Plastic surgery originates from the Greek word “plastikos” which means to mould.
History of plastic
Father of Indian plastic surgery – Susruta
Harold Delf Gilles is considered as the father of modern plastic surgery. He introduced the concept of tube pedicled flaps in reconstruction.
The dictum in plastic surgery is to replace like for like, tissues that are lost are replaced with similar tissues from the same person’s body, which are dispensable. This defect following the harvest is called the donor defect, which is minimized by the judicious use of the donor sites.
Plastic surgery broadly has two divisions
1. Reconstructive surgeries - which aim to correct tissue defects.
2. Cosmetic surgeries – to improve the aesthetic appearance
Reconstructive plastic surgery is needed for
Tissue defects due to Congenital causes like cleft lip and palate, hypospadias, syndactyly, vascular nevus, etc., limb injuries esp. when tendons and nerves are injured, facial injuries, second and third-degree burns raw area often needs skin grafts for healing and reducing the deformities some bedsores resistant to healing often need plastic intervention.
Nonhealing ulcers eg diabetic foot ulcers, heal by the use of plastic procedures, negative pressure wound therapy (VAC) helps increase the take of skin grafts in such difficult situations, fasciotomy for spreading cellulitis often needs skin grafts for faster healing, circumferential burns may need an escharotomy esp. for the fingers to restore blood circulation.
Cosmetic surgery involving the ear lobes like the second studs, keloid reduction split ear lobes, etc are often undertaken as day case surgeries, ear lobe reconstruction, liposuction for male gynecomastia, abdominoplasty for lax and following childbirth, breast aesthetic surgery, nasal reconstruction and Rhinoplasty, scar reducing therapy like silicone gel occlusion and pressure, resistant cases may need steroid (kenacort) injections also, nevus on the face are excised with the least scar possible, fat injection, PRP injection
Flaps for reconstruction are mostly used in hands and head and neck reconstruction. The groin flap is the workhorse for hand injuries.
1. Collagen sheet application
2. Meshed graft for early and max coverage from the available
3. Skin sheets
4. Grafts prevention and correction of post burn scars and contractures
Dr. Ajai Kumar Kammath, MBBS, MS, MCh
Consultant in plastic surgery