Face Lift | Rhytidectomy | Breast Enlargement

Plastic Surgery

Plastic surgery is a general term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. The word "plastic" derives from the Greek plastikos meaning to mould or to shape; its use here is not connected with modern plastics.

The principal areas of plastic surgery include two broad fields.

Reconstructive surgery, including microsurgery, focuses on undoing or masking the destructive effects of trauma, surgery or disease. Reconstructive surgery may include closing defects with flaps-that is, by moving tissue from other parts of the body.
Cosmetic (or aesthetic) surgery is most often performed in order to change features the patient finds unflattering. In many cases, however, there are medical reasons (for example, breast reduction when orthopedic problems are present).

History

The history of cosmetic surgery spans back to the ancient world. The Romans were able to perform simple techniques such as repairing damaged ears. Physicians in ancient India were utilizing skin grafts for reconstructive work as early as 800 B.C. In mid-15th century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially than involving the head or face, it was not until the 19th and 20th centuries that such surgeries became commonplace. The U.S.'s first plastic surgeon was Dr. John Peter Mettauer. He performed the first cleft palate operation in 1827 with instruments that he designed himself.

Reconstructive surgery

Reconstructive surgical techniques were developed rapidly in the period after the First World War when patients with survivable but disfiguring injuries required new approaches. The English military hospitals of the period trained surgeons from the world over in these new techniques. These surgeons then returned to the Americas, the Pacific and to Europe to propagate their advances. The main advances were with flap surgery-moving tissue from one location to another with an intact blood supply.

Ultimately, plastic surgeons have championed the use of microsurgical techniques to transfer remote tissue. They have for the past several decades been able to connect blood vessels that may be as small as 1-2mm in diameter to reperfuse the transferred tissue, thereby allowing coverage of a soft tissue defect when no local tissue is available.

Common cases of reconstructive surgery are breast reconstruction for women who have had a mastectomy, facial- and contracture surgery for burn victims, closing skin- or mucosa defects after removal of tumors in the head and neck region.

Sex reassignment surgery for transsexual people is another example of reconstructive surgery.

Foreskin restoration for men who have undergone circumcision is sometimes performed using reconstructive surgery.

There is a definite gray area between reconstructive and cosmetic surgery. For instance a "bat ear" correction is not considered cosmetic surgery, even though having prominent ears is not a debilitating or dangerous condition.

Cosmetic surgery

Cosmetic surgery is a very popular avenue for personal enhancement, as demonstrated by the 11.9 million cosmetic procedures performed in the U.S. alone in 2004. Although some may harbor a dim view of cosmetic surgery, seeing it as frivolous, the upsurge in number of procedures performed annually shows that cosmetic surgery has become acceptable to the mainstream American household.

However, it should be noted that elective procedures involve risk like any operation, and should therefore not be undertaken lightly. Within the US, critics of plastic surgery have noted that it is legal for any doctor (regardless of speciality) to perform plastic surgery; a practice which may lead to a suboptimal result. It is best to check a physician's credentials, looking for those MD's most commonly trained in cosmetic techniques (such as Board Certified Plastic Surgeons, Otolaryngologists, and Opthalmologists).

The most prevalent are listed below. Most of these types of surgery are more commonly known by their "common names." These are also listed when pertinent.

Abdominoplasty (or "tummy tuck"): reshaping and firming of the abdomen
Blepharoplasty (or "eyelid surgery"): Reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty
Augmentation Mammaplasty (or "breast enlargement" or "boob job"): Augmentation of the breasts
Muscle sculpting: Removal of the fat layer that is on top of chosen muscle to reveal a more appealing look after surgery (ie: six pack abs revealed through muscle sculpting)
Chemical peel: Removal of acne scars and sagging skin-not technically surgery and can be performed by a cosmetologist
Mastopexy (or "breast lift"): Raising of sagging breasts
Rhinoplasty (or "nose job"): Reshaping of the nose
Otoplasty (or ear surgery): Reshaping of the ear
Rhytidectomy (or "face lift"): Removal of wrinkles and signs of aging from the face
Suction-Assisted Lipectomy (or liposuction): Removal of fat from the body
Circumcision: Removal of the foreskin of the penis, esp. without any diagnosis
Chin augmentation: Augmentation of the chin with an implant (e.g. silicone) or by sliding genioplasty of the jawbone.
Cheek augmentation
Collagen injections

In addition, there is increasing concern about cosmetic surgeries not done in the United States, especially liposuctions performed at the Dominican Republic: while that type of surgery there is considerably cheaper, six women were reported in 2004 to have returned to the United States from the Dominican Republic with an infection after having liposuctions there, and, in 2001, a Puerto Rican woman died, in a very widely publicized case by Puerto Rican newspapers.

Related disciplines

Hand surgery is not strictly a field of plastic surgery, as it is also performed by many orthopedic surgeons, as well as fellowship trained general surgeons. However, many hand operations (such as reconstruction of injuries, replantations, rheumatoid surgery and surgery of congenital defects) are performed by plastic surgeons.
Maxillofacial surgery (surgery involving the jaw) is not usually considered a field of plastic surgery, although there is significant overlap of techniques and operations.
Craniofacial surgery mostly revolves around the treatment of pediatric congenital anomalies, such as cleft lip and palate

Addiction to cosmetic surgery

Some people appear to become addicted to cosmetic surgery, possibly because of body dysmorphic disorder. Sufficient amounts of repeated cosmetic surgery can lead to irreversible damage to the normal body structure. However, due to the high cost of repeated cosmetic surgery, this disorder is generally one limited to the wealthy.

###