Plastic surgery

Plastic surgery is a special kind of surgery that helps fix or change parts of the body. It has two main types: reconstructive surgery and cosmetic surgery.

Reconstructive surgery aims to restore or improve the function of a body part. This can include fixing faces, helping people with injuries in their mouths or hands, repairing small blood vessels, and treating serious burns.

Cosmetic surgery focuses only on making a person look better. An important part of plastic surgery is moving tissues to treat certain conditions.

For more information, see Reconstructive surgery.

Etymology

The word "plastic" in "plastic surgery" comes from an old Greek word. This word means "the art of modelling." It talks about reshaping the body. People began using this word in surgery in 1816. This was long before it was used for the man-made materials we see today.

History

See also: History of surgery

Ancient Period (3000 BCE–500 CE)
The oldest known ways to fix a broken nose are in an old Egyptian medical book called the Edwin Smith papyrus from around 1600 BC. People in India did reconstructive surgery as early as 800 BCE. One old book, the Sushruta Samhita, shows how to rebuild noses using skin flaps. An early physician named Sushrata helped shape early plastic and cataract surgery.

Roman doctors in the 1st century BCE fixed damaged ears with simple surgery. They studied older Greek writings because they did not dissect humans or animals for research.

Middle Ages to Early Modern Period (500–1800 CE)

During this time, doctors in the Abbasid Caliphate kept and added to medical knowledge with Arabic translations. An Arab doctor named Al-Zahrawi wrote about using silk thread in surgery and early ways to change the shape of breasts.

In Italy, doctors like Gaspare Tagliacozzi learned from Indian methods and wrote about rebuilding noses using skin from a patient’s arm.

Modern Period (1800–present)

In the 1700s, British doctors visited India to learn about nose rebuilding. One doctor, Joseph Constantine Carpue, brought these methods to England and did an early nose reconstruction in 1815.

In 1827, the first American plastic surgeon, John Peter Mettauer, did the first operation to fix a cleft palate.

Nascency of maxillofacial surgery

During World War I, new weapons like machine guns and explosive shells caused many soldiers to be hurt badly on their faces and heads. Better ways to stop infections meant that soldiers could live even with serious injuries.

Doctors had to act fast to save lives, often without time to think about how the face would look after. This made doctors need new ways to help these soldiers. Harold Gillies set up a special hospital to study and treat facial injuries. He knew that these injuries could make people feel sad, so he worked on ways to fix both how the faces looked and worked.

Gillies made new ways using skin and bone from other parts of the body to rebuild damaged faces. One big step was a way to move a piece of skin from one part of the body to the face while it was still connected, so it stayed healthy during the move.

Development of modern techniques

Sir Harold Gillies is called the father of modern plastic surgery. He was a doctor from New Zealand who worked in London. During the First World War, he helped soldiers who had serious face injuries.

Later, during World War II, plastic surgery teams were split up. Archibald McIndoe, who worked with Gillies, became very important. He helped people with severe burns and facial injuries. He also cared about helping patients feel normal again.

Sub-specialties

Plastic surgery is a big field with many smaller areas. In the United States, doctors who do this work are certified by the American Board of Plastic Surgery. Some of the main areas are:

Aesthetic surgery improves a person's appearance through operations on the face and body. This can be for looks or to help after an injury or illness.

Burn surgery has two parts. The first part treats a burn right after it happens. The second part helps fix the skin later, after it has healed.

Craniofacial surgery treats problems with the skull and face. For children, this often fixes issues they are born with, like cleft lip or palate. For adults, it helps repair damage from accidents or cancer.

Facial plastic surgery works on the face, head, and neck. It can improve looks or fix problems from an injury, illness, or something a person was born with.

Hand surgery deals with injuries and problems with the hands and wrists. This can include fixing birth problems or helping someone use their hand again after an injury.

Microsurgery moves tiny pieces of tissue to repair missing parts of the body, like in breast reconstruction or fixing hand injuries.

Pediatric plastic surgery helps children born with certain conditions, like cleft lip, extra fingers or toes, or hand problems. The goal is to help them grow and develop properly.

Techniques and procedures

In plastic surgery, doctors move skin from one place to another to help someone. This is called a skin graft. The skin can come from the person’s own body. This is called an autograft.

If there isn’t enough skin, doctors can grow skin in a lab or use special materials.

Sometimes, skin can come from another person who is a good match. This is called an allograft. Skin can also come from a different animal. This is called a xenograft. Good results in plastic surgery need careful planning. Cuts should follow natural lines on the skin, and doctors use the right materials to close the wound.

Cosmetic surgery procedures

Cosmetic surgery is a type of surgery done to help improve a person's looks or remove signs of aging. Some of these surgeries also help with comfort, like reducing back or neck pain. Others are done after treatments for breast cancer to restore the breast's natural shape.

Many people choose cosmetic surgeries to feel better about their appearance. These procedures include shaping the nose, eyelids, and face, as well as adding or removing fat and altering other body parts. Over the years, more people have been choosing these surgeries, especially women, but men and people of all ages are also included. The most common procedures today are nose reshaping, eyelid surgery, face lifts, fat removal, and breast augmentations. These surgeries use different materials, like silicone or fat from the body, to achieve the desired results.

Complications, risks, and reversals

All surgeries have some risks. When people have cosmetic surgery, some problems can happen. These can include hematoma, nerve injury, infection, scarring, implant failure, and end organ damage. For example, breast implants can sometimes break apart. Some studies show that filling certain breast implants more can help lower the chances of them breaking. Many people with breast implants may need them removed within ten years.

Psychological disorders

Some people feel very unhappy with how they look and think they have problems with their appearance that need to be fixed. This can be linked to a condition called body dysmorphic disorder. In this condition, a person becomes very worried about what they see as defects in their body or face, even if the issue is very small or not noticeable to others.

Many people with this condition turn to plastic surgery to try to fix these worries, but the surgery does not always make them feel better. In fact, it can sometimes make the problem worse because the real issue is in their thoughts, not their appearance.