An enigma of modern medicine-plastic surgery-common myths busted

As a young medical specialty, Plastic surgery has seen phemonenal developments recently, with immense potential to benefit an individual and society as a whole. However, poor awareness and wrong notions usually prevent this benefit. An insight into the worldwide growth of Plastic surgery is needed to clarify relevant facts.

The foremost false notion is when Plastic Surgery is equated to Cosmetic surgery. Though cosmetic surgery issues/news are more glamorous/attention catching, though it’s demand often portrayed as rapidly increasing, the fact is that cosmetic surgery procedures are still just a fraction of the entire spectrum of Reconstructive & Plastic surgery, more so in a country such as India.

Modern Plastic Surgery has it’s origin in treating complex gunshot wounds, deformities & disabilities that occurred during the first world war. Since then, surgeons began increasingly applying Plastic Surgery principles to improve results in existing procedures or treat problems without any existing treatment.

With the development of Microvascular Surgery in the 1960s, a Plastic Surgeon was able to give dramatic results by means of Reimplantation procedures & Microsurgical tissue transfer. The former allowed successful reattachment of a body part that is detached completely due to injury - amputated- hand, foot, digits, even ear, nose and scalp have be successfully reattached; the latter allows use of body tissues from one area (where they can be spared) to an area where tissue/body part has been damaged by injury, infection or even cancer. The most recent application of this has been Hand transplant and Face Transplant Surgery.

The field of Plastic Surgery expanded to include Burns Care, Craniofacial Surgery, Hand Surgery and Deformity & Disability correction for externally visible problems. Benefit of these principles are best appreciated in procedures of the hand, face and genitals, by making a dramatic difference to the outcome; very often as the critical difference in success & failure of the procedure.

Every Indian Plastic Surgeon takes pride from the fact that Ancient Plastic Surgery worldwide is traced to have it’s roots in the ‘Sushruta Samhita’ written by a Indian Physician ‘Sushruta’ in700BC. Of late, worldwide developments in Plastic surgery are coming from many Indian institutes; and both overseas surgeons (from ‘developed’ countries) and patients are visiting India to benefit from these advances.

Over the last decade, Cosmetic Surgery has caught the attention of both media and common man. As the glamour industy demanded enhancement of beauty, Plastic Surgery techniques came to their rescue. This led to a wrong notion that Cosmetic Surgery is meant only for the upper class in society. Cosmetic (Beauty/Appearance) problems in the rich & affluent have one fundamental difference in similar problems among the average/lower economic class. While the former seek to enhance beauty that is presently normal, the latter seek to restore to normal what is presently lost /damaged and is often a social need, especially when beauty/appearance is severely abnormal/distorted. Usually a person without smart looks in not considered approachable; consequently correcting this appearance can have dramatic benefits in their job or personal life.

Correcting a crooked nose of a young lady or balding scalp in a young male can help in a marriage alliance OR improve personal relationships; reducing oversized breasts of an old lady/young girl can relieve her of the daily embarrassment in addition to the shoulder or neck joint problems. Simple correction of a face scar can restore self-confidence in a person and give new meaning to life. This and other applications are unfortunately not illustrated to the general public, adding to the notion that these procedures are not meant for the common man. Matters cannot be farther from the truth.

Though initially available only in the Metro cities, obviously at a high cost-by Indian standards- these procedures are now increasingly available in smaller cities such as Mangalore, Baroda or Cuttack. This has resulted in a decrease in the treatment costs, but at the same quality that Indian healthcare is known for. Also, Cosmetic or Plastic Surgery procedures make a far greater impact on the lives of the less affluent section of society; correcting a hand deformity in the sole earning member can feed an entire family, correcting face deformity of a person cured of Leprosy can remove the disease stigma and help his/her integration into society. Both these facts make the need for Plastic and Reconstructive surgery far greater in smaller cities; However, society is deprived of this benefit due to the false notion that Plastic or Cosmetic Surgery is available only in big cities, that too at a prohibitive cost.

In spite of all these benefits, there are the darker issues too. With a rapidly spiraling demand, facilities offering cosmetic services are coming up at every street corner in larger cities. Unfortunately, many of these centers are run by people with inadequate or poor training; if the average person is lured by the aggressive publicity pursued by such centres they entail a high risk of complications or poor results. It takes about 12-13 years of rigorous medical training to qualify as a Plastic Surgeon, similar to that needed to be a Cardiac or Neurosurgeon- this alone guides the surgeon to make a sound decision by balancing the patient’s expectations with the problem severity. Thus, approaching the right person is essential for a treatment with predictable, safe results and thus and a new lease to life. Qualified Plastic surgeons in India are members of the national association as seen in at www.apsi.org.in

Thus, improved awareness is essential among the average person, to ensure society at large benefits from this medical specialty, while avoiding permanent scarring of a person’s body by falling into the wrong hands. This insight has been compiled to clarify the role of Reconstructive and Plastic Surgery, with improved benefits to society.