
What
is Plastic Sugery? 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
many types of reconstructive surgery, hand surgery, microsurgery, and the treatment
of burns. The word "plastic" derives from the Greek plastikos meaning to mould
or to shape; its use here is not connected with the synthetic polymer material
known as plastic. Techniques
and procedures In plastic surgery, the transfer
of skin tissue (skin grafting) is a very common procedure. Skin grafts can be
taken from the recipient or donors: Autografts are taken from the recipient. If
absent or deficient of natural tissue, alternatives can be cultured sheets of
epithelial cells in vitro or synthetic compounds, such as integra, which consists
of silicone and bovine tendon collagen with glycosaminoglycans. Allografts are
taken from a donor of the same species. Xenografts are taken from a donor of a
different species. Usually, good results are expected from plastic surgery that
emphasizes 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, and early removal of exposed sutures so that the wound is held
closed by buried sutures.
Reconstructive
surgery techniques were being carried out in India by 2000 BC. Sushruta, considered
the father of surgery, made important contributions to the field of plastic and
cataract surgery in 6th century BC. The medical works of both Sushruta and Charak
were translated into Arabic language during the Abbasid Caliphate in 750 AD. These
Arabic works made their way into Europe via intermediaries. In Italy the Branca
family of Sicily and Gaspare Tagliacozzi (Bologna) became familiar with the techniques
of Sushruta. British physicians traveled to India to see rhinoplasties
being performed by native methods. Reports on Indian rhinoplasty were published
in the Gentleman's Magazine by 1794. Joseph Constantine Carpue spent 20 years
in India studying local plastic surgery methods. Carpue was able to perform the
first major surgery in the Western world by 1815.Instruments described in the
Sushruta Samhita were further modified in the Western world. The ancient Egyptians
and Romans also performed plastic cosmetic surgery. The Romans were able to perform
simple techniques, such as repairing damaged ears from around the 1st century
BC. For religious reasons, they did not dissect either human beings or animals,
thus their knowledge was based in its entirety on the texts of their Greek predecessors.
Notwithstanding, Aulus Cornelius Celsus left some surprisingly accurate anatomical
descriptions, some of which — for instance, his studies on the genitalia and the
skeleton — are of special interest to plastic surgery. In 1465, Sabuncuoglu's
book, description, and classification of hypospadias was more informative and
up to date. Localization of urethral meatus was described in detail. Sabuncuoglu
also detailed the description and classification of ambiguous genitalia.[citation
needed] 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 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 surgery was
reduced by the introduction of sterile techniques and disinfectants. The invention
and use of antibiotics, beginning with sulfa drugs and penicillin, was another
step in making elective surgery possible. In 1792, Chopart performed
operative procedure on a lip using a flap from the neck. In 1814, Joseph Carpue
successfully performed operative procedure on a British military officer who had
lost his nose to the toxic effects of mercury treatments. In 1818, German surgeon
Carl Ferdinand von Graefe published his major work entitled Rhinoplastik. Von
Graefe modified the Italian method using a free skin graft from the arm instead
of the original delayed pedicle flap. The first American plastic surgeon
was John Peter Mettauer, who, in 1827, performed the first cleft palate operation
with instruments that he designed himself. In 1845, Johann Friedrich Dieffenbach
wrote a comprehensive text on rhinoplasty, entitled Operative Chirurgie, and introduced
the concept of reoperation to improve the cosmetic appearance of the reconstructed
nose. In 1891, American otorhinolaryngologist John Roe presented an example
of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic
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 1889 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 Sonstige Gesichtsplastik. Cosmetic
surgery Aesthetic plastic 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. In 2006, nearly
11 million cosmetic procedures were performed in the United States alone. The
number of cosmetic procedures performed in the United States has increased over
50 percent since the start of the century. Nearly 12 million cosmetic procedures
were performed in 2007, with the five most common surgeries being breast augmentation,
liposuction, nasal surgery, eyelid surgery and abdominoplasty. The increased use
of cosmetic procedures crosses racial and ethnic lines in the U.S., with increases
seen among African-Americans and Hispanic Americans as well as Caucasian Americans.
In Europe, the second largest market for cosmetic procedures, cosmetic surgery
is a $2.2 billion business. 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
- Buttock
augmentation ("butt implant"): enhancement of the buttocks using silicone implants
or fat grafting ("Brazilian butt lift") and transfer from other areas of the body
- Buttock
lift: lifting, and tightening of the buttocks by excision of redundant skin
- 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
- Lip
enhancement: surgical improvement of lips' fullness through enlargement
- 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"): elevates eyebrows, smooths forehead skin
- 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
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