Plastic surgery

Plastic surgery is a surgical specialty involving restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery covers a wide range of specialties, including craniofacial surgery, oral and maxillofacial surgery, hand surgery, microsurgery, and the treatment of burns. This kind of surgery focuses on restoring a body part or improving its function. In contrast, cosmetic surgery (or aesthetic surgery) focuses solely on improving the physical appearance of the body. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

Etymology The word plastic in plastic surgery refers to the concept of "reshaping" and comes from the Greek πλαστική (τέχνη), plastikē (tekhnē), "the art of modelling" of malleable flesh. This meaning in English is seen as early as 1598. In the surgical context, the word "plastic" first appeared in 1816 and was established in 1838 by Eduard Zeis, preceding the modern technical usage of the word for the synthetic polymer material by 70 years.

Research considerations Clinical research in plastic surgery requires careful consideration of factors that may influence surgical outcomes and the interpretation of evidence. Unlike many medical interventions, surgical results can be affected by variations in operative techniques, surgeon experience, patient selection, perioperative management, and differences in outcome assessment methods. Researchers should therefore consider these factors when designing studies and interpreting their findings. Systematic reviews and meta-analyses in plastic surgery should address methodological issues such as study heterogeneity, publication bias, and differences in surgical techniques. Standardized reporting methods and well-designed prospective studies are important for improving the quality of evidence and supporting safe, evidence-based clinical practice.

History Ancient Period (3000 BC–500 AD) Treatments for the repairing of a broken nose are first mentioned in the Egyptian medical text known as the Edwin Smith papyrus (c. 1600 BC).The early trauma surgery textbook was named after the American Egyptologist, Edwin Smith, one of the earliest known surgical texts focused on trauma care. Reconstructive surgery techniques were being carried out in India by 800 BC. Particularly as documented in Sushruta Samhita, which describes methods for nasal reconstruction using skin flaps. Sushrata, a physician of the 6th century BC, made significant contributions to early plastic and cataract surgery and is widely regarded as a foundational figure in reconstructive surgery. Roman physicians in the 1st century BCE also performed plastic reconstructive surgeries, using simple techniques, to repair damaged ears. For religious reasons, they did not dissect either human beings or animals, thus, their knowledge was based in its entirety on the texts of their Greek predecessors. Notwithstanding, Aulus Cornelius Celsus left some accurate anatomical descriptions, some of which—for instance, his studies on the genitalia and the skeleton—are of special interest to plastic surgery. Middle Ages to Early Modern Period (500–1800 CE) Surgical practices continued to develop during the Abbasid Caliphate from 750 CE, where physicians preserved and expanded earlier medical knowledge through Arabic translations. The Arab physician, surgeon, and chemist Al-Zahrawi (936–1013) described the use of silk thread sutures in surgery to achieve good cosmesis, meaning an improved visual/bodily appearance, and documented what is thought to be the first attempt at reduction mammaplasty for the management of gynaecomastia. He gives detailed descriptions of other basic surgical techniques such as cautery and wound management. The Arabic translations made their way into Europe via intermediaries. In Italy, the Branca family of Sicily and Gaspare Tagliacozzi of Bologna (1545–1599) became familiar with the techniques of Sushruta. Tagliacozzi was a Bolognese surgeon who popularized a rhinoplasty procedure involving the use of a skin flap from the patient's upper arm to reconstruct the nose. He wrote about this procedure in his book, "De curtorum chirurgia per insitionem" ('On the surgery of mutilations through grafting', (Venice, c.1597)).Earlier examples of a rhinoplastic procedure may be seen in the case of Federico da Montefeltro (1422–1482), Duke of Urbino, who sustained severe facial injuries during a jousting accident and whose nasal bridge was possibly surgically modified to improve his field of vision.

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