Definition of Plastic and Reconstructive Surgery

Plastic and reconstructive surgery refers to a variety of operations performed in order to repair or restore body parts to look normal, or to change a body part to look better. These types of surgery are highly specialized. They are characterized by careful preparation of the patient's skin and tissues, by precise cutting and suturing techniques, and by care taken to minimize scarring. Recent advances in the development of miniaturized instruments, and improved surgical techniques have expanded the range of plastic surgery operations that can be performed.

Purpose of Plastic and Reconstructive Surgery

Although these three types of surgery share some common techniques and approaches, they have somewhat different emphases. Plastic surgery is usually performed to treat birth defects and to remove skin blemishes such as warts, acne scars, or birthmarks. Cosmetic surgery procedures are performed to make the patient look younger or enhance his or her appearance in other ways.

Precautions

Medical:

Some patients should not have plastic surgery because of certain medical risks. These groups include:

• Patients recovering from a heart attack, severe infection (for example, pneumonia), or other serious illness.
• Patients with infectious hepatitis or HIV infection. • Cancer patients whose cancer might spread (metastasize).
• Patients who are extremely overweight. Patients who are more than 30% overweight should not have liposuction.
• Patients with blood clotting disorders.
• Smokers
• Severe Diabetes (for very invasive procedures)

Psychological:

Plastic and reconstructive surgeries have an important psychological dimension because of the high value placed on outward appearance in society. Many people who are born with visible deformities or disfigured by accidents later in life develop emotional problems related to social rejection. Some people have unrealistic expectations of plastic surgery results. It is important for anyone considering nonemergency plastic or cosmetic surgery to be realistic about its results.

Description

Plastic surgery and Cosmetic Surgery

Plastic surgery includes a number of different procedures that usually involve skin. Operations to remove excess fat from the abdomen ("tummy tucks"), dermabrasion to remove acne scars or tattoos, and reshaping the cartilage in ears (otoplasty) are common applications of plastic surgery.

Most cosmetic surgery is done on the face. It is intended either to correct disfigurement or to enhance the patient's features. In adults, the most common procedures are remodeling of the nose (rhinoplasty), removal of baggy skin around the eyelids (blepharoplasty), facelifts (rhytidectomy), or changing the size of the breasts (mammoplasty). Although many people still think of plastic surgery as only for women, growing numbers of men are choosing to have facelifts and eyelid surgery, as well as liposuction and abdominoplasties "tummy tucks."

Reconstructive surgery

Reconstructive surgery is often performed on burn and accident victims. It may involve the rebuilding of severely fractured bones, as well as skin grafting.

Preparation & Patient Education

Preparation for non-emergency plastic or reconstructive surgery includes patient education, as well as medical considerations. Some operations, such as the removal of warts or small birthmarks can be done as outpatient procedures under local anesthesia. Most plastic and reconstructive surgery, however, involves general anesthesia and, on occasion, stay in the hospital.

Medical preparation

Preparation for plastic surgery includes the surgeon's detailed assessment of the parts of the patient's body that will be involved. Facelifts and cosmetic surgery in the eye area require very close attention to the texture of the skin and the placement of surgical cuts (incisions). Patients scheduled for plastic surgery under general anesthesia will be given a physical examination, blood and urine tests, and other tests to make sure that they do not have any previously undetected health problems or blood clotting disorders. The doctor will check the list of other prescription medications that the patient may be taking to make sure that none of them will interfere with normal blood clotting or interact with the anesthetic. Patients are asked to avoid using aspirin or medications containing aspirin for a week to two weeks before surgery, because these drugs lengthen the time of blood clotting. The patient will be asked to sign a consent form before the operation.

Patient education

The doctor will meet with the patient before the operation is scheduled, in order to explain the procedure and to be sure that the patient is realistic about the expected results. This consideration is particularly important if the patient is having cosmetic surgery.

Aftercare Medical & Psychological

Medical

Medical aftercare following plastic surgery under general anesthesia includes bringing the patient to a recovery room, monitoring his or her vital signs, and giving medications to relieve pain as necessary. Patients who have had outpatient procedures are usually given antibiotics to prevent infection and are sent home as soon as their vital signs are normal.

Risks

The risks associated with plastic and reconstructive surgery include the postoperative complications that can occur with any surgical operation under anesthesia. These complications include wound infection, internal bleeding, pneumonia, and reactions to the anesthesia. In addition to these general risks, plastic and reconstructive surgeries carry specific risks:

• Formation of undesirable scar tissue • Persistent pain, redness, or swelling in the area of the surgery
• Infection inside the body related to inserting a prosthesis.
• Anemia or fat embolisms from liposuction
• Loss of normal feeling or function in the area of the operation. For example, it is not unusual for women who have had mammoplasties to lose sensation in their nipples.