Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Rehabilitation is as important as the surgery itself. Hand therapy begins within the first few weeks. A certified hand therapist guides the patient through specific protocols to prevent stiffness while protecting the repairs.
The regimen progresses from passive motion (the therapist moves the finger) to active motion (the patient moves it). This prevents the tendons from sticking to the bone and scar tissue (adhesions). Failure to comply with therapy almost always results in a stiff, useless finger.
As the nerves regenerate, the brain must “re learn” how to interpret the signals. Sensory re-education exercises involve touching different textures, identifying objects with the eyes closed, and temperature discrimination.
This training helps reduce hypersensitivity and improve the digit’s functional use. It helps the brain reintegrate the replanted part into the body map.
Almost all reimplantation patients experience cold intolerance. The replanted digit reacts painfully to freezing temperatures and takes longer to warm up. This is due to the loss of the standard thermal regulation mechanism in the vessels.
This symptom is usually permanent, though it may improve slightly over 2 years. Patients are advised to wear gloves, use hand warmers, and avoid prolonged exposure to extreme cold.
Nerve regeneration is slow, growing at about 1 millimeter per day. For a fingertip amputation, feeling may return in a few months. For a finger amputated at the palm, it may take 6 months to a year for sensation to reach the tip.
The quality of sensation is rarely perfect. Two-point discrimination (the ability to distinguish two distinct points of touch) is usually diminished compared to a normal finger.
It is common to need secondary surgeries. The most common is tenolysis, where the surgeon goes back in to cut scar tissue thatis holding the tendons down. This frees the tendon and improves the range of motion.
Tenolysis is typically performed 3 to 6 months after the initial surgery, once the tissues have softened and the bones have healed. It is often followed by immediate, intensive therapy.
The nail matrix is often damaged in fingertip amputations. The new nail may grow deformed, split, or ridged. In some cases, if the nail bed is severely scarred, the nail may not grow at all or may grow very slowly.
Patients should keep the nail trimmed short to prevent it from catching. Occasionally, a procedure to remove the nail matrix is performed if the deformed nail causes pain or infection.
The replanted digit will often look different. It may be slightly thinner (atrophy) or shorter than the original. The skin may be a slightly different color or texture. Scars will be present.
While function is the priority, cosmetic improvements can sometimes be addressed later, such as scar revision or fat grafting to improve the finger’s contour.
Returning to work depends on the occupation. Desk jobs can often be resumed within weeks. Manual labor or jobs requiring heavy lifting or exposure to cold/vibration may require months of recovery or a permanent change in duties.
The surgeon and therapist will provide specific guidelines on lifting restrictions and the use of protective splints during work activities.
The success of a reimplantation is judged by the patient’s ability to use the hand. A “successful” replant is one that the patient incorporates into daily activities, rather than bypassing it.
Grip strength in the replanted hand is typically 50 to 80 percent of the uninjured side. The range of motion varies but is rarely full. However, the presence of the digit allows for a broader grasp and better dexterity than amputation.
Living with a replanted digit requires adjustment. Patients may feel self-conscious about their appearance. They may also deal with chronic mild pain or sensitivity.
Support groups and continued interaction with the hand therapy team help patients adapt. Most patients report high satisfaction with the decision to replant, valuing the restoration of body wholeness.
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Tympanoplasty is highly successful, with success rates generally reported between 85% and 90% for closing the hole permanently.
If the surgery is done behind the ear, there will be a small scar in the crease, but it is usually hidden by the ear itself and fades over time. Transcanal surgeries leave no visible external scar.
Usually, only your tissue is used for the eardrum. If the hearing bones need repair, a tiny titanium or plastic part might be used, but you cannot feel it.
Surgeons use a speculum or retractors to hold the ear canal open and steady, allowing them to work with both hands under the microscope.
Most patients report mild to moderate discomfort rather than severe pain. The anesthesia wears off gently, and pain medication is provided for home use to manage any soreness.
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