Plastic surgery after injuries and military operations: new challenges

The last few years have been a big deal for all of Ukraine. The full-scale invasion has left thousands of military folks and civilians with serious injuries, which doctors are dealing with every day on the front lines and behind the scenes.

In this context, Ukrainian plastic surgery has gone way beyond just making people look good.

In cases involving traumatized soldiers, it has become part of overall rehabilitation, restoring appearance for socialization and overcoming psychological problems, and returning to normal life.

Plastic surgery after trauma and injury—it's not just about beauty

The perception of plastic surgery as exclusively aesthetic medicine is currently somewhat incorrect. In fact, the profession of plastic surgeon combines two areas: reconstructive and aesthetic. The first is designed to restore the function and appearance of the body after trauma, surgery, congenital defects, and diseases. The second improves appearance, reduces age-related changes, and harmonizes the proportions of the body and face. Both are extremely important in modern society. But it is in the context of the war in Ukraine that reconstructive surgery for men and women wounded in combat often comes to the fore.

New challenges — new patients

After the full-scale invasion, we saw a completely new category of patients. People with mine and explosive injuries, burns, soft tissue and facial bone defects. Most of these patients are young men and women, our defenders, who previously had active social lives and civilian professions.

They need to regain the ability to live without constant discomfort and pain, and to socialize without problems. In these cases, a plastic surgeon can give a wounded soldier a chance at recovery, both physical and mental.

The complexity of surgical interventions after combat injuries

Reconstructive surgery after combat injuries often consists of several stages. One patient may undergo several operations with long periods of healing, rehabilitation, and preparation for the next stages.

Ukrainian surgeons are currently working with the following types of facial injuries sustained during combat operations:

• Skull and soft tissue injuries after shrapnel, mine and explosive wounds, burns, etc. A plastic surgeon can perform reconstructive rhinoplasty and otoplasty for such patients, as well as scar revision to improve appearance, relieve pain, and increase skin elasticity.
• Limb injuries — tissue transplantation, lipofilling (restoration of lost volume using the patient's own fat), etc. can be performed to close visual and functional defects of injured arms and legs.
• Burns — elasticity and normal appearance of the skin are restored after healing and/or skin grafting to the affected area, as well as mobility of the body part, especially in the joint area.

In some cases, plastic surgeons use free tissue transplantation techniques, where part of the skin, muscle, or bone is taken from one (healthy) part of the body and transplanted to another (affected) area. These are complex but very effective operations that significantly improve the patient's quality of life.

Modern technologies for restoring the patient's appearance

Today, Ukrainian plastic surgeons can use various innovative technologies from around the world, such as 3D modeling, modern implants with a lifetime guarantee, innovative suture materials, and more. In some cases, parts of joints and bones damaged by mine and explosive injuries can even be printed on a 3D printer using a special PEEK polymer, taking into account the individual anatomy of the patient. Individual implants are then made from titanium and inserted into the patient during surgery.

Thanks to the support of donors, international partners, and grants, Ukrainian plastic surgeons are able to perform operations free of charge for injured soldiers.

Plastic surgery is an important part of a soldier's return to normal life

The psychological aspect of plastic surgery is no less important for a traumatized soldier. A person who has suffered fragmented injuries to the soft tissues of the face, lost teeth, or received large scars (e.g., from burns) on exposed areas of the body often faces difficulties in socialization and may experience difficulties in their personal life, when applying for a job, etc. That is why plastic surgery can be more than just a reconstruction of appearance; it can help a soldier return to a normal, socially active life.

I often see how, after plastic surgery and the completion of rehabilitation, soldiers who have undergone surgery get rid of their complexes, return to work, and start families. This is the main reward for me as a doctor — to give the defenders of Ukraine a chance at a dignified life.

Plastic surgery after combat injuries is not about achieving the perfect appearance for the patient (although I always strive to achieve the best possible aesthetic result), but about giving them the opportunity to live a full life, free from pain, psychological complexes, and prejudice from society.