Plastic & Reconstructive Surgery Specialties

The Department of Plastic and Reconstructive Surgery performs many surgical procedures to restore both form and function for patients with a variety of needs. Lahey’s skilled specialists in reconstructive surgery also perform a number of procedures as members of multidisciplinary teams working alongside other surgical experts. Among the surgical procedures performed at Lahey Hospital & Medical Center are:

• Breast reconstruction after mastectomy
• Reduction mammoplasty
• Sentinel lymph node biopsy

The Department of Plastic and Reconstructive Surgery performs many surgical procedures to restore both form and function for patients with a variety of needs. Lahey’s skilled specialists in reconstructive surgery also perform a number of procedures as members of multidisciplinary teams working alongside other surgical experts. Among the surgical procedures performed at Lahey Hospital & Medical Center are:

Lahey plastic and reconstructive specialists also offer a variety of the most popular surgical and nonsurgical cosmetic procedures for men and women. In addition to performing cosmetic consultations at our Burlington and Peabody offices, our physicians also provide services at the Center for Cosmetic and Laser Surgery in Lexington. To contact the Center for Cosmetic and Laser Surgery directly, please call 877-867-0707.

Surgical

Nonsurgical

• Dermal fillers (Restylane, Juvederm, and Radiesse)
• Elimination of fine lines and wrinkle reduction (Botox)
• Laser hair removal
• Laser skin resurfacing (Fraxel re:store)
• Skin care product regimen
• Sclerotherapy
• Volume enhancing injections (Sculptra)

The Department of Plastic and Reconstructive Surgery provides a comprehensive, multidisciplinary approach to the diagnosis and treatment of children and adult patients with congenital and acquired craniomaxillofacial anomalies. This includes patients with developmental malformations of the jaws and related facial structures, and those suffering from obstructive sleep apnea. Our experienced, multidisciplinary team of experts work together to identify a patient’s needs and provide the best individualized treatment.

Conditions & Procedures

Introduction to Lymphedema

The lymphatic system is a network of lymph nodes and lymphatic vessels. Its primary function is to transport and filter lymph fluid throughout the body. This fluid contains mostly water and protein and is a vital component in maintaining the body’s fluid levels.

Lymphedema is a medical condition that may occur when regional lymph nodes are compromised due to surgery, radiation or injury, or if there is a congenital deformity within the lymphatic system. This results in an abnormal accumulation of fluid in the surrounding tissue and eventually in the entire limb. Lymphedema can be manifested in two ways:

• Primary lymphedema is a rare inherited condition in which lymph nodes and lymph vessels are absent or abnormal. It typically affects just the legs and is more common in women than men. This condition can be present at birth, or develop during puberty or after age 35.
• Secondary lymphedema can be caused by a blockage or cut in the lymphatic system, usually the lymph nodes in the groin area and the armpit. Blockages may be caused by infection, cancer, or scar tissue from radiation therapy or the surgical removal of lymph nodes. Surgeries for the treatment of breast, uterine/cervical, melanoma, prostate, and throat/mouth cancers may lead to the incidence of lymphedema.

Lahey Hospital & Medical Center’s Lymphedema Center offers a multidisciplinary team approach for the evaluation and treatment of lymphedema. The Vascular Medicine Department provides many specialists with expertise in vascular diseases, including lymphedema. In addition, physical therapy provides Vodder- and Lerner-trained therapists who are certified in the treatment of lymphedema.

Lymphedema Treatment at Lahey

Complete Decongestive Physiotherapy (CDP)

There are various treatments for lymphedema. At Lahey Hospital & Medical Center, one method utilized is complete decongestive physiotherapy (CDP). A patient may be directly referred to physical therapy, or may be seen first in Vascular Medicine for an evaluation and to rule out any vascular complications. A referral is then made to physical therapy, where the extent of the therapy needed is determined. CDP is usually administered daily for approximately two to four weeks.

CDP treatment consists of many integral components. The first is manual lymph drainage (MLD), which utilizes specific techniques to assist in mobilizing fluid. Compression bandaging of the affected limb(s) with specialized minimally elastic cotton bandages is applied following MLD to prevent re-accumulation of lymph fluid. The patient wears the bandaging continuously in the time between treatments. MLD and compression bandaging continues until sufficient decongestion is obtained. CDP will not be effective without the combination of MLD and compression bandaging. Patients perform specific exercises twice daily and apply a low pH, lanolin-based skin lotion daily to keep skin healthy and prevent infections.

When sufficient decongestion is obtained, the maintenance phase of therapy begins. The patient is fitted for a custom compression garment, which is worn daily, and compression bandages are worn nightly. This process is necessary to ensure continued decongestion and reduce the risk of developing serious cellulitis infections. Again, depending on the patient’s condition, the extent of compression will vary. Some patients will need to wear a form of compression at all times, while others will require it less often.

Please note that CDP is not a cure for lymphedema. It is, however, a treatment method that may allow a significant decrease in swelling, pain discomfort and the risk of serious infection, while also increasing the patient’s mobility. Therapy is extremely effective in obtaining these goals, but lymphedema is a lifelong condition that requires a continued commitment to maintenance.

Affiliations of Lahey’s Lymphedema Center

Lahey Hospital & Medical Center’s Lymphedema Center is a sponsor of the National Lymphedema Network. This non-profit organization’s mission is to create awareness of lymphedema through education and to promote and support the availability of quality medical treatment for all individuals at risk for, or affected by, lymphedema.

The Lymphedema Center also has an affiliation with the Greater Boston Lymphedema Network. This patient-oriented group meets monthly here at Lahey Hospital & Medical Center, with the goal of educating and supporting patients and their families with regard to lymphedema. Guest speakers are invited to share their information on various topics including lymphedema, lipedema, venous insufficiencies, cancer, acupuncture, herbal medicines and nutrition.

For further information or referrals, we can be reached through:

• Lymphedema Center: 781-744-2760
• Vascular Medicine Department: 781-744-8470

Melanoma is a cancer that develops in the skin cells (melanocytes) that are responsible for giving our skin color. The world class resources of Lahey Hospital & Medical Center are used to devise a personalized treatment plan for treating invasive and non-invasive melanoma, including removal of the disease, sentinel lymph node biopsy, and the most advanced surgical techniques to restore function and appearance.

When necessary, we provide the latest post-surgical immunotherapy care and access to a variety of clinical trials that allow for a spectrum of treatment options. As part of our commitment to melanoma research, our translational research team, including Kimberly Reiger-Christ, PhD, are participants in a national clinical trial designed to more fully understand the mutations (changes in DNA) that cause melanoma.

Lahey’s Department of Neurosurgery evaluates and performs surgery for various disorders of the peripheral nervous system, including compressive neuropathy, tumors and trauma.

Our approach with compressive neuropathy (e.g., carpal tunnel and ulnar nerve compression), is to perform the least invasive surgery to provide the optimal clinical outcome. Tumors of the peripheral nervous system are removed using the operating microscope, often preserving the affected nerve. Peripheral nerve trauma often requires microsurgical repair, and possibly nerve grafting.

Peter Dempsey, MD, and Subu N. Magge, MD, are specialists in the treatment of disorders of the peripheral nervous system.

Following weight reduction surgery, or any substantial amount of weight loss, the skin and tissues often lack elasticity and cannot conform to the reduced body size. As a result, skin that has been severely stretched, sags.

Body contouring after major weight loss improves the shape and tone of your underlying tissue that supports fat and skin and removes excess sagging fat and skin. This is a rapidly growing field of plastic surgery. Areas treated include upper arms that may sag and appear loose and full, breasts that have flattened and drooped, the abdominal area that produces a pannus that extends around the sides and into the lower back area, resulting in an apron-like overhang and the buttocks, and groin and thighs that sag.

Surgical body contouring following major weight loss improves the shape and tone of your underlying tissue that supports fat and skin and removes excess sagging fat and skin. The result is a more normal appearance to the body, with smoother contours. This is, in essence, the final phase of your total weight loss experience.

For individuals living with a wound that won’t heal, everyday activities can be a battle. Lahey Hospital & Medical Center’s Wound Clinic, through the Department of Plastic and Reconstructive Surgery, offers comprehensive outpatient wound care, in-depth patient education, and a customized care plan for each individual.

We offer leading-edge treatments such as debridement, biologic skin substitutes, compression dressings for peripheral edemas, and advanced dressings. We utilize the most up-to-date approaches to wound healing, and we remain current in new scientific advances in wound care.

Type of Wounds We Treat

At Lahey’s Department of Plastic and Reconstructive Surgery, we treat all types of wounds including:

• Diabetic ulcers or wounds to the lower extremities
• Venous or pressure ulcers (bed sores)
• Surgical wounds
• Radiation tissue damage
• Wounds due to poor blood flow or other underlying medical conditions
• Skin grafts and flaps
• Osteomyelitis or bone infection
• Wound care is a much needed service in our community, and we strive to provide the very best care for all of our patients.

About Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy is a treatment in which you breathe 100 percent oxygen inside a comfortable, see-through pressurized chamber. Blood oxygen saturation is increased to 15 to 20 times its normal level, dramatically improving your body’s healing capabilities and greatly improving outcomes of certain types of non-healing wounds.

Hyperbaric oxygen therapy has proven effective in fighting infection and building new blood vessels and healthy tissue. Depending on your diagnosis, this therapy accelerates healing by stimulating oxygen-dependent, wound-healing mechanisms to function more efficiently.

Our Locations

Beverly Hospital’s Wound and Hyperbaric Medicine Center
500 Cummings Center
Suite 1800
Beverly, MA 01915

Winchester Hospital’s Wound Healing and Hyperbaric Center
75 Riverside Avenue
Suite 4
Medford, MA 02155