Plastic
surgery is the branch of surgery concerned with the correction of physical deformities and disfigurements caused
by birth defects, injuries, or disease. It is also known as reconstructive
surgery. Examples of such operations include the rebuilding of lost or deformed ears, noses, or jaws; the repair of cleft lip or cleft palate; the reconstruction of a breast after mastectomy; the repair of damage after burns; the correction of birthmarks or scars; and the implantation of material to give a normal appearance to the body where a part was absent at birthÑfor example, a missing chest muscle.
Transplantation, which includes the grafting of skin, bone, muscle, cartilage, tendons, and nerves, is an important technique in
plastic surgery. The tissue to be transplanted is obtained from the patient whenever possible, or from a genetically compatible donor. Cartilage from a rib is often used to reconstruct missing or damaged ears or noses. Bone from a rib or the hip can be used to reconstruct the lower jaw. Transplanted tendons, nerves, and muscles can restore function to an injured hand.
Skin grafts are used to replace skin that has been destroyed by severe burns. The usual procedure, called the split-thickness graft, involves cutting a section from the donor that is sufficiently thick to contain enough living cells to grow on the damaged area. At the same time, enough live dermal tissue is left behind at the donor site for healing to occur. Sometimes skin from a donor who is genetically incompatible is used temporarily to cover a burned area that still has living cells. Although these grafts, called xenografts, are eventually rejected, they protect the damaged tissue until healing occurs. Another skin-grafting technique, called a skin flap or pedicle flap, involves leaving one end of the donor skin attached to its original siteÑsuch as a cheek, to cover a nose woundÑso that the blood supply is maintained until the area being repaired begins to heal and to establish its own supply of blood.
Another area of plastic surgery, called aesthetic (or cosmetic) surgery, is intended to improve a patient's self-image by correcting a feature that the person finds objectionable although it is not an actual deformity. This kind of surgery also includes the minimizing of age-related features such as wrinkles and sagging skin. Once considered the surgery of the rich and famous, aesthetic surgery is now sought by people from all walks of life.
Some of the most common types of aesthetic surgery include rhinoplasty, to reduce the size of a nose; otoplasty, to correct prominent ears; blepharoplasty, to remove drooping skin from around the eyes; rhytidectomy (commonly called a face-lift), to tighten skin and remove wrinkles of the face; reconstructions of receding or prominent chins; and breast augmentation, using implants to enlarge the breasts. A technique called lipectomyÑthe removal of adipose tissue (fat) by suction (also known as liposuction)Ñis used particularly on the abdomen and thighs, but it is also sometimes used in face surgery, as in the removal of fat cells on a large chin. Chemical face peeling removes fine wrinkles and minor skin blemishes, and dermabrasion (abrasion of the skin) is employed to remove acne scars. Plastic surgeons also perform hair transplants to correct baldness. An important part of aesthetic surgery is counseling to be certain that the patient has realistic expectations of the outcome.