Understanding Plastic Surgery: Beyond Aesthetics to Comprehensive Reconstruction - Dr Aadithya Rangarajan

Plastic surgery is a branch of surgery encompassing a plethora of procedures directly or indirectly related to improving quality or function, or enhancing appearance for aesthetic or corrective purposes. Contrary to the common belief that ‘plastic surgery’ means ‘cosmetic surgery’, this speciality also includes reconstructive surgery. Together, plastic surgery aims to restore and transform lives.

The Term Plastic Surgery - Why This Name?

Unlike the names of other branches in surgery which are self-explanatory or well comprehended namely: Neurosurgery, Gastrosurgery, Vascular Surgery, Paediatric Surgery, Urology, Orthopaedics, the term Plastic Surgery is largely misunderstood or misinterpreted among the people. The speciality has no real connection to the material ‘plastic’ that we are aware of.

‘Plastikos’ in Greek means ‘to mould or to shape something’. Since this speciality involves rearrangement, re-shaping of tissues to improve the aesthetic appearance or functional outcome in an individual, the name Plastic Surgery seems apt. Another exclusive feature of this speciality is that it is not confined to a specific organ or tissue. The principles of Plastic Surgery can be implemented to any part from head to toe.

India and Plastic Surgery - Lesser known fact!

The principles and techniques included in Plastic Surgery, vis-a-vis preoperative planning, skin grafts, cheek flap for nasal reconstruction is mentioned in the ancient manuscript - Sushruta Samhita dated 600 BC, by Sushruta known as Father of Surgery. Besides reconstructive surgery, Sushruta also performed corrective surgeries to repair torn earlobes and lips, thereby enhancing the aesthetic appearance of the face.

Plastic Surgery - In the Present Era

Sir Harold Delf Gillies, a New Zealand surgeon, is considered the Father of Modern Plastic Surgery. He was a pioneer of facial reconstruction surgeries during the First World War. The war victims suffered very severe facial injuries due to heavy artillery and shells with shrapnel and were beyond recognition. From then, the speciality of plastic surgery has evolved to the present, wherein different subspecialties are gaining popularity and recognition.

Paediatric plastic surgery is an exclusive niche subspecialty for children. It includes, but is not limited to, the management of birth defects like cleft lip and palate, hand deformities, ear deformities, pigmented skin lesions, and many more. Lymphedema, once considered untreatable, is now evaluated in detail and managed by plastic surgeons.

Reconstructive and microsurgery are integral parts of trauma, peripheral nerve tumours, compressive neuropathy, cancer, and diabetic foot management. Innovations in reconstructive surgery have seen a giant leap with advancements like implantation, reimplantation, and transplantation.

Aesthetic or cosmetic surgery, one of the most popular subspecialties, aims to improve an individual's appearance. Commonly performed cosmetic procedures include liposuction, abdominoplasty, gynaecomastia correction, breast augmentation and reduction, rhinoplasty, Botox, and fillers. Burns and the management of chronic, complex wounds have been included in the armamentarium of plastic surgeons.

Altogether, it is important to understand that this speciality is not limited to cosmetic surgery, but is multifaceted and multidimensional. It is crucial for people in society to comprehend the versatility of a qualified plastic surgeon and seek advice appropriately.