Plastic surgery is a medical Surgical specialties interested in the correction of form and function. While famous for aesthetic surgery, plastic surgery also includes a variety of fields: craniofacial surgery, hand surgery, burn surgery, microsurgery, and pediatric surgery. The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic.
Plastic surgery was being carried out in India by 2000 BCE. Sushruta (6th century BCE) made important contributions to the field of Plastic and Cataract surgery. The medical works of both Sushruta and Charak were translated into Arabic language during the Abbasid Caliphate (750 CE). These Arabic works made their way into Europe via intermediaries. In Italy the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) became familiar with the techniques of Sushruta.
British physicians traveled to India to see Rhinoplasty being performed by native methods. Reports on Indian Rhinoplasty were published in the Gentleman's Magazine by 1794. Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods. Carpue was able to perform the first major surgery in the Western world by 1815. Instruments described in the Sushruta Samhita were further modified in the Western world.
The Romans were able to perform simple techniques such as repairing damaged ears from around the 1st century BC. Due to religious reasons they didn't approve of the dissection of both human beings and animals, thus their knowledge was based in its entirety on the texts of their Greek predecessors. Notwithstanding this Aulus Cornelius Celsus has left some surprisingly accurate anatomical descriptions, some of which —for instance, his studies on the genitalia and the skeleton— are of special interest to plastic surgery.
In 1465, Sabuncuoglu's book, description, and classification of hypospadias was more informative and up to date. Localization of urethral meatus was described in detail. Sabuncuoglu also detailed the description and classification of ambiguous genitalia (Kitabul Cerrahiye-i Ilhaniye -Cerrahname-Tip Tarihi Enstitüsü, Istanbul) 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 surgery became commonplace.
Up until the techniques of anesthesia became established, all surgery on healthy tissues involved great pain. Infection from surgery was reduced once sterile technique and disinfectants were introduced. The invention and use of antibiotics beginning with sulfa drugs and penicillin was another step in making elective surgery possible.
In 1792, Chopart performed operative procedure on a lip using a flap from the neck. In 1814, Joseph Carpue successfully performed operative procedure on a British military officer who had lost his nose to the toxic effects of mercury treatments. In 1818, German surgeon Carl Ferdinand von Graefe published his major work entitled Rhinoplastik. Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap. In 1845, Johann Friedrich Dieffenbach wrote a comprehensive text on rhinoplasty, entitled Operative Chirurgie, and introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. In 1891, American otorhinolaryngologist John Roe presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896, James Israel, a urological surgeon from Germany, and In 1889 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects. In 1898, Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty. In 1928, Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik.
The U.S.'s first plastic surgeon was Dr. John Peter Mettauer. In 1827, he performed the first cleft palate operation with instruments that he designed himself. The New Zealander Sir Harold Gillies, an otolaryngologist, developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in World War I. 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. Plastic surgery as a specialty evolved tremendously during the 20th century in the United States. One of the founders of the specialty, Dr. Vilray Blair, was the first chief of the Division of Plastic and Reconstructive Surgery at Washington University in St. Louis, Missouri. In one of his many areas of clinical expertise, Blair treated World War I soldiers with complex maxillofacial injuries, and his paper on "Reconstructive Surgery of the Face" set the standard for craniofacial reconstruction. He was also one of the first surgeons without a dental background to be elected to the American Association of Oral and Plastic Surgery (later the organizations split to be renamed the American Association of Plastic Surgeons and the American Association of Oral and Maxillofacial Surgeons) and taught many surgeons who became leaders in the field of plastic surgery
In plastic surgery the transfer of skin tissue (skin grafting) is one of the most common procedures. (In traditional surgery a "graft" is a piece of living tissue, organ, etc., that is transplanted.
Usually, good results are expected from plastic surgery that emphasizes:
Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance. It is generally covered by insurance coverage but this may change according to the procedure required.
Common reconstructive surgical procedures are: breast reconstruction for women who have had a mastectomy, cleft lip and palate surgery, contracture surgery for burn survivors; one of the complication of severe burns''.Curling's_ulcer]), creating a new outer ear when one is congenitally absent, and closing skin and mucosa defects after removal of tumors in the head and neck region.
Plastic surgeons developed the use of microsurgery to transfer tissue for coverage of a defect when no local tissue is available. tissue flaps comprised of skin, muscle, bone, fat or a combination, may be removed from the body, moved to another site on the body and reconnected to a blood supply by suturing arteries and veins as small as 1-2 mm in diameter.
It is important to distinguish the terms "plastic surgery" and "cosmetic surgery": Plastic Surgery is a recognized surgical specialty and is defined 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, refers to surgery that is designed to improve cosmetics alone. Many other surgical specialists are also required to learn certain cosmetic procedures during their training programs. Contributing disciplines include dermatology, general surgery, plastic surgery, otolaryngology, maxillofacial surgery, and oculoplastic surgery.
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.
In recent years, a growing number of patients seeking cosmetic surgery have visited other countries to find doctors with lower costs. These medical tourists seek to get their procedures done for a cost savings in countries including Cuba, Thailand, Argentina, India, and some areas of eastern Europe. The risk of complications and the lack of after surgery support are often overlooked by those simply looking for the cheapest option.
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