Reconstructive Surgery in Ankara, Turkey

Reconstructive surgeries are surgical procedures performed to correct congenital or acquired tissue loss, deformities, and functional impairments. Within this scope, aesthetic and functional improvement can be achieved after trauma, tumor surgeries, burns, and congenital anomalies.

Reconstruction can be performed in different body regions such as the face, hand, nose, ear, and breast. Surgical planning is based on the principle of replacing missing tissue while preserving aesthetic integrity. When necessary, vascular and nerve repairs can also be performed using microsurgical techniques.

Free tissue transfer is one of the fundamental methods of reconstructive surgery. Tissue taken from another area of the body is transplanted to the damaged site. This procedure is performed with micovascular connections that require advanced technology and helps achieve natural tissue compatibility.

Reconstructive surgery aims not only to restore appearance but also to regain functionality. These procedures, which improve the patient’s quality of life, are planned with a multidisciplinary approach. Postoperative follow-up and rehabilitation are also integral parts of the treatment.

What Is Reconstructive Surgery?

Reconstructive surgery is a surgical specialty aimed at repairing tissue loss and deformities caused by congenital anomalies, trauma, burns, infections, or after cancer surgery. The main goal is to restore function as well as achieve an aesthetically acceptable appearance. Skin grafts, flap surgery, and microsurgical techniques are among the most commonly used methods. It aims to support both physical recovery and a better quality of life.

How is the relationship between aesthetic surgery and reconstructive surgery?

When people hear “plastic surgery,” they often think only of cosmetic procedures such as rhinoplasty or facelifts. However, aesthetic surgery is only one branch of the plastic surgery tree, while reconstructive surgery forms the trunk and roots. In practice, it is neither possible nor correct to separate these two concepts sharply. A successful repair must also look good, and a cosmetic procedure should protect or improve function.

For a plastic surgeon, “form” and “function” are inseparable. Consider a patient with a severe facial injury: the priority is to protect vital function, but rebuilding a face the patient can recognize in the mirror and feel comfortable showing socially is also an essential part of treatment. For this reason, even when reconstructive surgery is medically necessary, aesthetic principles are carefully applied in every technique.

What strategic planning do surgeons use in tissue-loss reconstruction?

When tissue loss occurs, surgeons often rely on a traditional decision-making framework called the “reconstructive ladder.” In this model, options are organized from the simplest to the most complex. In the past, surgeons would start at the lowest rung and move upward if needed. Modern practice has evolved toward the “reconstructive elevator” approach: rather than trying the simplest option first, surgeons may go directly to the technique that provides the best functional and aesthetic outcome. If the best solution for a particular patient is an advanced microsurgical procedure, it may be chosen from the start without wasting time.

Key factors considered when defining the surgical strategy include:

• The patient’s overall health status
• The location of tissue loss
• The depth of the wound
• Smoking status
• Age
• History of previous surgeries

Each factor directly affects the answer to “Should we use a simple closure, or do we need tissue transfer?” The goal is to achieve maximum benefit with minimal harm.

What are skin grafts and how are they applied?

Skin grafts—often described as “patches”—involve taking a piece of skin from a healthy area of the body and transferring it to the damaged area without its own blood supply. This technique can be lifesaving in extensive burns or in degloving injuries where skin is completely lost. A critical feature of grafts is that survival depends on nourishment from the wound bed. In the first days, the transplanted skin absorbs plasma from the recipient site like a sponge to stay alive.

Stages of graft healing include:

• Plasmatic imbibition
• Connection of vascular networks
• New vessel formation
• Onset of lymphatic circulation

Immobility is essential for success. If the graft shifts or if blood collects underneath, nutrition is disrupted and the graft may fail. Surgeons choose different thicknesses depending on needs. Split-thickness grafts tend to take more easily but may contract after healing. Full-thickness grafts offer better quality, less contraction, and improved color match, but require an excellent wound bed to survive.

How does flap surgery differ from grafting?

Unlike grafts, flaps bring their own “supply kit” with them. When a tissue segment is transferred together with its blood vessels (and sometimes muscle, bone, or fat), this is called flap surgery. It is one of the most powerful tools in plastic surgery. In injuries where bone, tendon, or cartilage is exposed—structures with poor blood supply—skin grafts cannot survive because they cannot be nourished from below. In these cases, flaps that carry their own circulation become necessary.

Advantages of flap surgery include:

• Having its own blood supply
• Providing volume
• Higher resistance to infection
• Ability to cover exposed bone
• More aesthetically pleasing outcomes

In chronic, infected, non-healing wounds (such as diabetic foot ulcers or pressure sores), bringing a well-vascularized muscle flap can be like pumping fresh blood into the region. This can sometimes be even more effective than antibiotics in clearing infection.

How does a tissue expander (expander balloon) system work?

Tissue expansion is an intelligently designed technique that uses the body’s natural ability to adapt. Think of how abdominal skin gradually stretches during pregnancy as the baby grows. Tissue expanders work on the same principle. The surgeon places a deflated silicone balloon under healthy skin. After surgery, at regular intervals (often weekly), sterile saline is injected into the balloon through a port to slowly inflate it.

Common uses of tissue expansion include:

• Scalp defects
• Burn scar correction
• Breast reconstruction
• Removal of large moles

This controlled stretching signals skin cells to multiply, creating new skin. Once enough extra skin is produced, a second procedure removes the expander and uses the newly created skin to cover the defect. The greatest advantage is that the expanded tissue is the patient’s own skin, offering excellent match in color, texture, hair-bearing quality, and sensation.

Why are microsurgical techniques considered the peak of reconstruction?

Microsurgery involves repairing vessels and nerves—often only slightly thicker than a hair—by suturing them under high-magnification microscopes with specialized instruments. This technique has revolutionized plastic surgery. Limbs that once had to be amputated and massive wounds that could not be closed can now be repaired. With the “free flap” method, a complex tissue unit is harvested from areas such as the back, abdomen, or leg, completely detached along with its vessels, and then transferred to the area of need.

Microsurgery is used in:

• Replantation of amputated limbs
• Filling defects after cancer surgery
• Facial paralysis treatment
• Lymphedema surgery
• Jaw reconstruction

In experienced centers, success rates are high. However, these procedures require patience and precision. Even a small technical error while suturing vessels can stop blood flow and lead to loss of the transferred tissue. For this reason, microsurgery is widely regarded as the technological and technical summit of reconstructive surgery.

What are the breast reconstruction options?

Breast reconstruction after mastectomy is among the most important procedures for restoring both physical integrity and emotional recovery. Today, the goal is not merely to create a volume under clothing, but to achieve a natural-looking, soft breast that is symmetric with the other side and integrates with the patient’s body. Reconstruction can be performed immediately (at the same time as cancer surgery) or delayed until after treatments are complete.

Main breast reconstruction methods include:

• Silicone implants
• The patient’s own tissue (autologous reconstruction)
• Fat grafting
• Latissimus dorsi flap with implant combination

The choice is entirely individualized. Implant-based reconstruction is shorter and recovery is typically faster. Autologous reconstruction—especially using abdominal tissue—often provides a more natural result. These tissues age with the patient, respond to weight changes, and feel warmer and more natural. If postoperative radiotherapy is planned, the strategy may change and definitive reconstruction is often postponed until after radiotherapy.

How is 3D technology used in facial injuries?

The face is both the “showcase” of identity and the center of critical functions such as eating, speaking, breathing, and vision. Reconstructing bony defects (after cancer surgery or ballistic trauma) requires millimetric accuracy. In the past, surgeons relied on intraoperative estimation, but technological advances now allow digital preoperative planning.

Benefits of 3D technology include:

• Shorter operative time
• Improved symmetry
• More accurate bone cuts
• Better-fitting implants

For example, if half of the jawbone must be removed, the angles and placement of a fibula bone segment can be planned on a computer before surgery. Using CT data, patient-specific cutting guides are produced with 3D printers. This allows the surgeon to place the guide and perform precise cuts without losing time deciding intraoperatively. The technology has produced transformative results for preserving facial shape and chewing function.

Is burn treatment and scar correction possible?

Burn injury is a long-term condition: even after the initial trauma resolves, scars and contractures can continue to limit function and affect life quality. Burn care has two key phases: the acute phase and the late phase. In the acute phase, the priority is to save life and close open wounds as quickly as possible. In the late phase, the focus is improving scars and restoring movement limitations. Deep scars over joints can reduce skin elasticity and lead to stiffness or joint “freezing.”

Methods used to treat burn sequelae include:

• Z-plasty
• Tissue expanders
• Skin grafts
• Laser treatments
• Fat grafting

Surgeons can release tight scar tissue using Z-shaped incisions to lengthen the skin and improve joint mobility. For larger areas, a tissue expander can generate extra healthy skin, then the scarred area is removed and replaced. In recent years, fat grafting has become an effective tool to soften burn scars and improve color and texture.

When should cleft lip and palate surgeries be performed?

Cleft lip and palate are among the most common congenital anomalies and can significantly affect feeding, speech, and psychological development. Treatment is team-based and follows a structured timeline. Families often ask most about “timing.”

A commonly accepted schedule is:

• Cleft lip repair: around 3 months
• Cleft palate repair: between 9 and 12 months
• Speech therapy: around age 2
• Alveolar bone grafting: around age 9
• Rhinoplasty: after age 17

The goal of cleft lip repair is to restore lip muscle continuity for feeding and to create a natural “Cupid’s bow.” Palate repair should be completed before the child begins speaking, so the palate muscles can function properly for sound production. When performed at the right time with the right technique, children can grow up with speech and appearance comparable to their peers.

How is cartilage used in microtia (ear reconstruction)?

Microtia—congenital underdevelopment or absence of the external ear—is one of the most artistic applications of reconstructive surgery. In this procedure, the surgeon works like a sculptor, creating an ear framework from the patient’s own tissue. The best material is typically the child’s rib cartilage.

Key details of the microtia reconstruction process include:

• Usually performed between ages 7 and 9
• Chest wall development should be adequate
• Rib cartilage is harvested
• Cartilage is carved into an ear framework
• The framework is placed under the skin

The process is typically performed in two or three stages. In the first stage, the carved cartilage framework is placed beneath the skin in the ear area. In the second stage, the ear is elevated to create the natural angle between the ear and the head. With modern approaches such as the Nagata technique, highly natural-looking ears with realistic contours can be achieved.

Why does hand surgery require such a delicate approach?

The hand is both powerful and extremely delicate, enabling our interaction with the world. Its anatomy is dense and complex: tendons, nerves, vessels, and bones are tightly packed into a small space. For this reason, hand injuries often mean more than a superficial cut. Even a tiny cut can prevent finger flexion if a tendon is severed, or cause lifelong sensory loss if a nerve is injured.

Conditions commonly addressed in hand surgery include:

• Tendon lacerations
• Nerve entrapments
• Replantation of amputated fingers
• Hand fractures
• Congenital hand anomalies

In hand surgery, even the most perfect operation represents only half of success; the other half is postoperative rehabilitation. Early physiotherapy helps prevent adhesions and preserves range of motion. The surgeon’s job does not end in the operating room—it continues until the patient can use the hand effectively.

How have stem cells and fat grafting changed treatment?

In recent years, plastic surgery has been increasingly recognized not only as “cutting and stitching,” but also as a science of tissue regeneration. At the center of this shift is fat tissue. Once seen merely as a filler, fat has been found to be a rich source of stem cells—sometimes even richer than bone marrow. Fat harvested via liposuction is processed and purified, then injected into the area of concern.

Biological benefits of fat grafting include:

• Stimulating new blood vessel formation
• Improving tissue quality
• Accelerating wound healing
• Softening hardened tissues
• Revitalizing skin tone

Fat grafting can act as a “biological repair agent,” especially for radiotherapy-damaged, stiff tissues, chronic non-healing wounds, and depressed scars. Stem cells within the injected fat interact with surrounding tissues and support repair processes.