Name of the Procedure:

Adjacent Tissue Transfer or Rearrangement, Eyelids, Nose, Ears and/or Lips (10.1 sq cm to 30.0 sq cm)

Summary

This procedure involves moving or rearranging nearby tissue to repair defects or damage, ranging from 10.1 to 30.0 square centimeters, on areas such as the eyelids, nose, ears, or lips.

Purpose

The procedure is used to address tissue loss or defects caused by trauma, surgery, burns, or congenital conditions. The goal is to restore function and appearance to the affected areas, improving both aesthetics and functionality.

Indications

• Tissue defects or damage on the eyelids, nose, ears, or lips.
• Trauma, surgery, or burns resulting in significant tissue loss.
• Congenital anomalies requiring correction.
• Presence of skin lesions or tumors that need removal and subsequent reconstruction.

Preparation

• Patients may need to fast for a specific period before the procedure.
• Adjustments to current medications might be necessary, particularly blood thinners.
• Pre-operative assessments including physical examinations, blood tests, and imaging studies.

Procedure Description

1. Anesthesia is administered, typically local anesthesia with sedation, but sometimes general anesthesia.
2. The surgeon makes incisions around the defect site to create flaps of adjacent tissue.
3. These tissue flaps are then carefully moved or rearranged to cover the defect.
4. The flaps are sutured into place ensuring adequate blood supply to the newly positioned tissue.
5. The surgical site is then dressed to protect the area and promote healing.

Duration

The procedure typically takes between 1 to 3 hours, depending on the complexity and size of the defect.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

The procedure involves a team of healthcare professionals including:

• A plastic or reconstructive surgeon
• Surgical nurses
• An anesthesiologist

Risks and Complications

• Common risks: bleeding, infection, hematoma, and scarring
• Rare risks: tissue necrosis, nerve damage, poor wound healing, or asymmetry
• Complications are managed with medications, wound care, or possibly additional surgeries.

Benefits

• Restoration of form and function to the affected area.
• Improved aesthetic appearance and self-confidence.
• Enhanced quality of life by addressing functional impairments.

Recovery

• Patients may experience swelling, bruising, and mild pain post-procedure.
• Pain management with prescribed medications.
• Specific instructions for wound care and activity restrictions.
• Follow-up appointments to monitor healing.
• Recovery time varies but typically spans several weeks to a few months, depending on the extent of the procedure.

Alternatives

• Primary closure for smaller defects.
• Skin grafting as an alternative but may have a less desirable cosmetic result.
• Non-surgical treatments such as dermal fillers for less severe defects.
• Each alternative has its own risks, benefits, and suitability depending on the defect's size, location, and severity.

Patient Experience

• Patients will feel the effects of anesthesia during the procedure and should not feel pain.
• Post-procedure, mild to moderate discomfort managed with pain relievers.
• Gradual improvement in appearance and function with normal activities resuming as advised by the surgeon.