Siamswan Clinic – Leading Plastic Surgery in Bangkok Thailand

• Basic goal of Plastic Surgery is to treat surgically by:

o Correction of disfigurement.
o Restoration of impaired function.
o Improvement of physical appearance.

• Generally the term Plastic Surgery refers to the molding and reshaping of body tissues:

o Bone.
o Fat.
o Muscle.
o Cartilage.
o Skin.

• Generally during Plastic Surgery:

o Tissue may be moved to fill a depression, to cover a wound, or to improve appearance.
o Tissue may be completely removed to alter the contours of a feature.
Benefits of Plastic Surgery

• The correction of a congenital or acquired deformity.
• The correction of a perceived physical imperfection.
• Possible social benefits.
• Psychological benefits.

1. To correct severe functional impairments caused by:

o Burns.
o Traumatic injuries.

2. To correct acquired or congenital abnormalities, such as:

o Cleft lip.
o Cleft palate.
o Facial bone fractures.
o Tumours.

3. To compensate for tissue removed in:

o Cancer or other surgery.

• e.g. following mastectomy.

• Autografts: Skin grafts taken from the recipient.

o If absent or deficient of natural tissue, alternatives can be:

• Cultured Sheets of epithelial cells in vitro.
• Synthetic compounds (i.e. silicone).

• Allografts: Skin grafts taken from a donor of the same species.
• Xenografts: Skin grafts taken from a donor of a different species.

Micro Surgery
Extremely fine needles and sutures make it possible to rejoin small blood vessels and other minute structures under an operating microscope.

Techniques used in Plastic Surgery

Among the techniques which are commonly used in plastic surgery are:

• Incision.
• Excision.
• Chemosurgery.
• Electrosurgery.
• Laser surgery.
• Dermabrasion.
• Liposuction.

Prognosis in Plastic Surgery

Usually, the good results are expected if plastic surgery is performed by:

• Careful planning of incisions so that they fall in the line of natural skin folds or lines.
• Appropriate choice of wound closure.
• Use of best available suture materials.
• Early removal of exposed sutures so that the wound is held closed by buried sutures.

Cosmetic surgery

Cosmetic surgery is a very popular form of surgery; as an example, the American Society of Plastic Surgery reported that in 2006 nearly 11 million cosmetic Plastic Surgery were performed in the United States alone.[2]

Within the U.S,. critics of Plastic Surgery note that it is legal for any doctor, regardless of speciality, to perform cosmetic 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 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, refers to surgery that is designed to improve cosmetics, or appearance. In several countries including Australia, many doctors who are not qualified as surgeons also perform cosmetic procedures.[3]

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
• Blepharoplasty (or "eyelid surgery"): Reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty Plastic Surgery
• Augmentation Mammaplasty/breast augmentation (or "breast enlargement" or "boob job"): Augmentation of the breasts. This can involve either saline or silicone gel prosthetics.
• Buttock Augmentation (or "butt augmentation" or "butt implants"): Enhancement of the buttocks. This procedure can be performed by using silicone implants or fat grafting and transfer from other areas of the body. Plastic Surgery
• Chemical peel: Minimizing the appearance of acne, 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 photodamage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid (AHA), or salicylic acid (BHA) as the active agent. Plastic Surgery
• Mastopexy (or "breast lift"): Raising or reshaping of 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
• 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. Plastic Surgery
• Cheek augmentation
• Collagen, fat, and other tissue filler injections (eg hyaluronic acid)
• Laser skin resurfacing
• Injection of dermal fillers (collagen, hyaluronic acid, fat, and others

History

The history of Plastic Surgery reaches back to the 700's BCE. Physicians in ancient India including Sushruta 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).[4][5]

The 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 Plastic Surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgery became commonplace.

Up until the techniques of anesthesia became established, all surgery on healthy tissues involved great pain. Infection from Plastic Surgery was reduced once sterile technique and disinfectants were introduced. The invention and use of antibiotics beginning with sulfa drugs and penicillin was another step in making elective surgery possible.

History of modern Plastic Surgery

Chopart in 1791 performed operative procedure of a lip using a flap from the neck. Joseph Carpue in 1814 successfully performed operative procedure in a British military officer who had lost his nose to the toxic effects of mercury treatments.Carl Von Graefe the German surgeon in 1818 published his major work entitled Rhinoplastik. Carl Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap.In 1845 Dieffenbach wrote a comprehensive text on rhinoplasty , entitled "Operative Chirurgie". He introduced Plastic Surgery the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. In 1891 John Roe, an American otorhinolaryngologist presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for Plastic Surgery indications. In 1892 Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896 James Israel, a urological surgeon from Germany, and In 1989 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects. In 1898 Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty . In 1928 Jacques Joseph published "Nasenplastik und Plastic Surgery Sonstige Gesichtsplastik". [3]

The U.S.'s first Plastic Surgery 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.

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 Plastic 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, the best approach to providing care to them is an interdisciplinary approach which includes oral and maxillofacial surgeons, otolaryngologists, speech therapists, occupational therapists and geneticists. Plastic Surgery
• Hand surgery is a field that is also practiced by some general surgeons and orthopedic surgeons (see Hand surgeon). Plastic Surgery receive 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 Surgery 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 Surgery.
• Maxillofacial surgery is surgery of the bony and soft-tissues of the face and cranium, and is an important aspect of Plastic Surgery. 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.
See also
• Body modification
• Botox
• Breast reconstruction, Breast reduction, Breast implant, Breast lift
• Facial feminization surgery
• Microsurgery
• Operation Smile
• Oral and Maxillofacial Surgery
• Orthopedic surgery
Plastic Surgery
• See Category:Plastic Surgery
References
1. ^ Johnson D, Whitworth I (2002). "Recent developments in Plastic Surgery.". BMJ 325 (7359): 319-22. PMID 12169510.
2. ^ 2006: Nearly 11 Million Cosmetic Surgeries in U.S.. March 22, 2007.
3. ^ Anderson, Laurence (2006). Looking Good, the Australian guide to skin care, cosmetic medicine and cosmetic surgery. Sydney: AMPCo. ISBN 0-85557-044-X..
4. ^ Rana RE, Arora BS (Jan-Mar 2002). "History of Plastic Surgery in India.". J Postgrad Med (India) 48 (1): 76-8. PMID 12082339. Retrieved on 2006-11-19.
5. ^ Paul O'Keeffe. Rhinoplasty Overview. Retrieved on 2006-11-19.
Further reading
• Fraser, Suzanne (2003). Cosmetic surgery, gender and culture. Palgrave. ISBN 1-4039-1299-8.
• Gilman, Sander (2005). Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery. Duke University Press. ISBN 0-8223-2144-0.
• Haiken, Elizabeth (1997). Venus Envy: A History of Cosmetic Surgery. Johns Hopkins University Press. ISBN 0-8018-5763-5.
External links
• The American Society of Plastic Surgery
• The American Society for Aesthetic Plastic Surgery
• The American Board of Plastic Surgery
• Emedicine's History of Plastic Surgery entry
• The American Society of Plastic Surgery
• The Canadian Society of Plastic Surgery