Indications and Procedures (Magill’s Medical Guide, Sixth Edition)
The intent of plastic, reconstructive, and cosmetic surgery is to restore a body part to normal appearance or to enhance or cosmetically alter a body part. The techniques and procedures of all three surgical applications are similar: extremely careful skin preparation, the use of delicate instrumentation and handling techniques, and precise suturing with extremely fine materials to minimize scarring.
Reconstructive surgery. Notable examples of reconstructive surgery involve the reattachment of limbs or extremities that have been traumatically severed. As soon as a part is separated from the body, it loses its blood supply; this leads to ischemia (lack of oxygen) to tissues, which in turn leads to cell death. When an individual cell dies, it cannot be resuscitated and will soon start to decompose. This process can be greatly slowed by lowering the temperature of the severed body part. Packing the part in ice for transport to a hospital is a prudent initial step.
An important consideration in any reconstructive procedure is site preparation. The edges, or margins, of the final wound must be clean and free of contamination. Torn skin is removed through a process called debridement. A sharp scalpel is used gently to cut away tissue that has been crushed or torn. All bacterial contamination must be removed from the site prior to closure to prevent postoperative contamination. Foreign material such as...
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Uses and Complications (Magill’s Medical Guide, Sixth Edition)
Reconstructive, plastic, and cosmetic surgeries all have their complications, ranging from severe—such as the rejection of transplanted tissue—to minor but unpleasant—such as noticeable scars. In addition, there is an inherent risk in any procedure that requires the patient to undergo general anesthesia. With reconstruction, which involves the repair of damaged tissues and structures, the initial injuries sustained by the patient present further obstacles and dangers. The following examples from each type of surgery illustrate the risks involved.
For example, a surgeon who must perform a skin graft can choose between a split or a full thickness graft. A split thickness graft site will heal with relatively normal skin, thus providing opportunities for additional grafting at a later date. It also produces less pronounced scarring. A limitation of this technique, however, is an increased likelihood for the graft to fail. Full thickness grafts are stronger and more likely to be successful, but they lead to more extensive scarring, which is aesthetically undesirable and renders the site unsuitable for later grafts. The surgeon’s decision is based on the needs of the patient and the severity of the injury.
The minimization of scarring is a major concern for many patients undergoing plastic surgery. The prevention of noticeable scars involves an understanding of the natural lines of the skin. All areas of the...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The origins of plastic, reconstructive, and cosmetic surgery are fundamental to the earliest surgical procedures, which were developed to correct superficial deformities. Without any viable methods of anesthesia, surgical interventions and corrections were limited to the skin. For example, present-day nose reconstructions (rhinoplasty) are essentially similar to procedures developed four thousand years ago. Hindu surgeons developed the technique of moving a piece of skin from the adjacent cheek onto the nose to cover a wound. Similar procedures were developed by Italians using skin that was transferred from the arm or forehead to repair lips and ears as well as noses. Ironically, wars have provided opportunities to advance reconstructive techniques. As field hospitals and surgical facilities became more widely available and wounded soldiers could be stabilized during transport, techniques to repair serious wounds evolved.
Skin grafts have been used since Roman times. Celsus described the possibility of skin grafts in conjunction with eye surgery. References were made to skin grafts in the Middle Ages. The evolution of modern techniques can be traced to the early nineteenth century, when Cesare Baronio conducted systematic grafting experiments with animals. The modern guidelines for grafting were formulated in 1870. Instruments for creating split thickness grafts were developed in the 1930’s, and applications of...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Grazer, Frederick M., and Jerome R. Klingbeil. Body Image: A Surgical Perspective. St. Louis, Mo.: Mosby Year Book, 1980. The emphasis in this work is on cosmetic surgery. The authors are skilled plastic surgeons who concentrate primarily on the cosmetic aspects of their profession.
Loftus, Jean M. The Smart Woman’s Guide to Plastic Surgery. 2d ed. Dubuque, Iowa: McGraw-Hill, 2010. Covers such topics as breast augmentation, liposuction, and face lifts, giving an overview of each procedure and discussing decision making, smart questions to ask, expectations, possible complications, and recovery.
Narins, Rhoda, and Paul Jarrod Frank. Turn Back the Clock Without Losing Time: Everything You Need to Know About Simple Cosmetic Procedures. New York: Three Rivers Press, 2002. A user-friendly guide to procedures that covers laser resurfacing and includes “frequently asked questions” for each treatment.
Rutkow, Ira M. American Surgery: An Illustrated History. Philadelphia: Lippincott-Raven, 1998. This historical review of surgery includes sections on the evolution and practice of plastic, reconstructive, and cosmetic surgical techniques. This book is useful for individuals who want to know the context from which plastic surgery emerged.
Townsend, Courtney M., Jr., et al., eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia: Saunders/Elsevier, 2008. A...
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Plastic Surgery (Encyclopedia of Science)
Plastic surgery is the branch of medicine concerned with the reconstruction and repair of defects in the body. Reconstructive plastic surgery repairs deformities or disfigurements caused by injuries, disease, or birth defects. It seeks not only to make a person look more normal but to function better as well. Cosmetic plastic surgery is performed solely for the purpose of improving the appearance of the body.
Origin of name
Many people have the mistaken belief that plastic surgery got its name because it involves the use of some sort of plastic or other manmade material. In fact, the term plastic surgery comes from the Greek word "plastikos," which means to mold or to shape. The first published use of that word was by German surgeon Karl Ferdinand von Graefe (1787840), one of the pioneers of plastic surgery. Von Graefe operated on the cleft palate (a birth defect in the roof of the mouth) and the eye and developed the first satisfactory procedure to correct the nose, called rhinoplasty (pronounced RYE-no-pla-stee), which he described in his 1818 book Rhinoplastik.
However, von Graefe was by no means the first or the earliest to perform such surgery. In fact, many believe that plastic surgery is one of the oldest forms of surgery. Some say that the earliest known surgery of any type dates back to the Peruvians of about 10,000 B.C., who...
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