Plastic Surgery

Surgery is one of the oldest disciplines of medicine. By using surgical procedures, the treatment of wounds or illnesses that can’t be treated with drugs or any alternative treatment method is called surgery.

Plastic and Reconstructive Surgery

Plastic and Reconstructive Surgery are two of the fields of  surgery which try to improve body shape or correct any defects in the body like congenital or acquired anomalies, shape and function disorders. Terminologically, plastic derives from the Greek word “plasticos” and denotes “reshaping”, “modelling”. Reconstructive originates from Latin and refers to “reconstracting or remodelling”.

Plastic Surgery and Reconstructive Surgery deal with surgical problems arising in  the body. Shape and functional defects on body may be based on congenital,  acquired or traumatic disorders. For instance,  this surgical discipline includes  such impairments as cleft lip/palate, syndactyly, vascular masses (like  hemangioma), traumatic injuries, facial injuries after traffic accidents, cuts and   organ ruptures, skin and soft tissue tumors and chronic wounds. Moreover,  plastic surgery deals with losses in the framework of bone (facial bones,  metacarpus, etc.) and cartilage (cartilage of the ear and nose, etc), malformations,  pathological conditions. Along with conventional surgical procedures,  microsurgery, laser systems, endoscopy systems, chemical agents and drugs can  be applied as well.

In conclusion, Plastic and Reconstructive Surgery aim to repair any defects that have an influence on body surface, skin and bones. During this process, the main principle is to repair lost tissues with similar tissues.

The Scope of Areas of Plastic and Reconstructive Surgery:

·         Facial deformities- facial asymmetry, congenital masses, rare facial clefts

·         Cleft lips/palates

·         Craniofacial- maxillofacial anomalies (disorders and deficiencies in jaw, face and cranium)

·         Orthognathic surgery (Temporomandibular disorders)

·         Microtia, prominent ear and other deformities

·         Defects, tumors, and ruptures in nose

·         Salivary gland disorders

·         Congenital tumors, nevus (moles), masses, vascular malformations, hemangiomas

·         Bone and soft tissue injuries of the face

·         Maxillofacial surgery ( bone fractures and defects caused by traffic accidents, tumors and other reasons, bone deformities, maxillofacial surgery)

·         Head and neck tumors and repair of these disorders

·         Absence of breast (amastia), asymmetrical breast or excess breast tissue

·         Breast reconstruction after cancer

·         Gynecomastia ( enlargement of breast tissue in males)

·         Congenital anomalies of the genital organs (epispadias, hypospadias, vaginal agenesis, etc.)

·         Repair of the genital organs, replantation of ruptured organs

·         Chest and abdominal wall defects

·         Hand surgery (trauma, tumors, finger transfers, extension and repairs of fingers, etc.)

·         Deficiencies and deformities in hands and feet

·         Peripheral neuropathies (trauma, neuropathies, defects, masses)

·         Skin and soft tissue tumors

·         Acute burn and post-burn deformities, spasms, shrinkages, soft tissue injuries arised from electrical materials and chemicals

·         Various infections, wounds on the skin and under the skin because of various infections, radiation and similar effects

·         Chronic wounds (pressure sores, venous ulcers, diabetic foot ulcers, etc.)

Repair of disorders is performed in plastic surgery with a simplistic approach and the method having the least damage. Primary wound closure is desired initially; in case of any tissue loss, graft (skin patch) should be applied. In such cases which this procedure is improper as deep and complex tissue loss, open fractures and tendon injuries, flap applications should be applied. Flaps are used considering state and local of the tissue defect; it ranges from local flaps (skin flaps) to composite flap (involving more than one tissue).

Basic rule in plastic surgery is to apply repair procedures by using similar tissues to lost tissues. In both plastic and aesthetic surgery, it is primarily preferable to use autologous tissues (that are taken from the patient). If the autologous tissues are not compatible, other methods like homografts, heterografts and alloplastic materials could be used. For instance, in patients with extensive burns, skin grafts (skin patches) taken from the intact areas are principally preferred. 

In case these tissues are insufficient, tissues that are taken from other people, cadavers (homograft and even animals (heterograft) are to be applied. Other than auto-grafts, they act as a biological cover, but it isn’t seen possible to keep them on the wound. Another example may be given for the loss of bone. Bones are taken from other parts of the body and are applied to the defects in facial bone losses. On the contrary, alloplastic (porous polyethylene, hydroxyapatite, titanium, etc.) materials may be applied when the tissues or materials are inadequate and can not be used.