To put it slightly differently, plastic surgery is essentially reconstructive. The plastic surgeon tries to restore not only form but, more importantly, function. The basic techniques used are the same as in any other form of surgery.
Skin cancer is eminently amenable to permanent cure by plastic surgery as well as by several other means, leaving a presentable and satisfactory result.
For internal cancer, involving massive or deforming removal of tissue, plastic surgery is particularly required to restore or minimise the defect, thereby enabling the patient to carry on a relatively normal life.
Bodily disfigurement and disability from road accidents are on the increase. These injuries range from minor facial cuts to dreadful loss of tissue, requiring immediate attention by a plastic surgeon.
The commonest form of disfigurement is residual surface scarring, particularly of the face. Unfortunately, once the skin is scarred, some form of scar must forever remain, but most scars, particularly about the face, can be dramatically improved by plastic surgery and in some cases become so insignificant that it takes close searching to find any sign of them.
Reshaping the nose. Rhinoplasty, or nasal repair, is now commonplace, but each case must be carefully assessed from many points of view before the patient is advised whether an operation would be favorable or not.
General anesthesia is usually employed and the operation is quite free from pain. The only unpleasantness arises from a blocked-up nose or puffy black eyes, but these go down in a day or so.
There are no external incisions, all cutting and reshaping being done from the inside. The nose is then immobilized by plaster of paris or other materials, and the period in bed varies from a few days to two weeks.
After three weeks the nose is respectable again, although it still may be a little swollen and numb about the lip. These effects disappear over the next month or so, and in due course the nose feels perfectly normal again.
Facelift operations are being demanded by an increasing number, but most plastic surgeons advise against them almost as often as they agree that they would be of value.
The most frequent reason for refusal is that any improvement in appearance would be so limited that the major operation involved would not be justified. However, the operation undoubtedly can make an older woman's face look younger and prettier, and in many cases the results are worthwhile.
A long incision is made on each side of the face from within the hairline of the temples, downwards in front of the ear to the lobe where it turns backwards, and upwards to the neck hairline, and then downwards and backwards for a short distance.
The only visible part of the resulting scar is the section in front of the ear, but with time it becomes quite difficult to see. After the incision is made, the skin of face and neck is undercut and stretched backwards and upwards, eliminating wrinkles.
Care is taken not to produce an overstrained result, which would give undue prominence to bony cheeks or give rise to slit-like Chinese eyes.
The redundant skin is removed and the remaining skin stitched in its new position.
After the operation some bruising is usual and may take up to three weeks to clear. Time in hospital . varies between one and two weeks and healing is almost invariably rapid and uncomplicated.
Double chin is usually taken care of by a full-scale facelift.
However, some double chins are due not only to skin redundancy but to a large pad of fat as well. In such cases a facelift improves the chin-line only to a limited extent, because the pad of fat remains untouched.
To reduce this fatty tissue would entail making an incision beneath the chin. As a general rule this is not a practical proposition, because the resulting scar frequently thickens, and so is unacceptable. Furthermore, postoperative absorption of fat may produce a rather depressed area, leaving the patient worse off.
Thus, double chin can, with limitations, be improved, but every case needs a careful assessment.
Mammaplasty, or increasing or reducing the size of the breasts by surgery, is not done as frequently as might popularly be thought.
Ideally, increasing the breast size would best be done by introducing a suitable substance of the desired shape and size, but as yet such a substance has not been found.
Large breasts, however, which sometimes reach gigantic size, causing the sufferer much misery, can be reduced by surgery.
Drooping breasts can also be improved.
Prospective candidates for any type of breast reconstruction should bear in mind that a good deal of scarring may remain, and that the major operation involved requires in almost every case blood transfusion.