Paarl_WHAT DO PLASTIC _Feb 2022

What do plastic surgeons do?

By Amori Struwig on behalf of Dr Dehan Struwig, Plastic and Reconstructive Surgeon

In the mind of the public plastic surgery is usually related to beauty and vanity. It is often thought that the “plastic” in plastic surgery refers to the use of artificial materials such as silicone, to create a new look, a new person, and a new lease on life. But plastic surgery will not turn you into a plastic doll or an artificial being.

Early Egyptian physicians are the earliest contributors to the science of plastic surgery, with texts dating back to 3000BC containing descriptions of surgical procedures to manage facial trauma. The oldest reference to reconstructive surgery is traced back to India, 600BC, where forehead skin was used to reconstruct the faces of criminals who had their noses severed in acts of punishment.

In the 15th century, the Branca family of Sicily became famous for their use of a similar technique. And in the 16th-century Tagliacozzi used and refined several other methods for the reconstruction of deformed ears and noses. All this, long before the artificial material “plastic” was ever invented.

The word “plastic” in “plastic surgery” is derived from the Greek word “plastikos”, which means “to mould or shape” and the Latin word “plasticus”, which means “capable of moulding” and herein lays the meaning:

This specific type of surgery, called “Plastic surgery” is a specific type of surgery, unlike any other, which is capable of moulding, and re-moulding skin and body tissue in an effort to re-create an appearance or to reconstruct function or working ability, so that the patient can gain normal appearance and function.

The term “plastique” was probably first used by the French surgeon Desault in 1798. However, the term only established itself after the publication of the surgical manual “Handbuch der Plastischen Chirurgie” by Ziess.

Why is it called Plastic AND Reconstructive Surgery?

Many advances were made during the years following the Branca family’s innovative techniques, especially toward the end of the 19th century, but the real impetus for growth

of modern plastic surgery lies in the blood and guts of the First and Second World Wars.

These wars, unlike others, made use of weapons that wreaked such immense destruction of human flesh, as had never been witnessed before.

Some surgeons treating the severely wounded soldiers felt compelled to do more than merely close the horrible wounds they were confronted with. They wanted to reconstruct human lives and souls, as much as appearances. Thus the art of surgery with cosmetically pleasing results was born.

Reconstructive surgery refers to the surgical techniques used by plastic surgeons in an effort to correct abnormalities of the face or other parts of the body, caused by congenital defects, other developmental abnormalities, injuries, previous or concurrent surgery, infections, tumours or other diseases.

The main purpose of reconstructive surgery is therefore to improve function. But no plastic surgeon will improve function without also attempting to improve appearance.

So what is cosmetic surgery then?

Cosmetic surgery or aesthetic surgery is restorative in nature – normal structures of the body are repaired or reshaped mainly in an effort to improve a patient’s appearance.

These procedures evolved naturally from reconstructive procedures – plastic surgeons realised that if they could correct gross deformities, they could also improve the appearance of lesser deformities.

Cosmetic surgery procedures might involve reshaping parts of the body, eliminating wrinkles or enhancing certain features. Nevertheless, patients choosing this type of surgery do so to obtain an image with which they are comfortable and which makes them feel more confident.

With the advances in surgical methods, methods of anesthetic and the nature of artificial materials, it has become easier for surgeons to assist in restoring and reshaping human features.

Are all cosmetic surgery procedures performed by plastic surgeons?

Any surgeon can perform a cosmetic procedure: an ear, nose and throat specialist can perform a cosmetic procedure on a nose or ear, and a family physician can perform a cosmetic procedure on any part of the anatomy, but only a plastic and reconstructive surgeon has undergone specialised training and education to perform these procedures, specifically with the aim of achieving cosmetically pleasing results.

A specialist surgeon, registered with the Health and Professions Council of South Arica as a Plastic and Reconstructive Surgeon, has graduated from an accredited Medical School, firstly as a doctor of Medicine and Surgery (M.B., Ch.B.), and has furthermore completed at least 5 years of post-graduate medical education, specifically in Plastic and Reconstructive Surgery.

Is it all about beauty and vanity?

Some call a boob job, a boob job, but what if your breasts were so big, that you suffered continuously from backache and chronic fungal infections? Or what if your eyelids hung over your eyes in such a way that you had to lift your chin to see anything? Can we really call that cosmetic? And then we still need to think of the lady who had a breast removed due to breast cancer – surely that cannot be called “cosmetic” surgery.

Not to mention the child seemingly scarred for life when she accidentally pulled the pot of boiling oil over her head, or ran into a glass door; or the young man with multiple scars on his face after a car accident.

However, all these procedures are performed by plastic surgeons and while they enhance one patient’s features during a so-called “beauty” operation, they are also quite capable of re-structuring a face (or any other part of the body) that is deformed due to an accident, a deformity or a disease.

And yes, sometimes the boundaries are vague – arguably some procedures can be perceived as purely in search of beauty. But then, everyone has to make that decision for himself in the end.

You see, Plastic and Reconstructive Surgeons not only beautify the body, but also the soul. The Plastic and Reconstructive Surgeon is concerned about the patient as a total human being of whom he takes care, and therefore has to consider not only the physical features of the patient but also those elements that contribute to creating a complete human being.

For some patients, this includes beauty.

The hands of an artist

Plastic surgeons use their hands and touch as an expression not only of their knowledge and skill, but also of their passion for beauty, art and creativity.

Art and science are complementary, and the work of plastic surgeons proves this point. It is therefore not uncommon to find plastic surgeons that enjoy creative and artistic hobbies in their private lives.

Plastic surgeons are truly blessed, as the human body is their canvas, their clay, their passion – their work allows them to live their art.

The beauty of the patient is therefore the plastic surgeon’s main aim – regardless of whether he is doing a facelift, or removing a skin lesion that could be cancer, or suturing a wound on a patient’s leg or face. Restoring the “natural look” that was part of a person prior to surgery or injury is visible testimony to the plastic surgeon’s skill.

So what do plastic and reconstructive surgeons do?

It is a myth to believe that plastic surgeons devote their lives to satisfy the whims of the vain. Only a very small group of plastic surgeons devote their lives exclusively to cosmetic surgery.

Many plastic surgeons spend many hours and long nights in the accident and emergency units of hospitals, using their surgical skill, art and experience to restore human bodies damaged by accidents – piecing together faces broken during a collision, carefully debriding and dressings limbs damaged by fire or suturing wounds cause by guns, knives, household accidents and dog bites.

They spend countless hours in operating theatres doing reconstructive procedures on patients with genetic disorders and who suffer from cancer.

Plastic surgeons perform surgery on any part of the anatomy, except the central nervous system.

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