Plastic, reconstructive and cosmetic surgery

Plastic and reconstructive surgery

Reconstructive surgery is a branch of surgery that aims at the so-called "restitutio ad integrum" of multiple parts of the body, that is, restoring the structure and function of tissues and organs after they have been altered by malformation, disease or accident.
Thanks to constant updating of techniques and instruments, there is a diverse range of reconstructive options belonging to both conventional surgery and microsurgery.
Reconstructive plastic surgery is also concerned with correcting physical abnormalities that may cause discomfort or embarrassment, so as to improve the patient's quality of life. It is for these very reasons that there is usually a cost-coverage by health insurance companies.

Cosmetic surgery

The goal of cosmetic surgery is to correct imperfections due to disorders or changes within the physiological aging process, always considering the individuality of each patient.
Through treatments aimed at correcting alterations in the face or body, cosmetic surgery aims to achieve greater acceptance, awareness and personal well-being.

Plastic and reconstructive surgery treatments

• Breast reshaping with oncoplastic technique: using a wide range of breast plastic surgery techniques, the breast tissue remaining after tumor removal is reshaped to give the breast a harmonious new shape.
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• Breast reconstruction with prosthetic means: complete breast reconstruction after demolitive oncologic surgery. Reconstruction with prosthetic means can be performed in one stage (direct reconstruction with definitive breast implant) or in two stages (reconstruction with temporary expander that is then replaced after a few months with definitive breast implant).
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• Hybrid/composite breast reconstruction: a surgical technique of "reverse expansion," which initially involves the use of a tissue expander. Once the desired expansion is reached, the expander is partially emptied and the missing tissue volume is filled with autologous fat taken from the abdomen or thighs (autologous fat transplantation, "lipofilling").
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• Microsurgical breast reconstruction: complete breast reconstruction after demolitive oncologic surgery using excess tissue (flap) from one's own body (autologous). The harvested tissue is transposed to the breast site and connected to the thoracic vessels with microsurgical technique by suturing arterial and venous vessels (anastomoses).
• Reconstruction of the nipple and areola: complete reconstruction of the nipple after oncological operations that have forced its removal or after removal/necrosis of the nipple in cases of complex breast reduction. It can be associated with autologous breast fat transplantation ("lipofilling" or "autologous fat grafting").
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• Correction of congenital malformations and breast asymmetries: correction of alterations in breast shape or volume present since birth (e.g., tuberous breast) or caused by trauma/surgery. This type of surgery may also involve the use of breast implants.
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• Reduction mammaplasty: reduction of breast volume by removal of both skin and breast tissue.
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• Dermopigmentation of the areola and nipple of the breast: commonly called "tattooing," through the deposition of colored pigments (which are individually adapted from patient to patient), dermopigmentation allows the shape and color of the natural breast areola to be recreated after it has been removed or altered by previous surgery.
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• Reconstructive skin tumor surgery: integumentary reconstruction of multiple body parts after excision of skin tumors (e.g., lipoma, basal cell carcinoma, spinocellular carcinoma, melanoma).
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• Postbariatric surgery (after massive weight loss "massive weight loss") or abdominoplasty: reduction of excess skin and fat in the abdomen with repositioning of the umbilicus.
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• Lipedema therapy: diffuse or localized reduction of one or more fatty deposits that may be located in various parts of the body.
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• Treatment for lymphedema: lymphedema is represented by an accumulation of lymphatic fluid in the soft tissues. The basic therapy is compression therapy using adherent sheaths and frequent manipulation for lymphatic drainage. more information
  In selected cases, surgical treatment can improve lymphedema; the following can be used:
  • Pure liposuction treatment.
  • Microsurgical techniques: microsurgical restoration of lymphatic pathways to other lymphatic vessels or veins or lymph node transfer.
• Orthoplastic surgery: associating with the expertise of orthopedics and traumatology is a fundamental approach in cases of complex trauma, orthopedic oncology, treatment of soft tissue and/or bone infections (chronic osteomyelitis) and allows to achieve both anatomical and functional reconstruction.
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Cosmetic surgery treatments

• Breast augmentation: volumetric breast augmentation with silicone implants that are inserted inside the breast through a skin incision. It can be combined with the technique of autologous fat transplantation ("composite breast augmentation") with fat suctioned from one's own body.
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• Reduction mammaplasty: reduction of breast volume by removal of both skin and breast tissue.
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• Mastopexy: reshaping of the breast by removal of part of its outer skin envelope but without removal of breast tissue, with an overall "lifting" effect.
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• Gynecomastia and Pseudogynecomastia: removal of glandular and/or fatty tissue at the level of the breast region in a male patient.
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• Mammary areola dermopigmentation: commonly referred to as "tattooing," through the deposition of colored pigments (which are individually adapted from patient to patient), dermopigmentation allows the shape and color of the natural mammary areola to be recreated after it has been removed or altered by surgery.
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• Skin firming and re-tensioning: removal of excess skin and adipose tissue exuded after major weight loss (by diet or bariatric surgery) in different areas of the body (arms, chest, abdomen, legs, lumbar region).
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• Firming of arms and thighs: removal of excess skin and fatty tissue from arms (brachioplasty) and legs (cruroplasty) hesitated after major weight loss. Treatment can be performed in the same operating session; abdominoplasty and liposuction can then be added.
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• Liposuction: diffuse or localized reduction of one or more fatty deposits that may be located in various parts of the body.
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• Autologous fat transplantation or "lipofilling" (e.g., of the breast and face): harvesting of adipose tissue (subcutaneous fat) from predefined areas of the body (outer/inside thighs, hips, abdomen) by liposuction for the purpose of filling and corrections of retracted scars or volume-deficient areas of the body and face.
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• Prominent ("floppy") ear correction: correction of ear position by removal of retroauricular skin and cartilage remodeling.
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• Face Lift / Temporal Lift / Neck Lift: skin retensioning of areas with facial laxity to rejuvenate the shape of the face. Can be combined with a blepharoplasty and/or forehead or neck retensioning.
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• Rhinoplasty/Rhinoseptoplasty: correction of the external and/or internal structure of the nose by reshaping the cartilages and nasal bones.
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• Lower and/or upper blepharoplasty: removal of excess skin on the upper or lower eyelid that can be combined with removal of eyelid fat bags with the aim of lightening the eyes.
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• Female genital surgery: excision of excess skin and reshaping of the labia majora or labia minora.
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Plastic, reconstructive and aesthetic surgery in the EOC focuses its clinical research interest on several aspects that evaluate the efficacy and outcome of various reconstructive procedures after partial or total breast demolition surgery for breast cancer. Of particular importance in this area is the collaboration with the Centro di Senologia della Svizzera Italiana EOC, the University Hospital of Basel, as well as with colleagues at "Klinik Rechts der Isaar" in Munich. In addition, a new tissue expansion device for the breast is being evaluated, both from a clinical and technical point of view and from a radiological point of view, thanks to work with colleagues in the radiology service of Centro di Senologia della Svizzera Italiana EOC.

As for experimental research, there is currently active collaboration with several institutions in terms of "expertise" and/or sharing of personnel (students or residents). The main topics are tissueengineering ("tissue engineering"), the use of induced pluripotent stem cells (in collaboration with the University Zurich), research on adipose tissue and the stem cells it contains (with the Universität des Saarlandes, Homburg), and projects geared towardcomposite tissue allografts, such as face and hand transplantation.

There also remains an ongoing commitment to the training of young physicians and residents in plastic, reconstructive and aesthetic surgery, regularly offering master's or doctoral work with the option of participating in an MD-PhD program in collaboration with other universities and thus enabling an academic career.