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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 Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implica ...
includes
craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
, hand surgery,
microsurgery Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) whic ...
, and the treatment of
burn A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
s. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning,
cosmetic Cosmetic may refer to: *Cosmetics, or make-up, substances to enhance the beauty of the human body, apart from simple cleaning *Cosmetic, an adjective describing beauty, aesthetics, or appearance, especially concerning the human body *Cosmetic, a t ...
(or aesthetic) surgery aims at improving the appearance of it.


Etymology

The word ''plastic'' in ''plastic surgery'' means "reshaping" and comes from the Greek πλαστική (τέχνη), ''plastikē'' (''tekhnē''), "the art of modelling" of
malleable Ductility is a mechanical property commonly described as a material's amenability to drawing (e.g. into wire). In materials science, ductility is defined by the degree to which a material can sustain plastic deformation under tensile stres ...
flesh Flesh is any aggregation of soft tissues of an organism. Various multicellular organisms have soft tissues that may be called "flesh". In mammals, including humans, ''flesh'' encompasses muscles, fats and other loose connective tissues, but ...
. This meaning in English is seen as early as 1598. The surgical definition of "plastic" first appeared in 1839, preceding the modern "engineering material made from
petroleum Petroleum, also known as crude oil, or simply oil, is a naturally occurring yellowish-black liquid mixture of mainly hydrocarbons, and is found in geological formations. The name ''petroleum'' covers both naturally occurring unprocessed crud ...
" sense by 70 years.


History

Treatments for the plastic repair of a broken nose are first mentioned in the Egyptian medical text called the Edwin Smith papyrus. The early trauma
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
textbook was named after the American
Egyptologist Egyptology (from ''Egypt'' and Greek , '' -logia''; ar, علم المصريات) is the study of ancient Egyptian history, language, literature, religion, architecture and art from the 5th millennium BC until the end of its native religious ...
, Edwin Smith. The
Romans Roman or Romans most often refers to: *Rome, the capital city of Italy * Ancient Rome, Roman civilization from 8th century BC to 5th century AD *Roman people, the people of ancient Rome *''Epistle to the Romans'', shortened to ''Romans'', a lette ...
also performed plastic cosmetic
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
, using simple techniques, such as repairing damaged ears, from around the 1st century BC. For religious reasons, they did not dissect either human beings or animals, thus, their knowledge was based in its entirety on the texts of their
Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...
predecessors. Notwithstanding,
Aulus Cornelius Celsus Aulus Cornelius Celsus ( 25 BC 50 AD) was a Roman encyclopaedist, known for his extant medical work, ''De Medicina'', which is believed to be the only surviving section of a much larger encyclopedia. The ''De Medicina'' is a primary source on ...
left some surprisingly accurate
anatomical Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
descriptions, some of which — for instance, his studies on the
genitalia A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...
and the
skeleton A skeleton is the structural frame that supports the body of an animal. There are several types of skeletons, including the exoskeleton, which is the stable outer shell of an organism, the endoskeleton, which forms the support structure inside ...
— are of special interest to plastic surgery. The Indian medical works of both Sushruta and
Charaka Charaka was one of the principal contributors to Ayurveda, a system of medicine and lifestyle developed in Ancient India. He is known as an editor of the medical treatise entitled ''Charaka Samhita'', one of the foundational texts of classical ...
, originally in
Sanskrit Sanskrit (; attributively , ; nominally , , ) is a classical language belonging to the Indo-Aryan branch of the Indo-European languages. It arose in South Asia after its predecessor languages had diffused there from the northwest in the late ...
, were translated into the
Arabic language Arabic (, ' ; , ' or ) is a Semitic language spoken primarily across the Arab world.Semitic languages: an international handbook / edited by Stefan Weninger; in collaboration with Geoffrey Khan, Michael P. Streck, Janet C. E.Watson; Walter ...
during the
Abbasid The Abbasid Caliphate ( or ; ar, الْخِلَافَةُ الْعَبَّاسِيَّة, ') was the third caliphate to succeed the Islamic prophet Muhammad. It was founded by a dynasty descended from Muhammad's uncle, Abbas ibn Abdul-Muttalib ...
Caliphate in 750 AD.Lock, Stephen etc. (200ĞďéĠĊ1). ''The Oxford Illustrated Companion to Medicine''. USA: Oxford University Press. . ''(page 607)'' The Arabic translations made their way into
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
via intermediaries. In
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical re ...
, the Branca family of
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...
and
Gaspare Tagliacozzi Gaspare Tagliacozzi (his last name has also been spelled Taliacotius, Tagliacoze or Tagliacozzio; Bologna, March 1545 – Bologna, 7 November 1599) was an Italian surgeon, pioneer of plastic and reconstructive surgery. Biography Tagliacozzi w ...
(
Bologna Bologna (, , ; egl, label= Emilian, Bulåggna ; lat, Bononia) is the capital and largest city of the Emilia-Romagna region in Northern Italy. It is the seventh most populous city in Italy with about 400,000 inhabitants and 150 different nat ...
) became familiar with the techniques of Sushruta.
British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories, and Crown Dependencies. ** Britishness, the British identity and common culture * British English, ...
physicians travelled to India to see rhinoplasties being performed by Indian methods.Lock, Stephen etc. (2001). ''The Oxford Illustrated Companion to Medicine''. USA: Oxford University Press. . ''(page 651)'' Reports on Indian rhinoplasty performed by a
Kumhar Kumhar is a caste or community in India, Nepal and Pakistan. Kumhar have historically been associated with art of pottery. Etymology The Kumhars derive their name from the Sanskrit word ''Kumbhakar'' meaning earthen-pot maker. Dravidian la ...
vaidya Vaidya (Sanskrit: ), or vaid is a Sanskrit word meaning "traditional practitioner of Ayurveda", an indigenous Indian system of alternative medicine. Senior practitioners or teachers were called ''Vaidyarāja'' ("physician-king") as a mark of respe ...
were published in the ''
Gentleman's Magazine ''The Gentleman's Magazine'' was a monthly magazine founded in London, England, by Edward Cave in January 1731. It ran uninterrupted for almost 200 years, until 1922. It was the first to use the term '' magazine'' (from the French ''magazine' ...
'' by 1794.
Joseph Constantine Carpue Joseph Constantine Carpue (4 May 1764 – 30 January 1846) was an English surgeon who was born in London. He was associated with St George's Hospital and Duke of York Hospital in Chelsea, London, Chelsea. He was a skilled surgeon and popular ...
spent 20 years in India studying local plastic surgery methods. Carpue was able to perform the first major surgery in the
Western world The Western world, also known as the West, primarily refers to the various nations and state (polity), states in the regions of Europe, North America, and Oceania.
in the year 1815.Lock, Stephen etc. (2001). ''The Oxford Illustrated Companion to Medicine''. USA: Oxford University Press. . ''(page 652)'' Instruments described in the ''Sushruta Samhita'' were further modified in the Western world. In 1465, Sabuncu's book, description, and classification of
hypospadias Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location in the head of the penis. It is the second-most common birth abnormality of the male reproductive system, affecting abou ...
were more informative and up to date. Localization of the
urethral meatus The urinary meatus, (, ) also known as the external urethral orifice, is the opening of the urethra. It is the point where urine exits the urethra in both sexes and where semen exits the urethra in males. The meatus has varying degrees of sensiti ...
was described in detail. Sabuncuoglu also detailed the description and classification of ambiguous genitalia. In mid-15th-century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgery became common. In 1814, Joseph Carpue successfully performed an operative procedure on a British military officer who had lost his nose to the toxic effects of
mercury Mercury commonly refers to: * Mercury (planet), the nearest planet to the Sun * Mercury (element), a metallic chemical element with the symbol Hg * Mercury (mythology), a Roman god Mercury or The Mercury may also refer to: Companies * Merc ...
treatments. In 1818, German surgeon
Carl Ferdinand von Graefe Carl may refer to: *Carl, Georgia, city in USA *Carl, West Virginia, an unincorporated community *Carl (name), includes info about the name, variations of the name, and a list of people with the name *Carl², a TV series * "Carl", List of Aqua Teen ...
published his major work entitled '' Rhinoplastik''. Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap. The first American plastic surgeon was John Peter Mettauer, who, in 1827, performed the first
cleft palate A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nose. The te ...
operation with instruments that he designed himself. In 1845,
Johann Friedrich Dieffenbach Johann Friedrich Dieffenbach (1 February 1792 – 11 November 1847) was a German surgeon. He was born in Königsberg and died in Berlin. Dieffenbach specialized in skin transplantation and plastic surgery. His work in rhinoplastic and maxillof ...
wrote a comprehensive text on rhinoplasty, titled ''Operative Chirurgie'', and introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. Another case of plastic surgery for nose reconstruction from 1884 at
Bellevue Hospital Bellevue Hospital (officially NYC Health + Hospitals/Bellevue and formerly known as Bellevue Hospital Center) is a hospital in New York City and the oldest public hospital in the United States. One of the largest hospitals in the United States ...
was described in
Scientific American ''Scientific American'', informally abbreviated ''SciAm'' or sometimes ''SA'', is an American popular science magazine. Many famous scientists, including Albert Einstein and Nikola Tesla, have contributed articles to it. In print since 1845, it i ...
. In 1891, American
otorhinolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...
John Roe presented an example of his work: a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896,
James Israel James Adolf Israel (2 February 1848 – 2 February 1926) was a German surgeon. Academic background Israel was a native of Berlin, where he was born to Jewish parents. In 1870, Israel received his medical doctorate from Friedrich-Wilhelm ...
, a
urological Urology (from Greek οὖρον ''ouron'' "urine" and ''-logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organ ...
surgeon from Germany, and in 1889 George Monks of the United States each described the successful use of
heterogeneous Homogeneity and heterogeneity are concepts often used in the sciences and statistics relating to the uniformity of a substance or organism. A material or image that is homogeneous is uniform in composition or character (i.e. color, shape, siz ...
free-bone grafting to reconstruct saddle nose defects. In 1898, Jacques Joseph, the German
orthopaedic Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
-trained
surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
, published his first account of reduction rhinoplasty. In 1928, Jacques Joseph published ''Nasenplastik und Sonstige Gesichtsplastik''.


Nascency of maxillofacial surgery

It is with the development of new weapons, such as
machine guns A machine gun is a fully automatic, rifled autoloading firearm designed for sustained direct fire with rifle cartridges. Other automatic firearms such as automatic shotguns and automatic rifles (including assault rifles and battle rifles) a ...
and explosive shells that the war began in the trenches, which led to an incalculable number of mutilations to the faces and the head because the trenches only made it possible to protect the body of the soldier during the World War I. The surgeons, who were not prepared for these injuries, were even less prepared for a large number of injuries and had to react quickly and intelligently to treat the greatest number. Facial injuries were hard to treat on the front line because of the sanitary conditions many infections could occur. Sometimes, some stitches were made on a jagged wound without thinking about the amount of flesh that has been lost, so scars after were hideous and disfigured soldiers. Some injured had important injuries and the stitches were not sufficient so some became blind, or were left with gaping holes instead of their nose.
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
, scared by the number of new facial injuries and the lack of good surgery decides to dedicate an entire hospital to the reconstruction of facial injuries as fully as possible. He took into account the psychological dimension.
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
introduce
skin grafts Skin grafting, a type of graft surgery, involves the transplantation of skin. The transplanted tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding or trauma * burns * areas of extensive skin loss du ...
to the treatments of soldiers, so they would be less horrified by looking themselves in the mirror. It is the multidisciplinary approach to the treatment of facial lesions, bringing together
plastic surgeons 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 includes craniofa ...
, dental surgeons, technicians, and specialized nurses, which has made it possible to develop techniques leading to the reconstruction of injured faces.
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
identified the need to advance the specialty of maxillofacial surgery which would be directly dedicated to the management of war wounds at this time. He has developed a new technique using rotational and transposition flaps but also bone grafts from the ribs and tibia to reconstruct facial defects caused by the weapons during the war
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
experimented with this technique so he knew that he have to start by moving back healthy tissue to its normal position and then he will be able to fill with tissue from another place on the body of the soldier. One of the most successful techniques in skin grafting had the aim of not completely severing the connection to the body. It was possible by releasing and lifting a flap of skin from the wound. The flap of skin, still connected to the donor site would then be swung over the site of the wound, this technique allows the maintenance of physical connection and ensured that blood was supplied to the skin and increase the chances of the skin graft being accepted by the body. At this time, we assist also to improving in treating infections also meant that important injuries had become survivable mostly thanks to the new technique of
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
. Some soldiers arrived at the hospital of
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
without noses, chins, cheekbones, or even eyes. But for them, the most important trauma was psychological.


Development of modern techniques

The father of modern plastic surgery is generally considered to have been Sir
Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...
. A New Zealand
otolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...
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 World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
. During
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
, he worked as a medical minder with the
Royal Army Medical Corps The Royal Army Medical Corps (RAMC) is a specialist corps in the British Army which provides medical services to all Army personnel and their families, in war and in peace. The RAMC, the Royal Army Veterinary Corps, the Royal Army Dental Corps a ...
. After working with the renowned French oral and maxillofacial surgeon
Hippolyte Morestin Hippolyte Morestin (1 September 1869 – 12 February 1919) was a French surgeon, and associate professor of anatomy at the University of Paris. He was one of the founders of cosmetic surgery. He was dubbed "The Father of the Mouths" after his brea ...
on skin graft, he persuaded the army's chief surgeon, Arbuthnot-Lane, to establish a facial injury ward at the
Cambridge Military Hospital Cambridge Military Hospital was a hospital completed in 1879 in Aldershot Garrison, Hampshire, England which served the various British Army camps there. During World War I, the Cambridge Hospital was the first base hospital to receive casualt ...
,
Aldershot Aldershot () is a town in Hampshire, England. It lies on heathland in the extreme northeast corner of the county, southwest of London. The area is administered by Rushmoor Borough Council. The town has a population of 37,131, while the Alders ...
, later upgraded to a new hospital for facial repairs at
Sidcup Sidcup is an area of south-east London, England, primarily in the London Borough of Bexley. It is south-east of Charing Cross, bordering the London Boroughs of Bromley and Greenwich. Before the creation of Greater London in 1965, it was in the ...
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 Sir Archibald Hector McIndoe (4 May 1900 – 11 April 1960) was a New Zealand plastic surgeon who worked for the Royal Air Force during the Second World War. He improved the treatment and rehabilitation of badly burned aircrew. Early life Archi ...
, joined the practice and became committed to plastic surgery. When
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
broke out, plastic surgery provision was largely divided between the different services of the
armed forces A military, also known collectively as armed forces, is a heavily armed, highly organized force primarily intended for warfare. It is typically authorized and maintained by a sovereign state, with its members identifiable by their distinct ...
, and Gillies and his team were split up. Gillies himself was sent to Rooksdown House near
Basingstoke Basingstoke ( ) is the largest town in the county of Hampshire. It is situated in south-central England and lies across a valley at the source of the River Loddon, at the far western edge of The North Downs. It is located north-east of Southa ...
, 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 The Queen Victoria Hospital (QVH), located in East Grinstead, West Sussex, England is the specialist reconstructive surgery centre for the south east of England, and also provides services at clinics across the region. It has become world-fam ...
in East Grinstead,
Sussex Sussex (), from the Old English (), is a historic county in South East England that was formerly an independent medieval Anglo-Saxon kingdom. It is bounded to the west by Hampshire, north by Surrey, northeast by Kent, south by the English ...
, and founded a Centre for Plastic and Jaw Surgery. There, he treated very deep burn, 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 Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be retur ...
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 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 Serendipity is an unplanned fortunate discovery. Serendipity is a common occurrence throughout the history of product invention and scientific discovery. Etymology The first noted use of "serendipity" was by Horace Walpole on 28 January 1754. ...
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 The Guinea Pig Club, established in 1941, was a social club and mutual support network for British and allied aircrew injured during World War II. Its membership was made up of patients of Archibald McIndoe in Ward III at Queen Victoria Hospit ...
at
Queen Victoria Hospital The Queen Victoria Hospital (QVH), located in East Grinstead, West Sussex, England is the specialist reconstructive surgery centre for the south east of England, and also provides services at clinics across the region. It has become world-fam ...
, Sussex. Among the better-known members of his "club" were
Richard Hillary Flight Lieutenant Richard Hope Hillary (20 April 1919 – 8 January 1943) was an Anglo-Australian Royal Air Force fighter pilot during the Second World War. He wrote the book '' The Last Enemy'' about his experiences during the Battle of Brit ...
, Bill Foxley and
Jimmy Edwards James Keith O'Neill Edwards, DFC (23 March 19207 July 1988) was an English comedy writer and actor on radio and television, best known as Pa Glum in ''Take It from Here'' and as headmaster "Professor" James Edwards in ''Whack-O!''. Early lif ...
.


Sub-specialties

Plastic surgery is a broad field, and may be subdivided further. In the United States, plastic surgeons are board certified by
American Board of Plastic Surgery The American Board of Plastic Surgery, Inc. was organized as a subsidiary of the American Board of Surgery in 1938. The American Board of Plastic Surgery, Inc. was given the status of a major specialty board in 1941. It is the one certifying body f ...
. Subdisciplines of plastic surgery may include:


Aesthetic surgery

Aesthetic surgery is a central component of plastic surgery and includes facial and body aesthetic surgery. Plastic surgeons use cosmetic surgical principles in all reconstructive surgical procedures as well as isolated operations to improve overall appearance.


Burn 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.


Craniofacial surgery

Craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
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, microtia, craniosynostosis, and pediatric fractures. Adult craniofacial surgery deals mostly with reconstructive surgeries after trauma or cancer and revision surgeries along with orthognathic surgery and facial feminization surgery. Craniofacial surgery is an important part of all plastic surgery training programs. Further training and subspecialisation is obtained via a
craniofacial fellowship In the United States, a craniofacial surgery fellowship is a one-year program that prepares orthodontists to perform cosmetic, dental, and craniofacial surgery as well as the clinical application of orthodontics. The fellowship allows surgeons to l ...
. Craniofacial surgery is also practiced by maxillofacial surgeons.


Ethnic plastic surgery

Ethnic plastic surgery Ethnic plastic surgery, or ethnic modification, is plastic surgery intended to change an individual's appearance to look more or less like a particular race or ethnicity. Popular plastic surgery procedures which may have an ethnically-motivated c ...
is plastic surgery performed to change ethnic attributes, often considered used as a way of "passing".


Hand surgery

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. The hand surgery field is also practiced by
orthopedic surgeons Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
and general surgeons. Scar tissue formation after surgery can be problematic on the delicate hand, causing loss of dexterity and digit function if severe enough. There have been cases of surgery to women's hands in order to correct perceived flaws to create the perfect engagement ring photo.


Microsurgery

Microsurgery Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) whic ...
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.


Pediatric plastic surgery

Children often face medical issues very different from the experiences of an adult patient. Many
birth defects A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
or syndromes present at birth are best treated in childhood, and
pediatric Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...
plastic surgeons specialize in treating these conditions in children. Conditions commonly treated by pediatric plastic surgeons include craniofacial anomalies, Syndactyly (webbing of the fingers and toes), Polydactyly (excess fingers and toes at birth), cleft lip and palate, and congenital hand deformities.


Prison plastic surgery

Plastic surgery performed on an incarcerated population in order to affect their
recidivism Recidivism (; from ''recidive'' and ''ism'', from Latin ''recidīvus'' "recurring", from ''re-'' "back" and ''cadō'' "I fall") is the act of a person repeating an undesirable behavior after they have experienced negative consequences of th ...
rate, a practice instituted in the early 20th century that lasted until the mid-1990s. Separate from surgery performed for medical need.


Techniques and procedures

In plastic surgery, the transfer of skin tissue (
skin graft Skin grafting, a type of graft (surgery), graft surgery, involves the organ transplant, transplantation of skin. The transplanted biological tissue, tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding o ...
ing) is a very common procedure. Skin grafts can be derived from the recipient or donors: *
Autograft Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person ('' auto-'' meaning "self" in Greek). The autologous tissue (also called autogenous, autogene ...
s are taken from the recipient. If absent or deficient of natural tissue, alternatives can be cultured sheets of epithelial cells ''in vitro'' or synthetic compounds, such as integra, which consists of
silicone A silicone or polysiloxane is a polymer made up of siloxane (−R2Si−O−SiR2−, where R = organic group). They are typically colorless oils or rubber-like substances. Silicones are used in sealants, adhesives, lubricants, medicine, cooking ...
and bovine tendon collagen with glycosaminoglycans. *
Allograft Allotransplant (''allo-'' meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, o ...
s are taken from a donor of the same species. *
Xenograft Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenograft ...
s are taken from a donor of a different species. Usually, good results would be expected from plastic surgery that emphasize careful planning of incisions so that they fall within the line of natural skin folds or lines, appropriate choice of wound closure, use of best available suture materials, and early removal of exposed sutures so that the wound is held closed by buried sutures.,


Reconstructive surgery

Reconstructive plastic surgery is performed to correct functional impairments caused by burns; traumatic injuries, such as facial bone fractures and breaks; congenital abnormalities, such as cleft palates or cleft lips; developmental abnormalities; infection and disease; and
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
or
tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
s. The goal of reconstructive plastic surgery is to restore both form and function. The most common reconstructive procedures are tumor removal, laceration repair, maxillofacial surgery, scar revision, hand surgery and
breast reduction plasty Reduction mammoplasty (also breast reduction and reduction mammaplasty) is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional Cleavage (breasts), bust that is propo ...
. According to the American Society of Plastic Surgeons, the number of reconstructive breast reductions for women decreased in 2018 by 4 percent from the year before. Breast reduction in men decreased in 2018 by 8 percent. In 2018, there were 57,535 performed. Some other common reconstructive surgical procedures include
breast reconstruction Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both wit ...
after a
mastectomy Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operat ...
for the treatment of cancer, cleft lip and palate surgery,
contracture In pathology, a contracture is a permanent shortening of a muscle or joint. It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spasti ...
surgery for
burn A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
survivors, and creating a new outer ear when one is congenitally absent. Plastic surgeons use microsurgery to transfer tissue for coverage of a defect when no local tissue is available. Free 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 to 2 millimeters in diameter.


Cosmetic surgery procedures

Cosmetic surgery is a voluntary or elective surgery that is performed on normal parts of the body with the only purpose of improving a person's appearance and/or removing signs of aging. Some cosmetic surgeries such as breast reduction are also functional and can help to relieve symptoms of discomfort such as back ache or neck ache. Cosmetic surgeries are also undertaken following breast cancer and mastectomy to recreate the natural breast shape which has been lost during the process of removing the cancer. In 2014, nearly 16 million cosmetic procedures were performed in the United States alone. The number of cosmetic procedures performed in the United States has almost doubled since the start of the century. 92% of cosmetic procedures were performed on women in 2014, up from 88% in 2001. 15.6 million cosmetic procedures were performed in 2020, with the five most common surgeries being Nose Reshaping, Eyelid surgery, Facelift, Liposuction, and breast augmentation. Breast augmentation continues to be one of the top 5 cosmetic surgical procedures and has been since 2006. Silicone implants were used in 84% and saline implants in 16% of all breast augmentations in 2020. The American Society for Aesthetic Plastic Surgery looks at the statistics for 34 different cosmetic procedures. Nineteen of the procedures are surgical, such as rhinoplasty or facelift. The nonsurgical procedures include
Botox Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium '' Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromus ...
and laser hair removal. In 2010, their survey revealed that there were 9,336,814 total procedures in the United States. Of those, 1,622,290 procedures were surgical (p. 5). They also found that a large majority, 81%, of the procedures were done on Caucasian people (p. 12). In 1949, 15,000 Americans underwent cosmetic surgery procedures and by 1969 this number rose to almost half a million people. The American Society of Plastic Surgeons (ASPS) estimates that more than 333,000 cosmetic procedures were performed on patients 18 years of age or younger in the US in 2005 compared to approx. 14,000 in 1996. In 2018, more than 226,994 patients between the ages of 13 and 19 underwent plastic surgery compared to just over 218,900 patients in the same age group in 2010. Concerns about young people undergoing plastic surgery include the financial burden of additional surgical procedures needed to correct problems after the initial cosmetic surgery, long-term health complications from plastic surgery, and unaddressed mental health issues that may have led to surgery. The increased use of cosmetic procedures crosses racial and ethnic lines in the U.S., with increases seen among African-Americans, Asian Americans and Hispanic Americans as well as Caucasian Americans. In Asia, cosmetic surgery has become more popular, and countries such as China and India have become Asia's biggest cosmetic surgery markets. South Korea is also rising in popularity due to their expertise in facial bone surgeries (see
cosmetic surgery in South Korea Cosmetic surgery, also referred to as aesthetic surgery, is a surgical procedure which endeavours to improve the physical aspects of one's appearance to become more aesthetically pleasing. It is closely linked to plastic surgery, but cosmetic su ...
). Plastic surgery is increasing slowly, rising 115% from 2000 to 2015. "According to the annual plastic surgery procedural statistics, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2015, a 2 percent increase over 2014." A study from 2021 found that requests for cosmetic procedures had increased significantly since the beginning of the COVID-19 pandemic, possibly due to the increase in
videoconferencing Videotelephony, also known as videoconferencing and video teleconferencing, is the two-way or multipoint reception and transmission of audio signal, audio and video signals by people in different locations for Real-time, real time communication. ...
; cited estimates include a 10% increase in the United States and a 20% increase in France. The most popular aesthetic/cosmetic procedures include: *
Abdominoplasty Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia ...
("tummy tuck"): reshaping and firming of the
abdomen The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
*
Blepharoplasty Blepharoplasty (Greek: ''blepharon'', "eyelid" + ''plassein'' "to form") is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With t ...
("eyelid surgery"): reshaping of upper/lower eyelids including Asian blepharoplasty *
Phalloplasty Phalloplasty is the construction or reconstruction of a penis or the artificial modification of the penis by surgery. The term is also occasionally used to refer to penis enlargement. History Russian surgeon Nikolaj Bogoraz performed the fir ...
("penile surgery"): construction (or reconstruction) of a penis or, sometimes, artificial modification of the penis by surgery, often for cosmetic purposes *
Mammoplasty Mammaplasty (also called mammoplasty or mastoplasty) refers to a group of surgical procedures, the goal of which is to reshape or otherwise modify the appearance of the breast. There are two main types of mammoplasty: # Augmentation mammaplasty ...
: **
Breast augmentation Breast augmentation and augmentation mammoplasty is a cosmetic surgery technique using breast-implants and fat-graft mammoplasty techniques to increase the size, change the shape, and alter the texture of the breasts. Augmentation mammoplasty is ...
s (" breast implant" or "boob job"): augmentation of the
breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and secret ...
s by means of fat grafting, saline, or silicone gel prosthetics, which was initially performed for women with
micromastia Micromastia (also called hypomastia, breast aplasia, breast hypoplasia, or mammary hypoplasia) is a medical term describing the postpubertal underdevelopment of a woman's breast tissue. Just as it is impossible to define 'normal' breast size, th ...
** Reduction mammoplasty ("breast reduction"): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with
gigantomastia Breast hypertrophy is a rare medical condition of the breast connective tissues in which the breasts become excessively large. The condition is often divided based on the severity into two types, macromastia and gigantomastia. Hypertrophy of the ...
and for men with
gynecomastia Gynecomastia (also spelled gynaecomastia) is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Updated by Brent Wisse (1 ...
**
Mastopexy Mastopexy (Greek μαστός ''mastos'' "breast" + -pēxiā "affix") is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. ...
("breast lift"): 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 *** Augmentation mastopexy ("breast lift with breast implants"): Lifting breasts to make them less saggy, repositioning the nipple to a higher location, and increasing breast size with saline or silicone gel implants. Recent studies of a newer technique for simultaneous augmentation mastopexy (SAM) indicate that it is a safe surgical procedure with minimal medical complications. The SAM technique involves invaginating and tacking the tissues first, in order to previsualize the result, before making any surgical incisions to the breast. *
Buttock augmentation Gluteoplasty (Greek ''gloutόs'', rump + ''plassein'', to shape) denotes the plastic surgery and the liposuction procedures for the correction of the congenital, traumatic, and acquired defects and deformities of the buttocks and the anatomy o ...
("butt implant"): enhancement of the
buttock The buttocks (singular: buttock) are two rounded portions of the exterior anatomy of most mammals, located on the posterior of the pelvic region. In humans, the buttocks are located between the lower back and the perineum. They are compose ...
s using silicone implants or fat grafting ("Brazilian butt lift") where fat is transferred from other areas of the body *
Cryolipolysis Fat removal procedures are used mostly in Plastic surgery#Cosmetic surgery procedures, cosmetic surgery with the intention of removing unwanted adipose tissue. The procedure may be invasive, as with liposuction, or noninvasive using laser therapy, ...
: refers to a medical device used to destroy fat cells. Its principle relies on controlled cooling for non-invasive local reduction of fat deposits to reshape body contours. * Cryoneuromodulation: Treatment of superficial and subcutaneous tissue structures using gaseous nitrous oxide, including temporary wrinkle reduction, temporary pain reduction, treatment of dermatologic conditions, and focal cryo-treatment of tissue * Calf Augmentation: done by silicone implants or fat transfer to add bulk to calf muscles *
Labiaplasty Labiaplasty (also known as labioplasty, labia minora reduction, and labial reduction) is a plastic surgery procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva. T ...
: surgical reduction and reshaping of the
labia The labia are part of the female genitalia; they are the major externally visible portions of the vulva. In humans, there are two pairs of labia: the ''labia majora'' (or the outer labia) are larger and thicker, while the ''labia minora'' are fol ...
*
Lip augmentation Lip augmentation is a cosmetic procedure that modifies the shape of the lips using fillers, such as collagen or implants. The procedure may be performed to increase lip size, correct asymmetry, create protrusion, or adjust the ratio of the top and ...
: alter the appearance of the lips by increasing their fullness through surgical enlargement with lip implants or nonsurgical enhancement with injectable fillers * Cheiloplasty: surgical reconstruction of the lip *
Rhinoplasty Rhinoplasty ( grc, ῥίς, rhī́s, nose + grc, πλάσσειν, plássein, to shape), commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two typ ...
("nose job"): reshaping of the
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...
sometimes used to correct breathing impaired by structural defects. *
Otoplasty Otoplasty ( el, οὖς, , "ear" + , , "to shape") denotes the surgical and non-surgical procedures for correcting the deformities and defects of the pinna (external ear), and for reconstructing a defective, or deformed, or absent external ear, co ...
("ear surgery"/"ear pinning"): reshaping of the
ear An ear is the organ that enables hearing and, in mammals, body balance using the vestibular system. In mammals, the ear is usually described as having three parts—the outer ear, the middle ear and the inner ear. The outer ear consists of ...
, most often done by pinning the protruding ear closer to the head. *
Rhytidectomy A facelift, technically known as a rhytidectomy (from the Ancient Greek () "wrinkle", and () "excision", the surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are mul ...
("face lift"): removal of wrinkles and signs of aging from the face ** Neck lift: tightening of lax tissues in the neck. This procedure is often combined with a facelift for lower face rejuvenation. **
Browplasty A forehead lift, also known as a browlift or browplasty, is a cosmetic surgery procedure used to elevate a drooping eyebrow that may obstruct vision and/or to remove the deep “worry” lines that run across the forehead. History The first docume ...
("brow lift" or "forehead lift"): elevates eyebrows, smooths forehead skin ** Midface lift ("cheek lift"): tightening of the cheeks * Genioplasty: augmentation of the chin with an individual's bones or with the use of an implant, usually silicone, by suture of the soft tissue **
Mentoplasty Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of ma ...
: surgery to the chin. This can involve either enhancing or reducing the size of the chin. Enhancements are achieved with the use of facial implants. Reduction of the chin involved reducing the size of the chin bone. *
Cheek augmentation Cheek augmentation is a cosmetic surgical procedure that is intended to emphasize the cheeks on a person's face. To augment the cheeks, a plastic surgeon may place a solid implant over the cheekbone. Injections with the patients' own fat or a sof ...
("cheek implant"): implants to the cheek *
Orthognathic Surgery Orthognathic surgery (), also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion ...
: altering the upper and lower jaw bones (through osteotomy) to correct jaw alignment issues and correct the teeth alignment * Fillers injections:
collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
,
fat In nutrition science, nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such chemical compound, compounds, most commonly those that occur in living beings or in food. The term often refers spec ...
, and other tissue filler injections, such as
hyaluronic acid Hyaluronic acid (; abbreviated HA; conjugate base hyaluronate), also called hyaluronan, is an anionic, nonsulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminoglycans ...
*
Brachioplasty A brachioplasty, commonly called an arm lift, is a surgical procedure to reshape and provide improved contour to the upper arms and connecting area of chest wall. Although "brachioplasty" is commonly used to describe a specific procedure for the u ...
("Arm lift"): reducing excess skin and fat between the underarm and the elbow *
Laser A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. The word "laser" is an acronym for "light amplification by stimulated emission of radiation". The fir ...
Skin Rejuvenation or
laser resurfacing Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds to the sk ...
: the lessening of depth of facial pores and exfoliation of dead or damaged skin cells * Liposuction ("suction lipectomy"): removal of fat deposits by traditional suction technique or ultrasonic energy to aid fat removal *
Zygoma reduction plasty Zygoma reduction, also known as cheekbone reduction surgery, is a surgery used to reduce the facial width by excising part of the zygomatic bone and arch. Wide cheekbones are a characteristic facial trait of Asians, whose skull shapes tend to be mo ...
: reducing the facial width by performing osteotomy and resecting part of the zygomatic bone and arch *
Jaw reduction Jaw reduction or mandible angle reduction is a type of surgery to narrow the lower one-third of the face—particularly the contribution from the mandible and its muscular attachments. There are several techniques for treatment—including surgical ...
: reduction of the mandible angle to smooth out an angular jaw and creating a slim jaw * Buccal Fat Extraction: extraction of the buccal pads *
Body contouring Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through the standard of care procedures ( Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion ...
: the removal of this excess skin and fat from numerous areas of the body, restoring the appearance of skin elasticity of the remaining skin. The surgery is prominent in those who have undergone significant
weight loss Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other conn ...
resulting in excess sagging skin being present around areas of the body. The skin loses elasticity (a condition called elastosis) once it has been stretched past capacity and is unable to recoil back to its standard position against the body and also with age. *
Sclerotherapy Sclerotherapy (the word reflects the Greek ''skleros'', meaning ''hard'') is a procedure used to treat blood vessel malformations (vascular malformations) and also malformations of the lymphatic system. A medicine is injected into the vessels, wh ...
: removing visible '
spider veins Telangiectasias, also known as spider veins, are small dilated blood vessels that can occur near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. These dilated blood vessels can develop anywhere on ...
' (Telangiectasia), which appear on the surface of the skin. *
Dermal filler Injectable filler (injectable cosmetic filler, injectable facial filler) is a soft tissue filler injected into the skin at different depths to help fill in facial wrinkles, provide facial volume, and augment facial features: restoring a smoother ap ...
s: Dermal fillers are injected below the skin to give a more fuller, youthful appearance of a feature or section of the face. One type of dermal filler is Hyaluronic acid. Hyaluronic acid is naturally found throughout the human body. It plays a vital role in moving
nutrient A nutrient is a substance used by an organism to survive, grow, and reproduce. The requirement for dietary nutrient intake applies to animals, plants, fungi, and protists. Nutrients can be incorporated into cells for metabolic purposes or excret ...
s to the cells of the skin from the blood. It is also commonly used in patients with
Arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...
as it acts like a cushion to the bones which have depleted the
articular cartilage Hyaline cartilage is the glass-like (hyaline) and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-gray in color, with a firm consistency and has ...
casing. Development within this field has occurred over time with synthetic forms of hyaluronic acid is being created, playing roles in other forms of cosmetic surgery such as facial augmentation. * Micropigmentation: is the creation of permanent makeup using natural pigments to places such as the eyes to create the effect of eye shadow, lips creating lipstick and cheek bones to create a blush like look. The pigment is inserted beneath the skin using a machine which injects a small needle at a very fast rate carrying pigment into the skin, creating a lasting colouration of the desired area. In 2015, the most popular surgeries were Botox, liposuction, eyelid surgery, breast implants, nose jobs, and facelifts. According to the 2020 Plastic Surgery Statistics Report, which is published by the American Society of Plastic Surgeons, the most surgical procedure performed in the U.S. was Rhinoplasty (Nose reshaping)accounting for 15.2% of all cosmetic surgical procedures that year, followed by Blepharoplasty (Eyelid surgery), which accounted for 14% of all procedures. The third most populous procedure was Rhytidectomy (Facelift) (10% of all procedures), then Liposuction (9.1% of all procedures).


Complications, risks, and reversals

All surgery has risks. Common complications of cosmetic surgery includes
hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillary, capillaries. A he ...
, nerve damage, infection, scarring, implant failure and organ damage.
Breast implants A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenital ...
can have many complications, including rupture. In a study of his 4761 augmentation mammaplasty patients, Eisenberg reported that overfilling saline breast implants 10-13% significantly reduced the rupture-deflation rate to 1.83% at 8-years post-implantation. In 2011 FDA stated that one in five patients who received implants for breast augmentation will need them removed within 10 years of implantation.


Psychological disorders

Though media and advertising do play a large role in influencing many people's lives, such as by making people believe plastic surgery to be an acceptable course to change our identities to our liking, researchers believe that plastic surgery obsession is linked to psychological disorders like
body dysmorphic disorder Body dysmorphic disorder (BDD), occasionally still called dysmorphophobia, is a mental disorder characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional meas ...
. There exists a correlation between those with BDD and the predilection toward cosmetic plastic surgery in order to correct a perceived defect in their appearance. BDD is a disorder resulting in the individual becoming "preoccupied with what they regard as defects in their bodies or faces." Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive. While 2% of people have body dysmorphic disorder in the United States, 15% of patients seeing a dermatologist and cosmetic surgeons have the disorder. Half of the patients with the disorder who have cosmetic surgery performed are not pleased with the aesthetic outcome. BDD can lead to suicide in some people with the condition. While many with BDD seek cosmetic surgery, the procedures do not treat BDD, and can ultimately worsen the problem. The psychological root of the problem is usually unidentified; therefore causing the treatment to be even more difficult. Some say that the fixation or obsession with correction of the area could be a sub-disorder such as anorexia or muscle dysmorphia. The increased use of body and facial reshaping applications such as
Snapchat Snapchat is an American multimedia instant messaging app and service developed by Snap Inc., originally Snapchat Inc. One of the principal features of Snapchat is that pictures and messages are usually only available for a short time before the ...
and
Facetune Facetune is a photo editing application used to edit, enhance, and retouch photos on a user's iOS or Android device created by Lightricks. The app is often used for portrait and selfie editing. The app implements a number of beauty filters ...
have been identified as a potential triggers of BDD. Recently, a phenomenon referred to as 'Snapchat dysmorphia' has appeared to describe people who request surgery to resemble the edited version of themselves as they appear through Snapchat Filters. As a protest to the detrimental trend, Instagram banned all augmented reality (AR) filters that depict or promote cosmetic surgery. In some cases, people whose physicians refuse to perform any further surgeries, have turned to "
do it yourself "Do it yourself" ("DIY") is the method of building, modifying, or repairing things by oneself without the direct aid of professionals or certified experts. Academic research has described DIY as behaviors where "individuals use raw and semi ...
" plastic surgery, injecting themselves and running extreme safety risks.


Minimally Invasive Cosmetic Medicine

With the growing popularity of plastic surgery, has also come a wide-spread increase in minimally invasive alternatives involving intradermal and intramusclular injectables, including various neurotoxins such as
Botox Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium '' Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromus ...
, Dysport, Xeomin, and Jeuveau, amongst others, alongside
hyaluronic acid Hyaluronic acid (; abbreviated HA; conjugate base hyaluronate), also called hyaluronan, is an anionic, nonsulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminoglycans ...
based dermal fillers.


See also

*
Biomaterial A biomaterial is a substance that has been engineered to interact with biological systems for a medical purpose, either a therapeutic (treat, augment, repair, or replace a tissue function of the body) or a diagnostic one. As a science, biomateria ...
*
Body modification Body modification (or body alteration) is the deliberate altering of the human anatomy or human physical appearance. In its broadest definition it includes skin tattooing, socially acceptable decoration (''e.g.'', common ear piercing in many s ...
* Cosmetic surgery in Australia * Dental trauma *
Ethnic plastic surgery Ethnic plastic surgery, or ethnic modification, is plastic surgery intended to change an individual's appearance to look more or less like a particular race or ethnicity. Popular plastic surgery procedures which may have an ethnically-motivated c ...
* List of plastic surgery flaps * ''
Plastic and Reconstructive Surgery ''Plastic and Reconstructive Surgery'' is a peer-reviewed medical journal and the official publication of the American Society of Plastic Surgeons. It covers all aspects of plastic and reconstructive surgery Reconstructive surgery is surgery p ...
'' *
Scalp reconstruction Scalp reconstruction is a surgical procedure for people with scalp defects. Scalp defects may be partial or full thickness and can be congenital or acquired. Because not all layers of the scalp are elastic and the scalp has a convex shape, the use o ...
*
Serdev suture Scarless Serdev Suture suspension liftinguse percutaneous skeletal fixation of movable fascias without Surgical incision, incisions. In Brazil known as ''fio elastico''., are used to correct early :wikt:ptosis, ptosis and flabbiness in areas of fac ...
*
Rejuvenation Rejuvenation is a medical discipline focused on the practical reversal of the aging process. Rejuvenation is distinct from life extension. Life extension strategies often study the causes of aging and try to oppose those causes in order to slow ...


References


Further reading

* * * * *


External links

*
Countries with the largest total number of cosmetic procedures
',
Statista   Statista is an online platform specialized in market and consumer data, which offers statistics & reports, market insights, cosumer insights and company insights in German, English, Spanish and French. In addition to publicly available thi ...
, 2019 {{DEFAULTSORT:Plastic Surgery Medical specialties Cosmetic surgery Cosmetic industry