Plastic surgery

Plastic surgery is a special kind of surgery that helps fix or change parts of the human 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 who have injuries in their mouths or hands, repairing small blood vessels, and treating serious burns.

Cosmetic surgery, on the other hand, focuses only on making a person look better. While there is no single clear definition for plastic surgery, an important part of it 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 meaning "the art of modelling." It refers to reshaping the body. People started using this word in surgery in 1816, long before it was used for man-made materials we see today.

History

See also: History of surgery

Ancient Period (3000 BCE–500 CE)
The earliest known treatments for fixing a broken nose appear in an old Egyptian medical text called the Edwin Smith papyrus from around 1600 BC. People in India were also doing reconstructive surgery as early as 800 BCE. One important ancient text, the Sushruta Samhita, describes 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 repaired 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 through Arabic translations. An Arab doctor named Al-Zahrawi described using silk thread in surgery and wrote about early methods 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 performed an early nose reconstruction in 1815.

In 1827, the first American plastic surgeon, John Peter Mettauer, performed 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 suffer serious injuries to their faces and heads. Better ways to stop infections meant that injuries that would have been deadly before could now be survived, leading to many soldiers living with serious facial damage.

Doctors had to act quickly to save lives, often without time to think about how the face would look afterward. This created a need for new surgical methods to help these soldiers. Harold Gillies set up a special hospital to study and treat facial injuries. He understood that these injuries could also affect a person's feelings and mental health, so he worked on techniques to restore both the look and function of his patients' faces.

Gillies created new methods using pieces of skin and bone from other parts of the body to rebuild damaged faces. One key advance was a technique where a piece of skin was moved from one part of the body to the face while still connected, ensuring it stayed alive and healthy during the transfer.

Development of modern techniques

Sir Harold Gillies is often 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, mostly from gunshots. He worked with other doctors to develop new ways to fix these 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, especially those from burning fuel. He also cared about helping patients feel normal again after their injuries.

Sub-specialties

Plastic surgery is a wide field that can be divided into smaller areas of focus. In the United States, doctors who do this work are certified by the American Board of Plastic Surgery. Some of the main areas include:

Aesthetic surgery looks at improving appearance through operations on the face and body. This type of surgery can be used for both cosmetic changes and to help after an injury or illness.

Burn surgery has two parts. The first part happens right after a burn injury to treat the wound. The second part happens later, after the burns have healed, to help rebuild and improve the skin's look and function.

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

Facial plastic surgery focuses on the face, head, and neck. It can improve looks or fix problems after an injury, illness, or something they were born with.

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

Microsurgery involves moving small pieces of tissue to repair missing parts of the body, such as in breast reconstruction or fixing injuries to the hand.

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

Techniques and procedures

In plastic surgery, moving skin from one place to another is a common way to help someone. This is called a skin graft. The skin can come from the person’s own body, which is called an autograft. If there isn’t enough skin, doctors can grow special layers of skin in a lab or use man-made materials.

Sometimes, skin can come from another person of the same kind, like a donor match, called an allograft. An example of this is a kidney transplant. Skin can also come from a different animal, called a xenograft. Good results in plastic surgery depend on careful planning so that cuts follow natural lines on the skin, using the right materials to close the wound, and removing any stitches that are showing early on.

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 come with some risks. When people have cosmetic surgery, some common problems can happen, such as hematoma, nerve injury, infection, scarring, implant failure, and end organ damage. For example, breast implants can sometimes have issues like breaking apart. Studies have shown that filling certain types of breast implants a bit more can help lower the chances of them breaking. Also, reports suggest that many people who get breast implants might need them taken out 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. Some people who cannot get more surgeries have tried to change themselves without a doctor, which can be very dangerous. The use of apps that change how people look in photos has also been linked to these worries, leading some to want surgery to look like their edited images.