Reconstructive Surgery/Microsurgery

At The Mount Sinai Hospital, our plastic and reconstructive surgeons have extensive expertise in reconstructive surgery, which restores function and corrects defects caused by accidents, illness, and even congenital deformities present from birth, as well as following cancer surgery. Some of the procedures our specialists perform include

  • Abdominal Wall Reconstruction: Abdominal Wall Reconstruction restores the strength and integrity of the abdomen for patients who suffer from conditions such as cancer, complex hernias, wound healing issues, and congenital abnormalities.

  • Breast Reconstruction: Our plastic surgeons work closely with breast surgeons, oncologists, pathologists, and radiologists to create a seamless, multidisciplinary experience for the breast cancer patient. We provide a warm, supportive environment for the breast cancer patient and offer access to state-of-the-art care. Research has shown that while breast reconstruction does not interfere with treatment or change cancer survival rates, it plays an important role in the emotional recovery process.

  • Body Contouring after Weight loss Surgery: Often times after weight loss surgery, patients experience a rapid decrease in Body Mass Index (BMI). Body Contouring after weight loss surgery helps to improve the overall shape and function of underlying tissue, by removing of excess skin and fat.

  • Chest Wall Reconstruction: Our Plastic and Reconstructive surgeons can reconstruct the chest wall for patients who have conditions such as congenital deformities, cancer, or problems with non-healing wounds. There are a number of techniques that involve the movement of healthy tissue and skin to rebuild the chest wall. Microsurgery is also used to connect veins to the area and maintain to blood flow.

  • Extremity Reconstruction: The plastic and reconstructive surgeons at Mount Sinai have vast experience in upper and lower extremity reconstruction. In the case of birth defects, cancer, trauma or burns that may cause deformity, our expert surgeons use are able to restore the appearance of extremities, as close to their natural form as possible.

  • Flap Reconstruction: Our surgeons can reconstruct breasts after mastectomy with tissue taken from another part of the body (autologous tissue) or with implants. The various techniques each have their advantages and disadvantages. Together, surgeons and patients choose a method that balances patient preference, body type, cancer type, and need for post-operative radiation and chemotherapy.

  • Free TRAM (Transverse Rectus Abdominis Muscle) Flap: A refinement of the older pedicled TRAM flap, this microsurgical technique completely detaches and reattaches the flap tissue with the aid of a microscope, allowing “free” transfer of lower abdominal skin, fatty tissue, and muscle. This technique minimizes problems at the abdominal donor site while maximizing the amount of tissue available for reconstruction. Microsurgical breast reconstruction has largely replaced the pedicled TRAM as the procedure of choice at The Mount Sinai Hospital.

  • General Reconstruction: We perform many techniques to reconstruct areas of the face, body and extremities. Reconstructive surgery corrects a wide range of defects resulting from several causes, including accidents, burns, tumors (and their removal), infections and diseases, as well as congenital (birth) deformities. Using a multidisciplinary approach, we collaborate with dermatologists and surgical oncologists in the reconstruction of cancer surgery defects. These reconstructive procedures include complex wound closures, skin grafts, the use of local tissue (flaps), and even the use of transferred tissue from other parts of the body using microsurgical techniques (often referred to as a “free flap”). Tissue expansion, as described for breast reconstruction, is also useful for creating new tissue for certain reconstructive procedures in many areas of the body.

  • Head and Neck Reconstruction: Head and neck reconstruction usually occurs following head and neck cancer surgery. Our Plastic and reconstructive surgeons work closely with your surgical oncologist and other providers involved with your care, to reconstruct and restore function to the head, neck and face.

  • Perforator TRAM Flap/DIEP (Deep Inferior Epigastric Perforator) Flap: The latest refinement in breast reconstruction, this microsugical technique transfers abdominal skin and fatty tissue to the breast without sacrificing any of the abdominal six-pack muscles. This technique requires meticulous dissection of the perforating blood vessels within the abdominal muscles. Reconstruction with perforator flaps requires a plastic surgeon who is also experienced in microvascular surgery.

  • Latissimus Dorsi (LD) Myocutaneous Flap: This previously popular technique transfers tissue from the back, using latissimus dorsi muscle as the blood supply. The procedure often requires the addition of an implant, making it a secondary choice to TRAM flaps as a reconstructive option.

  • SGAP (Superior Gluteal Artery Perforator) Flap: This technique transfers the skin and fatty tissue taken from the upper gluteal area to rebuild the breast. The scar ends along the panty line.

  • IGAP (In-the-Crease Gluteal Artery Perforator) Flap: This procedure takes skin and fatty tissue from the lower buttock to rebuild the breast. The buttock crease helps hide the resulting scar.

  • Skin Expansion: Mastectomy also removes skin and may leave no room for immediate implant placement. To create space, the surgeon inserts a balloon-like tissue expander beneath the skin and chest muscle. He or she gradually fills the expander by injecting it with saline, a salt-water solution, over several weeks. Once the skin has stretched enough, the surgeon removes the tissue expander and replaces it with a permanent breast implant, filled with either saline or silicone gel. Reconstruction of the nipple and areola, the darker skin surrounding the nipple, takes place in a separate operation. The actual procedure varies according to the individual patient. Some women do not require tissue expansion and receive a permanent breast implant as a one-stage reconstruction after mastectomy. Most women, however, are candidates for two-stage reconstruction.

  • Microsurgery: We have several microsurgeons on the faculty in the Division of Plastic and Reconstructive Surgery and perform many microsurgical procedures per year. Microsurgery is used in breast reconstruction, hand surgery, cancer reconstruction, facial reanimation after facial paralysis, and trauma of the lower extremities. Our Intensive Care Unit staff is highly experienced in caring for microsurgical free flap patients in the post-operative period.

Contact Us

Tel: 212-241-4410
Fax: 212-241-5999

5 East 98th Street
14th Floor
New York, NY 10029

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