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Reconstructive Surgery

Reconstructive surgery can change lives by restoring your appearance, functionality, and mobility. For some, reconstructive surgery can give you back a part of your life or provide something you never thought you would have.

Why choose Johns Hopkins for Reconstructive Surgery?

When you come to Johns Hopkins for reconstructive surgery, you are getting a quality of medical care that is hard to match. Rigorous medical training and a depth and breadth of knowledge, experience, and innovation mark our facility as one of the best in the world. Our surgeons are devoted to their profession and to providing attentive patient care. From the first consultation to the final check-up, our reconstructive surgeons make themselves available and accessible to patients and their families.

 

Surgery for Bedsores (Pressure Sores)

  • Bedsores, sometimes called pressure sores or decubitus ulcers, can develop in people who have been confined to bed for long periods of time, are unable to move for short periods of time, or who use a wheelchair or sit in one spot for long periods of time. Other complications, such as aging, circulation and decreased sensation, can increase the likelihood that a person will develop pressure sores. Hospital patients and nursing home residents, as well as those who are being cared for at home and who are confined to bed are most at risk to develop pressure sores.

  • Julie Ann CaffreyJulie Ann Caffrey, D.O., M.S.
    Burn Fellowship Program Director
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Surgery

    Rick RedettRichard James Redett, III, M.D.
    Director, Plastic and Reconstructive Surgery
    Director, Cleft Lip and Palate Center
    Director, Genitourinary Transplant Program
    Professor of Plastic and Reconstructive Surgery
    Professor of Pediatrics

    Robin YangRobin Yang, D.D.S., M.D.
    Director of Pediatric Plastic Surgery
    Division Chief of Oral and Maxillofacial Surgery and Dentistry
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Otolaryngology - Head and Neck Surgery

 

Facial Pain and Facial Paralysis

  • If you suffer from facial paralysis or chronic facial pain, there are several options to consider when searching for treatment including surgery, pain management, and rehabilitation therapies. Our patients are all ages and experience facial pain or paralysis due to trauma, illness, surgery, strokes or congenital conditions. We also treat chronic facial pain patients and are on the forefront of new methods in treating these devastating conditions.

  • We provide a comprehensive approach to treating patients with facial paralysis and/or chronic facial pain that can include pain management, rehabilitation therapies, or surgery to help relieve symptoms. Our experts consult with each other often, are leaders in their field and conduct research in the treatment of chronic facial pain. Over years of practice, they have built a reputation as being among the best facial reconstruction surgeons in the country. 

    Conditions We Treat

    • Facial paralysis, an inability to move the muscles of the face on one or both sides.
    • Trigeminal neuroma, rare tumors that may involve any part of the nerves of the face.
    • Moebius syndrome, a rare congenital (present at birth) condition that results from underdevelopment of the facial nerves that control some of the eye movements and facial expressions.
  • Dr. LifchezScott David Lifchez, M.D.
    Director, Plastic Surgery and Hand Surgery Service, Johns Hopkins Bayview Medical Center
    Chief, Plastic Surgery at Johns Hopkins Bayview Medical Center
    Program Director, Johns Hopkins/University of Maryland Plastic Surgery Residency
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Orthopaedic Surgery

    Dr. RedettRichard James Redett, III, M.D.
    Director, Plastic and Reconstructive Surgery
    Director, Cleft Lip and Palate Center
    Director, Genitourinary Transplant Program
    Professor of Plastic and Reconstructive Surgery
    Professor of Pediatrics

    Dr. RossonGedge David Rosson, M.D.
    Co-Director, Johns Hopkins Facial Palsy Center
    Director of Breast Reconstruction
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Oncology

    Dr. TuffahaSami Hani Tuffaha, M.D.
    Assistant Professor of Plastic and Reconstructive Surgery

     

    Dr. YangRobin Yang, D.D.S., M.D.
    Director of Pediatric Plastic Surgery
    Division Chief of Oral and Maxillofacial Surgery and Dentistry
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Otolaryngology - Head and Neck Surgery

    Nurse

    Kim Siefert, R.N.

 

Hand Injuries and Conditions

  • Hand injuries and conditions—from carpal tunnel syndrome to rheumatoid arthritis—can be mildly irritating or severely debilitating. Whether mild or severe, they often inhibit a person’s ability to live his or her life fully. In some cases, a person may not be able to work or enjoy recreational and daily activities.

    At Johns Hopkins our reconstructive hand surgeons can restore hands so that patients can return to the lives they enjoyed before an injury or disease disabled them.

    • When a hand injury or condition becomes severe, surgery can restore function and alleviate pain.
    • Hand surgery can include operating on the hand, as well as the lower arm up to the elbow.
    • Hand conditions that may require surgery include: abnormally shaped fingers or hands, amputations, ganglion cysts, DeQuervain’s diseasedupuytren’s contracture, flexor tendon injuries, fractures, lacerations, mallet finger, missing fingers, nailbed injuries, polydactyly (extra fingers), reflex sympathetic dystrophysyndactyly (webbed fingers), tendonitis, trigger finger, ulnar nerve compression and vascular disorders.
    • Joint reconstruction surgery replaces the arthritic surface with soft tissue, like a tendon, or a joint replacement implant. This surgery can relieve the pain of arthritis while preserving mobility of the joint. 

    Fellowship training in hand surgery, after specializing in surgery and completing residencies in plastic and reconstructive surgery, allows us to perform any kind of surgery needed to correct injuries and conditions in the hand and lower arm.

    The Center for Upper Extremity Restoration

    At Johns Hopkins, we treat hand and arm injuries and defects with the newest and most innovative technologies and procedures. The Center for Upper Extremity Restoration (CUER) offers comprehensive care with a multidiscplinary medical team including in plastic and reconstructive surgeons, trauma and critical care surgeons, orthepedicorthopaedic surgeons, physical medicine and rehabilitation specialists, as well as engineers and dedicated researchers.

  • Dr. CooneyDamon Sean Cooney, M.D., Ph.D.
    Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
    Assistant Professor of Plastic and Reconstructive Surgery

    Dr. LifchezScott David Lifchez, M.D.
    Director, Plastic Surgery and Hand Surgery Service, Johns Hopkins Bayview Medical Center
    Chief, Plastic Surgery at Johns Hopkins Bayview Medical Center
    Program Director, Johns Hopkins/University of Maryland Plastic Surgery Residency
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Orthopaedic Surgery

    Dr. MundyLily Mundy, M.D.

     

    Dr. ShoresJaimie Troyal Shores, M.D.

     

    Dr. TuffahaSami Hani Tuffaha, M.D.

     

    Hand Transplant and Arm Transplant Team

    Dr. BrandacherGerald Brandacher, M.D.

     

    Dr. CooneyDamon Sean Cooney, M.D., Ph.D.
    Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
    Assistant Professor of Plastic and Reconstructive Surgery

    Dr. ShoresJaimie Troyal Shores, M.D.

     

    Dr. TuffahaSami Hani Tuffaha, M.D.

     

    Physician Assistants

    Samantha MoranSamantha Moran, PA-C

     

    Raven Morris, PA-C

    Fellow

    Dr. JacobDeAsia Jacob, M.D.

     

    Hand Transplant and Arm Transplant Nurse

    Jane Littleton, R.N.

 

Head and Neck Tumors and Cancer

  • Once patients have undergone cancer treatment or removal, or had benign tumors removed from their face, head or neck, they are eager to return to their ordinary lives. Part of that return may involve undergoing reconstructive surgery at the site where cancerous tumors were removed. 

  • The reconstructive surgeons at Johns Hopkins can offer surgery to reconstruct facial features and restore skin on the neck and head. Employing a variety of materials, including skin and bone grafts and synthetic materials, they can restore appearance and functionality to affected areas.

  • Dr. CooneyDamon Sean Cooney, M.D., Ph.D.
    Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
    Assistant Professor of Plastic and Reconstructive Surgery

    Dr. GordonChad Ronald Gordon, D.O.
    Director, Neuroplastic and Reconstructive Surgery
    Co-Director, Multidisciplinary Adult Cranioplasty Center (MACC)
    Fellowship Director, Neuroplastic and Reconstructive Surgery, (Plastic Surgery)
    Professor of Plastic and Reconstructive Surgery
    Professor of Neurosurgery

    Dr. LifchezScott David Lifchez, M.D.
    Director, Plastic Surgery and Hand Surgery Service, Johns Hopkins Bayview Medical Center
    Chief, Plastic Surgery at Johns Hopkins Bayview Medical Center
    Program Director, Johns Hopkins/University of Maryland Plastic Surgery Residency
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Orthopaedic Surgery

    Dr. ManahanMichele Ann Manahan, M.D.
    Department Vice Chair for Faculty and Staff Development and Well-Being and Past Department Director of Patient Safety
    Professor of Plastic and Reconstructive Surgery

    Dr. YangRobin Yang, D.D.S., M.D.
    Director of Pediatric Plastic Surgery
    Division Chief of Oral and Maxillofacial Surgery and Dentistry
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Otolaryngology - Head and Neck Surgery

 

Jaw Surgery

  • Problems with the jaw can result in difficulty speaking, eating, swallowing, breathing and sleeping. Some children or adults may have a facial disfigurement, such as a severely receding chin or protruding jaw or an unbalanced appearance from the front or side. In some cases, jaw problems can be the source of other health problems, such as debilitating headaches or sleep apnea. A severe overbite or underbite may make it impossible to close the teeth or lips together.

  • At Johns Hopkins, several of our reconstructive surgeons, pediatric surgeons among them, specialize in facial reconstruction, including jaw surgery. Over years of practice, they have built a reputation as being among the best facial reconstruction surgeons in the country. 

    Jaw Surgery Treatment Options

    A reconstructive surgeon can correct jaw conditions and injuries through corrective surgical techniques including:

    • Osteotomy: a procedure involving cutting the jawbone and repositioning it using titanium screws and plates. This eliminates the need for wiring the teeth together.

    • Distraction osteogenesis: a procedure where the surgeon splits the jawbone and slowly moves it by inserting a screw either inside the mouth or outside, and turning it periodically over a few weeks. The advantage of the distraction technique is that it simultaneously increases bone length and the volume of the soft tissue around the bones.
    • Bone grafts: your surgeon may extract bone from your ribs, hips or skull , to create a new jawbone structure. A new jawbone can also be crafted using an alloplastic graft, a bone substitute created from synthetic materials. Reconstructive jaw surgery is major surgery that will require general anesthesia and a hospital stay of a few days as well as recovery time at home afterward.

    Corrective jaw surgery may be required for children for a number of conditions. For infants with Pierre Robin Sequence, a type of jaw surgery known as mandibular distraction may be required to alleviate airway obstruction and prevent the need for a tracheostomy. For children with cleft lip and palate, corrective (orthognathic) jaw surgery may be needed to correct an underbite that develops as a result of reduced growth of the upper jaw.

    In adult patients with overbite, underbite or crossbite, orthognathic surgery may be required when the teeth cannot be realigned with orthodontic care alone. Finally, jaw surgery for some adults may be required for severe obstructive sleep apnea.

  • Dr. GordonChad Ronald Gordon, D.O.
    Director, Neuroplastic and Reconstructive Surgery
    Co-Director, Multidisciplinary Adult Cranioplasty Center (MACC)
    Fellowship Director, Neuroplastic and Reconstructive Surgery, (Plastic Surgery)
    Professor of Plastic and Reconstructive Surgery
    Professor of Neurosurgery

    Dr. RedettRichard James Redett, III, M.D.
    Director, Plastic and Reconstructive Surgery
    Director, Cleft Lip and Palate Center
    Director, Genitourinary Transplant Program
    Professor of Plastic and Reconstructive Surgery
    Professor of Pediatrics

    Dr. YangRobin Yang, D.D.S., M.D.
    Director of Pediatric Plastic Surgery
    Division Chief of Oral and Maxillofacial Surgery and Dentistry
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Otolaryngology - Head and Neck Surgery

  • Learn more about the Cleft and Craniofacial Center

    Jaw Surgery and Obstructive Sleep Apnea | Facebook Live
    New approaches in maxillomandibular advancement surgery (or jaw surgery) can help treat obstructive sleep apnea in adults and children. Robin Yang, a dual-trained plastic and reconstructive surgeon and oral and maxillofacial surgeon, discusses these jaw surgery advancements.

Nerve Injuries and Conditions

  • Whether due to injury or birth defect, nerve injuries cause debilitating physical and psychological effects that can keep adults and children from making the most of their lives, working, playing, going to school, and enjoying time with family and friends.

    Our experts in peripheral nerve disorders are devoted to providing quality and attentive patient care, helping address both physical and emotional patient and family needs.

  • Johns Hopkins reconstructive surgeons have expertise in treating even the most complex brachial plexus injuries. The brachial plexus is a network of nerves that sends signals from the spinal cord to the shoulder, arm and hand. When those nerves are damaged, it is considered a brachial plexus injury, and it can cause pain or numbness, an inability to move your arm or hand, or a feeling of limpness. Injury can occur during birth, especially if it’s a difficult birth, from tumors putting pressure on nerves, trauma (such as an accident) or inflammation. At Johns Hopkins, we offer well-rounded multispecialty care to help you regain as much function as possible after a brachial plexus injury.

  • Peripheral nerves are those located outside of your brain and spinal cord. When these nerves are injured, the injury can interrupt the signals between the brain, spinal cord and the part of the body supported by the injured nerves.

    Treatment of peripheral nerve injuries requires a comprehensive approach that often involves specialists in several fields, including reconstructive surgery, neurosurgery and orthopaedics. The decision to repair peripheral nerve damage through surgery can be complex. It factors in the type of problem, severity of the pain and other symptoms, and how well other treatments have worked. Our team of experts will evaluate your injury and recommend treatment approaches that align with your health goals and lifestyle and offer the best outcomes.

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Occipital Release Surgery

  • Occipital neuralgia is most commonly caused by pinched, inflamed or injured occipital nerves, which run from the base of your neck to your scalp. Irritation of one of these nerves anywhere along its course can cause a shooting, zapping, electric or tingling pain. Sometimes people confuse their symptoms of occipital neuralgia with a migraine or tension headache. Because treatments for occipital neuralgia are different than those for headaches, it is important to visit your doctor for a diagnosis.
    • Diagnosis may be made by a physical examination to find tenderness in response to pressure along your occipital nerve. There is not one test to diagnose occipital neuralgia.
    • Imaging tests such as an MRI or computed tomography (CT) scan may be ordered by your doctor to search for the underlying cause of occipital neuralgia.

    A first of its kind clinical trial at Johns Hopkins aims to define best practices in occipital release surgery. Speak to your doctor to learn more or to participate.

    Our Specialty Center

    The Johns Hopkins Headache Center is committed to headache research and providing individualized care to select patients with headaches or facial pain disorders.

  • Dr. CooneyDamon Sean Cooney, M.D., Ph.D.
    Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
    Assistant Professor of Plastic and Reconstructive Surgery

    Dr. ReddySashank Kurapati Reddy, M.D., Ph.D.
    Associate Director, Johns Hopkins Institute for NanoBioTechnology (INBT)
    Medical Director, Johns Hopkins Technology Ventures Johns Hopkins University
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Biomedical Engineering

    Dr. RossonGedge David Rosson, M.D.
    Co-Director, Johns Hopkins Facial Palsy Center
    Director of Breast Reconstruction
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Oncology

   

Skin Cancer Reconstruction

  • If you are diagnosed with a type of skin cancer, your doctor may recommend surgery as the best option for removing the cancer and preventing its spread. Depending on the type of skin cancer and how much skin and tissue around the cancer needs to be removed, your doctor may recommend reconstructive surgery to replace the skin and tissue and to minimize scarring.

    This may include Mohs surgery, which is known as the most effective treatment for most types of skin cancer. This procedure removes the cancerous tissue and minimizes the loss of healthy tissue. 

  • Dr. CooneyDamon Sean Cooney, M.D., Ph.D.
    Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
    Assistant Professor of Plastic and Reconstructive Surgery

    Dr, LifchezScott David Lifchez, M.D.
    Director, Plastic Surgery and Hand Surgery Service, Johns Hopkins Bayview Medical Center
    Chief, Plastic Surgery at Johns Hopkins Bayview Medical Center
    Program Director, Johns Hopkins/University of Maryland Plastic Surgery Residency
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Orthopaedic Surgery

    Dr. ManahanMichele Ann Manahan, M.D.
    Department Vice Chair for Faculty and Staff Development and Well-Being and Past Department Director of Patient Safety
    Professor of Plastic and Reconstructive Surgery

    Dr. MansonPaul Nellis Manson, M.D.
    Professor of Plastic and Reconstructive Surgery

     

    Dr. TuffahaSami Hani Tuffaha, M.D.
    Assistant Professor of Plastic and Reconstructive Surgery

     

    Dr. YangRobin Yang, D.D.S., M.D.
    Director of Pediatric Plastic Surgery
    Division Chief of Oral and Maxillofacial Surgery and Dentistry
    Assistant Professor of Plastic and Reconstructive Surgery
    Assistant Professor of Otolaryngology - Head and Neck Surgery

 

Targeted Muscle Reinnervation (TMR)

  • Targeted muscle reinnervation (TMR) is a new surgical procedure that reassigns nerves that once controlled the arm and the hand. By reassigning existing nerves, doctors can make it possible for people who have had upper-arm amputations to control their prosethic devices by merely thinking about the action they want to perform. Once experimental, this innovative procedure is now available at The Johns Hopkins Hospital.

    People who undergo the targeted reinnvervation surgery will be fitted with and trained to use a myoelectric prosthetic arm.

  • Those interested in the procedure to better control their prosthetic arm must undergo a medical review to determine their eligibility. In general, patients must meet the following criteria:

    • Amputation above the elbow or at the shoulder within the last 10 years
    • Stable soft tissues
    • Willing to participate in rehabilitation

    Those who were born without part or all of their arm and those who have nerve damage, degeneration or paralysis are not candidates for this procedure.

  • Dr. RedettRichard James Redett, III, M.D.
    Director, Plastic and Reconstructive Surgery
    Director, Cleft Lip and Palate Center
    Director, Genitourinary Transplant Program
    Professor of Plastic and Reconstructive Surgery
    Professor of Pediatrics

    Dr. ShoresJaimie Troyal Shores, M.D.
    Clinical Director, Hand/Arm Transplant Program, Johns Hopkins Comprehensive Transplant Center
    Program Director, Hand and Upper Extremity Surgery Fellowship
    Associate Professor of Plastic and Reconstructive Surgery
    Associate Professor of Orthopaedic Surgery

 

Tissue Transplant

  • Tissue transfers (from one part of the patient’s body to another, also known as “flaps”) and tissue transplants (from a deceased donor) provide a means for reconstructive surgeons to repair parts of the body, restoring appearance and in many cases function and feeling. The most common reasons for patients to undergo tissue transfer or transplant is after treatment for cancer or after trauma, burn or injury.

    In tissue transfer, the plastic surgeon removes tissue, including skin, fat, muscle, nerves and bone, from one part of the body and moves it to the part of the body where it is needed. The arteries and veins are re-attached and, in some cases, the nerves are as well. One of the most well-known types of tissue transfer is used in breast reconstruction for women who have had a mastectomy as part of their treatment for breast cancer. Another common type of tissue transfer is done for patients who have been severely burned or have significant tissue damage from devastating injuries or accidents.

  • Our plastic surgeons have performed thousands of tissue transfers, including hand, arm, penis and face transplants, offering patients new opportunities and hope for the future. They have learned about and, in many cases, taught the latest and most effective surgical techniques. In addition, because they work at Johns Hopkins, they can call on any other kind of medical expertise needed right at the facility, from orthopedists and oncologists to pediatricians and dermatologists. Our reconstructive surgeons are devoted to their profession and that includes consultation with the patients, their families, and others as needed. From the first consultation to the final check-up, they make themselves available and accessible to patients.

    Specialty Center

    At Johns Hopkins, we treat hand and arm injuries and defects with the newest and most innovative technologies and procedures. The Center for Upper Extremity Restoration (CUER) offers comprehensive care with a multidiscplinary medical team including in plastic and reconstructive surgeons, trauma and critical care surgeons, orthepedic surgeons, physical medicine and rehabilitation specialists, as well as engineers and dedicated researchers.

    Tissue Transfer Treatment Options

    There are four kinds of tissue transfer:
    • Local flaps are an exact match to tissue and the shape of the space it’s being used for, such as the face.
    • Regional flaps are comprised of tissues taken from a nearby area and are often used to re-build large areas of vital structures including bone and nerves.
    • free flap, or free tissue transfer, involves the removal of tissue from an entirely different part of the body. This procedure requires optimal blood supply and advanced microvascular surgery.
    • Tissue transplants can be done for a range of conditions and injuries, including corneal transplants to restore sight and heart valves to repair damage done by heart disease. In reconstructive surgery, tissue transplants are used to:
    • Repair bones and soft musculoskeletal tissue, such as ligaments
    • Replace skin destroyed by burns
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