Subject: Surgery

Topic: Plastic Surgery

By: Muhammad Atif
Ahmad Ali
Plastic Surgery

Plastic Surgery
Definition
Plastic, reconstructive, and cosmetic surgery refers to a variety of operations performed
in order to repair or restore body parts to look normal, or to change a body part to look
better. These types of surgery are highly specialized. They are characterized by careful
preparation of a person's skin and tissues, by precise cutting and suturing techniques, and
by care taken to minimize scarring. Recent advances in the development of miniaturized
instruments, new materials for artificial limbs and body parts, and improved surgical
techniques have expanded the range of plastic surgery procedures that can be performed.

Purpose
Although these three types of surgery share some common techniques and approaches,
they have somewhat different emphases. Plastic surgery is usually performed to treat
birth defects and to remove skin blemishes such as warts, acne scars, or birthmarks.
Cosmetic surgery procedures are performed to make persons look younger or enhance
their appearance in other ways. Reconstructive surgery is used to reattach body parts
severed in combat or accidents, to perform skin grafts after severe burns, or to reconstruct
parts of person's body that were missing at birth or removed by surgery. Reconstructive
surgery is the oldest form of plastic surgery, having developed out of the need to treat
wounded soldiers in wartime.

Demographics
The top 10 most commonly performed elective cosmetic surgeries in the United States
include the following:

Liposuction
Breast augmentation
Eyelid surgery
Face-lift
Tummy tuck
Collagen injections
Chemical peel
Laser skin resurfacing
Rhinoplasty
Forehead lift

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Muhammad Atif Ahmad Ali
Plastic Surgery

There were approximately 29 million surgical procedures performed in the United States
in 2001. Because many plastic and reconstructive surgical procedures are performed in
private professional offices or as outpatient procedures, accurate statistics concerning the
number of procedures performed are not available.

Description

Plastic Surgery

Plastic surgery includes a number of different procedures that usually involve skin.
Operations to remove excess fat from the abdomen ("tummy tucks"), dermabrasion to
remove acne scars or tattoos, and reshaping the cartilage in children's ears (otoplasty) are
common applications of plastic surgery.

Cosmetic Surgery

Most cosmetic surgery is done on the face. It is intended either to correct disfigurement
or to enhance a person's features. The most common cosmetic procedure for children is
correction of a cleft lip or palate. In adults, the most common procedures are remodeling
of the nose (rhinoplasty), removal of baggy skin around the eyelids (blepharoplasty), face
lifts (rhytidectomy), or changing the size or shape of the breasts (mammoplasty).
Although many people still think of cosmetic surgery as only for women, growing
numbers of men are choosing to have facelifts and eyelid surgery, as well as hair
transplants and "tummy tucks."

Reconstructive Surgery

Reconstructive surgery is often performed on burn and accident victims. It may involve
the rebuilding of severely fractured bones, as well as skin grafting. Reconstructive
surgery includes such procedures as the reattachment of an amputated finger or toe, or
implanting a prosthesis. Prostheses are artificial structures and materials that are used to
replace missing limbs or teeth, or arthritic hip and knee joints.

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Muhammad Atif Ahmad Ali
Plastic Surgery

Diagnosis/Preparation

General Preparation

Preparation for non-emergency plastic or reconstructive surgery includes individual

education, as well as medical considerations. Some operations, such as nose reshaping or
the removal of warts, small birthmarks, and tattoos can be done as outpatient procedures
under local anesthesia. Most plastic and reconstructive surgery, however, involves a stay
in the hospital and general anesthesia.

Medical Preparation

Preparation for plastic surgery includes the surgeon's detailed assessment of the parts of
an individual's body that will be involved. Skin grafts require evaluating suitable areas of
skin for the right color and texture to match the skin at the graft site. Face lifts and
cosmetic surgery in the eye area require very close attention to the texture of the skin and
the placement of surgical cuts (incisions).

Persons scheduled for plastic surgery under general anesthesia will be given a physical
examination, blood and urine tests, and other tests to make sure that they do not have any
previously undetected health problems or blood clotting disorders. The surgeon will
check the list of prescription medications that the prospective patient may be taking to
make sure that none of them will interfere with normal blood clotting or interact with the
anesthetic.

Individuals are asked to avoid using aspirin or medications containing aspirin for a week
to two weeks before surgery, because these drugs lengthen the time of blood clotting.
Smokers are asked to stop smoking two weeks before surgery because smoking interferes
with the healing process. For some types of plastic surgery, individuals may be asked to
donate several units of their own blood before the procedure, in case a transfusion is
needed during the operation. The prospective patient will be asked to sign a consent form
before the operation.

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Muhammad Atif Ahmad Ali
Plastic Surgery

Personal Education

The surgeon will meet with the prospective patient before the operation is scheduled, in
order to explain the procedure and to be sure that the individual is realistic about the
expected results. This consideration is particularly important for people undergoing
cosmetic surgery.

Medical Considerations

Some people should not have plastic surgery because of certain medical risks. These
groups include:

Persons recovering from a heart attack, severe infection (for example, pneumonia), or
other serious illnesses
People with infectious hepatitis or HIV infections
Individuals with cancer whose cancer might spread (metastasize)
People who are extremely overweight (Individuals who are more than 30% overweight
should not have liposuction.)
Persons with blood clotting disorders
Psychological

Aftercare

Medical

Medical aftercare following plastic surgery under general anesthesia includes bringing
patients to a recovery room, monitoring their vital signs, and giving medications to
relieve pain as necessary. Persons who have had fat removed from the abdomen may be
kept in bed for as long as two weeks. Individuals who have had mammoplasties, breast
reconstruction, and some types of facial surgery typically remain in the hospital for a
week after the operation. Those who have had liposuction or eyelid surgery are usually
sent home in a day or two.

People who have had outpatient procedures are usually given antibiotics to prevent
infection and are sent home as soon as their vital signs are normal.

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Muhammad Atif Ahmad Ali
Plastic Surgery

Psychological

Some individuals may need follow-up psychotherapy or counseling after plastic or

reconstructive surgery. These people typically include children whose schooling and birth
defects, as well as persons of any age whose deformities or disfigurements were caused
by trauma from accidents, war injuries, or violent crimes have affected social
relationships.

Risks
The risks associated with plastic, cosmetic, and reconstructive surgery include the
postoperative complications that can occur with any surgical operation under anesthesia.
These complications include wound infection, internal bleeding, pneumonia, and
reactions to the anesthesia.

In addition to these general risks, some plastic, cosmetic, and reconstructive surgical
procedures carry specific risks:

Formation of undesirable scar tissue

Development of persistent pain, redness, or swelling in the area of the surgery
Infection inside the body related to inserting a prosthesis (These infections can result
from contamination at the time of surgery or from bacteria migrating into the area around
the prosthesis at a later time.)
Anemia or fat embolisms from liposuction
Rejection of skin grafts or tissue transplants
Loss of normal feeling or function in the area of the operation (For example, it is not
unusual for women who have had mammoplasties to lose sensation in their nipples.)
Complications resulting from unforeseen technological problems (The best-known
example of this problem was the discovery in the mid-1990s that breast implants made
with silicone gel could leak into the recipient's body.)
Normal Results

Normal results include an individual's recovery from the surgery with satisfactory results
and without complications.

Morbidity and Mortality Rates

Morbidity and mortality rates vary with the complexity and severity of different
procedures. Mortality is similar to that associated with all surgical procedures. Morbidity
is influenced by personal expectations. From a surgical perspective, most morbidity is
due to errors associated with anesthesia, procedure, pain medications, and after care.
From an individual's perspective, morbidity involves the degree to which actual results
compared to expected outcomes. The latter distinction is very subjective.

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Muhammad Atif Ahmad Ali