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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 reaches back to the ancient world. Physicians in Ancient India including the great Indian surgeon Susrutha were utilizing Skin Graft s for reconstructive work as early as the 8th Century BC and performed nose reconstruction, using a portion of the forehead, during periods where amputation of the nose was a punishment for certain crimes. The Romans were able to perform simple techniques such as repairing damaged ears from around the 1st Century BC . 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 that 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. Sir Harold Gillies developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in World War I ; he is considered to be the father of modern plastic surgery. His work was expanded upon during World War II by one of his former students and cousin, Archibald McIndoe , who pioneered treatments for RAF aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the Guinea Pig Club .


RECONSTRUCTIVE SURGERY


Common reconstructive surgeries are: Breast Reconstruction for women who have had a Mastectomy , Cleft Lip And Palate Surgery , Contracture surgery for Burn survivors, and closing skin and Mucosa defects after removal of tumors in the head and neck region. Sex Reassignment Surgery for Transsexual people is another example of reconstructive surgery.

Plastic surgeons have developed the use of Microsurgery to transfer tissue for coverage of a soft tissue defect when no local tissue is available. Tissue, such as a muscle, may be removed from the body, moved to another site on the body and reconnected to a blood supply by suturing blood vessels as small as 1-2 mm in diameter.

There is a definite gray area between reconstructive and cosmetic surgery. Many of the techniques of cosmetic surgery are utilized in reconstructive surgery to improve Cosmesis .


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 (the only official entity overseeing physician certification in the United States) as the subspecialty dedicated to the surgical repair of defects of form or function -- this includes cosmetic (or aesthetic) surgery, as well as reconstructive surgery. The term "cosmetic surgery" however, simply refers to surgery that is designed to improve cosmetics, or appearance. (One could argue that reconstructive surgery always has some cosmetic aspect to it, because form and function are often both important in plastic surgery repairs.) Thus there is no real art of "cosmetic surgery": it is a catch-all commercial phrase that laypeople understand easily and non-plastic surgeons eagerly use because they are not allowed to use the term "plastic surgery".

It is vital to check a physician's credentials, looking for those MDs who are actually board-certified by the American Board Of Plastic Surgery . Plastic Surgery training takes 5 to 7 years of surgical residency training after medical school, and even more depending on the residency program. Because cosmetic surgery is seen as lucrative, non-plastic surgeons who receive fewer years of training for their specialty, advertise that they perform "cosmetic surgery" which is not a true specialty, only a commerical term. Thus to gain cerdibility, these non-plastic surgeons have gotten together to draft fake "medical boards" that are NOT recognized by the American Board Of Medical Specialties , such as "American Board of Cosmetic Surgery" and "American Board of Facial Plastic and Reconstructive Surgery," both of which have been created and easily fool the layperson into thinking these physicians have actually been trained in Plastic Surgery. Remember, the American Board Of Medical Specialties only recognizes the American Board Of Plastic Surgery for certification of Plastic Surgeons in the United States, and require rigorous training standards in order to provide safe medical and surgical care.

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


  • s. This can involve either saline or silicone gel prosthetics.

  • s. This procedure can be performed by using silicone implants or fat grafting and transfer from other areas of the body.

  • scars and sagging skin—not technically surgery and can be performed by a Cosmetologist . Chemical peels commonly involve Phenol, TCA, or Glycolic acid as the active agent. Phenol peels, while the most effective, require cardiac monitoring and require longer recovery periods, thus diminishing their current popularity.

  • Mastopexy (or "breast lift"): Raising of sagging breasts

  • Labiaplasty : Surgical reduction and reshaping of the labia



  • 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

  • with an implant (e.g. silicone) or by Sliding Genioplasty of the jawbone.

  • Cheek Augmentation

  • Collagen, Fat, And Other Tissue Filler Injection s

  • does not endorse this procedure outside of controlled trials with IRB oversite.



RELATED DISCIPLINES

Plastic surgery is a broad field, and may be subdivided further. Plastic surgery training and approval by the American Board Of Plastic Surgery includes mastery of the following as well:

  • Craniofacial Surgery mostly revolves around the treatment of pediatric congenital anomalies, such as cleft lip and palate, craniosynostosis, and other disturbances in facial growth and development. Because these children have multiple issues, they are often taken care of in an interdisciplinary approach which include oral surgeons, otolaryngologists, speech therapists, occupational therapists, geneticists.


  • Hand Surgery is a field that has some overlap with General Surgeons and Orthopedic Surgeons (see Hand Surgeon ). Plastic surgeons receive full training in hand surgery, with some trainees deciding even to do an additional full-year hand Fellowship afterwards (this fellowship can also be pursued by general surgeons and orthopedic surgeons). In particular, plastic surgeons receive training in Microvascular Surgery , which is needed to replant and amputated hand or digit. Many hand operations (such as reconstruction of injuries, replantations, rheumatoid surgery and surgery of congenital defects) are performed by plastic surgeons.


  • Maxillofacial Surgery is surgery of the "maxilla" (which means Jaw ) and face, and is an important aspect of plastic surgery. This field grew from contributions by both the plastic surgeons and oral surgeons. Examples of repairs here would be traumatic Fractures of the jaw and face (such as from fights or vehicle accidents), tumors of the jaw and face.



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 Wealth y. However, others have been known to take out loans for repeat procedures.