Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The first six weeks are critical. Bones are knitting, tendons are healing, and flaps are establishing their blood supply. The repair is fragile. Strict adherence to weight-bearing restrictions and splinting protocols is mandatory.
Swelling can slow healing, so patients need to keep the limb raised. Activity should be limited to protect the repair. This time is called ‘active rest’ move what you safely can, but protect the healing area.
It’s very important to keep surgical sites clean. If there are pins from external fixators, they need to be cleaned every day to prevent infection. Stitches from flaps should also be kept clean and covered.
Once grafts have taken (usually after 1 week), they must be kept moisturized as they lack natural oils. Patients are taught to perform sterile dressing changes if needed.
Therapy often begins within days. “Passive” motion (the therapist moves the joint) keeps joints loose without stressing muscle repairs. “Active” motion (patient moves the joint) starts later once tendons are stronger.
Scar massage is initiated to prevent the skin from sticking to tendons and bones (adhesions). This is crucial in the hand, where gliding is essential. Therapy is a daily commitment.
Around 6-12 weeks, as bones and tendons solidify, strengthening begins. Resistance exercises rebuild atrophied muscles. Proprioception training (balance) helps prevent reinjury, especially after lower-limb trauma.
Work hardening programs simulate job tasks to prepare the patient for returning to work. The focus shifts from protection to function and endurance.
Traumatic scars can be hypertrophic (raised) or contractures (tight). Silicone sheets and compression garments are used to flatten scars. Laser treatments can reduce redness and improve texture.
If a scar crosses a joint and limits motion (contracture), surgical release (Z-plasty) may be needed later. Sun protection is mandatory to prevent permanent dark discoloration of the new scars.
Nerves heal slowly, about one millimeter per day. As feeling comes back, patients may notice tingling, shocks, or itching. Desensitization therapy means gently rubbing the area with different textures to help the brain get used to new sensations.
If a painful lump called a neuroma develops, it might need an injection or minor surgery. Patients who have numb areas need to be careful to protect them from burns or cuts, since they may not feel injuries there.
Titanium plates and screws are generally left in forever unless they cause problems. In some cases, hardware becomes palpable or painful in cold weather. If so, it can be removed once the bone is fully healed (usually 12+ months).
External fixators are taken off in the clinic once the bone is strong enough. The pin sites usually heal fast and leave only small scars.
Some injuries cause lasting changes. Patients may need to adjust to new limits, like using special tools for daily tasks, changing shoes, or wearing braces to help with walking.
The main goal is to help patients be as independent as possible. They learn new ways to do everyday things. Regular check-ups make sure they are adjusting well and help catch any late problems, like arthritis.
Recovery involves both the mind and body. PTSD or anxiety can last for some time. Support groups or counseling can help, and celebrating small steps forward keeps patients motivated.
Acceptance of the “new normal” is a process. The reconstructive team supports the patient in integrating the injury into their life story without letting it define them.
Reconstruction often needs more than one surgery. Later procedures are common to improve the results. These can include thinning a thick flap, loosening a tight scar, or moving a tendon to help with movement.
These follow-up surgeries are planned to get the best possible outcome. They are usually less involved than the first surgery and focus on improving how things work and look.
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Usually, no. Titanium plates are designed to stay in your body forever. However, if they irritate your skin, cause pain in cold weather, or protrude (in thin areas like the ankle or hand), we can remove them during a minor surgery once the bone is rock-solid.
This is common. Scar tissue and broken bones can be sensitive to changes in barometric pressure. It typically improves over the first year or two but can persist. Keeping the area warm and massaging the scar can help.
After nerve injury, the skin can become hypersensitive and painful to touch. Desensitization involves rubbing the area with different textures cotton, silk, wool, then rougher materials for minutes a day. This trains your brain to accept the touch as usual, not painful.
It depends on the injury. Once bones are fully healed and muscles are strong, many patients return to sports. However, you may need protective bracing. High-impact sports might be restricted if you have had a joint replacement or fusion.
Nerve recovery is unpredictable. Sensation often improves for up to 2 years. While you may not regain 100% of your feeling, most patients regain protective sensation (pain/hot/ cold), which is most important for safety.
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