Plastic Surgery

February 17, 2008 – 12:17 pm

By plastic surgery Dr. Jekyll can become Mr. Hyde and if Mr. Hyde wants to escape his creditors he can revert to Dr. Jekyll! Basically that is what the story of plastic surgery is about. It is a special type of surgery by which appearances can be changed. The operations may be cosmetic but the most valuable contribution to medical science is when plastic surgery is used for reconstruction of deadly defects that endanger life.
The word plastic has its origins in the Greek word plastikos, which means moulding or shaping. Here it has no connection with the synthetic substance called plastic. The history of plastic surgery goes back to ancient India when Sushruta did skin grafting in 8th century BC. His works clearly outline the steps in rhinoplasty and otoplasty. This stream of science continued to exist in India till the 18th century. The Romans managed very basic and simple experiments and there were some done during the middle ages. But Plastic Surgery hit the scene with a big bang from the 19th and exploded during the 20th century. The pace continues.
Plastic surgery belongs to a very specialized branch of surgery and can be performed only by authorized medical practitioners. The primary goal of plastic surgery is to rectify any disfigurement by means of surgery, correct and restore functions that have been disabled as well as improve appearances without causing harm to any other part of the body. So the name is appropriate in the sense that it remoulds and reshapes the human body. The changes involve bones, fats, muscles, cartilage and skin. During the operation the tissue might have to be removed to fill in a cavity, to swathe an injury or to beautify looks. To change the features the tissues may be totally removed and replaced.
There is a difference between plastic surgery and cosmetic operations. The latter is performed with the sole aim of beautification on people who are in all other respects healthy. Plastic surgery may truly be considered a blessing because it corrects defects that are there from birth or have later been acquired. This has great effects on the social and psychological plane.
Broadly there are three types of plastic surgery – reconstructive, constructive and anaplastic. Reconstructive involves cases relating to trauma or disease. Constructive deals with inborn or congenital deformities and defects. Anaplastic operation is about ugliness and beauty. Reconstructive surgery is vital in cases of burns and accidents. Constructive surgery rectifies cleft lips, cleft palates, bone fractures on the face and some forms of tumors. Anaplastic is important in cases where tissues have been removed, like mastectomy or other forms of cancer where amputation has been necessitated. The latest development in this field is the use of microsurgery. This involves the transfer of tissue from one part of the body to another. Tissue flaps comprise of bones, fat, skin and muscles. This is collected and removed to another part of the body and again connected to the blood stream by stitching arteries and veins whose diameter may be as small as 1-2 mm. In microsurgery extremely fine needles and delicate sutures are required to connect the blood vessels. This is done with the help of a powerful microscope specially manufactured for this purpose.
Thus it is technically difficult to define where reconstructive surgery ends and cosmetic surgery begins. The technique of one is often used for the other as and when a specific situation calls for it. The most common process is the transfer of skin, which is known as ‘grafting’. A living tissue is grafted on to another site without allowing it to die.
There are many types of grafts. Autograft is when the skin is taken from the body of the patient undergoing surgery. If the proper quality is not available then cultured grafting is done. Silicone is also used. Allografts means, taking skin from another human being. Xenograft involves taking of skin grafts from another species.
The most commonly used techniques in plastic surgery are performance of incision and excision, as well as chemo, electro, laser surgery. Dermabrasion and Liposuction are other techniques used in this stream of surgery. Plastic surgery will show good results if proceeded with care. It must be planned carefully where the surgery will be done taking into consideration each fold of the skin. The new one must blend into the old one in perfect harmony.
The most common types of cosmetic surgery are abdominoplasty (tummy tucking) umbilicoplasty (belly button fixing) and blepharoplasty (reconstruction of eyelids) Another Asian variety of the surgery will give a permanent eyeliner to the lids. The latter is also known as Asian blepharoplasty. Another cosmetic surgery helps to enlarge the breast and is known as mammaplasty. It involves the use of saline or gel. In this way buttocks too can be made to look more full and round. It involves grafting of fat. Facial marks of acne, pox or even wrinkles can be removed by chemcialpeel. For this active chemical agents are generally used. Maastopexy involves upliftment of breasts. The labia too can be reshaped. Otoplasty and rhinoplasty means reshaping of the ears and nose respectively. Rhytidectomy removes signs of ageing from the face. Clitoroplasty is done to clearly define the sex of the child if this is ambiguous from birth. It is done before the child reaches maturity so that when the child reaches adulthood it will have a clear idea of its gender. In this way the chin, cheek and nearly every part of the body can be given a facelift.
The two terms of plastic surgery and cosmetic surgery should be carefully delineated for public guidance. According to the American Board of Medical Specialties plastic surgery refers to repair by surgical means any type of defect or malfunction that includes cosmetics as well as reconstruction. But cosmetic surgery is only about improvement of appearances. In any case none but a doctor can proceed with cosmetic surgery. Unfortunately this is not always the case.

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