When a breast has been removed (mastectomy) because of cancer or other disease, it is possible in most cases to reconstruct a breast similar to a natural breast. A breast reconstruction can be performed as part of the breast removal operation or can be performed months or years later. There are two methods of breast reconstruction: one involves using an implant; the other uses tissue taken from another part of your body. There may be medical reasons why one of these methods is more suitable for you or, in other cases, you may be given a choice. Implants A silicone sack filled with either silicone gel or saline (salt water) is inserted underneath the chest muscle and skin. Before being inserted, the skin will sometimes need to be stretched to the required breast size. This is done by placing an empty bag where the implant will finally go, and gradually filling it with saline over weeks or months. The bag is then replaced by the implant in an operation that will probably take 2-3 hours under general anaesthesia (you will sleep through it). You will probably stay in hospital for 2-5 days. Flap Reconstruction A skin flap taken from another part of the body such as your back, stomach or buttocks, is used to reconstruct the breast. This is a more complicated operation than having an implant and may last up to 6 hours and require a 5- to 7-day stay in hospital.

Problems with the appearance or function of the hand can be the result of injury, birth defects or degenerative conditions. Transplantation Fingers or hands that have been accidentally cut off can be reattached by very detailed surgery that is performed under a microscope (microsurgery) and involves reconnecting tendons, blood vessels and nerves. Arthritis Arthritis is a condition in which a joint and the surrounding tissue become swollen and painful. If surgery is necessary, it may involve replacement of the joint with an artificial joint or removal or repair of swollen or damaged tissue. Birth Abnormalities Surgery may sometimes be required for hand abnormalities that are present at birth such as too many or too few fingers, webbed fingers or joints that won’t bend. Carpal Tunnel Syndrome A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake). Injuries Damage to tendons, nerves, joints and bones in the hand may require surgical repair. In some cases, tissue may be transferred from a healthy part of your body to the injured site (grafting).

Skin lesions can be divided into two groups: benign (non-cancerous): e.g. moles, cysts, warts, tags. These may be removed to prevent spreading (warts), stop discomfort if the lesion is being irritated by clothing/jewellery or to improve appearance. malignant (cancerous): basal cell and squamous cell carcinomas are generally slow growing and unlikely to spread to other parts of the body. Melanoma is a serious skin cancer that can spread to other parts of the body. Urgent removal is recommended. Surgery to remove skin lesions usually involves an office or outpatient visit, local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic) and stitches. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.

Surgery to reduce breast size involves making a cut (incision) around the areola (the dark area around the nipple) straight downwards and along the crease beneath the breast. Glandular tissue, fat and skin are removed and the breast reshaped. The surgery is performed under general anaesthesia (you will sleep through it) and will take 2-4 hours. You will probably stay in hospital 1-2 nights and will need to arrange for someone else to drive you home. You may need to take some medication for pain relief for several days and you must wear a special support bra continuously for 2 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take several months for the scars to fade.

This is an operation that can lift and reshape sagging breasts. The procedure usually involves removing skin from an area below the nipple and reshaping the breast. The surgery is performed under general anaesthesia (you will sleep through it) and will take about 2 hours. You will probably stay in hospital overnight and will need to arrange for someone else to drive you home the next day. Your breasts will be bruised and swollen for several days and you may need to take some medication for pain relief. You will need to wear a special support bra continuously for 3-4 weeks after surgery. You will probably be able to return to work after about 1 week. It will take several months for the scars to fade.

Scar appearance can be improved by various methods including a surgical procedure known as scar revision. This usually involves cutting out the old scar, closing the wound with stitches and, in some cases, moving the scar so that it is hidden by natural features of the body. Scar revision is usually performed under local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic). Sometimes you may also be given steroid injections at the time of surgery. Immediately following the procedure, you will need to remain at the clinic for about an hour, during which you will be encouraged to walk around. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.

If the scar to be revised or skin lesion being removed is particularly large, a skin graft may be performed. This involves transferring skin from another, healthy part of the body (donor site) to the injured site (recipient site). While skin grafting can improve the function of a damaged area, some scarring will be left at both the donor and recipient sites. Skin grafting is likely to be performed under general anaesthesia (you will be asleep during the procedure) in a hospital. The wound may take weeks or months to heal and you may need to wear a support bandage for a similar period.

The appearance of ears that are misshaped or protruding (‘bat ears’) can be improved surgically. This type of operation is often carried out in children. Cuts (incisions) are made behind the ears through which the cartilage in the ear can be reshaped or removed. The surgery lasts 1-2 hours and can be performed under local anaesthetic (the area treated is numb but you are awake), allowing you to go home the same day. For children, the procedure would be performed under general anaesthetic (they sleep through it) and they will remain in hospital overnight. You will need to wear head bandages for about 1 week and will probably be able to return to normal daily routines after that.

A naevus is a common skin growth composed of special pigment-producing cells. Naevi can vary in size, with small naevi requiring only simple surgery for removal, while the removal of larger naevi may require more than one operation and may involve skin grafts.

Also known as port wine stains or strawberry haemangiomas, these are non-cancerous, vascular skin lesions. These usually appear in the first month after birth and can grow very quickly for about 8 months. Haemangiomas generally start to fade and become smaller after 2-10 years of age but usually do not disappear completely. Treatment is not usually recommended unless the haemangioma is causing problems such as bleeding, feeding or breathing difficulties or impairing vision. Recommended treatments depend on the type and location of the haemangioma and include medication, laser treatment and surgery. If surgery is required, it usually does not require an overnight stay in hospital.

This procedure involves removing excess skin and fat from the stomach and tightening the muscles of the stomach wall. Cuts (incisions) are made across the lower stomach and around the tummy button and the muscles underneath are pulled together and stitched. The skin flap is stretched down and the excess skin removed. A new hole is made and the tummy button replaced. The surgery is performed under general anaesthesia (you will sleep through it) and will take 3-4 hours. You will probably have to stay in hospital for 2 days and will need to arrange for someone else to drive you home. Your stomach will be swollen and painful at first and you may need to take medication for pain relief for several days. You will possibly have to wear a special support garment for 2-3 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take 9-12 months for the scar to lighten.

This procedure removes unwanted pockets of fat from under your skin in specific parts of the body such as the chin, neck, upper arms, stomach, hips and thighs. Liposuction should not be regarded as a means of general weight loss, but instead as a way to improve the shape of particular areas of your body. A small cut (incision) is made, through which a narrow, hollow tube (cannula) is inserted. The tube is moved around to loosen the fat cells, which are then sucked out with a vacuum device. During the procedure you will lose a lot of fluid, so you will be given intravenous (injected straight into the vein) fluid to stop you becoming dehydrated. The procedure usually takes 1-3 hours and is carried out under local anaesthetic (the area being treated is numb but you are awake). You will probably be able to go home the same day but will need someone to drive you. However, if the procedure is more extensive and numerous areas are being treated at the same time, it may require general anaesthesia (you will sleep through it) and you may have to remain overnight in hospital. The area treated will be swollen and bruised after the surgery and you may need to take pain relief medication for several days. You will be given an elastic dressing or support garment that you may have to wear continuously for 2-3 weeks. You will probably be able to return to work after 1-2 weeks.