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Medical Services

Plastic & Reconstructive Surgery

Plastic surgery encompasses both cosmetic and reconstructive surgery.

Cosmetic surgery is performed to reshape normal structures of the body in order to improve a patient's appearance and self-esteem. Cosmetic surgery is usually not covered by health insurance because it is elective.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve functions, but may also be done to approximate a normal appearance. Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and levels of coverage may vary greatly.

Barnes-Jewish Hospital’s division of Plastic and Reconstructive Surgery serves metropolitan St. Louis as well as patients within a 350-mile radius that includes eastern Missouri, southern Illinois and western Kentucky.

The world's first donor nerve transplant - a procedure that can save what were previously considered irreparably damaged limbs - was performed by Dr. Susan Mackinnon, the head of the Division of Plastic and Reconstructive Surgery.

Many of the unique subspecialty programs in the division draw patients from across the country and around the world. Referring physicians and patients from outside the United States can make arrangements for patient treatment and family accommodations through our International Services.

Plastic and reconstructive surgery procedures include the following:

  • Major brachial plexus and peripheral nerve surgery, including carpal tunnel syndrome and tarsal tunnel syndrome. This is the only center in the country with a nerve transplant program.
  • Breast surgery, including reconstruction, breast reduction and breast augmentation.
  • Cosmetic surgery including body contouring through liposuction, facial laser resurfacing, dermabrasion and dermaplaning, facelift, forehead lift, blepharoplasty (eyelid surgery) and abdominoplasty.
  • Wound treatment, healing the conditions associated with diabetes, vascular problems and long-standing wounds and traumas.
  • Craniofacial, cleft lip and palate, using the team approach to meet the unique and complex needs of the patient from infancy through adulthood.
  • Hand surgery, including trauma, repetitive strain injuries, surgical treatment of osteoarthritis and rheumatoid arthritis.
  • Microsurgery/reconstructive surgery, to correct disfigurement and to restore function following cancer, trauma or other injuries.
  • Management of skin care, using the Obaji Skin Care System and Biomedic Skin Care system - two medical approaches to skin care.

Unique aspects about the program:

  • The only center in the country with a nerve transplant program
  • Breast Surgery Research Center for cosmetic and reconstructive surgery
  • Wound Healing Research Center
  • Leading training program in plastic and reconstructive surgery, with specialized training in hand, micro and peripheral nerve surgery, and craniofacial and cleft lip and palate surgery

Treatment for Peripheral Nerve Injuries

Injuries to the shoulder, arms and legs are common—numbering in the hundreds of thousands each year. Yet specialists who treat these regions of the body often are focused on other types of injuries and have limited expertise with the peripheral nervous system.

At the Center for Nerve Injury and Paralysis, neurosurgeons work together with plastic and reconstructive surgeons, neurologists and therapists to offer comprehensive treatment of peripheral nerve injuries and disorders. Treatment is available for both adult and pediatric conditions.

Innovative Surgical Options for Spinal Cord Injuries


The Center for Nerve Injury and Paralysis is led by Susan Mackinnon, MD, a pioneer in nerve surgery who is responsible for developing a variety of techniques to reroute healthy nerves to areas of the body left paralyzed by damaged nerves. Advancements like this have allowed Dr. Mackinnon and other Washington University surgeons at Barnes-Jewish Hospital to restore some hand function in patients with a spinal cord injury at the C6 and C7 vertebra, the lowest bones in the neck.

Instead of operating on the spine itself, surgeons are able to reroute working nerves in the upper arms to restore some function. Most recently, a quadriplegic patient with a spinal cord injury at the C7 vertebra underwent nerve transfer surgery at Barnes-Jewish and regained some hand function after undergoing intensive physical therapy. The case study, published online May 15 in the Journal of Neurosurgery, is, to the authors’ knowledge, the first reported case of restoring the ability to flex the thumb and index finger after a spinal cord injury. Read more at nerve.wustl.edu or news.wustl.edu.

Breast Conservation

It’s something many don’t know – federal law mandates insurance companies cover reconstruction after breast conservation surgery. Find out more in this "Cancer Connection" podcast with Terry Myckatyn, MD, Washington University plastic and reconstructive surgeon at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital. More information about lumpectomy after breast cancer.

 

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