Cosmetic Surgery

Plastic surgery

Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes two main fields: plastic and reconstructive 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.

Techniques and procedures

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).

• Autografts: Skin grafts taken from the recipient. If absent or deficient of natural tissue, alternatives can be:
  • Cultured Sheets of epithelial cells in vitro.
  • Synthetic compounds (e.g., Integra—a 2 layered dermal substitute consisting superficially of silicone and deeply of bovine tendon collagen with glycosaminoglycans).
• Allografts: Skin grafts taken from a donor of the same species.
• Xenografts: Skin grafts taken from a donor of a different species.

Usually, good results are expected from plastic surgery that emphasizes:

• Careful planning of incisions so that they fall in the line of natural skin folds or lines.
• Appropriate choice of wound closure.
• Use of best available suture materials.
• Early removal of exposed sutures so that the wound is held closed by buried sutures.

Reconstructive Surgery

"Reconstructive" redirects here. For other uses, see Reconstruction.

Reconstructive Plastic Surgery is performed to correct functional impairments caused by:

• burns
• traumatic injuries, such as facial bone fractures
• congenital abnormalities, such as cleft lip, or cleft palate
• developmental abnormalities
• infection or disease
• removal of cancers or tumours, such as a mastectomy for a breast cancer, a head or neck cancer or an abdominal invasion by a colon cancer

Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance.

Common reconstructive surgical procedures are: breast reconstruction for women who have had a mastectomy, cleft lip and palate surgery, contracture surgery for burn survivors, 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 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.

The most common reconstructive procedures are tumor removal, laceration repair, scar repair, hand surgery and breast reduction. According to the American Society of Plastic Surgeons, the number of reconstructive breast reductions for women increased in 2007 by 2 percent from the year before. Breast reduction in men also increased in 2007 by 7 percent.

Cosmetic or Aesthetic Surgery

Main article: Aesthetic cosmetic surgery

Aesthetic Surgery involves techniques intended for the "enhancement" of appearance through surgical and medical techniques, and is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal.

In 2006, nearly 11 million cosmetic surgeries were performed in the United States alone. The number of cosmetic sprocedures performed in the United States has increased over 50 percent since the start of the century. Nearly 12 million cosmetic surgeries were performed in 2007, with the five most common being breast augmentation, liposuction, nasal surgery, eyelid surgery and abdominoplasty. The increased use of cosmetic surgery crosses racial and ethnic lines in the U.S., with increases seen among African-Americans and Hispanic Americans as well as Caucasian Americans. In Europe, the second largest market for cosmetic procedures, cosmetic surgery is a $2.2 billion business. ^[8]

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.

• 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
• Mammoplasty
  • Breast augmentation ("breast enlargement" or "boob job"): Augmentation of the breasts. This can involve either fat grafting, saline or silicone gel prosthetics. Initially performed to women with micromastia
  • Breast reduction: Removal of skin and glandular tissue. Indicated to reduce back and shoulder pain in women with gigantomastia and/or for psychological benefit in women with gigantomastia/macromastia and men with gynecomastia.
  • Breast lift (Mastopexy): Lifting or reshaping of breasts to make them less saggy, often after weight loss (after a pregnancy, for example). It involves removal of breast skin as opposed to glandular tissue or scarless Serdev suture technique ^[9]
• Buttock Augmentation (or "butt augmentation" or "butt implants"): Enhancement of the buttocks. This procedure can be performed by using silicone implants or fat grafting and transfer from other areas of the body.
• Buttock lift (or "butt lift" or "brazilian butt lift"): Lifting, projection, tightening of the buttocks. This procedure can be performed by using the scarless Serdev suture technique without implants. ^[10]
• Chemical peel: Minimizing the appearance of acne, pock, and other scars as well as wrinkles (depending on concentration and type of agent used, except for deep furrows), solar lentigines (age spots, freckles), and photodamage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid (AHA), or salicylic acid (BHA) as the active agent.
• Labiaplasty: Surgical reduction and reshaping of the labia
• Rhinoplasty (or "nose job"): Reshaping of the nose
• Otoplasty (or ear surgery): Reshaping of the ear. Most often done by pinning the ear closer to the head.
• 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
• Brow lift: higher brow position by surgical or scarless Serdev suture
• Chin augmentation: Augmentation of the chin with an implant (e.g. silicone) by sliding genioplasty of the jawbone or by suture of the soft tissue.
• Cheek augmentation by suture Serdev suture
• Cheek lift/Midface lift using scarless suture technique.
• Collagen, fat, and other tissue filler injections (e.g. hyaluronic acid)
• Laser skin resurfacing
• Hilotherapy a therapy that provides relief from heamatoma, pain and swelling post-surgery without the dangers of Frostbite and Skin Necrosis

Plastic surgery sub-specialities

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 is divided into pediatric and adult craniofacial surgery. Pediatric craniofacial surgery mostly revolves around the treatment of congenital anomalies of the craniofacial skeleton and soft tissues, such as cleft lip and palate, craniosynostosis, and pediatric fractures. Because these children have multiple issues, the best approach to providing care to them is an interdisciplinary approach which also includes otolaryngologists, oral and maxillofacial surgeons, speech therapists, occupational therapists and geneticists. Adult craniofacial surgery deals mostly with fractures and secondary surgeries (such as orbital reconstruction) along with orthognathic surgery. Craniofacial surgery is an integral part of all plastic surgery training programs, and further training is frequently obtained via a craniofacial fellowship for additional expertise.
• Hand surgery is concerned with acute injuries and chronic diseases of the hand and wrist, correction of congenital malformations of the upper extremities, and peripheral nerve problems (such as brachial plexus injuries or carpal tunnel syndrome). Hand surgery is an important part of training in plastic surgery, as well as microsurgery, which is necessary to replant an amputated extremity. Most Hand surgeons will opt to complete a fellowship in Hand Surgery. The Hand surgery field is also practiced by orthopedic surgeons and general surgeons (see Hand surgeon).
• Microsurgery is generally concerned with the reconstruction of missing tissues by transferring a piece of tissue to the reconstruction site and reconnecting blood vessels. Popular subspecialty areas are breast reconstruction, head and neck reconstruction, hand surgery/replantation, and brachial plexus surgery.
• Burn surgery generally takes place in two phases. Acute burn surgery is the treatment immediately after a burn. Reconstructive burn surgery takes place after the burn wounds have healed. Reconstructive surgery generally involves plastic surgery.
• Pediatric plastic surgery. Children often face medical issues unique from the experiences of an adult patient. Many birth defects or syndromes present at birth are best treated in childhood, and pediatric plastic surgeons specialize in treating these conditions in children. Conditions commonly treated by pediatric plastic surgeons include craniofacial anomalies, cleft lip and palate and congenital hand deformities.