Whilst it would seem that plastic surgery is new and topical, it has, in fact, been around for a long time.

Its origins date back to the fourth century BC where plastic surgery was performed to reconstruct noses which were amputated as a punishment for infidelity.

People often  ask what the word plastic means and how it applies to surgery. Plastic surgery is indeed, a fascinating sub-speciality within surgery. It is a Greek word which means to remodel or reshape. Hence, plastic surgery is, in essence, remodelling or reshaping tissues.

This remodelling or reshaping is generally subdivided into two broad groups: reconstructive plastic surgery and cosmetic plastic surgery.

Reconstructive plastic surgery is the use of plastic surgery techniques to reconstruct defects which are caused by birth defects, trauma or cancer.

Cosmetic plastic surgery is the use of plastic surgery techniques to improve the appearance of part of a person’s anatomy.

Reconstructive plastic surgery techniques are important in a wide spectrum of problems.

A classic example would be the reconstruction of the lip and the palate in a child born with a cleft lip/palate defect. In this case, the aim of the reconstruction is not only to improve the appearance of the lip but to improve the function of the lip and the palate to allow the child to speak, eat and drink normally.

Commonly performed reconstructive procedures are skin grafts. These are most commonly performed for things such as burns trauma and for skin cancers.

More complex ways of moving tissues around the body for reconstruction include a variety of flaps. These techniques are used where skin grafts are not the best method. They are more complex and in fact, from a surgeon’s point of view, one of the very intriguing facets of plastic surgery. They are commonly used to cover important or vital structures and in reconstruction of defects created by surgery for cancer or trauma. A classic example would be a flap used to reconstruct a defect made after removal of a skin cancer on the nose. A flap used here, will often produce a far more acceptable appearance than a skin graft may. Another classic example would be the use of a flap to reconstruct an amputated breast after breast cancer.

Cosmetic plastic surgery is probably a more recent development within the realm of plastic surgery. ‘Recent’ actually means over the last 100-150 years. The first facelift recorded was done in 1890 on a member of the Austrian royal family.

Patients consider cosmetic plastic surgery for a number of reasons. The most common reason is that the patient feels that because of some aspect of their appearance, they stand out from the crowd. This may not actually be so. The patient may be well within the normal range of appearances but they may be socially or psychologically disabled by their personal concern about their appearance.

Secondly, patients consider cosmetic surgery simply to improve their appearance. The most common scenario for this, is to combat the effects of ageing and child bearing. It is only rarely that patients have cosmetic surgery with the aspiration of achieving pure beauty.

Thirdly, more men are considering cosmetic surgery because of concerns about their prospects in the workforce.

Cosmetic plastic surgery covers the full range of surgeries to the face, starting with things like prominent ears and going through eyelid, nose, lip and cheek surgery to extensive face and neck lifting surgery and endoscopic (keyhole) brow lifting surgery.

Cosmetic plastic surgery is commonly performed on the breasts. Probably the most common procedure is a breast reduction or breast lift, followed by breast enhancement by enlargement. There is a significant crossover with reconstructive surgery here, in that some girls present with very significant asymmetry between one side and the other, when cosmetic plastic surgery can be of great benefit to these girls.

Surgery for the treatment of resistant areas of fat is another major branch of cosmetic surgery. This ranges from liposuction through to the larger procedures of abdominoplasty. Whilst it is not a replacement for personal weight loss, it can be of assistance in areas where fat is resistant to weight loss programmes.

Whilst consideration of plastic surgery, whether reconstructive or cosmetic should not be taken lightly, it does provide opportunity for best outcomes in many surgical areas of need and improvement for individuals concerned about their appearance.