Patrick Byrne, director of facial plastic and reconstructive surgery at Johns Hopkins Health Care and Surgery Center in Green Spring Station, Maryland, believes his innovative ear reconstruction was one of the first performed in the world. Growing noses on foreheads or ears on arms before transplanting them to the conventional locations is based on surgical reconstruction techniques going back hundreds of years. It's called prelamination: Tissue that's going to be used to rebuild an area is constructed in multiple layers.the nose, for example. If the damage from disease or injury goes all the way through, then all three layers must be replaced: the skin on the outside, the cartilage, and the soft lining inside. The forehead skin tends to be the best match for the outside skin from an area called the paramedian forehead flap, described in medicine as early as 700 B.C. [Reconstructive surgeons have been using skin from this area of the forehead for nasal reconstruction for centuries.] Cartilage creates a three-dimensional form that will resemble a nose, and the choice to take it from the rib cage is pretty straightforward. A lot of nuance and challenge comes from the internal layer, the lining of the nose. If you don't have a pretty good blood supply nourishing the nose from the inside, over time it will fail. You'll be left with a mess of tissue that could be a deformity worse than the one you started with.
So this leads me to the next blog post I will make the woman who went through the reconstruction of growing an ear on her arm. Another topic that I will be going into is the way they coped with the situation since I want to touch basis for some psychological effects. This is a topic that will eventually lead me into other topics since it is very broad but one thing we know for sure is Medicine really is revolutionary.
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