What is Plastic, Reconstructive, and Aesthetic Surgery? What do they do?

Plastic, Reconstructive, and Aesthetic Surgery is a medical field aimed at restoring and improving the shape and function of the body. This area can be divided into two main branches: Plastic and Reconstructive Surgery and Aesthetic Surgery.

Plastic and Reconstructive Surgery (Reconstruction and Repair Surgery)

This branch focuses on correcting congenital or acquired deformities in both shape and function. The term “plastic” comes from the Greek word “plasticos,” which means “to mold” or “to shape,” while “reconstructive” comes from Latin and means “to rebuild.” The scope of plastic and reconstructive surgery includes:

• Congenital abnormalities (such as cleft lip and palate, fused fingers),
• Traumatic injuries (such as burns, facial injuries from traffic accidents, cuts, and amputations),
• Acquired conditions (such as skin and soft tissue tumors, chronic wounds),
• Loss of bones (especially in the face and hand bones) and cartilage (such as in the ears and nose), deformities, and pathological events (tumors, cysts, infections).

For these conditions, various surgical techniques, including microsurgery, laser systems, endoscopy, and chemical agents, may be used. The main principle in plastic and reconstructive surgery is to repair defects by using tissues that are as similar as possible to those lost.

Areas of Interest in Plastic and Reconstructive Surgery:

• Facial deformities: asymmetries, congenital masses, rare facial clefts,
• Cleft lip and palate,
• Craniofacial and maxillofacial anomalies (such as jaw, face, and skull bone deformities, irregularities, or deficiencies),
• Orthognathic surgery (jaw closure issues),
• Ear deformities (such as missing or protruding ears),
• Nose defects, tumors, and amputations,
• Salivary gland problems,
• Congenital tumors, nevi (moles), masses, vascular malformations, hemangiomas,
• Facial bone and soft tissue trauma,
• Maxillofacial surgery (bone defects, fractures, deformities, and functional issues caused by traffic accidents, tumors, and other reasons),
• Head and neck tumors and their reconstruction,
• Breast deformities: absence, asymmetry, or excess tissue,
• Breast reconstruction after cancer,
• Gynecomastia (enlarged breasts in men),
• Congenital anomalies of genital organs (e.g., epispadias, hypospadias, vaginal agenesis),
• Repair and replantation of amputated organs,
• Chest and abdominal wall defects,
• Hand surgery (trauma, tumors, finger transfers, repairs, extensions),
• Deformities and defects in the hands and feet,
• Peripheral nerve problems (trauma, neuropathies, defects, masses),
• Skin and soft tissue tumors,
• Acute and post-burn deformities, contractures, and damage from chemicals and electricity,
• Chronic wounds (such as pressure ulcers, venous ulcers, diabetic foot ulcers).

The main principle in plastic surgery for repair is to choose the simplest and least damaging method. If a wound can be closed with sutures (primary closure), it is done first. If there is tissue loss, skin grafts may be used. In more complex cases (e.g., deep tissue loss, open bone, and tendon injuries), flaps are used. Flaps are planned according to the defect’s location and type, ranging from simple local flaps (such as skin flaps) to composite flaps (which contain multiple types of tissue).

Aesthetic Surgery (Cosmetic Surgery)

Aesthetic (or cosmetic) surgery is a subfield of plastic surgery that focuses on improving the aesthetic appearance of the body to make it more beautiful and closer to perfection. Here, the problems are primarily aesthetic, not medical. However, aesthetic surgery often overlaps with reconstructive surgery in addressing functional and aesthetic problems. For example, correcting excessively large breasts (gigantomastia) not only addresses aesthetic issues but also medical problems. In some cases, surgery is necessary to correct aesthetic issues that non-surgical methods cannot solve.

Aesthetic surgery includes operations such as:

• Aesthetic rhinoplasty (nose surgery),
• Facelifts and facial rejuvenation,
• Eyelid surgery (blepharoplasty),
• Correction of protruding ears or other ear deformities,
• Chin surgery (mentoplasty),
• Breast augmentation, reduction, or lifting,
• Liposuction and body contouring,
• Abdominoplasty (tummy tuck),
• Hair transplantation,
• Laser treatments for skin resurfacing, vascular malformations, and pigmentation issues.

Subspecialties in Plastic Surgery:

• Aesthetic (Cosmetic) Surgery: Surgery to achieve a more aesthetic and proportionate body.
• Maxillofacial Surgery: Surgery of the facial bones, including fractures, tumors, and jaw corrections.
• Craniofacial Surgery: Surgery for skull bone deformities, often needed to address developmental issues.
• Microsurgery: Surgery performed under a microscope to reattach amputated limbs or repair small blood vessels and nerves.
• Hand Surgery: Treats traumatic injuries, congenital deformities, and functional issues of the hand.
• Endoscopic Surgery: Surgery performed using endoscopic tools for minimally invasive procedures.

Plastic and aesthetic surgery involves both surgical and non-surgical techniques to address various aesthetic and functional concerns.