The field of plastic surgery in medicine incorporates cosmetic as well as reconstructive surgery. The aim is to make best use of both function and appearance, irrespective of what the initial presentation had been. In the majority of cases, there exists an overlap of both cosmetic and reconstructive plastic surgical procedures. Therefore, in 1999, this specialty was renamed from Plastic and Reconstructive Surgery to just Plastic Surgery.
The origin plastic surgery lies in the Greek word ‘plastikos’ that simply means ‘mould or shape’. The key pillars of plastic surgery are based on rebuilding, reconstruction, or modification of the human body. The discipline may be further sub-divided into two categories, namely:
Both cosmetic and reconstructive surgical techniques are widely used globally.
Plastic surgery has discipline that has multiple sub-specialties. These include:
• Aesthetic surgery is a vital element of plastic surgery that encompasses surgical operations performed on the face and the body. In order to improve upon the appearance, surgeons make use of isolated operations or cosmetic surgical practices in combination with reconstructive surgical processes.
Burn surgery is an operation that is performed in two phases.
Craniofacial surgery can also be categorised under two sub-divisions comprising of:
Hand surgery is mostly relevant for chronic diseases and acute injuries concerning the wrist and hand. During the surgery, malformations of the upper extremities along with problems relating to peripheral nerves may be corrected. Common conditions include brachial plexus injuries or carpal tunnel syndrome.
Microsurgery usually includes the process of reconstructing any missing tissues. This is done by transferring a piece of tissue to the site where reconstruction is being performed and then relinking the blood vessels. Examples of microsurgeries include breast reconstruction, head and neck reconstruction, hand surgery/replantation, and brachial plexus surgery.
Paediatric plastic surgery is generally performed if the child is born with birth defects or any syndromes present at birth. Common instances where paediatric plastic surgery may be recommended are craniofacial anomalies, Syndactyly which is webbing of the fingers and toes, Polydactyly means that the child possess excess fingers and toes at birth, cleft lip and palate, and congenital hand deformities.
Plastic surgery has multiple areas of subspecialties. These include:
Head, face, and eyes
Mouth and teeth
Breasts
Abdomen
Hand and upper limb
Skin
In order to improve the overall cosmetic appearance of an individual through a process of reshaping and adjusting normal anatomical features is referred to as cosmetic surgery. The operation makes the physical appearance more visually appealing. Cosmetic surgery is not a medical necessity, unlike reconstructive plastic surgery.
Popular cosmetic or aesthetic surgical procedures are:
• Abdominoplasty or a tummy tuck is a process of reshaping and firming of the abdomen or stomach.
• Blepharoplasty, popularly known as eyelid surgery involves restructuring of upper or / and lower eyelids including Asian blepharoplasty.
• Penile surgery, otherwise called Phalloplasty in scientific terms requires construction or maybe a reconstruction of a penis. At times, it may also comprise of a non-natural reformation of the penis via a surgical procedure, mostly for cosmetic reasons.
• Breast reduction surgery or Mammoplasty is performed in order to minimise the size of the breasts to attain a shape and size that is more comfortable.
• Breast augmentations, commonly known as breast implant is basically increasing the size of the breasts by surgical means that includes fat grafting, saline, or gel prosthetics made of silicone. This process was previously used on women diagnosed with macromastia.
• Reduction mammoplasty or breast reduction involves skin and glandular tissue removal. This surgery is done to minimise back and shoulder pain in women suffering with gigantomastia and for men experiencing gynecomastia.
• Mastopexy or a breast lift is a process that includes lifting or reshaping of breasts to make them less saggy. This is mostly done post undergoing weight loss, for example, after a pregnancy. The process requires harvesting of breast skin as opposed to glandular tissue.
• Buttock augmentation, popularly called butt implant is a general augmentation of the rear end making use of silicone implants or fat grafting that is transferred from other parts of the body.
• Buttock lifting is a cosmetic surgery performed with the objective of tightening the buttocks via excision of excess skin.
• Cryolipolysis denotes a medical instrument utilised to kill fat cells. The theory works on the principle where the body contours are reshared relying on attainting the right balance of controlled cooling for non-invasive local reduction of fat deposits.
• Cryoneuromodulation is a form of treatment of superficial and subcutaneous tissue structures using gaseous nitrous oxide. The surgery also involves treating temporary wrinkle reduction, temporary pain reduction, treatment of dermatologic conditions, and focal cryo-treatment of tissue.
• Calf Augmentation is done by using silicone implants or a fat transfer to enlarge bulk to the calf muscles.
• Labiaplasty is process that involves a surgical reduction and reshaping of the labia.
• Lip enhancement ensures improvement of lips' fullness through enlargement via surgery.
• Cheiloplasty is a surgical reshaping of the lip.
• Rhinoplasty, commonly known as nose job means reshaping of the nose through a surgical intervention.
• Otoplasty or ear surgery / ear pinning implies restructuring of the ear, most frequently performed by pinning the protruding ear closer to the head.
• Rhytidectomy, or referred to as a face lift is a surgical intervention that removes wrinkles and signs of ageing from the face.
• Neck lift involves tightening of lax tissues in the neck area via a procedure that is periodically combined with a facelift for lower face rejuvenation.
• Browplasty or a brow lift or forehead lift means elevating the eyebrows, and smoothening of the forehead skin.
• Midface lift or a cheek lift that is basically tautening of the cheeks.
• Genioplasty is the process of augmentation of the chin using the individual's bones or with the help of an implant, preferably silicone, by suture of the soft tissue.
• Cheek augmentation or a cheek implant is the process of adding implants to the cheek area.
• Orthognathic Surgery involves modifying the upper and lower jaw bones through a process called osteotomy which also corrects jaw and teeth alignment problems.
• Administering collagen, fat, and other tissue filler injections, like hyaluronic acid.
• Brachioplasty or an Arm lift aims to reduce surplus skin and fat in the middle of the underarm and the elbow.
• Laser Skin Rejuvenation or laser resurfacing is performed with the goal of lessening the depth in pores of the face.
• Liposuction or suction lipectomy is done to remove any fat deposits by using a traditional suction technique or ultrasonic energy to help in removing the fat.
• Zygoma reduction plasty involves minimising the facial width by carrying out an osteotomy and resecting a specific area of the zygomatic bone and arch.
• Jaw reduction is a process performed to correct the mandible angle in order to smoothen out an angular jaw and creating a slim jaw.
Any part of the body that has been affected aesthetically or functionally via defects of a congenital nature, developmental abnormalities, tumorous growths, infection, trauma or disease may require reconstructive plastic surgery. The main goal of the surgery is done to enhance functionality and capability directed towards certain parts of the body. Some reconstructive surgery may also be partly aimed at achieving a more typical physical appearance of the area that has been impacted.
A wide variety of procedures are covered under reconstructive plastic surgery. The common types are:
• Breast Reconstruction is aimed at reshaping the breast to attain a normal shape, size, symmetry and appearance following a mastectomy. Two breast reconstruction procedures can be done, namely:
Implant-based reconstruction
Flap reconstruction
• Breast Reduction, also known as mammaplasty is a procedure for breast reduction that is performed to remove excess breast fat, tissue and skin in order to achieve a breast size that is more in proportion with the overall body.
• Cleft Lip and Palate Repair is done to correct common defects at birth to restore a more normal appearance.
• Hand or Foot Surgery is performed to rectify conditions that affect the hand, namely:
Carpal tunnel syndrome
Rheumatoid arthritis
Dupuytren’s contracture
If tumours, webbed feet or additional toes are present, then foot surgery may have to performed.
• Scar Revision may be attempted to reduce the affect of the scar on the appearance and help it to merge in the with surrounding skin more effectively.
• Skin Cancer Removal can be accomplished by cutting off the tumorous growth, any other skin lesions making use of specialised surgical techniques
• Tissue Expansion is a procedure that permits the body to grow additional skin in part of the body. This process is commonly used for breast reconstruction or breast removal.
• Regenerative medicine is a new branch of medicine that uses stem cells extracted from the human body to replace, regenerate and engineer new cells, tissues or organs in order to restore normal functions in the body. Areas that are part of regenerative medicine include:
Different techniques and procedures may be used to perform various types of cosmetic and reconstructive plastic surgeries including:
• Endoscopic surgery is carried out with the help of an endoscope which is a tubular probe having a small camera and a bright light at one end, inserted through a tiny incision. Visuals are transmitted back to the screen that assists the surgeon during the surgical procedure to manipulate the endoscope and perform the operation.
• Flap surgery is a process where live, healthy tissues are extracted from one location of the body and transported to the site that has lost skin, fat, muscle movements and possibly skeletal support. Different forms of flap surgeries are:
Local flap
Regional flap
Bone/soft tissue flap
Musculocutaneous flap (muscle and skin flap)
Microvascular free flap
• Laser technology is fast becoming an essential tool in performing plastic surgeries that allows the surgeon to perform the operation causing minimal bleeding, bruising and scarring.
• Skin grafts are utilised to cover the skin that has suffered some form of damage or is missing. A healthy portion of the skin from another part of the body is extracted and grafted on the damaged site to restore normal appearance of functioning to it. There are three different types of skin grafts that may be utilized, depending upon the size and location of needed skin. These include:
Split-thickness skin graft
Full-thickness skin graft
Composite skin graft
• Tissue expansion is a process where a expander which is a balloon like instrument is inserted under the skin that secretes liquid into the area required repair, assisting it to expand and stretch the skin.
About the Department
At Fortis Hospital in Chennai, our Department of Plastic, Cosmetic and Reconstructive Surgery is run by a team of specialists who are able to provide a comprehensive range of surgical services. Being true pioneers in their field of expertise, our surgeons appreciate and value the human sentiment that develops as a result of undergoing any form of reconstructive or cosmetic plastic surgery. Having travelled abroad, keeping up to date with ongoing research work and keeping on top of the latest surgical developments in the field, our specialists offer modern surgical treatments that are minimally-invasive as far as possible.
The care team adapts a multi-level approach by working with experts from allied medical disciplines such as surgical oncologists, dermatologists, bariatric and orthopaedic surgeons, offering accurate diagnosis and treatment plans. With world-class facilities and surgical equipment, a specialised ICU and 24 hour back-up support, our patients care is a combination of experience and compassion.
At Fortis, Chennai’s, Department of Cosmetic and Reconstructive Plastic Surgery, the purpose of our staff is to facilitate and support in opting for the treatment that best suits your needs and budget while treating you with the highest level of compassionate care.
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Consultant Plastic, Cosmetic & Reconstructive Surgery
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