Plastic surgery: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Nancy Sculerati MD
No edit summary
mNo edit summary
 
(41 intermediate revisions by 11 users not shown)
Line 1: Line 1:
'''Plastic surgery''' is "an extremely diverse surgical specialty whose chief purpose is to restore form and function".(reference for quote:John L. Burns, M. D. , Steven J. Blackwell, M. D.,Chapter 72 –  Plastic Surgery, in: Townsend: Sabiston Textbook of Surgery, 17th ed., Copyright © 2004 Saunders, An Imprint of Elsevier)
{{subpages}}
{{TOC|right}}
'''Plastic surgery'''<ref>The word "plastic" derives from the Greek ''plastikos'' meaning to mold or to shape; its use here is not connected with modern [[Plastic|plastics]].</ref> is "an extremely diverse surgical specialty whose chief purpose is to restore form and function".<ref>quoted from: John L. Burns, M. D. , Steven J. Blackwell, M. D.,Chapter 72 –  Plastic Surgery, in: Townsend: Sabiston Textbook of Surgery, 17th ed., Copyright © 2004 Saunders, An Imprint of Elsevier.</ref> The field of plastic surgery is unique among modern surgical specialties because the entire body, with the exception of the Central Nervous System, is potentially within the province of the General Plastic Surgeon. Besides general plastics, there are regional specialties such as facial plastic surgery and ophthalmologic (eye) plastic surgery. The training of the surgeon may differ depending on whether the specialty is general or facial plastic surgery.  Whether general or regional, plastic surgery includes two broad types of surgery. These types are divided on the basis of the ''purpose'' of the surgery.
* [[Reconstructive Surgery| Reconstructive surgery]], including [[microsurgery]], focuses on undoing or masking deformities from trauma, surgery or disease.
* [[Cosmetic Surgery|Cosmetic (or aesthetic) surgery]] is performed in order to change features the patient finds unflattering.
==History==
The history of Plastic Surgery reaches back to the ancient world. Understanding the development of the field helps clarify what procedures and techniques fall into the realm of modern plastic surgery. Before the 20th Century, there was little ability for any surgeon to offer effective pain relief during an operation or to combat infection after one. All surgery was painful and fraught with a relatively high risk of complications and death. It is not surprising then, that the first operations in plastic surgery were reconstructive.


The word "plastic" derives from the Greek ''plastikos'' meaning to mold or to shape; its use here is not connected with modern [[plastics]].
===Reconstruction of facial features deformed by trama===
The [[Ancient Rome|Romans]] were able to perform simple techniques such as repairing damaged ears from around the [[1st century BC]].


Plastic surgery is unusual among modern surgical specialties because the entire body, with the exception of the Central Nervous System, is potentially within the province of the General Plastic Surgeon. The principal areas of plastic surgery include two broad fields.
Physicians in [[Indian subcontinent|ancient India]] including the great Indian surgeon [[Susrutha]] were utilizing [[skin graft]]s for reconstructive work as early as the [[8th century BC]]. His work ''Sushruta Samhita'' describes [[rhinoplasty]] and [[otoplasty]]. This knowledge of plastic surgery existed in [[India]] up to the late 18th century as can be seen from the reports published in ''Gentleman's Magazine'' (October 1794). [http://vigyanprasar.com/dream/jan2000/article2.htm] [http://members.ozemail.com.au/~oknoses/Overview.html]
* Reconstructive surgery, including [[microsurgery]], focuses on undoing or masking the destructive effects of [[Physical trauma|trauma]], surgery or [[disease]]. Reconstructive surgery may include closing defects using skin grafts or with local, regional or distant flaps&mdash;that is, by moving tissue from other parts of the body.
* Cosmetic (or aesthetic) surgery is most often performed in order to change features the patient finds unflattering. In many cases, however, there are medical reasons (for example, [[breast reduction]] when [[orthopedics|orthopedic]] problems are present).


==History==
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.  
The history of cosmetic surgery reaches back to the ancient world. Physicians in [[Indian subcontinent|ancient India]] including the great Indian surgeon [[Susrutha]] were utilizing [[skin graft]]s for reconstructive work as early as the [[8th century BC]]. His work ''Sushruta Samhita'' describes [[rhinoplasty]] and [[otoplasty]]. This knowledge of plastic surgery existed in [[India]] up to the late 18th century as can be seen from the reports published in ''Gentleman's Magazine'' (October 1794). [http://vigyanprasar.com/dream/jan2000/article2.htm] [http://members.ozemail.com.au/~oknoses/Overview.html]


The [[Ancient Rome|Romans]] were able to perform simple techniques such as repairing damaged ears from around the [[1st century BC]]. 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 century|19th]] and [[20th century|20th centuries]] that such surgeries became commonplace.  
However, because of the dangers associated with surgery in any form, it was not until the [[19th century|19th]] and [[20th century|20th centuries]] that such surgeries became commonplace, even for reconstructive purposes.


The [[United States|U.S.'s]] first plastic surgeon was [[John Peter Mettauer|Dr. John Peter Mettauer]]. He performed the first [[cleft|cleft palate]] operation in [[1827]] with instruments that he designed himself. The New Zealander [[Harold Gillies|Sir Harold Gillies]] developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in [[World War I]], he is considered to be the father of modern plastic surgery. His work was expanded upon during [[World War II]] by one of his former students and cousin, [[Archibald McIndoe]], who pioneered treatments for [[Royal Air Force|RAF]] aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the [[Guinea Pig Club]].
===Repair of birth defects===


==Reconstructive surgery==
The [[United States of America|U.S.'s]] first plastic surgeon was [[John Peter Mettauer|Dr. John Peter Mettauer]]. He performed the first [[cleft|cleft palate]] operation in 1827 with instruments that he designed himself. The New Zealander [[Harold Gillies|Sir Harold Gillies]] developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in [[World War I]], he is considered to be the father of modern plastic surgery. His work was expanded upon during [[World War II]] by one of his former students and cousin, [[Archibald McIndoe]], who pioneered treatments for [[Royal Air Force|RAF]] aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the [[Guinea Pig Club]].


Common reconstructive surgeries are: [[breast reconstruction]] for women who have had a [[mastectomy]], [[cleft|cleft lip and palate surgery]], [[contracture]] surgery for [[burn]] survivors,  and closing skin and [[mucosa]] defects after removal of tumors in the head and neck region. [[Sex reassignment surgery]] for [[transsexual]] people is another example of reconstructive surgery.  
Common reconstructive surgeries are: [[breast reconstruction]] for women who have had a [[mastectomy]], [[cleft|cleft lip and palate surgery]], [[contracture]] surgery for [[burn]] survivors,  and closing skin and [[mucosa]] defects after removal of tumors in the head and neck region. [[Sex reassignment surgery]] for [[transsexual]] people is another example of reconstructive surgery.  


===Care of wounds: plastic skin closure and repair of tissue defects===
Although wound closure is a part of every type of surgery that requires a substantial incision, plastic surgery has had a strong focus on optimal techniques of skin closure and the repair of open wounds.
Plastic surgeons have developed the use of [[microsurgery]] to transfer tissue for coverage of a defect when no local tissue is available. Tissue "flaps" comprised 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.
Plastic surgeons have developed the use of [[microsurgery]] to transfer tissue for coverage of a defect when no local tissue is available. Tissue "flaps" comprised 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.


There is a definite gray area between reconstructive and cosmetic surgery. Many of the techniques of cosmetic surgery are utilized in reconstructive surgery to improve [[cosmesis]].
Besides such specialized operations for restroring the integrity of the body, plastic surgery utilizes a set of principles for skin and wound closure that are aimed to minimize scarring and to camouflage the presence of scars.
 
==Cosmetic surgery==
 
Cosmetic surgery is a very popular avenue for personal enhancement, as demonstrated by the 11.9 million cosmetic procedures performed in the U.S. alone in [[2004]].  As for any operation, cosmetic procedures involve risk, and should therefore not be undertaken lightly. Within the US, critics of plastic surgery note that it is legal for any [[Physician|doctor]], regardless of speciality, to perform "cosmetic surgery", but not "plastic surgery". It is thus important to distinguish the terms "plastic surgery" and "cosmetic surgery": Plastic Surgery is recognized by the [[American Board of Medical Specialties]] (the only official entity overseeing physician certification in the United States) as the subspecialty dedicated to the surgical repair of defects of form or function -- this includes cosmetic (or aesthetic) surgery, as well as reconstructive surgery.  The term "cosmetic surgery" however, simply refers to surgery that is designed to improve cosmetics, or appearance.  (One could argue that reconstructive surgery always has some cosmetic aspect to it, because form and function are often both important in plastic surgery repairs.)  Thus there is no real art of "cosmetic surgery": it is a catch-all commercial phrase that laypeople understand easily and non-plastic surgeons eagerly use because they are not allowed to use the term "plastic surgery".
 
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]]
* [[Abdominal etching]] (or "ab etching": Specialized and trademarked liposuction surgery for male and female patients that affords six-pack abs or a flat, athletic, or countoured stomach.
* [[Blepharoplasty]] (or "eyelid surgery"): Reshaping of the eyelids or the application of permanent eyeliner, including [[Asian blepharoplasty]]
* [[breast implant|Augmentation Mammaplasty]] (or "breast enlargement" or "boob job"): Augmentation of the [[breast]]s. This can involve either saline or silicone gel prosthetics.
* [[Buttock Augmentation]] (or "butt augmentation" or "butt implants"): Enhancement of the [[buttock]]s. This procedure can be performed by using silicone implants or fat grafting and transfer from other areas of the body.
* [[Chemical peel]]: Minimizing the appearance of [[acne]], [[chickenpox|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 [[skin cancer|photodamage]] in general. Chemical peels commonly involve [[carbolic acid]] (Phenol), [[trichloroacetic acid]] (TCA), [[glycolic acid]] (AHA), or [[salicylic acid]] (BHA) as the active agent.
* [[Mastopexy]] (or "breast lift"): Raising of sagging breasts
* [[Labiaplasty]]: Surgical reduction and reshaping of the labia
* [[Rhinoplasty]] (or "nose job"): Reshaping of the [[nose]]
* [[Otoplasty]] (or ear surgery): Reshaping of the [[ear]]
* [[Rhytidectomy]] (or "face lift"): Removal of wrinkles and signs of aging from the face
* [[Liposuction|Suction-Assisted Lipectomy]] (or ''liposuction''): Removal of fat from the body
* [[Chin augmentation]]: Augmentation of the [[chin]] with an implant (e.g. silicone) or by [[sliding genioplasty]] of the jawbone.
* [[Cheek augmentation]]
* [[Collagen]], [[fat]], and other tissue filler injections (eg [[hyaluronic acid]])
* [[Mesotherapy]] : An alternative to liposuction where fluids are injected to break down and dissolve the fat (still a speculative treatment).
 
==Related disciplines==
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]] mostly revolves around the treatment of pediatric congenital anomalies, such as cleft lip and palate, craniosynostosis, and other disturbances in facial growth and development.  Because these children have multiple issues, they are often taken care of in an interdisciplinary approach which include oral surgeons, otolaryngologists, speech therapists, occupational therapists, geneticists.
 
* [[Hand surgery]] is a field that has some overlap with [[general surgery|general surgeons]] and [[orthopedic surgery|orthopedic surgeons]] (see [[Hand surgeon]]).  Plastic surgeons receive full training in hand surgery, with some trainees deciding even to do an additional full-year hand [[fellowship]] afterwards (this fellowship can also be pursued by general surgeons and orthopedic surgeons). In particular, plastic surgeons receive training in [[microvascular surgery]], which is needed to replant an amputated hand or digit.  Many hand operations (such as reconstruction of injuries, replantations, rheumatoid surgery and surgery of congenital defects) are performed by plastic surgeons.
 
* [[Maxillofacial surgery]] is surgery of the "maxilla" (which means [[jaw]]) and face, and is an important aspect of plastic surgery.  This field grew from contributions by both the plastic surgeons and oral surgeons.  Examples of repairs here would be traumatic [[fractures]] of the jaw and face (such as from fights or vehicle accidents), tumors of the jaw and face.
 
== Addiction to cosmetic surgery ==
 
Some people appear to become addicted to cosmetic surgery, possibly because of [[body dysmorphic disorder]]. Sufficient amounts of repeated cosmetic surgery can lead to irreversible damage to the normal body structure. However, due to the high cost of repeated cosmetic surgery, this disorder is generally one limited to the [[wealth]]y.  However, others have been known to take out loans for repeat procedures.
 
==See also==
* [[microsurgery]]
* [[breast reconstruction]], [[Breast reduction]], [[Breast implant]], [[Breast lift]]
* [[Operation Good Samaritan]][http://www.opgoodsam.org]
* [[Operation Smile]]
* [[Body modification]]
* [[Botox]]
* ''[[Dr. 90210]]''
* ''[[Extreme Makeover]]''
* ''[[Nip/Tuck]]''
 
===Plastic surgeons===
* [[Harry J. Buncke]]
* [[Wallace Chang]]
* [[Harold Gillies]]
* [[G. Patrick Maxwell]]
* [[Archibald McIndoe]]
* [[Joseph Murray]]
* [[Ivo Pitanguy]]
 
==External links==
* [http://www.plasticsurgery.org/ The American Society of Plastic Surgeons]
* [http://www.surgery.org The American Society for Aesthetic Plastic Surgery]
* [http://www.abplsurg.org/ The American Board of Plastic Surgery]
* [http://www.emedicine.com/plastic/topic433.htm Emedicine's History of Plastic Surgery entry]
 
{{Medicine}}


[[Category:Plastic surgery| Plastic surgery]]
===Cosmetic surgery===
[[Category:Surgical specialties]]
Until advancements in medicine allowed some surgical procedures to be low risk, cosmetic surgery was not a reasonable undertaking by either surgeon or patient. In the 20th century, such surgery became practical and, with improvements in techniques that allowed greater chances of a good results, and improvements in medicine that continued to reduce the risk, cosmetic surgical procedures have become more common than reconstrucive procedures.
[[Category:Human appearance]]


[[de:Plastische Chirurgie]]
==References==
[[es:Cirugía plástica]]
<references/>[[Category:Suggestion Bot Tag]]
[[eu:Kirurgia plastiko]]
[[fr:Chirurgie plastique]]
[[he:ניתוח פלסטי]]
[[ja:形成外科学]]
[[pt:Cirurgia Plástica]]
[[sr:Пластична хирургија]]
[[sv:Plastikkirurgi]]
[[zh:整容]]
[[Category:Health Sciences Workgroup (Top)]]
[[Category:Health Sciences Workgroup]]
[[Category:CZ Live]]

Latest revision as of 16:01, 4 October 2024

This article is developing and not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and subject to a disclaimer.

Plastic surgery[1] is "an extremely diverse surgical specialty whose chief purpose is to restore form and function".[2] The field of plastic surgery is unique among modern surgical specialties because the entire body, with the exception of the Central Nervous System, is potentially within the province of the General Plastic Surgeon. Besides general plastics, there are regional specialties such as facial plastic surgery and ophthalmologic (eye) plastic surgery. The training of the surgeon may differ depending on whether the specialty is general or facial plastic surgery. Whether general or regional, plastic surgery includes two broad types of surgery. These types are divided on the basis of the purpose of the surgery.

History

The history of Plastic Surgery reaches back to the ancient world. Understanding the development of the field helps clarify what procedures and techniques fall into the realm of modern plastic surgery. Before the 20th Century, there was little ability for any surgeon to offer effective pain relief during an operation or to combat infection after one. All surgery was painful and fraught with a relatively high risk of complications and death. It is not surprising then, that the first operations in plastic surgery were reconstructive.

Reconstruction of facial features deformed by trama

The Romans were able to perform simple techniques such as repairing damaged ears from around the 1st century BC.

Physicians in ancient India including the great Indian surgeon Susrutha were utilizing skin grafts for reconstructive work as early as the 8th century BC. His work Sushruta Samhita describes rhinoplasty and otoplasty. This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman's Magazine (October 1794). [1] [2]

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, it was not until the 19th and 20th centuries that such surgeries became commonplace, even for reconstructive purposes.

Repair of birth defects

The U.S.'s first plastic surgeon was Dr. John Peter Mettauer. He performed the first cleft palate operation in 1827 with instruments that he designed himself. The New Zealander Sir Harold Gillies developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in World War I, he is considered to be the father of modern plastic surgery. His work was expanded upon during World War II by one of his former students and cousin, Archibald McIndoe, who pioneered treatments for RAF aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the Guinea Pig Club.

Common reconstructive surgeries are: breast reconstruction for women who have had a mastectomy, cleft lip and palate surgery, contracture surgery for burn survivors, and closing skin and mucosa defects after removal of tumors in the head and neck region. Sex reassignment surgery for transsexual people is another example of reconstructive surgery.

Care of wounds: plastic skin closure and repair of tissue defects

Although wound closure is a part of every type of surgery that requires a substantial incision, plastic surgery has had a strong focus on optimal techniques of skin closure and the repair of open wounds. Plastic surgeons have developed the use of microsurgery to transfer tissue for coverage of a defect when no local tissue is available. Tissue "flaps" comprised 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.

Besides such specialized operations for restroring the integrity of the body, plastic surgery utilizes a set of principles for skin and wound closure that are aimed to minimize scarring and to camouflage the presence of scars.

Cosmetic surgery

Until advancements in medicine allowed some surgical procedures to be low risk, cosmetic surgery was not a reasonable undertaking by either surgeon or patient. In the 20th century, such surgery became practical and, with improvements in techniques that allowed greater chances of a good results, and improvements in medicine that continued to reduce the risk, cosmetic surgical procedures have become more common than reconstrucive procedures.

References

  1. The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with modern plastics.
  2. quoted from: John L. Burns, M. D. , Steven J. Blackwell, M. D.,Chapter 72 – Plastic Surgery, in: Townsend: Sabiston Textbook of Surgery, 17th ed., Copyright © 2004 Saunders, An Imprint of Elsevier.