Plastic Surgery is always a mystery to the public.
The word plastic denotes the ability of the plastic surgeon to mould tissues the way plastic can be moulded to various shapes. There is no better word for this and therefore the name. Plastic Surgeons use many of the ‘normal’ surgery instruments. The difference however, is in the planning of the steps, the meticulous care and utmost skill in execution of the surgical procedure and the patience and perseverance to try and achieve perfection each and every time. Unlike public perception, Plastic surgery is more than skin surgery. Plastic surgeons deal with skin, fat, muscles, arteries, nerves and a few bones too. And with all parts of the human body! There is no regional limitation (head/ chest/hand etc.) unlike other branches eg. ENT, Eye surgeon, Head and neck, Gyneacology etc As our understanding has increased and diagnostic modalities have become more accurate and sophisticated; plastic surgery today is vastly different from what it was earlier. Using knowledge and technology, the scope of Plastic surgery is truly varied and wide.
Sub specialties of Plastic Surgery are:
1. Reconstructive surgery:
This deals with replacement of lost tissue or function, often by using body parts for overcoming the problem. Loss of tissue may occur following trauma (injury) or cancer etc. The challenge is to tailor the treatment and surgery to suit the need of the patient – restore shape, restore movement etc. It can range from repairing a damaged fingertip to restoring its form, repairing a badly injured hand and replacing skin, tendon etc; repairing blood vessels, nerves etc . Diabetic wounds leading to loss of tissue may also be corrected in this way. This constitutes 40% of a plastic surgeon’s work.
2. Paediatric plastic surgery:
Deals with correction of defects that a new born may be born with. The commonest is cleft of the lip and palate. Abnormalities in the hand (fused or extra fingers etc), blood vessel tumours in the face, birth marks, large swellings, deformed ears etc can all be corrected.
3. Cosmetic surgery:
Deals with a voluntary need for a change in external appearance in a healthy patient. Most people believe plastic surgery means only this! But this makes up for only 20% of a plastic surgeon’s practice. It might be the navel, breast, nose…and any other part of the body that catches the fancy of people who think they want it changed! This is hence an expanding branch which moves forward with public imagination!
4. Burns :
When a patient who has suffered burns escapes out of the horror alive, his/her skin is as scarred as the psyche! One of the main problem in burns is loss of skin with subsequent scarring . Correcting this and replacing the skin (skin grafting) is the solution.
5. Microvascular surgery:
Many a times, we get patients who have had an accident and a finger or even a limb has been cut off. Attempting to suture the severed organs is a challenging and time consuming surgery, not to mention the technical finesses involved in it. Small blood vessels of 1-2 mm and small nerves must be aligned and sutured together so that life and function is restored to the severed organ. These are repaired using a microscope. Tissues in our body can also be shifted from place to place using this technique.
You need to know that: Plastic surgeons do not use ‘plastic’ during surgery as some people imagine! We try to use the body’s own tissues as much as possible as we believe nothing can replace the natural tissues in our body! Sometimes we may use ‘implants’ which are made of different materials. Plastic surgeons cannot perform scar less surgeries. Nobody can. Scars will always occur when skin is cut. It is nature’s way of healing a wound. Plastic surgeons can only try to hide it or make it as inconspicuous as possible so that the scar does not look ugly. The final results of such also depends on the ability of the body to heal normally and hence may vary from person to person. Plastic surgeons cannot and have never ‘changed faces’ by putting skin from the thighs! The skin on the thigh is dark, grows hair and has different patterns as compared to facial skin. How could an aesthetic surgeon imagine such a blatant disregard of tissue nature? In fact, even on the face the nature of skin differs from forehead to nose to cheek to chin! Skin graft to the face is a last choice, if at all! Plastic surgeons even stitch the skin with utmost care and love! We use fine suture materials that will not leave any mark. We also sometimes use ‘gum’ or ‘tapes’ Plastic surgery is not always expensive. The experience, skill, duration and the special materials contribute to the cost. Some surgeries take 8- 10 hours to perform