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Plastic and Reconstructive Surgery

Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes two main fields: body modification and reconstructive surgery. The word “plastic” derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic.

Reconstructive plastic surgery is performed to correct functional impairments caused by burns; traumatic injuries, such as facial bone fractures; congenital abnormalities; developmental abnormalities; infection and disease; and cancer or tumors. Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance.

The most common reconstructive procedures are tumor removal, laceration repair, scar repair, hand surgery, and breast reduction. According to the American Society of Plastic Surgeons, the number of reconstructive breast reductions for women increased in 2007 by 2 percent from the year before. Breast reduction in men also increased in 2007 by 7 percent. Some other common reconstructive surgical procedures include breast reconstruction after a mastectomy, cleft lip and palate surgery, contracture surgery for burn 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.

Aesthetic surgery involves techniques intended for the “enhancement” of appearance through surgical and medical techniques, and is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal.

The most prevalent aesthetic/cosmetic procedures include:

  • Abdominoplasty (“tummy tuck”): reshaping and firming of the abdomen
  • Blepharoplasty (“eyelid surgery”): reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty
  • Mammoplasty:
    • Breast augmentations (“breast implant” or “boob job”): augmentation of the breasts by means of fat grafting, saline, or silicone gel prosthetics, which was initially performed to women with micromastia
    • Reduction mammoplasty (“breast reduction”): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with gigantomastia and/or for psychological benefit men with gynecomastia
    • Mastopexy (“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 or scarless Serdev suture technique
  • Buttock augmentation (“butt implant”): enhancement of the buttocks using silicone implants or fat grafting and transfer from other areas of the body
    • Buttock lift (“Brazilian butt lift”): lifting, projection, and tightening of the buttocks using the scarless Serdev suture technique without implants
  • Chemical peel: minimizing the appearance of acne, chicken pox, 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 photodamage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid (AHA), or salicylic acid (BHA) as the active agent.
  • Labiaplasty: surgical reduction and reshaping of the labia
  • Rhinoplasty (“nose job”): reshaping of the nose
  • Otoplasty (“ear surgery”): reshaping of the ear, most often done by pinning the ear closer to the head
  • Rhytidectomy (“face lift”): removal of wrinkles and signs of aging from the face
    • Browplasty (“brow lift” or “forehead lift”): higher brow position by surgical or scarless Serdev suture
    • Midface lift (“cheek lift”): tightening of the cheeks
  • Suction-assisted lipectomy (“liposuction”): removal of fat from the body
  • Chin augmentation (“chin implant”): augmentation of the chin with an implant, usually silicone, by sliding genioplasty of the jawbone or by suture of the soft tissue
  • Cheek augmentation (“cheek implant”): implants to the cheek
  • Fillers injections: collagen, fat, and other tissue filler injections, such as hyaluronic acid
  • Laser skin resurfacing
  • Cryolipolysis experimental treatment in which subcutaneous fat cells are induced into apoptosis by means of suction cup isolation and cooling