Reconstructive Surgery

Reconstructive Surgery

Dr. Damian Marucci is a leading plastic surgeon who specialises in reconstructive surgery for patients in Kogarah and throughout Sydney. With years of experience and outstanding talent, Dr. Marucci has helped numerous patients achieve their physical goals, enhancing their confidence and overall outlook on life following cancer or trauma. To learn more about the array of reconstructive surgery options available, contact our Kogarah clinic today.

 

 

Reconstructive Surgery Procedures

Dr. Marucci aims to provide outstanding results for patients who want to restore their appearance. He specialises in a variety of reconstructive surgery procedures, including:

Breast Reconstruction

Breast cancer is common, affecting more than one in ten women. The treatment of breast cancer often involves surgery, radiotherapy, and chemotherapy. Although the surgical treatment of breast cancer is effective at controlling the disease, mastectomy can leave patients with a decrease in self-esteem and sometimes a decreased sense of femininity.

Dr. Marucci has a particular interest in breast reconstruction for women who have survived cancer. It is one of the most important parts of his practice. There are many techniques for breast reconstruction. Reconstruction may involve breast implants, the patient’s own tissue, or a combination of the two.

Breast implants alone are an option for women who have not had previous radiotherapy and who do not want scars elsewhere on their body. This type of reconstruction generally involves minimal downtime and results in a permanently youthful (“perky”) breast.

If a patient has had previous radiotherapy and still desires the advantages of a breast implant reconstruction, a muscle from the back can be used to cover the breast implant. This leaves a scar on the back, but it decreases the chance of the implant becoming exposed or infected.

Finally, if a patient has enough loose tissue on their tummy or on their back, it is often possible to reconstruct a breast using only the patient’s own tissue – without the potential disadvantages of a breast implant. Dr. Marucci is an expert at reconstructive microsurgery using the tissues of the tummy in order to reconstruct a breast that feels natural, behaves naturally, and loses and gains weight with the patient. This is called a “free flap” – and the patient gets a “tummy tuck” at the same time. This type of reconstructive microsurgery involves using the tissue which would otherwise be thrown away as part of a “tummy tuck” to recreate a breast. The blood vessels supplying the skin and fat of the tummy are joined under the microscope with blood vessels in the chest so this “flap” of tissue survives in its new location.

As you can see, there are many different types of breast reconstruction. Dr. Marucci is proficient with all techniques and will decide WITH you (and not FOR you) what the reconstructive plan will be.

Types of Skin Cancer

Due to our sunny climate, Australia has the highest rate of skin cancer in the world. Some skin cancers are more serious than others, and require specialised multi-disciplinary treatment. Dr. Marucci is part of a team – including dermatologists, GPs, radiation oncologists, and oncologists – who deal with these often complex cancers on a daily basis, serving Sydney’s south and the Sutherland Shire.

Basal Cell Carcinoma (BCC) is the most common type of skin cancer. There are many sub-types of BCC. BCCs tend to grow in the one area and only very rarely travel to other parts of the body. Some BCCs can be treated with topical therapies, such as creams or phototherapy (like a laser). Others require surgery. Sometimes radiotherapy is required to decrease the chance of a skin cancer returning.

Squamous Cell Carcinomas (SCC) are the next most common form of skin cancer. Treatment of SCC almost always involves some form of surgery. There is a small risk of SCCs travelling to the glands or other parts of the body.

Melanoma is a very serious form of skin cancer. The treatment is surgical excision, although other forms of treatment may be required. Often tests need to be performed to make sure that the melanoma hasn’t travelled to the glands or other parts of the body.

Reconstructive Surgery after Skin Cancer

Just because you have a skin cancer, doesn’t mean you will end up with horrible scars. Dr. Marucci is an accomplished plastic surgeon who offers the full range of surgical reconstructive options in order to give you the best possible cosmetic result.

Most cancers are small enough that they can be removed and the wound stitched back together. This is called “primary closure” and can usually be done under local anesthetic as day surgery.

If the cancer is too large, tissue may need to be moved around in order to reconstruct the area from where the cancer was. Dr. Marucci is an expert at performing these “local flaps”, which aim to restore the form and function of the operated area. If the cancers defect is too large for a local flap, Dr. Marucci can perform a skin graft (where a thin layer of skin is taken from one part of the body and transferred to the wound).

Rarely, even more complex forms of reconstruction are required – such as a “free flap” – where tissue from one part of the body is removed with its blood supply and then “plugged in” to a new blood supply near the cancer defect. This is called “reconstructive microsurgery”. Dr. Marucci applies his skill as a reconstructive microsurgeon to many types of defects – not just skin cancers, but also breast reconstruction, head and neck reconstruction, and lower limb reconstruction.

Head and Neck Reconstructive Surgery

Head and neck cancer is common in Australia. Treatment almost always involves a number of different specialists – head and neck surgeons, plastic surgeons, oncologists, radiation oncologists, speech and language therapists, dentists, and dieticians. Dr. Marucci is a member of the multi-disciplinary head and neck services at St. George Hospital – serving Sydney’s south and the Sutherland Shire – and at St. Vincent’s Hospital.

The surgical removal of head and neck cancers can lead to problems with swallowing, speech, and can affect a patient’s appearance and self image. Dr. Marucci provides these patients with a range of reconstructive options, in order to give a result which is both functional and aesthetically pleasing.

Often, head and neck reconstruction involves the use of microsurgery to move tissues from one part of the body to another. A segment of tissue (skin, fat, muscle, or bone – whatever is required) is moved with its artery and vein into the head and neck region. This segment of tissue is called a “flap”. The flap artery and flap vein are then joined to an artery and vein in the neck, so the flap now has its own blood supply in a new location.

Dr. Marucci is an accomplished reconstructive microsurgeon. He has honed his technique over many years – during his training here in Sydney, his fellowship in Oxford and during his time as a consultant plastic surgeon at St. George and St. Vincent’s Hospitals. Dr. Marucci is often consulted on the most difficult reconstructive cases and brings to each one his breadth of knowledge, training, care, and compassion to ensure that all of his patients receive the highest standard of care with the lowest risk of complications.

Learn More about Reconstructive Surgery

If you are considering reconstructive surgery, it is important that you choose the right plastic surgeon for the job. To learn more about how Dr. Marucci can help you, or to learn more about reconstructive surgery in general, contact our Kogarah clinic today.