WORLD PLASTIC SURGERY DAY
Dr Rahul Gorka
In the world of medicine, few disciplines are as captivating and transformative as Plastic surgery. With its ability to reshape and restore the human body, plastic surgery represents the harmonious fusion of science and artistry. It is an intricate dance between the precision of medical expertise and the creativity of aesthetic vision, resulting in remarkable transformations that touch the lives of countless individuals.
Plastic surgery is a scientific field that utilises extensive knowledge of anatomy, surgical skills, and advanced technologies to address various concerns such as birth defects, traumatic injuries, deformities and age-related changes. Plastic surgeons undergo rigorous training to become experts in accomplishing these goals.
World Plastic Surgery Day, observed annually on 15th July, celebrates Plastic Surgery’s remarkable progress and contributions to the vast field of Burns, Reconstructive, Microvascular and Aesthetic surgery. This day not only recognises the profound impact of Plastic Surgery on improving the lives of individuals around the globe but also highlights the advancements and innovations in this field.
History of Plastic Surgery: Sushruta is considered the “Father of Plastic Surgery.” He lived in India sometime between 1000 and 800 BC and is credited for advancing medicine in ancient India. He followed the principle of “S?nubandhen Jèvitah : through continuity, it lives” (Sanskrit) and played a pivotal role in elucidating the importance of blood supply for tissue flap survival. He successfully employed cheek tissue to reconstruct the nose and ears ( Nose-cutting was a common punishment for political betrayal and women for adultery). This foundational understanding laid the groundwork for the development of modern reconstructive surgery.
British physicians travelled to India to see rhinoplasties being performed by Indian methods. Reports on Indian rhinoplasty performed by a Kumhar (potter) Vaidya were published in the Gentleman’s Magazine by 1794. Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods. Carpue was able to perform the first major surgery in the Western world in the year 1815. Instruments described in the Sushruta Samhita were further modified in the Western world.
Sir Harold Gillies is generally considered the “father of modern plastic surgery”. A New Zealand otolaryngologist working in London, he developed many modern facial surgery techniques in caring for soldiers with disfiguring facial injuries during the First World War. Gillies and his colleagues developed many plastic surgery techniques; more than 11,000 operations were performed on more than 5,000 men (mostly soldiers with facial injuries, usually from gunshot wounds.
Subdivisions of Plastic Surgery:
- Aesthetic surgery- Aesthetic surgery involves procedures that enhance the appearance of the face and body. Plastic surgeons apply aesthetic surgery principles to improve a person’s appearance, self-esteem and self-confidence. It includes Nose Reshaping (Rhinoplasty), Eyelid surgery (Blepharoplasty), Anti-ageing surgery (Facelift), Body contouring surgery (Liposuction), Hair transplant and breast augmentation(Breast implants/Fat grafting) and many others.
- Reconstructive Surgery includes procedures like breast reconstruction after breast removal for cancer treatment, cleft lip and palate repair, creating a newear/nose/thumbor any other body part when it is congenitally absent or lost due to trauma/cancer/infection.
- Burns surgery generally takes place in two phases. Acute burn surgery is the treatment immediately after a burn. Reconstructive burn surgery takes place after the burn wounds have healed. It may require skin grafting/flap surgery. Burn scars, Contractures, and Keloid treatment are also part of Burns reconstructive surgery.
- Craniofacial surgery- Paediatric craniofacial surgery mostly revolves around the treatment of birth anomalies of the head, facial skeleton and soft tissues, such as cleft lip and palate, microtia (ear abnormality), craniosynostosis(fused skull bones), and traumatic fractures. Adult craniofacial surgery deals mostly with reconstructive surgeries after trauma or cancer, revision surgeries, orthognathic surgery, and facial feminization surgery.
- Hand surgery deals with injuries, diseases, and malformations of the hand and wrist. It also addresses issues related to peripheral nerves, like brachial plexus injuries and carpal tunnel syndrome. Hand surgery is a significant aspect of plastic surgery training, including microsurgery techniques for reattaching severed limbs.
- Microsurgery generally involves reconstructing missing tissues by transferring tissue to the reconstruction site and reconnecting blood vessels. Popular subspecialty areas are breast reconstruction, head and neck reconstruction, hand surgery/replantation, and brachial plexus surgery. These surgeries require magnifying devices/equipment like microscope/loupe and specialised superfine instruments.
- Gender reassignment, urogenital and Cosmetic Gynaecology: Gender reassignment surgery focuses on procedures that help individuals transition to their desired gender. Urogenital and Cosmetic Gynaecology involves procedures that address aesthetic and functional concerns related to the genital area in both men and women.
As with any field, plastic surgery continues to evolve, driven by scientific and artistic advancements. New technologies, innovative techniques, and ongoing research further push the boundaries of what is possible. Plastic surgeons collaborate with scientists, engineers, and other medical professionals to pioneer ground-breaking procedures and improve outcomes. This synergistic relationship between science and art ensures that the field of plastic surgery remains at the forefront of medical innovation.
Recent Advancesand Future Prospects:
o 3D Imaging and Printing: With 3D imaging, surgeons can create a digital model of a patient’s body, allowing them to visualize, precisely measure and plan the outcome of the surgery before it takes place. It allows surgeons to create customized implants and prosthetics that fit a patient’s body perfectly eg. Facial implants.
o Virtual reality (VR) technology: With VR technology, patients can see what they would look like after a particular procedure, and better understand its process and potential outcomes.
o Artificial Skin:used in burns and trauma wounds.
o Limb Allotransplantation:India’s first hand transplant was carried out successfully at the Amrita Institute of Medical Sciences, Kochi, on 13th January 2015.
o Minimal Access Plastic Surgery: Small incision endoscopic surgeries.
o Migraine Surgery- Nerve decompression
o Regenerative Medicine/Tissue Engineering- Stem cells, PRP
o Artificial Intelligence/ Robotics in Plastic Surgery- enables surgeons to perform complex procedures with greater precision, flexibility, and control
As we celebrate World Plastic Surgery Day, it is important to recognize and appreciate the tireless efforts of plastic surgeons worldwide. Their dedication to improving lives through transformative procedures deserves admiration and support.
India, known as the Land of Sushruta, is leading in promoting “World Plastic Surgery Day” every year. World Plastic Surgery Day brings together experts who aim to create awareness about Plastic surgery. This event highlights how these procedures can bring about positive transformations in individuals’ lives by restoring their confidence and enabling them to overcome physical limitations of form and function for a better quality of life.
(The author is working as Assistant Professor (Burns and Plastic Surgery) at AIIMS Vijaypur, Jammu).
