The half of the specialty nobody advertises
The full name is Plastic and Reconstructive Surgery. The second word almost never appears in advertising, because it does not sell — and yet it is where the whole specialty comes from: the techniques used today to rejuvenate a face were originally developed to rebuild the face of someone who had lost one.
Dr. Arístides Arellano practises under a specialty licence in Plastic and Reconstructive Surgery (0002008), issued by the DGP, and the reconstructive branch has been part of his practice since his training in Buenos Aires and his time at Prof. Ivo Pitanguy’s clinic in Rio de Janeiro.
What does facial trauma reconstruction treat?
The face is the territory where an injury carries the greatest functional and human cost, because it cannot be hidden under clothing. It is reconstructed after:
- Accidents — road, occupational, domestic — with loss of skin or tissue, disfiguring scars or contour defects.
- Animal bites, particularly frequent in children and almost always on the face.
- Facial burns and their sequelae — contractures that limit closing the eye or the mouth. See burn sequelae surgery.
- Defects after skin-cancer excision — the most frequent scenario in real practice, and where excising and reconstructing in the same operation changes the result entirely. See skin cancer surgery.
- Old facial scars, contracted or hypertrophic, and keloids.
- Eyelid, ear and nose reconstruction — the three most technically demanding subunits of the face.
How it is rebuilt: the reconstructive ladder
Reconstructive surgery follows an ordered principle —the reconstructive ladder—: use the simplest technique that solves the case well, and only climb a rung when the previous one is insufficient. Complexity is not a merit; the result is.
- Direct closure, following the skin’s relaxed tension lines, which is what makes a facial scar disappear into a natural crease instead of crossing it.
- Skin grafts — split- or full-thickness, with the donor site chosen so colour and texture match the face. See grafts and flaps.
- Local flaps — the fine instrument of the face: neighbouring tissue moved while keeping its own blood supply, bringing skin of the same colour, thickness and texture. It is what allows a nasal ala or an eyelid to be rebuilt without a visible patch.
- Tissue expanders — when more skin is needed than exists, it is "grown" by progressively expanding the neighbouring skin.
- Reconstruction by aesthetic subunits — the face is read in units (nose, eyelid, lip, cheek). Rebuilding while respecting their borders is what keeps the eye from detecting the repair.
- Refinement with fat grafting — fat restores volume and improves the quality of skin and scar over reconstructed tissue.
Dr. Arístides Arellano’s track record in reconstructive surgery
Documented in his credential archive:
- Symposium on cutaneous tissue loss (1988) and Update course: tissue expanders (1989).
- Observership at the Ivo Pitanguy Clinic, Rio de Janeiro (1989), with a letter from the professor — the most influential reconstructive school in Latin America.
- International Symposium: Plastic Surgery in Childhood (1989).
- Fellow of the International College of Surgeons (1994).
- Certificate from the Mexican Burns Association (1992).
How is it performed?
It depends entirely on the defect. It can range from an outpatient procedure under local anaesthesia to major surgery under general anaesthesia, and it is frequently planned across several surgical stages: reconstruction rarely ends in a single operation, and later refinement is part of the plan from the outset, not an unforeseen event.
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
Facial trauma reconstruction has no catalogue price and never will: no two defects are alike. The cost depends on the technique, on how many surgical stages the case requires, and on hospital and anaesthetist fees. It is defined at the consultation, with clear written information. If your injury arises from an accident covered by insurance, or from oncologic treatment in an institution, it is worth reviewing at the consultation which part of the process is covered.
Recommended post-surgical treatments
Dr. Arístides may recommend hyperbaric chamber sessions —of particular interest where flaps or grafts depend on tissue oxygenation for viability—, 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 graft or flap viability. Varies considerably by technique.
- Weeks 2–6Suture removal and progressive return. The reconstructed area is protected.
- Months 3–12The scar matures. This is the period in which the refinements needed are defined.
- Later stagesReconstruction rarely ends in a single operation: refinements are part of the plan from the start.
Frequently asked questions
How much does facial trauma reconstruction cost in Puebla?
It has no catalogue price and never will: no two defects are alike. The cost depends on the technique, on how many surgical stages the case requires, and on hospital and anaesthetist fees. It is defined at the consultation, with clear written information. If your injury arises from an accident covered by insurance, or from oncologic treatment in an institution, it is worth reviewing at the consultation which part of the process is covered.
Can an old facial scar be reconstructed?
Frequently yes. An old, contracted or poorly oriented scar can be surgically redesigned so that it follows the skin’s relaxed tension lines and disappears into a natural crease, and then improved in texture and colour with laser. It does not vanish —no scar vanishes— but it can become far less evident. Results may vary.
What is a flap and how does it differ from a graft?
A graft is skin moved entirely separated from its blood supply, which must receive blood from the bed it is placed on. A flap is tissue moved while keeping its own blood supply, which is why it brings skin of the same colour, thickness and texture as its neighbour. On the face the local flap is the fine instrument: it is what allows a nasal ala or an eyelid to be rebuilt without leaving a visible patch.
Is reconstruction done in a single operation?
Rarely. Reconstruction is frequently planned across several surgical stages, and later refinements are part of the plan from the outset, not an unforeseen event. This is explained clearly at the assessment so you know from the start what lies ahead.
What is done with the defect left after removing a facial skin cancer?
It is reconstructed, and ideally in the same operation as the excision. Having the same surgeon excise with an oncologic margin and reconstruct the affected subunit is what allows a functional and aesthetic result far superior to simply closing the defect without planning.
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 update course on tissue expanders (1989) and the International Symposium on Plastic Surgery in Childhood (1989); 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.