What is body trauma reconstruction?
It is the surgery that closes and rebuilds what a trauma left open in the trunk or the limbs: a wound that will not heal, a loss of skin that cannot be sutured, exposed bone or tendon, a scar that contracts and limits the movement of a joint.
Here plastic surgery does not work for aesthetics: it works for function and, in serious cases, to save the limb. A wound with exposed bone or tendon does not close on its own or with dressings — it needs coverage with living, well-vascularised tissue, and providing that is exactly what a plastic and reconstructive surgeon does.
What is reconstructed?
- Complex or long-standing wounds that will not close by secondary intention, with loss of substance.
- Exposure of critical structures — bone, tendon, osteosynthesis hardware — where coverage is urgent and determines the prognosis of the limb.
- Accident sequelae, road and occupational, with contour defects or disfiguring scars.
- Contracted scars limiting the mobility of a joint —elbow, knee, armpit, hand— where the priority is recovering range of movement before appearance.
- Burn sequelae of the trunk and limbs. See burn sequelae surgery.
- Defects after removal of skin and soft-tissue tumours. See skin cancer surgery.
- Chronic ulcers and hard-to-close wounds, assessed case by case.
How it is rebuilt
The same ordered principle as in the face applies —the reconstructive ladder—: the simplest technique that solves the case well, climbing a rung only when the previous one is insufficient. In the body, the choice is further conditioned by what lies beneath the defect: covering well-vascularised muscle is not the same as covering a bare tendon or bone.
- Direct closure when the defect allows it.
- Skin grafts —split- or full-thickness—, the solution when the bed is well vascularised and no critical structures are exposed. See grafts and flaps.
- Local and regional flaps: tissue moved while keeping its own blood supply. It is the only real solution when bone, tendon or hardware is exposed — a simple graft does not take on those surfaces, and that is the technical reason flaps exist.
- Tissue expanders to generate additional skin when the neighbouring skin is insufficient.
- Z-plasties and release plasties in contracted scars, to reorient tension and restore the joint’s range of movement.
- Fat grafting as a contour refinement and to improve the quality of scar tissue.
Dr. Arístides Arellano’s track record
Documented in his credential archive:
- Symposium on cutaneous tissue loss (1988) — precisely the problem this page addresses.
- Update course: tissue expanders (1989) and Symposium on rehabilitation (1988).
- Certificate from the Mexican Burns Association (1992).
- Observership at the Ivo Pitanguy Clinic, Rio de Janeiro (1989), with a letter from the professor.
- Fellow of the International College of Surgeons (1994).
- Specialty licence in Plastic and Reconstructive Surgery (0002008), issued by the DGP.
How is it performed?
It depends on the defect and the structures involved. It may require local, regional or general anaesthesia, and it is frequently planned across several surgical stages. In cases that warrant it, treatment is coordinated with the other specialists involved —traumatology, orthopaedics, internal medicine—: reconstruction does not happen in isolation from the rest of the patient’s treatment.
All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
Body trauma reconstruction has no catalogue price: it depends entirely on the defect, the structures involved, the coverage technique and the number of surgical stages. It is defined at the consultation, with clear written information. If your injury arises from an occupational or road accident covered by insurance, it is worth reviewing at the consultation which part of the process is covered.
Recommended post-surgical treatments
The hyperbaric chamber is of particular interest here: the viability of a flap or a graft depends on tissue oxygenation, and that is precisely what it aims to act upon. Dr. Arístides may recommend it alongside manual lymphatic drainage and, on the matured scar, laser treatment. See the full guide: Post-surgical recovery and care.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Recovery · step by step
- First weeksWound care and close monitoring of flap or graft viability. Rest of the reconstructed area.
- Weeks 2–6Suture removal and progressive mobilisation. In contracted scars, rehabilitation begins early.
- Months 3–12The scar matures and the refinements needed are defined. Range of movement is regained.
- Later stagesReconstruction rarely ends in a single operation: refinements are part of the plan from the start.
Frequently asked questions
How much does body trauma reconstruction cost in Puebla?
It has no catalogue price: it depends entirely on the defect, the structures involved, the coverage technique required and the number of surgical stages. It is defined at the consultation, with clear written information. If your injury arises from an occupational or road accident covered by insurance, it is worth reviewing at the consultation which part of the process is covered.
Why will a wound with exposed bone or tendon not close with dressings?
Because bare bone and tendon lack the vascularity needed for a skin graft to take on them, or to close by secondary intention. They need coverage with living, well-vascularised tissue, and that is the technical reason flaps exist: tissue moved while keeping its own blood supply. It is a situation in which coverage is urgent and determines the prognosis of the limb.
Can I regain movement if a scar limits my joint?
Frequently yes. Contracted scars limiting the elbow, knee, armpit or hand are treated with release plasties and z-plasties, which reorient the tension of the scar and restore range of movement. In these cases function takes priority over appearance, and subsequent rehabilitation is part of the treatment.
What is the difference between a graft and a flap?
A graft is skin moved entirely separated from its blood supply, which must receive blood from the bed it is placed on; it only works over a well-vascularised bed. A flap is tissue moved while keeping its own blood supply, which is why it can cover surfaces on which a graft would not take, such as exposed bone or tendon.
Is body reconstruction coordinated with other doctors?
In cases that warrant it, yes: treatment is coordinated with traumatology, orthopaedics or internal medicine as appropriate. Reconstruction does not happen in isolation from the rest of the patient’s treatment, particularly where there are fractures, osteosynthesis hardware, or conditions affecting healing.
What is Dr. Arístides Arellano’s training in reconstructive surgery?
He practises under a specialty licence in Plastic and Reconstructive Surgery (0002008) issued by the DGP. He took part in the Symposium on cutaneous tissue loss (1988), the Symposium on rehabilitation (1988) and the update course on tissue expanders (1989); he holds a certificate from the Mexican Burns Association (1992); he completed an observership at the Ivo Pitanguy Clinic in Rio de Janeiro (1989), and has been a Fellow of the International College of Surgeons since 1994. The documents are in the credentials section of this site.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.