FORT BRAGG, N.C. (Jan. 15, 2016) - When most people think of plastic surgeons, cosmetic procedures like nose jobs and face lifts are what usually come to mind.

While the plastic surgeons at Womack Army Medical Center, WAMC, do perform limited cosmetic procedures, their primary focus is reconstructive and medically-necessary procedures. These procedures include those that restore function, correct a serious birth defect, restore body form after a serious injury, revision of disfiguring scars, or after a medically-necessary mastectomy.

Many of these reconstructive procedures require surgeons skilled in microsurgery, which involves the use of specialized microscopes and precision instruments to perform intricate operations on tiny structures.

WAMC is growing its microsurgery capability with five procedures recently performed at the hospital. Three of these were breast reconstruction surgeries, administered after women with breast cancer underwent mastectomies.

"There are different options for patients who have mastectomies," said Lt. Col. Juan Ortiz, chief of surgery, WAMC. "They can use an artificial implant or use something of their own to reconstruct their breast. We should be able to provide multiple options for these patients, and we do."

Womack Army Medical Center is one of two breast health centers of excellence in the Department of Defense. In addition to certifying that the clinic provides quality care to patients, it also means that the entire provider team works closely together from diagnosis through treatment and recovery. This helps facilitate better communication throughout the entire care team, including the operating room teams, which perform mastectomies and reconstruction surgeries when needed.

The breast reconstruction surgeries, with the most recent being a bilateral surgery meaning both breasts were removed and reconstructed, consist of a free tissue transfer where skin is removed from another portion of the body and transferred to the breast. The skin and tissue for transfer are usually removed from the abdomen, buttocks or mid-thigh.

"It's a complex surgery requiring a dedicated surgical team, which is something we have been able to establish here at Womack," Ortiz said. "Lt. Col. Bradford Scanlan, the chief of plastic surgery, is a key player in these procedures. It's a true team effort. Everyone is trained to be an asset during these intricate surgeries, including the operating room tech, the anesthesiologist and the entire team of providers."

Ortiz said that the microsurgery doesn't add any additional risk beyond a normal surgical procedure for the patient. The team uses laser-assisted fluoroscopy after the tissue transfer is complete to determine that blood is flowing to the area. The new area will glow during the fluoroscopy if it has good blood flow. If the area is not glowing, the surgeons will immediately fix the area while the patient is still in the operating room.

Other microsurgical procedures performed at WAMC include a jaw reconstruction for a service member injured in a training accident and surgery to repair leg trauma received in a motorcycle accident.

"It's important that we continue to offer these procedures and expand our capacity to provide this care," Ortiz said. "This is increasingly becoming the standard of care across the field and helps us continue to meet patient desires and expectations."