conducting your male breast reduction. In this case, he will make an incision under the arm or the areola, through which glandular tissue and fat will be removed. If both fat and glandular tissue need to be removed, then the surgeon will combine the excision approach with liposuction. In the combined approach, liposuction will be performed following the excision. During liposuction, a cannula, or thin tube, is inserted into the tiny incisions that removes the fat by way of a vacuum device.
Many men are back to work as quickly as 3-7 days following breast reduction surgery. Expect some swelling, decreased sensation and bruising to occur after surgery. This usually resolves in 2-3 weeks. Dr. Sattler will advise you to postpone exercise for about 4 weeks, and you may need to wait a few months to appreciate the final result of your surgery. It should also be emphasized that regular exercise, and healthy choices and lifestyle are necessary in ensuring lasting results. Dr. Sattler welcomes your questions and concerns about male breast reduction surgery in LA County. Please contact us at our office in Glendora located near Arcadia and Azusa if you would like to learn more about the cost, risks, and benefits of male breast reduction. You should know that some insurance companies pay for having this procedure done.
Scar revision is used to enhance the appearance of scars resulting from injuries, surgeries, or other traumas. While surgical treatment can certainly improve your scar aesthetically, it cannot recover your skin to its pre-injury status. Scar revision basically replaces a scar with a smaller one. It is important to remember that your plastic surgeon will work with you during what can be an emotionally-charged process so that your needs and expectations can be met.
Individuals who have experienced significant loss of regional tissue, injury that crosses aesthetically distinct areas of the face, function limitation, unsatisfactory wound closure, and poor post-injury wound management may want to consider scar revision surgery. You may want to consider scar revision surgery if your scars:
Span across anatomic regions
Are constantly subjected to wrinkling of the skin
Are deeply traumatic
The types of scars that may respond to revision are keloid scars, hypertrophic scars, and contractures. Keloid scars are an abnormal proliferation of scar tissue that grows beyond the boundaries of the original wound. Hypotrophic scars, like keloids, are raised scars, but they don't grow beyond the boundaries of the injury, and they may reduce in size over time. Contractures occur when scar tissue pulls the edges of skin together, possibly restricting movement.
During scar revision surgery, skin tissue is removed in a specific shape or pattern that aids in diminishing the size of the original scar. Partial or serial excisions are common approaches to scars too large to be excised in one sitting, and that have insufficient available skin for a local skin flap closure. In this procedure, an ellipse is excised from the scar's center, and the sides of wound are undermined for closure.
This hypertrophic scar has formed a contracture, restricting finger motion. Using Z-plasty, the scar is removed and incisions are made on each side, creating small triangular skin flaps, which are rearranged and interlocked to cover the affected area.
Contractures respond well to the Z-plasty and W-plasty techniques because they minimize the visibility of scars by repositioning them along the natural lines and creases of your skin. In Z-plasty scar revision, the surgeon makes a Z-shaped incision so that the middle line of the Z runs along the scar tissue. The flaps of skin formed by the other lines of the Z are rotated and sewn into a new position that reorients the scar about 90 degrees, minimizing that the appearance of the scar by breaking up the straight line of the scar into smaller units. Like the Z-plasty, the W-plasty diminishes the visibility of a scar by turning a straight line into an irregular one, but it does not entail the formation and repositioning of skin flaps. During W-plasty surgery, a series of short incisions are made to form a zigzag pattern that replaces the straight line of the scar. Other surgical techniques used in scar revision include flaps, grafts, fusiform and shave excisions, laser skin surfacing, and dermabrasion. Your plastic surgeon will recommend the course of action best suited to the nature of your scar and your goals for surgery.
Excision approaches like the Z and W-plasty typically necessitate pain medication, rest, and wound and bandage care. If skin grafts or flaps are used, postoperative care will begin in the hospital. Patients receiving skin grafts are typically expected to return to Dr. Sattler's office at regular intervals so that the graft sites can be monitored. Please contact our plastic surgery practice in Glendora nearby Arcadia and Azusa if you are interested in learning more about the benefits, costs or possible side effects of scar revision surgery in LA County and the San Gabriel Valley.
Wound care is important for any reconstructive surgery that seeks to correct damage caused to nerves muscles, the skeleton, or skin. Plastic and reconstructive surgeons select methods to address wound care based on the size, severity, and features of the wound. Examples of approaches to wounds include skin grafts, tissue expansion, and flap and microsurgery. Direct closure, the most simple of wound care procedures, may be performed on skin-surface wounds that have straight edges, such as a simple cut. Wound care can sometimes mean using devices to get a wound ready for a surgical procedure. A wound vac on a wound will help make it smaller so that it will be easier to graft or flap later.
Wound care is intended to assist individuals suffering from severe burns, or severe scarring from burns and other injuries, and wounds that cannot heal normally. The goal is to improve appearance and function of skin deformed by burns and other trauma, and to help prevent infection, morbidity and diseases to the wound.
Skin grafts assist in closing a wound that lacks sufficient soft tissue to adequately cover the traumatized area and insure healing. This procedure may be conducted with local or general anesthesia depending on the extent of the wound, and it is completed in combination with a reconstructive procedure. If Dr. Sattler is treating you for a burn wound, he may use a split-thickness skin graft that is composed of the layers of skin closest to the surface. Full-thickness skin grafts are often selected to treat burn wounds that are both deep and large, or to cover joints where maximum skin elasticity and movement are necessary. Composite grafts consist of layers of skin, fat, and sometimes even cartilage from the donor site in order to provide the wound more support. Grafts are also distinguished according to the type of material used. They can be autografts, in which the tissue is taken from another part of the patient's body. Allografts are made from tissues of another human being, and even xenografts from other species. During tissue expansion, a silicone balloon expander is inserted under the skin under treatment. The expander comprises a tiny tube and self-sealing valve that allows the surgeon to gradually fill the expander with saline solution; the valve is usually left just beneath skin surface. When enough extra skin has grown, the expander is removed and the new skin is used to close the wound. Local or general anesthesia may be used. Flap and microsurgery are often used in severe injuries that require maximal precision, for example, in reconnecting blood vessels. During microsurgery, Dr. Sattler will use a microscope in order to aid in the intricate task of repairing nerves, reconstructing damaged skin, muscles, and other tissues depending on the wound. Flap surgery involves the transplantation of living tissue from one part of the body to another. Some flaps carry their own blood supply, while others must be attached to a blood supply at the recipient site, usually with microsurgery. Flap surgery can help restore form and function to traumatized areas of the body exhibiting damaged skin, fat, muscle movement, and/or skeletal support. Again, depending on the extent of the wound and complexity of the procedure, either local or general anesthesia may be used.
Regardless of your wound and the procedure used, you can expect some discomfort and swelling, symptoms that can be managed with pain medication. Dressings will be applied which should remain dry and intact in order to ensure proper healing. Either absorbable, non-absorbable sutures or staples may be used. Your surgeon will be sure to review detailed instructions on how you are to care for the suture lines; some sutures require regular treatment with antimicrobial ointment, while others require little maintenance. Non-absorbable sutures will be removed within one to three weeks after surgery. Dr. Sattler welcomes your questions and concerns regarding wound care in LA County. Please contact his office at the plastic surgery center in Glendora nearby Arcadia and Azusa if you would like to set up a consultation.
Laser technology has made a tremendous impact in many areas of medicine, and especially in plastic surgery. A medical laser allows your surgeon to blast away imperfections or growths with minimum bleeding, bruising, and scarring. Currently, there are many lasers available, but not all lasers are alike. If you're planning to have laser surgery, it's best to find a plastic surgeon who is experienced with, and has access to, a variety of devices. Dr. Sattler was one of the first plastic surgeons to have a laser as part of his private practice. He has experience with many kinds of lasers. He is really excited about getting his lasers operating after January 2011.
Board certified plastic surgeon Jon Sattler M.D. offers laser surgery, along with several other procedures in LA County for improvement of the skin.
The yellow pulsed-dye laser uses a type of dye as its active medium. It has a pulsing beam that is heavily absorbed by hemoglobin, which gives blood its red color. This laser is often used for performing surgery on children who have pinkish birthmarks called port-wine stains. The laser destroys the abnormal blood vessels, lightening the birthmark to the point of being barely noticeable. Scarring, which was a problem with earlier laser models, is minimal with the yellow pulsed-dye laser.
The "pigment-blasting" laser family, the Q-switch ruby, the Q-switch YAG, and the alexandrite is a group of lasers that are effective in eliminating the black and blue pigments of tattoos, pigmented lesions and the brown patches and spots that often occur with aging. Though the removal of decorative tattoos is considered a cosmetic procedure, the removal of "traumatic tattoos" is a reconstructive process. Traumatic tattoos occur when material particles are forced under the skin through an accident such as an explosion or collision.
The carbon dioxide laser, sometimes called the "workhorse" of lasers, is an invisible light absorbed by water, the primary component of human skin. When the beam is focused, it can cut tissue and seal blood vessels simultaneously. When defocused, it vaporizes. These characteristics make it the treatment of choice for removing warts and many types of skin growths.
The YAG laser has been shown to be effective in the surgery of various types of hemangiomas, which are skin growths with heavy concentrations of blood vessels. It delivers highly-focused energy and-unlike other lasers-its tip can be placed directly on the skin, mimicking a scalpel.
The argon laser is similar to the yellow pulsed-dye laser. The argon laser emits a blue-green light that is absorbed heavily by the color red. It is particularly effective in treating abnormalities that have a proliferation of blood vessels, such as blood blisters, "spider" blood vessels on the face, "strawberry" birthmarks, hemangiomas, and bulky vascular tumors.
The copper vapor laser is a newer type of laser that emits a yellowish light. Its uses include treating brown or red pigmented areas.
The number of laser treatments you'll need depends largely upon the size and severity of the defect. A child with a large birthmark may need six to ten laser treatments to achieve satisfactory results. Only one treatment may be needed to remove some small spider veins on the face.
Lasers have a number of valuable uses, but a laser should not be viewed as a "magic wand" that improves the results of any type of surgery. For traditional kinds of surgery and most plastic surgery, the scalpel is still the proven instrument of choice.
Are you interested in laser reconstructive surgery in the San Gabriel Valley? Contact Dr. Sattler's office, the Plastic Surgery Center of Glendora to find out more about the reconstructive procedures and laser treatments we offer to residents of the San Gabriel Valley and surrounding areas.