Our Summary

This research paper discusses the increased use of evidence-based medicine (EBM) in plastic surgery. EBM means using the best current evidence along with the doctor’s expertise and the patient’s preferences to make healthcare decisions. In the late 2000s, important articles were published that introduced EBM to plastic surgery and described different levels of evidence. The American Society of Plastic Surgeons sponsored a meeting where they agreed to include more EBM in their field. Over the last ten years, a journal called Plastic and Reconstructive Surgery has included more EBM through articles with high levels of evidence, new sections of the journal, and new tools to help authors conduct studies. The authors of the paper suggest that EBM fits well with the innovative and problem-solving nature of plastic surgery. They believe that EBM is becoming a bigger part of plastic surgery, but that effort is needed to keep this trend going. They predict that in the next decade, many articles in their journal will be based on high levels of evidence.

FAQs

  1. What is evidence-based medicine (EBM) in the context of plastic surgery?
  2. How has the American Society of Plastic Surgeons responded to the use of EBM in plastic surgery?
  3. What are the predictions for the future involvement of EBM in plastic and reconstructive surgery?

Doctor’s Tip

A doctor might tell a patient considering reconstructive surgery to carefully research and choose a board-certified plastic surgeon with experience in the specific procedure they are interested in. It is important for patients to have realistic expectations and to openly communicate their goals and concerns with their surgeon. Additionally, patients should follow their surgeon’s post-operative care instructions closely to ensure the best possible outcome.

Suitable For

Patients who are typically recommended reconstructive surgery include those who have experienced trauma, such as burns, accidents, or injuries, that have resulted in deformities or functional impairments. Other candidates for reconstructive surgery may include individuals with congenital anomalies, such as cleft lip and palate, or those who have undergone cancer treatment and require reconstruction of affected areas. Additionally, patients who have undergone significant weight loss and have excess skin that may be causing physical discomfort or psychological distress may also be recommended for reconstructive surgery. Ultimately, the decision to undergo reconstructive surgery is based on a combination of medical necessity, individual patient goals, and the expertise of the plastic surgeon.

Timeline

Before reconstructive surgery:

  1. Patient consults with a plastic surgeon to discuss their goals and concerns.
  2. Doctor evaluates the patient’s medical history, performs a physical examination, and discusses potential surgical options.
  3. Patient undergoes pre-operative testing and preparation, which may include imaging studies and blood work.
  4. Surgical plan is finalized, and informed consent is obtained from the patient.
  5. Surgery is performed, and the patient is closely monitored during the recovery period.

After reconstructive surgery:

  1. Patient experiences post-operative pain, swelling, and bruising, which is managed with medication and follow-up appointments.
  2. Patient follows post-operative care instructions, which may include wound care, physical therapy, and restrictions on activities.
  3. Patient attends follow-up appointments with the plastic surgeon to monitor healing and address any concerns.
  4. Patient gradually resumes normal activities and sees improvement in the appearance and function of the treated area.
  5. Patient may undergo additional procedures or treatments to optimize the results of the reconstructive surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the reconstructive surgery procedure?

  2. How many times have you performed this specific type of reconstructive surgery, and what is your success rate?

  3. What is the expected recovery time and post-operative care for this type of reconstructive surgery?

  4. Are there any alternative treatment options to consider before undergoing reconstructive surgery?

  5. Can you provide me with before and after photos of previous patients who have undergone similar reconstructive surgery procedures?

  6. What is the cost of the reconstructive surgery procedure, and will my insurance cover any part of it?

  7. What are the long-term results and potential outcomes of the reconstructive surgery procedure?

  8. Will I need additional follow-up appointments or treatments after the reconstructive surgery?

  9. How will the reconstructive surgery procedure impact my daily activities, such as work and exercise?

  10. What are your qualifications and experience in performing reconstructive surgery, and are you board-certified in plastic surgery?

Reference

Authors: Rohrich RJ, Cohen JM, Savetsky IL, Avashia YJ, Chung KC. Journal: Plast Reconstr Surg. 2021 Oct 1;148(4):645e-649e. doi: 10.1097/PRS.0000000000008368. PMID: 34495896