Many of the issues that exist for cosmetic surgery patients exist for noncosmetic patients in areas such as reconstructive surgery and trauma. Although cosmetic and noncosmetic patients usually are considered separate in terms of elective versus nonelective, there are other issues in dealing with reconstructive surgery patients versus those undergoing cosmetic surgery. This article reviews a variety of issues specific to noncosmetic reconstructive surgical patients and discusses issues unique to pediatric patients, craniomaxillofacial trauma patients, patients who have skin cancer defects, scar revision patients, and major reconstruction after cancer resections and craniomaxillofacial trauma.