Plastic and Reconstructive Surgery

Plastic and Reconstructive Surgery is a specialized branch of surgery focused on the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk, and external genitalia. It uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

History

The history of Plastic and Reconstructive Surgery can be traced back to ancient times, with evidence of skin grafts being used in India around 800 BC. The field has evolved significantly over the centuries, with major advancements occurring during and after both World Wars, as surgeons were challenged to treat large numbers of injured soldiers. The term "plastic" in plastic surgery derives from the Greek word plastikos, meaning to mold or to shape; it does not relate to the synthetic polymer material known as plastic.

Types of Procedures

Plastic and Reconstructive Surgery encompasses a wide range of procedures, which can be broadly categorized into two main types: reconstructive surgery and cosmetic (or aesthetic) surgery.

Reconstructive Surgery

Reconstructive surgery is performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease. It is generally performed to improve function but may also be done to approximate a normal appearance. Common reconstructive surgeries include:

• Breast Reconstruction following mastectomy
• Cleft Lip and Palate surgery
• Hand surgery for conditions like carpal tunnel syndrome or rheumatoid arthritis
• Burn Repair Surgery
• Reconstruction after skin cancer removal

Cosmetic Surgery

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Common cosmetic procedures include:

• Rhinoplasty (nose reshaping)
• Liposuction
• Abdominoplasty (tummy tuck)
• Breast Augmentation
• Facelift (Rhytidectomy)

Training and Certification

Surgeons wishing to specialize in plastic and reconstructive surgery must complete a residency in plastic surgery. In the United States, they can then become board certified by the American Board of Plastic Surgery. Certification in other countries varies, but always involves extensive training and examination.

Ethical Considerations

Plastic and reconstructive surgeons face unique ethical considerations, particularly in cosmetic surgery, where the line between enhancing well-being and pandering to societal or individual vanity can be thin. Surgeons must navigate these issues carefully, ensuring that patients have realistic expectations and fully understand the risks involved.

Future Directions

The field of Plastic and Reconstructive Surgery continues to evolve, with advancements in technology and technique leading to more effective and less invasive procedures. Areas of rapid growth include Tissue Engineering, Regenerative Medicine, and the use of 3D Printing for surgical planning and the creation of implants.