Plastic surgery is a branch of surgery that has in practice since Sushruta .
Modern plastic surgery has its beginning from reconstruction of the World war I & II injuries.
It is known as Plastic surgery because the word plastic is for Imitation and not the real.
Reconstruction is recreating near natural from available tissues. Use of material plastic is limited to the use of Silastic material which is an inert material used to fill the volume gap be it on nose or chin or breast or otherwise.
Pure cosmetic surgery is attributed to surgery where a normal looking face/area is to altered in shape/size. Like person with a normal nose or breast wants it made larger/smaller/sharper etc.
Cosmetic Surgery :-
The Common procedures are :-
1)Hair Transplant for Baldness.
Baldness is ageing phenomenon. It has a familial/ Hereditary tendency.
Usually the hairs from the front and vault are lost.
Hairs at Temples and Occiput are permanent in nature.
The advantage is that the hair roots maintain their permanent status even at the new site.
2)Forehead Lift for forehead lines/wrinkles
3)Eye-lid surgery -for baggy eye lids. :-
With ageing the eyelids become wrinkled and baggy. These can be easily smoothened by surgical excision of the extra skin.
4)Face lift -for aged/wrinkled face.
The wrinkles of ageing can be easily removed by Face lift.
A scar is made in front of the tragus going up in the hairs and going down around the ear lobule behind the ear. This a very safe and rewarding surgery.
4)Nose surgery-to reshape the nose. Rhinoplasty:-
The skin of the nose is to be viewed as scaffolding and a tent. Nose surgery is to be done from inside the nose so there are outside marks. By altering (bringing in to thin, bringing out to broaden)the bony/cartilage support from under the skin a desired result can be obtained.
Sometimes a piece of silastic is put to fill the depression on the bridge of the nose and support the tip of the nose.
5)Reshaping prominent ears.
the Prominent ears - called Bats ears need tucking back.
6)Dermabrasion for acne scars. The scars are subjected to Dermabrasion. It is peeling procedure. The area is usually healed after 7-10 days. Strict sunlight avoidance for minimum three months is necessary.
7)Scar revision.
A contour defect after skin graft is improved with local flap and primary closure of donor defect.
Skin expansion is done to remove large scar areas.In this technique a Silastic balloon is inserted under the normal area.This is regularly filled with water.After about 6-12 weeks the overlying skin get stretched enough.The balloon is then removed and the stretched skin used to drape over the excised scar.Large scar areas and contour gaps can thus be filled.
8)Removing wrinkled skin for rejuvenation-
Skin of back of hand, loose baggy skin from the Upper arm, bottom can be excised under surgery to give the firm rounded appearance.
9)Cosmetic Faciomaxillary surgery for Chin/ jaw advancement or pushback.
Surgical correction of face bone to improve or reduce the cheeck bone prominence, chin, jaw is possible. The surgery is done from inside the mouth or from areas where scars can be covered.
10)Breasts Surgery -
The breast tend to change shape after pregnancies and ageing.The breast can either be made larger or smaller or lifted up. To enlarge the breast an implant of Silastic is put under the breast, usually under the Pectoral muscle. To reduce the breast size or to lift the sagging breast there a techniques where essentially a cut is made around the nipple. this along with desired(in volume, along with overlying skin) breast tissue is separated. The excess is removed and now the nipple is relocated to newer position and the skin/breast tissue draped around it.
11)Excision of enlarged male breasts(Gynaecomastia).
12)Surgery for Sweaty armpits.
13)Liposuction to reduce contours and remove excess fat, cellulite. Contour reduction by Liposuction. People develop contour deformity like a double chin, on the tummy esp. the areas above umbilicus, on the sides of the tummy as a fold under the blouse, on the sides of the thighs. This abnormal deposition of fat sometimes does not go even after vigorous dieting and exercises. It is like permanent fat. These can be corrected by Liposuction.In this procedure a specially designed cannula is pushed under skin and the fat cells are sucked by high vaccum. By manipulation of the cannula large bumps and fat areas can be sucked. The reduction is almost permanent as that even after liposuction the person puts on fat again there are less fat cells available to multiply and proportionately less fat is deposited in these areas.
14)Fat reinjection-Sometimes there are area of depression on the body because of loss of body fat/ mass from under the skin(on the cheeks, other dimpled scars areas breast). The fat removed by liposuction can be reinjected to fill the contour .
15)Abdominoplasty or tummy tuck to give back a flat tummy. The bulging tummy after middle ages and after completion of family is common problem. A linear scar is made at the pubic hair level. Skin with excess fat is lifted from the abdominal muscles extra skin with stretch marks and fat is excised. The tummy is flat/smooth(virginial) as a end result.
16) Click for Surgery to increase Length and Girth of Penis.
17) Click for Penile Implant. -for Impotence
18) Click for Vaginoplasty,Hymanoplasty and Sex change surgery.
19)Surgical treatment of Vitiligo
.PROBLEMS IN PLASTIC SURGERY:-
Problems in plastic surgery are either because of inherent nature of tissues or when result and expectations do no match.
Problems of inherent nature of skin/tissues are:-
a)Hypertrophy/Keloidal scar
b)Residual swelling:-
c)Scar widening and residual scar:-
d)Colour/ texture match.
e)Unhappiness- Expectation versus result:- People have a notion that once plastic surgery has been all will be well as soon as bandages are out. They will wake up to new reality.
Patient should therefore have more than one meeting if required to fully understand - problem, surgery, end result, time, complications before finally deciding to go for Plastic esp. Cosmetic surgery. When the result matches with or is more than expectation then only the patient is happy.