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The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (from the tip of the hand to the shoulder). Dr. Concannon specializes in hand surgery and has written two textbooks on the topic.

Hands help us eat, dress, write, earn a living, create art, and do many other activities. To do these tasks and activities, our hands require sensation and movement, such as joint motion, tendon gliding, and muscle contraction. When a problem takes place in the hand, care must be given to all the different types of tissues that make function of the hand possible. The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (from the tip of the hand to the shoulder). Many conditions occur in the upper extremity that can be treated by a hand surgeon. These conditions include immediate care of an injury, treatment and reconstruction of old injuries, congenital problems, arthritis, infection, and new growths and tumors. Hand surgeons also treat other problems such as nerve compression syndromes and swelling of tendons. Microsurgery is used for the reattachment of amputated parts and certain hand reconstructions.

Hand Surgery and Your Plastic Surgeon
 
Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand. At the forefront of these advances have been plastic surgeons-specialists whose major interest is improving both function and appearance. Plastic surgeons undergo intensive training in hand surgery, and they (along with orthopedic surgeons) treat patients with a wide range of hand problems.

This information is designed to give you a basic understanding of the most common hand problems — what they are, what plastic surgeons can do for them, and the results you can expect. It can't answer all of your questions, since each problem is unique and a great deal depends on your individual circumstances. Please be sure to ask Dr. Concannon if there is anything about the procedure you don't understand.

If You're Considering Hand Surgery

If you're considering hand surgery, a consultation with a plastic surgeon is a good place to start. The surgeon will examine you, discuss the possible methods of treatment for your problem, and let you know if surgery is warranted. If it is, the surgeon will discuss the procedure in detail, including where the surgery will be performed (in the surgeon's office, an outpatient surgery center, or a hospital), the anesthesia and surgical techniques that will be used, possible risks and complications, the recovery and rehabilitation period, and the probable outcome in terms of function and appearance.

Don't hesitate to ask Dr. Concannon any questions you may have during the initial consultation-including any concerns you have about the recommended treatment and the costs involved. (Since hand surgery is performed primarily to correct physical abnormalities, it usually is covered by insurance. Check your policy or call your carrier to be sure.)

All Surgery Carries Some Uncertainty and Risk

Thousands of successful hand operations are performed each year. While the procedures are generally safe when performed by a qualified and experienced plastic surgeon, complications can arise.

In all types of hand surgery, the possible complications include infection, poor healing, loss of feeling or motion, blood clots, and adverse reactions to the anesthesia. These complications are infrequent, however, and they can generally be treated. You can reduce your risks by choosing a qualified surgeon and by closely following his or her advice.

Hand Injuries

The most common procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. Modern techniques have greatly improved the surgeon's ability to restore function and appearance, even in severe injuries.

Among the techniques now used by plastic surgeons:

•Grafting — the transfer of skin, bone, nerves, or other tissue from a healthy part of the body to repair the injured part;

•Flap surgery — moving the skin along with its underlying fat, blood vessels, and muscle from a healthy part of the body to the injured site;

•Replantation or transplantation — restoring accidentally amputated fingers or hands using microsurgery, an extremely precise and delicate surgery performed under magnification. Some injuries may require several operations over an extended period of time.

The SMAS is a layer beneath the skin that invests the facial muscles. By tightening the SMAS, the jowls are lifted, the neck is tightened, and the cheeks are elevated. This "deep" or "two-layer" facelift is an improvement over earlier skin-only techniques.

Q. How Long Does a Facelift Last?

A. No one can say for sure. The clock is turned back but keeps on running. Ten years later, you will look better than if you never had surgery. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.

Q. Can Surgery Be Done Without Scars?

A. The scars from facelift surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

Q. How Long Will I Be Out From Work?
 
A. Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.

Q. How Can I Hide Things During the Time Until I Return to Normal?

A. Dr. Concannon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.

Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel it's well worth the effort.