Plastic surgery
Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic (or aesthetic) surgery aims to improve the appearance of it.[1][2] A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.
Occupation
- Physician
- Surgeon
- Doctor of Medicine (M.D.)
- Doctor of Osteopathic medicine (D.O.)
- Bachelor of Medicine, Bachelor of Surgery (M.B.B.S. or MBChB)
Etymology[edit]
The word plastic in plastic surgery is in reference to the concept of "reshaping" and comes from the Greek πλαστική (τέχνη), plastikē (tekhnē), "the art of modelling" of malleable flesh.[3] This meaning in English is seen as early as 1598.[4] In the surgical context, the word "plastic" first appeared in 1816 and was established in 1838 by Eduard Zeis,[5] preceding the modern technical usage of the word as "engineering material made from petroleum" by 70 years.[6]
In plastic surgery, the transfer of skin tissue (skin grafting) is a very common procedure. Skin grafts can be derived from the recipient or donors:
Usually, good results would be expected from plastic surgery that emphasize careful planning of incisions so that they fall within the line of natural skin folds or lines, appropriate choice of wound closure, use of best available suture materials, and early removal of exposed sutures so that the wound is held closed by buried sutures.[34]
Cosmetic surgery is a voluntary or elective surgery that is performed on normal parts of the body with the only purpose of improving a person's appearance or removing signs of aging. Some cosmetic surgeries such as breast reduction are also functional and can help to relieve symptoms of discomfort such as back ache or neck ache. Cosmetic surgeries are also undertaken following breast cancer and mastectomy to recreate the natural breast shape which has been lost during the process of removing the cancer. In 2014, nearly 16 million cosmetic procedures were performed in the United States alone.[35] The number of cosmetic procedures performed in the United States has almost doubled since the start of the century. 92% of cosmetic procedures were performed on women in 2014, up from 88% in 2001.[36] 15.6 million cosmetic procedures were performed in 2020, with the five most common surgeries being Nose Reshaping, Eyelid surgery, Facelift, Liposuction, and breast augmentation. Breast augmentation continues to be one of the top 5 cosmetic surgical procedures and has been since 2006. Silicone implants were used in 84% and saline implants in 16% of all breast augmentations in 2020.[37] The American Society for Aesthetic Plastic Surgery looks at the statistics for 34 different cosmetic procedures. Nineteen of the procedures are surgical, such as rhinoplasty or facelift. The nonsurgical procedures include Botox and laser hair removal. In 2010, their survey revealed that there were 9,336,814 total procedures in the United States. Of those, 1,622,290 procedures were surgical (p. 5). They also found that a large majority, 81%, of the procedures were done on Caucasian people (p. 12).[38]
In 1949, 15,000 Americans underwent cosmetic surgery procedures and by 1969[39] this number rose to almost half a million people.[40] The American Society of Plastic Surgeons (ASPS) estimates that more than 333,000 cosmetic procedures were performed on patients 18 years of age or younger in the US in 2005 compared to approx. 14,000 in 1996. In 2018, more than 226,994 patients between the ages of 13 and 19 underwent plastic surgery compared to just over 218,900 patients in the same age group in 2010.[39][41] Concerns about young people undergoing plastic surgery include the financial burden of additional surgical procedures needed to correct problems after the initial cosmetic surgery, long-term health complications from plastic surgery, and unaddressed mental health issues that may have led to surgery.[42] The increased use of cosmetic procedures crosses racial and ethnic lines in the U.S., with increases seen among African-Americans, Asian Americans and Hispanic Americans as well as Caucasian Americans. In Asia, cosmetic surgery has become more popular, and countries such as China and India have become Asia's biggest cosmetic surgery markets.[43] South Korea is also rising in popularity due to their expertise in facial bone surgeries (see cosmetic surgery in South Korea).
Plastic surgery is increasing slowly, rising 115% from 2000 to 2015. "According to the annual plastic surgery procedural statistics, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2015, a 2 percent increase over 2014."[44] A study from 2021 found that requests for cosmetic procedures had increased significantly since the beginning of the COVID-19 pandemic, possibly due to the increase in videoconferencing;[45] cited estimates include a 10% increase in the United States and a 20% increase in France.[46]
The most popular aesthetic/cosmetic procedures include:
In 2015, the most popular surgeries were Botox, liposuction, eyelid surgery, breast implants, nose jobs, and facelifts.[55] According to the 2020 Plastic Surgery Statistics Report, which is published by the American Society of Plastic Surgeons, the most surgical procedure performed in the U.S. was Rhinoplasty (Nose reshaping) accounting for 15.2% of all cosmetic surgical procedures that year, followed by Blepharoplasty (Eyelid surgery), which accounted for 14% of all procedures. The third most populous procedure was Rhytidectomy (Facelift) (10% of all procedures), then Liposuction (9.1% of all procedures).[56]
Complications, risks, and reversals[edit]
All surgery has risks. Common complications of cosmetic surgery includes hematoma, nerve injury, infection, scarring, implant failure and end organ damage.[57][58] Breast implants can have many complications, including rupture. In a study of his 4761 augmentation mammaplasty patients, Eisenberg reported that overfilling saline breast implants 10–13% significantly reduced the rupture-deflation rate to 1.83% at 8-years post-implantation.[59] In 2011 FDA stated that one in five patients who received implants for breast augmentation will need them removed within 10 years of implantation.[60]
Psychological disorders[edit]
Though media and advertising do play a large role in influencing many people's lives, such as by making people believe plastic surgery to be an acceptable course to change our identities to our liking,[61] researchers believe that plastic surgery obsession is linked to psychological disorders like body dysmorphic disorder.[62] There exists a correlation between those with BDD and the predilection toward cosmetic plastic surgery in order to correct a perceived defect in their appearance.[63]
BDD is a disorder resulting in the individual becoming "preoccupied with what they regard as defects in their bodies or faces". Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive.[63] While 2% of people have body dysmorphic disorder in the United States, 15% of patients seeing a dermatologist and cosmetic surgeons have the disorder. Half of the patients with the disorder who have cosmetic surgery performed are not pleased with the aesthetic outcome. BDD can lead to suicide in some people with the condition. While many with BDD seek cosmetic surgery, the procedures do not treat BDD, and can ultimately worsen the problem. The psychological root of the problem is usually unidentified; therefore causing the treatment to be even more difficult. Some say that the fixation or obsession with correction of the area could be a sub-disorder such as anorexia or muscle dysmorphia.[64] The increased use of body and facial reshaping applications such as Snapchat and Facetune have been identified as a potential triggers of BDD. Recently, a phenomenon referred to as 'Snapchat dysmorphia' has appeared to describe people who request surgery to resemble the edited version of themselves as they appear through Snapchat Filters.[65] As a protest to the detrimental trend, Instagram banned all augmented reality (AR) filters that depict or promote cosmetic surgery.[66]
In some cases, people whose physicians refuse to perform any further surgeries, have turned to "do it yourself" plastic surgery, injecting themselves and running extreme safety risks.[67]