Plastic Surgeon/Plastic Surgery

Jai Ganesh · 2025-03-21 17:45:59

Plastic Surgeon/Plastic Surgery

Gist

A plastic surgeon is a medical doctor specializing in plastic and reconstructive surgery, trained to perform procedures that enhance or restore physical appearance and function. They address both cosmetic and reconstructive needs, including conditions caused by birth defects, trauma, burns, or disease.

Plastic surgeons, a surgical specialty, focus on restoring, reconstructing, or altering the human body, encompassing both reconstructive surgery (repairing defects or injuries) and cosmetic surgery (enhancing appearance).

Summary

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery covers a wide range of specialties, including craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. This category of surgery focuses on restoring a body part or improving its function. In contrast, cosmetic (or aesthetic) surgery focuses solely on improving the physical appearance of the body. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

Development of modern techniques

The father of modern plastic surgery is generally considered to have been Sir Harold Gillies. A New Zealand otolaryngologist working in London, he developed many of the techniques of modern facial surgery in caring for soldiers with disfiguring facial injuries during the First World War.

During World War I, he worked as a medical minder with the Royal Army Medical Corps. After working with the French oral and maxillofacial surgeon Hippolyte Morestin on skin grafts, he persuaded the army's chief surgeon, Arbuthnot-Lane, to establish a facial injury ward at the Cambridge Military Hospital, Aldershot, later upgraded to a new hospital for facial repairs at Sidcup in 1917. There Gillies and his colleagues developed many techniques of plastic surgery; more than 11,000 operations were performed on more than 5,000 men (mostly soldiers with facial injuries, usually from gunshot wounds). After the war, Gillies developed a private practice with Rainsford Mowlem, including many famous patients, and travelled extensively to promote his advanced techniques worldwide.

In 1930, Gillies' cousin, Archibald McIndoe, joined the practice and became committed to plastic surgery. When World War II broke out, plastic surgery provision was largely divided between the different services of the armed forces, and Gillies and his team were split up. Gillies himself was sent to Rooksdown House near Basingstoke, which became the principal army plastic surgery unit; Tommy Kilner (who had worked with Gillies during the First World War, and who now has a surgical instrument named after him, the kilner cheek retractor) went to Queen Mary's Hospital, Roehampton; and Mowlem went to St Albans. McIndoe, consultant to the RAF, moved to the recently rebuilt Queen Victoria Hospital in East Grinstead, Sussex, and founded a Centre for Plastic and Jaw Surgery. There, he treated very deep burns, and serious facial disfigurement, such as loss of eyelids, typical of those caused to aircrew by burning fuel.

McIndoe is often recognized for not only developing new techniques for treating badly burned faces and hands but also for recognising the importance of the rehabilitation of the casualties and particularly of social reintegration back into normal life. He disposed of the "convalescent uniforms" and let the patients use their service uniforms instead. With the help of two friends, Neville and Elaine Blond, he also convinced the locals to support the patients and invite them to their homes. McIndoe kept referring to them as "his boys" and the staff called him "The Boss" or "The Maestro".

His other important work included the development of the walking-stalk skin graft, and the discovery that immersion in saline promoted healing as well as improving survival rates for patients with extensive burns—this was a serendipitous discovery drawn from observation of differential healing rates in pilots who had come down on land and in the sea. His radical, experimental treatments led to the formation of the Guinea Pig Club at Queen Victoria Hospital, Sussex. Among the better-known members of his "club" were Richard Hillary, Bill Foxley and Jimmy Edwards.

Details

It is a common misunderstanding that the word plastic in plastic surgery means artificial. Rather, the word originated from the ancient Greek word plastikos, which means to mold or give form. Plastic surgery is a surgical specialty involved with both the improvement in a person's appearance and the reconstruction of facial and body tissue defects due to illness, trauma, or birth disorders.

Plastic surgery restores and improves function, as well as appearance. It can involve surgery on any part of the anatomy, except the central nervous system, including, but not limited to, the following:

* Skin (including skin cancer, scars, burns, birthmarks, and tattoo removal)
* Maxillofacial (the facial skeleton)
* Congenital anomalies (including deformed ears, cleft palate, and cleft lip)
* Doctors who perform plastic surgery

It is important to select a doctor who is certified in plastic surgery by the American Board of Plastic Surgery. Generally, a surgeon who is board-certified in plastic surgery has graduated from an accredited medical school and has completed at least 5 years of graduate medical education--usually 3 years of general surgery and 2 years of plastic surgery. In addition, the surgeon must practice plastic surgery for 2 years and pass comprehensive written and oral exams to become board-certified. Board certification is renewed every 10 years to ensure ongoing competency in the specialty.

What does plastic surgery include?

Plastic surgery includes both reconstructive and aesthetic (cosmetic) procedures:

Reconstructive plastic surgery

In general, reconstructive surgery is done on abnormal structures of the body that may be caused by the following:

* Trauma
* Infection
* Developmental abnormalities
* Congenital (present at birth) anomalies
* Disease
* Tumors

This type of surgery is usually done to improve function, but may also be done to change appearance.

Cosmetic (aesthetic) plastic surgery

Cosmetic surgery is done to repair or reshape otherwise normal structures of the body, generally, to improve appearance.

Details

Plastic surgery is a broad surgical subspecialty that, unlike other specialties, isn't confined to a single organ system. As a result, it is a technically demanding and naturally creative field that is constantly changing and reinventing itself. Plastic surgeons treat pathologies that range from congenital anomalies to cancer, trauma and degenerative conditions. Additionally, plastic surgeons are inherent team players since they work alongside other specialties like general surgery, gynecology, neurosurgery, ophthalmology, oral surgery, orthopedic surgery, otolaryngology and urology to reconstruct any anomaly or defect in the body to restore both form and function.

Cosmetic:

Aesthetic (Cosmetic) Surgery

Cosmetic or aesthetic surgery includes various rejuvenating procedures encompassing the entire body. For example, aesthetic surgery includes facelifts for age-related changes, rhinoplasty for nasal correction and blepharoplasty for excess eyelid skin. Breast and body surgeries are very common procedures and include breast augmentation, mastopexy, abdominoplasty and body contouring procedures after weight loss. The field also includes the use of various injectables, such as fillers and neurotoxins, to address asymmetries and age-related changes. Trainees can pursue further fellowship training if they desire.

Hand/Peripheral Nerve:

Hand/Upper Extremity

Plastic surgeons may care for both pediatric and adult patients with hand/upper extremity deformities related to traumatic, oncologic, degenerative and congenital/syndromic etiologies. Traumatic cases may necessitate bony fixation, soft tissue repair and reconstruction and even replantation of all or part of the hand and upper extremity after amputation. In addition, nerve and tendon repairs and transfers are important techniques for the restoration of sensation and function to the upper extremity. Trainees may pursue additional fellowship training in this field.

Nerve Surgery

Plastic surgeons perform nerve surgeries to treat a variety of conditions such as nerve decompression (i.e. for carpal tunnel syndrome), brachial plexus injury, facial reanimation, repair following traumatic injury, targeted muscle reinnervation after amputation and nerve transfers to treat injury. These various modalities aim to improve the quality of life in patients with either congenital, acquired or traumatic nerve pathologies.

Reconstruction:

Microsurgery

Microsurgery is a field of plastic surgery that involves the use of loupe or microscope magnification to anastomose small blood vessels (arteries and veins), nerves and lymphatics. Such techniques may be used in cases of free tissue transfer for reconstruction following cancer or trauma. As you can see below, plastic surgeons perform reconstructive surgery all over the body and often work with other surgical disciplines. Trainees have the option of pursuing additional fellowship training in this field.

Breast Reconstruction

Plastic surgeons play a critical role in the multidisciplinary care of patients with breast cancer. Reconstructive options after breast cancer surgery include implant-based or autologous reconstruction after mastectomy.

Head/Neck and Dermatologic Surgical Oncology

Plastic surgeons care for cancers of the head/neck region including melanoma, squamous cell carcinoma and osteosarcomas. As one of the oldest subspecialties in plastic surgery, head/neck surgical oncology includes the management of cancer and the reconstruction of tumor defects. Plastic surgeons also partner with dermatologists for reconstruction of defects from Mohs surgery for skin cancer, particularly those in cosmetically sensitive areas such as the face or hands. Reconstructive techniques range from local rotational, transposition and advancement flaps to pedicled and free flaps. Plastic surgeons have the unique training to be able to problem-solve the reconstruction of defects from anywhere on the body.

Chest/Abdominal Wall Reconstruction

Complex reconstructive surgeries of the chest and abdomen are a common aspect of plastic surgery practice. Plastic surgeons restore the chest wall following tumor resection using mesh or rigid fixation for skeletal reconstruction, as well as pedicled or free tissue coverage. For the abdominal wall, plastic surgeons utilize an understanding of abdominal wall anatomy to manage complex and recurrent defects.

Lower Extremity Reconstruction

Orthopedic surgeons often partner with plastic surgeons for reconstruction and salvage of the lower extremity after trauma, tumor resection or chronic wounds. This requires an understanding of principles shared with orthopedic surgery, such as wound management and fracture fixation, as well as reconstructive principles to provide locoregional flaps and microvascular techniques for soft tissue coverage.

Lymphedema Treatment

Lymphedema affects nearly 250 million people worldwide. It can present as the primary pathology or can result from filariasis or, more commonly in the United States, lymph node dissection for cancer surgery. Modern surgical techniques for lymphedema range from direct excision or liposuction to more complex procedures such as lymphovenous anastomosis and lymph node microvascular transfer. The goals of these treatment options are to lessen long-term disability and functional impairment while improving quality of life.

Burn Reconstruction

Plastic surgeons are integral to the care of both pediatric and adult patients suffering from burn injuries. Reconstructive techniques include skin grafting, the use of various biologic matrices, allografts, flaps and free tissue transfer.

Pediatric/Craniofacial:

Cleft Lip/Palate Surgery

It is estimated that one in seven hundred children will be born with a cleft lip or palate and plastic surgeons are a critical component of the multidisciplinary care of these patients. Plastic surgery procedures include not only cleft lip and palate surgery but also primary and revisional rhinoplasties. Some surgeons may also have the opportunity to participate in missions around the world treating underserved patients and communities. Fellowships are available to further specialize in treating these patients.

Craniofacial Surgery

Craniofacial surgeons partake in the care of both pediatric and adult patients with craniofacial deformities related to various congenital, oncologic or traumatic etiologies. Techniques include ear and nose reconstruction, fracture fixation for maxillofacial fractures, skeletal reconstruction and cranial vault remodeling. Trainees may elect to pursue further training in this field.

Orthognathic Surgery

Orthognathic surgery corrects dentofacial anomalies of the upper and lower jaw. Correcting these irregularities realigns the jaws and teeth to improve not only a patient's bite but also their breathing and facial appearance. Patients with cleft lip and palate often have orthognathic surgery during their longitudinal care. Surgeons who perform orthognathic surgery work closely with orthodontists and oral surgeons.

Additional Information

Plastic surgery is a surgical specialty involved with both the improvement in a person's appearance and the reconstruction of facial and body tissue defects due to illness, trauma, or birth disorders. Plastic surgery restores and improves function, as well as appearance.

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#1 2025-03-21 17:45:59

Plastic Surgeon/Plastic Surgery

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