Plastic surgeons- Do you really know what they do?

People in today’s world are more health conscious and are aware of the different medical specialties. Despite the tremendous advancements in the field of Plastic surgery, there seems to be a limited knowledge among the general public and also among medical Professionals regarding the spectrum of plastic surgery. As a medical specialty, plastic surgery is poorly understood by both the general public and some medical professionals as well. Plastic surgery is a unique specialty that defies definition, has no organ system of its own, and is based on principles rather than specific procedures.

Unlike other medical disciplines, plastic surgery is not defined by an anatomic area (Ophthalmology, ENT, thoracic surgery) or organ system (gastroenterology, urology,) or patient age group (pediatrics, adolescent medicine, geriatrics).It deals with everything from head to toe; but is associated with the prefix Plastic which symbolizes nothing to the common man and medical community at large.

We all understand the role the media plays in informing and educating the public on issues of the day, but it seems that when it comes to plastic surgery, the press has a one track mind that leads them to cosmetic surgery. Plastic surgeons are often portrayed in the media as glamorous beings who give people a new lease of life through a ‘nip and a tuck’.

However, the reconstructive side of our work goes largely unreported. In India, 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 all of us as plastic surgeons, plastic surgery is not just cosmetic and we need to educate and inform the public and non plastic surgical specialties as to what it is that plastic surgeons actually do. We understand that the name of our specialty itself is not understood by many. Unlike other specialties, where the name itself indicates the work being done by that particular specialty, plastic surgery lags behind on this front. It is easy to understand that an Ophthalmologist deals with eyes, and Pediatrician deals with kids, but when it comes to Plastic surgery, we are at a loss. The word Plastic surgery is actually derived from the Greek word ‘Plastikos’ which means to mould.

The spectrum of Plastic surgery is very wide. Plastic surgeons are trained in cranio-maxillo-facial reconstructions, which can be congenital or acquired, cosmetic surgeries, hand and peripheral nerve surgeries, burn management and post burn reconstruction, genitourinary reconstructions, occuloplastic surgeries, bed sore reconstructions, lower limb reconstructions,vascular as well as lymphatic surgeries, post oncologic reconstructions, and almost all sorts of surgeries which involve restoration of form and function.

There are many misconceptions regarding our specialty of Plastic surgery. Plastic surgery misconceptions pour from our television, movies, magazines and other sources. There is an overwhelming mass of information from uncertain sources, and shortage of facts, which frustrate the potential patients and make them have unrealistic expectations from Plastic surgery.

Myths and Facts of Plastic Surgery

Myth : surgery is called plastic surgery because it involves use of Plastic.
Fact : word plastic was derived from the Greek word ‘Plastikos’ which means ’To mould’, which gave rise to the term Plastic surgery. Although silicone and other types of implants are used in Plastic surgery, it is the art of remodeling of the tissues which gave rise to this name-Plastic surgery.

Myth : There are no scar marks left after plastic surgery.
Fact : All plastic surgeries heal with scars. Plastic surgeons are trained for delicate tissue handling ,and making tissue incisions in strategic positions to minimize their visibility. Because of all this and use of fine sutures, the quality of scar is much better after Plastic surgical procedure is done. Proper post operative care of the scar further minimizes the scar to some extent. Every one heals differently because of genetic and personal health factors.

Myth : Plastic surgery and Cosmetic surgery are the same and Plastic surgery is meant only for improving looks.
Fact : Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic. Plastic surgery has got a very broad spectrum, and can be divided into further subspecialties like Hand surgery, Microsurgery, Craniomaxillofacial surgery, Pediatric plastic surgery and Cosmetic surgery. Plastic surgery is mostly involved with improvement of function first and then form and looks.

Myth : Plastic surgery is very expensive and meant only for rich and famous.
Fact : Most of the Plastic surgery procedures are affordable to the common people. The vast majority of people undergoing plastic surgery are the common people. It is probably because of the glamour associated with the term plastic surgery, that it is considered very expensive.

Myth : The entire face can be changed using plastic surgery.
Fact : This statement is not entirely a myth. Cadaveric face transplants have been done successfully in some countries. However it needs prolonged immunosuppression, and long term results are yet to be evaluated. It will take a couple of years before face transplantations will be regularly performed in India. As of now, improvement in certain aspects like hair, nose, eyes, chin can be made using Plastic surgery.

Myth : Plastic and cosmetic surgery procedures are very risky.
Fact : The risk involved in Plastic surgery is similar to risk involved in other surgeries.

Myth : Plastic surgery is possible at specialized centers and corporate hospitals only.
Fact : Apart from corporate hospitals, Plastic surgery is routinely being done across many government institutes as well as smaller centers in India.

Patient Safety

Patient safety is the prevention of errors and adverse effects to patients associated with health care.

Questions to ask your Plastic Surgeon : Here is a brief checklist of questions you can ask your surgeon during the consultation. This is important to ensure your safety and satisfaction while contemplating a plastic

surgical procedure : Are you a member of the Association of Plastic Surgeons of India ?
Were you trained specifically in the field of plastic surgery ?
How many years of plastic surgery training have you had ?
Do you have hospital privileges to perform this procedure? If so, at which hospitals ?
How many procedures of this type have you performed ?
Am I a good candidate for this procedure ?
Where and how will you perform my procedure ?
How long of a recovery period can I expect, and what kind of help will I need during my recovery ?
What are the risks and complications associated with my procedure ?
How are complications handled ?

Important facts : Plastic surgical procedures may require sedation or general anesthesia. Therefore, a full medical history including diagnostic tests is recommended. Part of this medical history requires that you provide candid answers to questions about your general state of health.

including : A full disclosure of health history including any illness, prior surgery of any kind and complications from prior surgery All types of allergies and any reaction to prior anesthesia Current medications, the use of vitamins, alcohol, tobacco etc The use of oral contraceptives by women Before surgery, you must follow all of your plastic surgeon's instructions.

This may include : Cessation of smoking Stop taking certain types of medications that may increase your risk of abnormal bleeding.

On the day of surgery, you may be asked to :Avoid eating or drinking anything within a defined time period prior to surgery Follow all the postoperative instructions carefully. Your cooperation will influence the outcome of your surgery.