PLASTIC SURGERY

Geeta Mohan
PLASTIC SURGERY

• In the term plastic surgery, the

adjective plastic implies sculpting or reshaping,
which is derived from the Greek
word plastikē (tekhnē), "the art of modelling" of
malleable flesh. This meaning in English is attested
as early as 1598.
• The father of modern plastic surgery is generally
considered to have been Sir Harold Gillies
PLASTIC SURGERY

Plastic surgery is a broad field, and may be subdivided further

Sub disciplines of plastic surgery may include:
1) Aesthetic surgery
Aesthetic surgery is an essential 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
 PLASTIC SURGERY

2) 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.
PLASTIC SURGERY

3) Craniofacial surgery
Craniofacial surgery 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, cranio
synostosis, and pediatric fractures.
Adult craniofacial surgery deals mostly with fractures and
secondary surgeries (such as orbital reconstruction) along
with ortho-gnathic surgery.
Craniofacial surgery is an important part of all plastic
surgery training programs. Craniofacial surgery is also
practiced by Maxillo-Facial surgeons
PLASTIC SURGERY

Adult craniofacial surgery Pediatric craniofacial surgery

PLASTIC SURGERY

3) 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 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.
PLASTIC SURGERY
PLASTIC SURGERY

4) Microsurgery
Microsurgery 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.
 PLASTIC SURGERY

• Pediatric plastic surgery

Children often face medical issues very different from
the experiences of an adult patient. Many birth
defects or syndromes present at birth are best
treated in childhood, and pediatric 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.
PLASTIC SURGERY

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 or tumors.
Reconstructive plastic surgery is usually performed
to improve function, but it may be done to
approximate a normal appearance.
 PLASTIC SURGERY

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 for men with gynecomastia
• Lip enhancement: surgical improvement of lips' fullness through
enlargement
• Rhinoplasty ("nose job"): reshaping of the nose
• Otoplasty ("ear surgery"/"ear pinning"): reshaping of the ear, most
often done by pinning the protruding ear closer to the head.
 PLASTIC SURGERY

• Rhytidectomy ("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 ("brow lift" or "forehead lift"): elevates eyebrows,
smooths forehead skin
• Midface lift ("cheek lift"): tightening of the cheeks
• Genioplasty ("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
• Orthognathic Surgery: manipulation of the facial bones
through controlled fracturing
PLASTIC SURGERY

• Fillers injections: collagen, fat, and other tissue

filler injections, such as hyaluronic acid
• Laser Skin Rejuvenation or laser resurfacing: the
lessening of depth in pores of the face
• Liposuction ("suction lipectomy"): removal of fat
deposits by traditional suction technique or
ultrasonic energy to aid fat removal
• The most popular surgeries are Botox, liposuction,
eyelid surgery, breast implants, nose jobs, and
facelifts
 PLASTIC SURGERY

Complications and risks

• All surgery has risks. Common complications of
cosmetic surgery includes hematoma, nerve
damage, infection, scarring, implant failure and
organ damage.
• Breast implants can have many complications,
including rupture. In 2011 FDA stated that 1 in 5
patients who received implants for breast
augmentation will need them removed within 10
years of implantation
• The most important part after the surgery is wound
care.
 PLASTIC SURGERY

WOUND CARE
• Wound care is an important part of any dermatosurgical
procedure, especially in the case of plastic surgery. The wound
caused by a surgery should heal with minimal scarring, more so if
the region is the face or the exposed parts of the body like the
arms and neck region. The care of the wound is important or the
expertise of the surgeon is in vain.
• The first step is local rest. The area where surgery was
performed should be rested and it should not be allowed to move
as healing is reduced if there is movement. The area such as lips
and fingers should be kept immobile with splints for a week.
• Antibiotics are necessary if the procedure involved skin grafting.
This prevents the site from being infected. Normally a broad-
spectrum antibiotic is prescribed.
Plastic surgery

• The post operative pain and swelling is reduced by the use of

analgesics and anti-inflammatory drugs
• Dressing the wound appropriately and the frequency of
dressing vary with the type of surgery.
• Removal of suture should be done 7 to 15 days after the
operation. If done earlier the wound can open up and
scarring can occur.
• The site needs to be monitored for the appearance of any
complications such as redness, secondary infections, the
wound opening up or hypertrophic granulation tissue.
• The use of the appropriate material for suturing is important.
There are now non-absorbable suture materials such as
polypropylen or proline. This is a monofilament synthetic
suture material with very high tensile strength and minimal
tissue reactivity and does not get knotted. The suturing
technique should be such that the results should be good
with minimum scarring.
 PLASTIC SURGERY

Hypertrophic Scars and Keloids

Even if all steps are followed meticulously there may be a
possibility of formation of exuberant fibrous repair tissues
called hypertrophy scars and keloids.
Hypertrophic scars are raised areas that are confined to
the site of original injury but keloids extent beyond the
site and often with claw like extensions. The keloids and
hypertrophic scars look unpleasant especially if they are
seen on the face and ears or in the exposed areas of the
body.
The keloids and hypertrophic scars are treated with
injection of triamcinolone acetonoid every month this
reduces the volume and flattens the scar. An application
of silicone cream is also recommended.
Plastic surgery
PLASTIC SURGERY