July 15th, is observed as ‘World Plastic Surgery Day’ to create awareness about this enigmatic branch of medicine. Hence this article.
Plastic Surgery-Scope and Possibilities.
When Sanjana (name changed), a twenty five year graduate could not get an alliance for long, it was time for her parents to do some re-thinking about the deformity in her face. Decades earlier, a viral infection in a nerve left her face paralysed. She struggled through her adolescence and college-life with a hitherto spotless face that would deviate to one side whenever she smiled. Quite understandably, she started avoiding (and perhaps was about to forget) smiling.
That was when she sought plastic surgery to set her face and her life straight. Now that her facial muscles on one side were totally thinned out and not working, her chewing muscle was redirected towards the corner of her lips. Now, whenever she twitched this muscle, it would produce a smile on her face. With a little physiotherapy and training after the surgery, her once lifeless face started lighting up as she learned to smile again. What is more, she got married the next year and now, receives her husband every evening with a pleasant smile which she says comes effortlessly by now.
Sanjana is one of the countless people who benefit from the miracles of Plastic Surgery every day in every corner of the world. This July 15th, as we celebrate ‘World Plastic Surgery Day’, it is time to explore this unique field of medicine to know how it has touched the mankind.
Brief History of Plastic Surgery
Indian subcontinent, the cradle of civilization that it is, is also the land where the craft of plastic surgery sprang as far back as in pre-
Christian era. Sushruta, the ancient Indian surgeon while reconstructing chopped-off noses from patients’ own forehead skin must have been oblivious of the place his technique would hold for millennia under the name ‘Indian Forehead Flap’. He was arguably the first plastic surgeon in the world.
Modern plastic surgery however evolved only in the early and mid twentieth century building ironically on the experience gained during the great wars. Today, with advances in science, technology, environment and lifestyles, the field is continually evolving defining and redefining its own boundaries and often challenging human imagination. Let us then explore the scope of and possibilities with plastic surgery as relevant to our own life.
What is plastic surgery?
It is but necessary to bust some of the common myths about plastic surgery that have been imprinted in public mind mainly by reckless fiction scriptwriters. It is not about changing faces to morph identities or alter avatars. Plastic surgery is that branch of medicine which handles one’s tissues to either correct defects and deformities or to enhance their appearance. The objectives of surgery divide plastic surgery into two main categories-reconstructive surgery and cosmetic surgery. The former corrects deficiencies or defects in tissues to achieve normalcy while the latter strives to enhance normal tissues to look more aesthetically pleasing. While much of the plastic surgery practiced in a developing country like India is reconstructive in nature, cosmetic surgery is fast catching up.
Curiously, unlike all other medical specialties, Plastic Surgery is restricted neither to one particular region of the body nor to one type of disease.
How plastic surgery touches a common man?
It is not just a privilege of those with excess money to dunk to avail plastic surgery. Trust me, it is for everyone. When a child is born with a deformity in face, say a cleft lip or palate, it is a routine plastic surgery that corrects it. When one loses a major chunk of tissue in an accident or while removing a cancer, plastic surgeon replaces the tissues. Even amputated limbs and fingers can be re-joined by anastomosing blood vessels and nerves if operated sufficiently early. It is because of plastic surgery that a burns survivor can get back into social life.
Unwanted fat deposits refractory to diet and exercise can be removed by a simple procedure called ‘liposuction’. Some of the fat thus removed can be injected in appropriate places to ‘sculpt’ the body as desired. Women with smaller breasts can boost up their busts and their confidence with either fat grafts or silicone implants. Those with heavier and troublesome breasts can get them reduced too. Breast cancer survivors can have their lost breasts entirely reconstructed. A crooked nose can be straightened; a short one elongated and a bulky nose reduced. Thin lips can be made to pout and large ones trimmed. Scars can fade, blemishes disappear and a bald head can have natural hair (auto-)transplanted from elsewhere. Sagging tissues-be it eyelids, facial skin, neck, abdomen or thigh-can be lifted up for a youthful feel and appearance. Tummy-tuck, face-lift, chin/jaw contouring, chemical peeling, skin-resurfacing, botox therapy, fillers etc are some of the fancy names for commonly performed plastic surgical procedures aimed at enhancing cosmesis. Re-virginity surgery (hyemenoplasty), vaginal rejuvenation, penile lengthening, transgender surgeries etc are also increasing in demand. Dimple creation, PRP, microneedling, Lasers and similar energy devices are on the horizons of Plastic Surgery that is ever expanding. Most of these are now available in your neighborhood.
Microsurgery is a sub-specialty in plastic surgery in which tissues that are barely visible through naked eyes viz-blood vessels, nerves etc are operated upon using magnification through an operating microscope. With this, transferring tissues to a body defect from a distant donor site is made possible by joining the minute arteries and veins. This often proves invaluable in reconstructing tissues lost in trauma or to cancer. Limbs and fingers that are totally cut-away are also re-attached using this technique. Paralysis,-of face or limbs due to injury to nerves-can also be reversed. Microsurgery (microvascular or microneural surgery) although requires specialized instrumentation and training, one does not have to run to metropolitan cities for that anymore.
Why does plastic surgery sound scary sometimes?
With lax legislation and a lack of regulation on surgical practice, innocent unsuspecting patients often end up with unqualified or untrained practitioners. This naturally culminates in complications spoiling the reputation of plastic surgery as a whole. It happens in India as also elsewhere in the world. Simple as the procedures like liposuction or Botox therapy may seem, there still is a wealth of science and art behind each one of them which only a qualified care-giver is aware of. Hence, care-seekers (patients) should consciously look into the qualification of any practitioner offering plastic surgical procedures and choose wisely. It is also a good policy to trust your family physician in guiding you to the right specialist.
Serving mankind being the essence of medicine, Plastic Surgery does so in its own way by striving to: Repair; Reconstruct; Rejuvenate.
DR KIRAN PETKAR
MS, MCh, DNB
Head, Dept Of Plastic Surgery,
Ananta Institute Of Medical Sciences