What is Plastic Surgery
Meaning of Plastic Surgery?
What is plastic surgery? It is a surgical specialty focused on altering the appearance of the body, as seen in the English term plastic surgery. The word "plastic" does not refer to synthetic materials but comes from the ancient Greek word plastikos, which means "to mold or give form," referring to changing shape.
Scope of Plastic Surgery
The field of plastic surgery covers all parts of the body except for internal organs. It involves altering the external appearance from head to toe, without directly involving internal organs like the brain, eyes, inner ear, respiratory tract, digestive tract, or organs in the chest and abdomen. If involvement is necessary, a specialist in this field, called a plastic surgeon, who may not have sufficient knowledge of internal organs, will often work with specialists of those organs. Additionally, plastic surgery is not only concerned with form but also with the function of that body part.
Form and Function: The Core of Plastic Surgery
Plastic surgery is a field that places great importance on appearance, or form, but also pays attention to the body's function. It is about achieving both form and function, with a strong emphasis on form. This differs from other medical specialties that often prioritize function over form. For example, when performing intestinal surgery, a general surgeon is not concerned with the aesthetic appearance of the repaired intestine, as long as it is not blocked and functions properly. However, a good plastic surgeon, after dealing with internal tissues, will prioritize a normal appearance and suture the wound with the expectation of a beautiful, inconspicuous scar. Therefore, a plastic surgeon is a surgeon who repairs abnormal body appearances to look normal and modifies normal appearances to be more aesthetically pleasing according to current trends, while also considering the function of that organ.
A plastic surgeon is a surgeon who repairs abnormal body appearances to look normal and modifies normal appearances to be more aesthetically pleasing according to current trends, while also considering the function of that organ.
Reconstructive vs. Cosmetic Surgery
Fellow doctors often know that the field of plastic surgery consists of two types of work: reconstructive surgery and cosmetic surgery (or aesthetic surgery). However, few doctors truly understand the difference between these two areas. Cosmetic or aesthetic surgery involves operating on a normal body to alter its appearance to be more desirable to the individual (which often follows societal values). Reconstructive surgery, on the other hand, involves operating to correct a deformed or abnormal body, for whatever reason, to restore it to normal.
What Conditions Require Reconstructive Surgery?
An abnormal body that requires plastic and reconstructive surgery can have various causes. In medicine, we tend to group the causes of illness into categories: birth defects, trauma, tumors (both cancerous and non-cancerous), and infection. This is commonly referred to in Thailand as “congenital, trauma, tumor, infection.” This classification of causes also applies to external physical deformities in the field of plastic surgery. Examples of conditions where humans have an abnormal appearance and require reconstructive plastic surgery include cleft lip and palate, deformities from burns, breast deformities from breast cancer surgery, facial and body deformities from injuries (such as road accidents, assaults, weapons, or war), and hand and finger deformities from rheumatoid arthritis. At this point, anyone might think they understand the meaning of plastic and reconstructive surgery, but in practice, many people treat patients without this understanding.
| Work on... | Subspecialty Name |
|---|---|
| Face and Head | craniofacial surgery |
| Burns | burn surgery |
| Post-mastectomy breast surgery | breast reconstruction after mastectomy |
| Post-cancer surgery on face and neck | head and neck cancer reconstruction |
| Surgery requiring a microscope | microsurgery |
| Hand and fingers | hand surgery |
Common Misconceptions and The Grey Area
Many people misinterpret plastic and reconstructive surgery as cosmetic surgery simply because they lack a proper understanding. The author once encountered a patient with a congenital ear deformity who was denied treatment and referral to a higher-level hospital by one hospital. The patient was informed that they could not use their treatment rights because the ear deformity was not life-threatening and the surgery was considered cosmetic. If this line of thinking were correct, patients with untreated cleft lips or those who have had surgery but still have a deformed upper lip and nose (cleft lip and nose deformity) should also be denied treatment rights, as an untreated cleft lip or an abnormal upper lip and nose are not life-threatening, and the surgery should also be considered cosmetic. There are many other diseases and conditions like this, where there is an abnormal appearance without any impact on the body's function, yet they are not denied rights, such as polydactyly (extra fingers), preauricular tags, mild eyelid ptosis, and mild facial clefts. By now, you can see that reconstructive and cosmetic surgery are very closely related. In fact, they are blended components. Plastic surgeons perform them simultaneously, and they support each other.
How Reconstructive Skills Enhance Cosmetic Results
The ability to perform reconstructive surgery enhances the success of cosmetic surgery. For a plastic surgeon to successfully repair or reconstruct a deformed or missing body part, they must have excellent anatomical knowledge, be familiar with the body not just in theory, be skilled in various repair and reconstruction methods, and be able to solve problems that arise from surgery if any mistakes occur. Therefore, when a plastic surgeon performs cosmetic surgery, which is done on a normal organ with normal anatomy, it is an easy task. They tend not to randomly destroy body tissues, resulting in fewer complications. If any problems arise after surgery, they can usually solve them themselves. They just need to understand the patient's needs and expectations and the values related to beauty. However, to become a skilled plastic surgeon, one must undergo specialized training and work hard to accumulate experience.
The Rigorous Path to Becoming a Plastic Surgeon
The path to becoming a plastic surgeon is not easy in any country in the world. After graduating from medical school for 6 years, one must apply for further study at a medical school, which is well-known in the medical community for being highly competitive. The 6 years of medical education to become a general practitioner (GP) today is very different from the past, with fewer skills, including procedural skills. When studying to become a specialist, which is officially called training, if one wants to be a plastic surgeon, they must go through 2 years of general surgery, which treats all types of surgical diseases, with heavy workload, intense on-call duties, rigorous academics, and intensive skill development. This is followed by another 3 years of specialized plastic surgery, which is just as arduous as general surgery. Even after passing such rigorous training and obtaining a board certification (called a board-certified plastic surgeon), a newly graduated surgeon is still considered a novice in terms of skill. It takes several years of continuous work after completing the training to become truly proficient. However, with the high-level skills gained from such intensive training, plastic surgeons are extremely valuable national assets, helping many people, both those who are ill and those who want to be beautiful, not just doctors who only perform cosmetic procedures.
Plastic Surgeon vs. Cosmetic Surgeon
In our society, there is a group of doctors who only work in the field of beauty. These are not plastic surgeons. This group of doctors is called cosmetic surgeons. They have not undergone training in medical schools in a manner that is accepted in the medical community, including the Medical Council, and therefore do not have board certification. They are general practitioners and doctors in other fields who are interested in earning income from the beauty industry. Many strive to learn through short-term courses in various places, both domestically and internationally. They may receive numerous certificates, but this does not make them plastic surgeons, and they do not have the ability to perform reconstructive surgery. In addition, there are some specialties that have been recently approved by the Medical Council, recognized as specialized fields with only a few years of training without going through general surgery, and they receive board certification with a name similar to a plastic surgeon. These are also not plastic surgeons. The public often does not understand and is very confused about this matter.
Conclusion
In conclusion, plastic surgery is a type of surgery that repairs, reconstructs, enhances, or changes various external parts of the body, both from abnormal to normal (called plastic and reconstructive surgery) and from normal to more beautiful (called cosmetic surgery or aesthetic surgery). The doctors who work in this field must have undergone specialized training to be called true plastic surgeons.