Exploring Plastic Surgery

Dr Kh Palin *

'Beauty of mind is the best cosmetic'.

Wrong perception about Plastic Surgery:

Up until fairly recently, plastic surgery was largely viewed as an eccentric luxury. It carried a stigma to an extent that people often went to great lengths to conceal their surgical self-improvement efforts. Today, however, it is not uncommon to overhear an excited post-op patient telling anyone who will listen all about her brand new breasts.

In Manipur, it is not uncommon for us to encounter patients who after completion of all the procedures will ask when plastic surgery will be done and plastic will be used! "For me, please put a good plastic material". "Don't go closer to fire after plastic surgery, you will melt" . These are the few words from our patients we encounter in our practice as a plastic surgeon. This is not true. We don't use plastic materials in plastic surgery nor will it be melted near the heat.

'Plastic' in 'Plastic Surgery' comes from the ancient Greek word 'Plastikos' which means 'fit for moulding or give form' and was first used by Karl Ferdinand Von Graefe in his famous Rhinoplastik in 1818. Moreover Hollywood or Bollywood have really confused the general perception of plastic surgery as Madhuri Dixit transformed to Sridevi after an accident and plastic surgery within minutes. This has developed an unrealistic expectation in the minds of the public.

After analyzing the results of the survey on "Awareness and Perception of Plastic Surgery among Healthcare Professionals" in India as well as abroad it is alarming to find the ignorance of our specialty amongst the members of the medical community as well. We feel that if our colleagues from other specialties are not aware of the spectrum of work we do, we ourselves are to be blamed for it. We lag behind in awareness creation of our specialty. It justifies the need for observing 'Plastic Surgery Day' on 15th July every year.

"Those who cannot remember the past are condemned to repeat it". – Santayana

Father of Plastic Surgery: Susruta of India is regarded as the Father of Plastic Surgery after his important contribution in the reconstruction of amputated nose from the forehead skin of ex-criminas in 600 BC. The technique is accepted as Indian style of rhinoplasty.

Father of Modern Plastic Surgery: War Drives Plastic Surgery Developments. For better or worse, the driving force behind most plastic surgery developments during the late 1800s and early 1900s was war, with the awful injuries it often inflicts on its participants. In World War I, New Zealand ENT Surgeon working in London, Harold Gillies developed many of the techniques of modern facial surgery in caring for soldiers suffering from disfiguring facial injuries. He is regarded as the Father of Modern Plastic Surgery.

In 1980s Mathew and Nahai discovered different blood supply to skin which enabled plastic surgeons to transplant skin with muscle or even with bone. Advancement in operating microscope technology improves the results of re implantation surgery of digits by reconnecting a blood supply by suturing arteries and veins as small as 1 to 2 mm (even smaller) in diameter.

Prof. G. Nilamani Sharma started the 'Era of Plastic Surgery' at RIMS, Manipur in 1982. Now Manipur has 4 Plastic Surgeons : Dr. G. N. Sharma and Dr. Sanjib Nepram at RIMS and Dr. Kh. Palin and Dr. AK Ibohal at Shija Hospitals, Langol. It is fortunate to have MCh (Plastic Surgery) training course at RIMS since the last 2 years. Manipur needs more plastic surgeons. The plastic surgery work in Manipur is at par with the national or international standard.

To remove all confusion and shorten the definition 'Plastic Surgery is problem solving surgical discipline and spans the entire body and does not have a defined anatomic area.'

It is artificially divided into Reconstructive and Aesthetic/ Cosmetic.

Cosmetic surgery seeks to improve the patient's features or self esteem on a purely aesthetic level, in the absence of any actual deformity or trauma (Liposuction, Hair transplantation, Rhinoplasty, Breast surgery etc).

On the other hand, the purpose of reconstructive surgery is to correct any physical feature which is grossly deformed or abnormal by accepted standards-either as the result of a birth defects like cleft lip and palate, Limb traumas like leg bone exposure due to skin loss, cancer surgery, Burn and post burn defects, microsurgery like finger replantation, maxillofacial traumas. Often, reconstructive surgery addresses not only a deformed appearance, but also seeks to correct or improve some deficiency or abnormality in the function of the body part in question.

Top 4 countries for cosmetic surgery: According to the new statistics, 17.5% of all procedures were performed in the U.S, and 14.3% were performed in Brazil. China accounted for 12.7% of cosmetic surgery procedures, followed by India at 5.2%.

Top 5 plastic surgery procedure: The ISAPS Global Survey reveals a new trend with liposuction representing 18.8% of all surgical procedures, followed by breast augmentation at 17%, and blepharoplasty (upper or lower eyelid lift) at 13.5%, rhinoplasty (nose reshaping) at 9.4% and abdominoplasty ("Tummy Tuck") at 7.3%.

The top five non surgical procedures are: toxins or neuromodulators injections (Botox, Dysport) (32.7%), hyaluronic acid injections (20.1%), laser hair removal (13.1%), autologous fat injections (taking a patient's fat from one location and transferring it in the same patient in another location) (5.9%) and IP Laser treatment (4.4%).

Medical Tourism

Medical tourism is said to be the second most popular industry now-a-days. The increase in the number of medical tourists each year denotes that the medical tourism industry will soon be on the boom. The patients who long for quick and effective cure of the diseases visit India on medical tourism. The world class infrastructure and highly qualified team of doctors available in India favours the booming demand for medical tourism services.

The greatest impetus for the growth of medical tourism in India is the difference in the cost and the increasing world-class medical facilities available in here. A simple rhinoplasty costs 2.64 Lakh in US, Rs.60,000 in India's metros but will only cost around Rs.30,000 in Manipur. If such is the difference then who is not tempted to avail the dual benefit of cure for sure and explore for sure.

Anti Aging Medicine:

British novelist Doris Lessing (1919), making reference to the popularization of science fiction in the 1970s, remarked:
'What a phenomenon it has been-exploding out of nowhere, unexpectedly of course, as always happens when the human mind is being forced to expand; this time star wars, galaxy-wise, and who knows where next'.

Everybody wants to live longer and look younger. Anti aging wave is the greatest wave of the century. But unlike tsunami, the impact is less felt as it has happened in the last two decades. Longevity and healthy aging is a reality. Medical scientists have confirmed that chronic inflammation is the cause of aging. Free Radicals is the culprit for inflammation and is largely influenced by lifestyle. Stem Cell may become The Ultimate Anti-Aging Therapy

'Future belongs to those who believe in the beauties of their dreams'.

(A special feature on the occasion of Plastic Surgery Day which is being observed worldwide on July 15)