It is important to start defining the words that give name to this specialty, Plastic Surgery.
The term plastic surgery comes from the Greek word “plastikos”, which means “to create, form or mold something”, and from “cheirourgia”, or “working with the hand”. We can thus say that Plastic Surgery is the therapy that modifies or gives form to tissues, manually and with the help of instruments.
Plastic surgery treats face and body alterations and covers two aspects or types of complementary interventions, which differ in purpose, although it’s often difficult to establish their limits.
Repairing Plastic Surgery covers congenial deformities and those caused by burns, traumatisms, infections, tumors and mutilating operations, trying to restore the normal aspect to people who have suffered deforming accidents, reconstructing body parts destroyed by breast or face cancer operations, covering with skin implants skin loss caused by burns, closing bedsores in paraplegics, treating scars which prevent arm or hand straightening, opening eyelids, correcting facial distortions caused by facial paralysis, and many more.
Plastic Surgery treats the cause of those discomforts that have their origin in any physical alteration or deformity, trying to obtain the person’s satisfaction and balance with his/her own body. In other words, it treats the body’s natural forms in order to improve them, to beautify them or rejuvenate them.
Although Plastic Surgery covers certain demands of the public, we cannot think of extending its use indiscriminately. The use of surgery is only justified when the balance tips to benefits instead of to risks.
It’s the surgeon’s responsibility to minimize risks through rigorous preoperatives, a well- prepared surgical team and good installations. He also chooses the surgical technique to be used, and even the patient himself/herself. We often have patients who have unrealistic expectations and who wouldn’t benefit from a good result no matter how good it might be. It’s better not to operate in these situations in order to avoid both patient’s and surgeon’s frustration.
On the other hand, we can ask what the purpose of Plastic Surgery is. If the function of Repairing Plastic Surgery is perfectly understood as aimed at correcting clear defects, cruel to those who suffer them, it is harder to accept surgery that has the aim of well being, beauty, perfection, youth…
When our external image doesn’t fit the other, the inner one, the desired one, the one we think corresponds with us; when a defect means unhappiness, shame, discomfort, dissatisfaction, why cannot we remedy it? Why must we bear it as if it were an unavoidable stigma? Every human being tends to balance. Plastic Surgery can help, in certain cases, to recover this balance.
Today, the surgical treatment of burns, ulcers, scars and skin tumors, congenial or acquired craniofacial, genital and extremity deformities, all belong to this Specialty as well as reconstructing surgery for facial mutilations and plastic surgery.
The increasing complexity of this Field has lead to a branching in many subspecialties, which have been included or which collaborate with other specialties, working in interdisciplinary teams, vital for the treatment of certain pathologies. The sum and combination of each specialty’s knowledge, and the specific technical training are the clues to obtain better results.
Therefore, we can consider the following as real specialties in the field of Plastic Surgery: craniofacial surgery, microsurgery, preorbital surgery, tumor reconstruction surgery, hand surgery, genital surgery, pediatric plastic surgery and plastic surgery.
- Aston SJ, Beasley RW, Thorne CN. Grabbs and Smith’s Plastic Surgery. Philadelphia, Lippincott-Raven. 1997.
- Berson, M.I.: Atlas of Plastic Surgery, p.295, 2nd Edition, Grune and Stratton, N.Y., 1963
- Coiffman, F. Cirugia Plastica y estética. 2ª. Ediciones Científicas y Técnicas, S.A.Barcelona, 1994.
- Converse JM, McCarthy JG, Brauer RO, Ballantyne DL. Transplantation of skin: grafts and flaps: In reconstructive Plastic Surgery. 2a, Saunders, Philadelfia, 1977.
- Fomon S. Cirugía Plástica y Reparadora.. Ed. Labor, B. Aires. 1943.
- Gelbke H, Stoffregen J. Cirugía Plástica y Reconstructora. Vol I. Ed. Toray, Barcelona, 1967Grabb W, Smith J. Cirurgia Plástica. Salvat Edit. Barcelona, 1984.
- Grabb and Smith. “Plastic Surgery”. Little, Brown and Company. 4ª ed. 325-345, 1991.
- Millard R. Principlization of Plastic Surgery. Little, Brown an Co. Boston, 1986.
- Skoog T: Plastic Surgery. New Methods and Refinements. Philadelphia, WB Saunders, 1974.