Confusion to Confession - Tales of Plastic Surgeons

Dr Indranil Dutta *

“Doctor, Doctor!– screamed a young man holding his amputated right thumb in a packet running to our department in hope to rejoin it. And yes after 6 hours of tenuous surgery the thumb was successfully reimplanted.”

“Young boy due to motorbike accident, lost half of the sole, came to us if we can do something so that he can walk again. Yes, we did Microvascular Free Tissue Transfer and within 3 months he started walking.”

Yes, you might think it as a fairytale story, you might think of a magician who performs all this surgery. No, we are not magicians; we are Plastic & Reconstructive Surgeons.

Unlike other super-specialties such as Cardiothoracic Surgery, Neurosurgery and Urology, Plastic Surgery has no adhesion to a specific organ system. Plastic surgeons operate in all areas of the body from head to toes- to restore your functional loss; to beautify you.

We are all proud as it’s all started in India in 600 BC with Sushruta – Father of Plastic Surgery. Every year, 15th July is celebrated as World Plastic Surgery Day.

Plastic surgeons improve quality of life in people who experience severe injuries, life-changing illnesses and congenital defects. They use a variety of surgical techniques to enhance appearance and improve function in affected areas. Plastic surgeons also specialize in cosmetic surgery to improve appearance for aesthetic purposes.

What is a plastic surgeon?

Plastic surgeons repair injuries and congenital (present at birth) defects affecting appearance or function. They use reconstructive and cosmetic techniques to restore areas impacted by major illnesses such as cancer. They also perform procedures to enhance physical features for aesthetic reasons.

Their areas of expertise include Breasts and chest; Extremities, such as your arms, legs, hands and feet; External genitalia; Facial structures, like your mouth, face, ears, head and neck; Skin.

What conditions do plastic surgeons repair or restore?

Birth/Congenital Defects: Cleft lip and palate; Congenital hand differences; Craniosynostosis; Hypospadias; Microtia (Deformed Ear); Syndactyly (webbed fingers or toes).

Trauma: Burns; Complex wounds; Cuts involving delicate tissue, such as your hands, feet, lips, eyelids, nose, genitals or nerves; Maxillo-Facial fractures; Scars & Contractures that limit natural movement.

Cancer reconstruction: Head and neck cancer; Breast cancer; Colorectal cancer; Gynecologic cancer; Skin cancer.

Gender dysphoria: Plastic surgery to treat gender dysphoria is for transgender individuals whose physical appearance doesn’t reflect their gender identity.

Is a plastic surgeon the same as a cosmetic surgeon?

Cosmetic surgery and reconstructive surgery are both sub-specialties of plastic surgery. Cosmetic surgery is a part of all plastic surgeons’ training. Cosmetic Surgical procedures should be done by Plastic surgeons as per NMC, India.

What do plastic surgeons do?

Plastic surgeons use various techniques to treat severe injuries, improve function and restore a natural-looking appearance.

o Microsurgery involves the use of a microscope to help surgeons carry out complex procedures. You may need microsurgery to reconnect tiny blood vessels or nerves.
o Skin Grafts are sections of healthy skin that surgeons shave off and attach to a different area of your body. After surgery, the graft survives by connecting to existing blood vessels. Skin grafts help repair large wounds, including burns.

o Flaps & Free flap surgery. A flap uses a person’s own tissue to repair defects caused by cancer resection or trauma. Skin, fat and sometimes muscle are often moved from another area.
o Tissue expansion involves placing a balloon-like device under your skin and filling it with saline to slowly stretch or expand it. During a second procedure, surgeons remove the expander and use the skin to close a wound that covers a large area. Tissue expansion is often used in breast reconstruction.

o Complex wound care is for people with large or complex wounds. Plastic surgeons can sometimes use techniques to close the wound while minimizing scarring. They may use a variety of techniques, including microsurgery and skin grafts.

o Onco-Reconstruction – Breast Reconstruction, Jaw reconstruction, Head & Neck Cancer Reconstruction
o Brachial Plexus and Claw correction
o Diabetic Foot Surgery

What types of cosmetic procedures do plastic surgeons perform?

o Facelift rejuvenates a youthful appearance by tightening skin that has become loose with aging.
o Blepharoplasty removes excess skin, muscle and fatty tissue from eyelids and creates new eyefolds.
o Rhinoplasty or Nose Job reshapes your nose to enhance appearance or repair medical issues.
o Hair Transplant adds fullness to hair on your head by transplanting it from other areas of your body.
o Injectables are products such as Botox ® or Juvaderm ® (Fillers) that are administered to correct facial wrinkles.
o Lasers can perform peels, hair removal and treatment of spider veins.
o Liposuction can help remove difficult-to-lose fat deposits.
o Breast augmentation helps increase the volume and shape of your breast.
o Breast reduction removes fat, skin and other tissue to make breasts smaller.
o Breast lift elevates and reshapes your breast to achieve a more youthful figure.
o Body contouring shapes areas of your body and tightens skin.
o Tummy tuck removes excess fat and skin from your abdomen.
o Arm lift tightens sagging skin.
o Thigh lift helps restore a more youthful figure.
o Body lifts tighten sagging buttock skin.
o “Mommy makeovers” restore much of your pre-pregnancy appearance.