Overview and Definition

Plastic surgery is a branch of medicine concerned with the restoration—or in some instances, the "correction"—of both form and function for various parts of the body. The term "plastic" does not allude to an artificiality that the field is unfairly known for; in fact, the surgical definition of the word "plastic" actually predates the modern usage of the term. In plastic surgery, the term "plastic" is used to denote the reshaping or sculpting of human flesh.

The field of plastic surgery is best known for aesthetic or cosmetic surgery, which is the improvement of an individual's appearance for aesthetic purposes. Aesthetic or cosmetic surgery is just one branch of the field; plastic surgery can also involve microsurgery, hand surgery, craniofacial surgery, burn treatments, and reconstructive surgery.

The field of plastic surgery roots back to the times of Ancient Egypt and has developed over thousands and thousands of years. Many consider the otolaryngologist Sir Harold Gillies, who hailed from New Zealand but practiced in London, as the father of modern plastic surgery. He is credited for the development of various techniques used in modern plastic surgery, which he developed when he set out to help First World War soldiers who suffered with injuries that disfigured their faces. His first plastic surgery patient—Walter Yeo—received a flap surgery in 1917.

In order to practice plastic surgery today, an individual must have undergraduate degree with premed units, be a Doctor of Medicine and Osteopathic Medicine, as well as be a qualified surgeon who has trained extensively in the field.

Branches of plastic surgery include the following:

  • Microsurgery, a form of surgery that requires the use of an operating microscope in to perform surgical intervention and treatment in extremely small nerves and blood vessels, usually one millimeter in diameter. Plastic surgeons can specialize in this branch, especially if they are going to perform free tissue transfer. This reconstructive procedure involves the culling of donor tissues to be transferred to another part of the body that requires reconstruction. Microsurgeons—especially those in the field of plastic surgery—can perform the reconstruction of a mandible after resectioning as form of oral cancer treatment or management, traumatic tissue loss in most parts of the body, the absence of congenital tissue, and the resection of the breasts as form of breast cancer treatment or management.

  • Hand surgery is another branch of the field that involves the reattachment or reconstruction of limbs and soft tissues in the hand.

  • Craniofacial surgery is a subspecialty in the field that usually involves procedures performed on the skull, head, face, jaws, neck and other associated or related structures. There are craniofacial surgical procedures that involve bone manipulation, but this subspecialty is not specific to certain kinds of tissue or bone—craniofacial surgeons work on soft tissues, muscles, teeth, nerves, blood vessels, bones, and skin. Craniofacial surgery can involve the improvement or restoration of form and function including disfiguring medical conditions such as rare clefts in the craniofacial structures, facial fractures, cleft palate, cleft lip, hemifacial microsomia, Crouzon's Syndrome, Treacher Collins Syndrome, and Apert's Syndrome.

  • Reconstructive surgery is one of the most popular branches of the field, as its practice aims to perform surgical intervention on various parts of the body—aside from the craniofacial area—to restore appearance and function. Reconstructive surgery is typically recommended after severe trauma and injuries, or after management or treatment of certain kinds of cancer.

  • Burn treatments are not a highly specific niche of the practice of surgery, but its practice aims to provide the restoration of the function and appearance of body parts affected or damaged by serious burns. Burn treatments in the realm of plastic surgery typically includes skin grafts (perhaps the most common kind of surgical procedure for burn patients), tissue expansion, free flap procedure, and microsurgery to restore the function of blood vessels and nerves.

  • Cosmetic surgery is perhaps the best-known branch of plastic surgery. While the other branches of the field are concerned with necessary treatments for damage caused by injuries, illness, or accidents, cosmetic surgery is purely optional. Cosmetic surgery aims to improve the appearance of a patient or remove the visible signs of aging. This branch is also the most lucrative, with millions and millions of people around the world having procedures done in order to improve or preserve their looks. Popular cosmetic procedures include eyelid surgery, rhinoplasty, abdominoplasty, breast augmentation, facelifts, and liposuction. Other procedures also include penile surgery, breast reduction, breast lift, butt implants, butt lift, chemical peels for the removal of scars and other unsightly marks, body contouring, labiaplasty, ear pinning, brow and forehead lift, cheek lift, chin implant, orthognathic surgery, keloid removal, arm lift, filler injections, and resurfacing or rejuvenation of the skin through laser treatments.

When should you see a Plastic Surgeon?

Cosmetic surgeons, while licensed and highly qualified medical professionals, should only be seen if the surgical procedures you wish to be done on your face or other parts of your body are of a cosmetic or aesthetic nature. If you wish to improve your appearance or improve your psychological or emotional state through your looks, then a cosmetic surgeon is the right fit for you.

If, however, you wish to restore both form and function to body parts that are damaged by illness or injury, then you might want to seek out a plastic surgeon specializing on whatever part of the body you are seeking reconstruction for. In the case of disfiguring illnesses or injury, as well as congenital defects that are interfering with how you live your daily life, you definitely have to consult and seek treatment or surgical procedures from a qualified plastic surgeon who has done training and good work in the past.

Disfiguring illnesses can include cancer; many management methods and treatments for this condition can involve surgical procedures that might necessitate the removal of a certain part of the body. A plastic surgeon can help you restore the appearance of the affected area, as well as restore the function of that area that will help you live life as normally as possible.

References:

  • University of Michigan Health System, Reconstructive Burn Surgery
  • American Society of Plastic Surgeons, Reconstructive Procedures
  • Melvin Shiffman, Cosmetic Surgery: Art and Techniques
  • Isabella Mazzola, Plastic Surgery: Principles
  • Stephen Lock, et. al., The Oxford Illustrated Companion to Medicine
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