Chirurgia onkologiczna – rola chirurga plastycznego w rekonstrukcji po leczeniu nowotworów

Oncological surgery – the role of a plastic surgeon in reconstruction after cancer treatment

Introduction

Oncological treatment, while life-saving, often leaves visible marks on the patient's body. Operations to remove tumors, mastectomies, or tissue resections can lead to permanent changes in the body's appearance and function. This is where plastic surgery plays a crucial role, helping patients regain self-confidence, improve their quality of life, and return to normal functioning through tissue reconstruction. In this article, we will present how a plastic surgeon supports the oncological treatment process and what reconstructive techniques are currently available.

Oncological surgery and plastic surgery – cooperation for a better outcome

Oncological surgery focuses on removing cancerous changes from the body, while the task of plastic surgery is to recreate lost tissues, restore function, and improve body aesthetics. The cooperation of these two medical fields is crucial so that the patient after cancer treatment not only recovers but also regains a sense of self-worth and life comfort.

The role of a plastic surgeon in reconstruction after cancer treatment

A plastic surgeon supports the oncological treatment process by:

• Breast reconstruction after mastectomy,
• Tissue reconstruction after skin cancer resection,
• Facial reconstruction after tumor removal,
• Reconstruction of soft tissues and bones.

Thanks to modern techniques, it is possible to achieve a natural appearance and restore the function of removed or deformed body parts.

Breast reconstruction after mastectomy

What is breast reconstruction?

Breast reconstruction is the surgical recreation of the breast after its complete or partial removal (mastectomy). It is the most commonly performed reconstructive procedure in women after oncological treatment. It can be performed immediately after mastectomy (immediate reconstruction) or at a later time (delayed reconstruction).

Methods of breast reconstruction:

Breast implants

• Silicone inserts placed under the pectoral muscle.
• Advantages: shorter operation time, quick recovery.
• Disadvantages: necessity to replace implants after years.

Autologous tissue transplant (TRAM, DIEP, latissimus dorsi)

• Using the patient's own fat and skin tissue.
• Advantages: natural appearance, permanent effect.
• Disadvantages: longer operation time, longer recovery.

Hybrid technique

• Combining an implant with fat tissue transplant to achieve a more natural effect.

Advantages of breast reconstruction:

• Improved aesthetics and body symmetry,
• Increased self-confidence and psychological comfort,
• Better social integration after cancer treatment.

Tissue reconstruction after skin cancer treatment

Skin cancers, such as melanoma, basal cell carcinoma (BCC), or squamous cell carcinoma (SCC), often require the removal of cancerous lesions along with a margin of healthy tissue. The plastic surgeon recreates skin defects, ensuring minimal scarring and restoration of a natural appearance.

Reconstruction techniques:

• Skin grafts – taking skin from another part of the body and placing it in the defect area.
• Skin flaps – moving a segment of skin from adjacent areas, which allows for blood supply to be maintained.
• Flap reconstruction – a more complex method, using both skin and blood vessels.

Facial reconstruction after tumor removal

Facial and neck cancers, especially malignant changes, often require aggressive surgical treatment. After tumor removal, the plastic surgeon uses various techniques to restore natural appearance and functionality.

Reconstructive methods:

• Skin grafts – reconstruction of defects after lesion excision.
• Local and distant flaps – reconstruction of more complex structures.
• Facial implants – used in cases of large bone defects (e.g., mandible, nose).

Limb and soft tissue reconstruction

In the case of treating bone or soft tissue cancers, a plastic surgeon may use techniques to reconstruct anatomical structures, including:

• Bone grafts – reconstruction of bone fragments after tumor resection,
• Muscle reconstruction – restoring muscle function after surgery.

How does preparation for reconstructive procedures proceed?

• Surgical consultation – discussing patient expectations and choosing the appropriate method.
• Oncological assessment – confirming no contraindications for reconstruction.
• Preparation for surgery – laboratory tests, imaging, and health assessment.
• Surgery planning – the surgeon and oncologist jointly establish the treatment strategy.

Recovery after reconstructive procedures

The recovery period depends on the type of operation and reconstructive technique:

• Breast implants: return to form after 2–3 weeks.
• Autologous reconstruction: 4–6 weeks of rehabilitation.
• Skin grafts: complete healing within 3–4 weeks.

Patients are regularly monitored to detect possible complications and assess the healing effect.

Possible risks and complications

Like any surgical intervention, reconstructive procedures also carry certain risks:

• infections,
• hematomas,
• graft rejection,
• sensory disturbances,
• asymmetries:

Summary

Oncological surgery, supported by the capabilities of plastic surgery, gives patients a chance to return to a normal life, both in terms of health and aesthetics. Thanks to modern reconstruction techniques, it is possible to rebuild tissues, improve symmetry, and restore the function of operated areas. The cooperation between an oncologist and a plastic surgeon allows for a comprehensive approach to treatment, ensuring not only health but also the patient's psychological comfort.