Plastic surgery

{{Short description|Medical surgical specialty}} {{About||the medical journal|Plastic Surgery (journal){{!}}''Plastic Surgery'' (journal)}} {{See also|Reconstructive surgery}} {{Use dmy dates|date=August 2019}} {{Infobox occupation | name= Plastic surgeon | image= De curtorum chirurgia 8.jpg | caption= Engraving from ''De Curtorum Chirurgia per Insitionem'' "(On the Surgery of Mutilation by Grafting)" (1597) by [[Gaspare Tagliacozzi]] | official_names= * Physician * Surgeon | type= [[Specialty (medicine)|Specialty]] | activity_sector= [[Medicine]], [[surgery]] | competencies= | formation= * [[Doctor of Medicine]] (M.D.) * [[Doctor of Osteopathic medicine]] (D.O.) * [[Bachelor of Medicine, Bachelor of Surgery]] (M.B.B.S. or MBChB) | employment_field= [[Hospital]]s, [[clinic]]s | related_occupation= }}

'''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 [[burn]]s. This kind of surgery focuses on restoring a body part or improving its function. In contrast, [[#Cosmetic surgery|cosmetic surgery]] (or aesthetic surgery) focuses solely on improving the physical appearance of the body.<ref>{{cite web|url=https://www.rcseng.ac.uk/patient-care/cosmetic-surgery/what-is-cosmetic-surgery/|title=What is Cosmetic Surgery|website=Royal College of Surgeons|access-date=15 January 2013}}</ref><ref>{{cite web | title = Plastic Surgery Specialty Description | publisher = American Medical Association | url = https://www.ama-assn.org/specialty/plastic-surgery-specialty-description | access-date = 13 July 2020}}</ref>

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 [[Tissue (biology)|flesh]].<ref>[[Oxford English Dictionary]], ''s.v.'' [http://www.oed.com/view/Entry/145291 'plastic']</ref> This meaning in English is seen as early as 1598.<ref>{{cite web|url=https://www.britannica.com/science/plastic-surgery|title=plastic surgery |website=OED Online|publisher=Britannica|access-date=12 February 2015}}</ref> In the surgical context, the word "plastic" first appeared in 1816 and was established in 1838 by Eduard Zeis,<ref>{{Cite book |last=Zeis |first=Eduard |title=Handbuch der plastischen Chirurgie |publisher=Reimer |year=1838 |location=Berlin |language=German}}</ref> preceding the modern technical usage of the word for the [[plastic|synthetic polymer material]] by 70 years.<ref>{{cite web|title=Plastic|url=http://www.etymonline.com/index.php?term=plastic|publisher=Etymonline|access-date=2 March 2014}}</ref>

==History== {{See also|History of surgery}}'''Ancient Period (3000 BCE–500 CE)'''

Treatments for the repairing of a broken nose are first mentioned in the Egyptian medical text known as the [[Edwin Smith papyrus]]<ref name="cossurg">{{cite book| vauthors = Shiffman M |title=Cosmetic Surgery: Art and Techniques|publisher=Springer|isbn=978-3-642-21837-8|page=20|date=2012-09-05}}</ref><ref name=":1">{{Cite web|first=Oscar|last=Holland|title=From ancient Egypt to Beverly Hills: A brief history of plastic surgery|url=https://www.cnn.com/style/article/plastic-cosmetic-surgery-history-scn/index.html|access-date=2021-10-03|website=[[CNN]] |date=30 May 2021 |language=en}}</ref> (c. 1600 BC).The early trauma [[surgery]] textbook was named after the American [[Egyptologist]], Edwin Smith,<ref name=":1" /> one of the earliest known surgical texts focused on trauma care. Reconstructive surgery techniques were being carried out in [[India]] by 800 BCE.<ref name="EP">MSN Encarta (2008). [http://www.encarta.es/encyclopedia_761577922/Plastic_Surgery.html ''Plastic Surgery''] {{webarchive|url=https://web.archive.org/web/20080922005722/http://www.encarta.es/encyclopedia_761577922/Plastic_Surgery.html |date=22 September 2008 }}.</ref> particularly as documented in [[Sushruta]] Samhita, which describes methods for nasal reconstruction using skin flaps. Sushrata, a [[physician]] of the 6th century BCE,<ref name="Dwivedi&Dwivedi">Dwivedi, Girish & Dwivedi, Shridhar (2007). [http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf ''History of Medicine: Sushruta – the Clinician – Teacher par Excellence''] {{Webarchive|url=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |date=10 October 2008 }}. [[National Informatics Centre|National Informatics Centre (Government of India)]].</ref> made significant contributions to early plastic and [[cataract]] surgery and is widely regarded as a foundational figure in reconstructive surgery.[[File:Edwin Smith Papyrus v2.jpg|thumb|Plates vi & vii of the Edwin Smith Papyrus at the Rare Book Room, [[New York Academy of Medicine]]<ref>"Academy Papyrus to be Exhibited at the Metropolitan Museum of Art". The New York Academy of Medicine. 27 July 2005. {{cite web |url=http://www.nyam.org/news/2493.html |title=The New York Academy of Medicine: News & Publications: Academy Papyrus to be Exhibited at the Metropolitan Museum of Art |access-date=2008-08-12 |archive-url=https://web.archive.org/web/20101127161922/http://www.nyam.org/news/2493.html |archive-date=27 November 2010 }}. Retrieved 2008-08-12.</ref>]][[File:Aulus Cornelius Celsus.jpg|thumb|170px|left|The Roman scholar [[Aulus Cornelius Celsus]] recorded surgical techniques, including plastic surgery, in the 1st century AD.]] [[Ancient Romans|Roman]] physicians in the 1st century BCE<ref>{{Cite web |last1=Themes |first1=U. F. O. |last2=admin |date=2016-02-21 |title=History of reconstructive and aesthetic surgery |url=https://plasticsurgerykey.com/history-of-reconstructive-and-aesthetic-surgery/ |access-date=2026-04-28 |website=Plastic Surgery Key |language=en-US}}</ref> also performed plastic reconstructive [[Surgery in Ancient Rome|surgeries]], using simple techniques, to repair damaged ears.<ref>{{Cite journal |date=2023-05-04 |title=Forgotten Pioneers of Plastic and Reconstructive Surgery During the Medieval Period |url=https://journals.lww.com/10.1097/SCS.0000000000009176 |journal=Journal of Craniofacial Surgery |language=en |volume=34 |issue=3 |pages=1144–1146 |doi=10.1097/SCS.0000000000009176 |issn=1049-2275 |last1=Atiyeh |first1=Bishara |last2=Habal |first2=Mutaz B. |pmid=36727967 |url-access=subscription }}</ref> For religious reasons, they did not [[Dissection|dissect]] either human beings or animals, thus, their knowledge was based in its entirety on the texts of their [[Ancient Greece|Greek]] predecessors. Notwithstanding, [[Aulus Cornelius Celsus]] left some accurate [[anatomical]] descriptions,<ref>Wolfgang H. Vogel, Andreas Berke (2009). "''[https://books.google.com/books?id=t_5pzrF1QocC&pg=PA97 Brief History of Vision and Ocular Medicine]''". Kugler Publications. p.97. {{ISBN|90-6299-220-X}}</ref> some of which—for instance, his studies on the [[genitalia]] and the [[skeleton]]—are of special interest to plastic surgery.<ref>P. Santoni-Rugiu, ''A History of Plastic Surgery'' (2007){{page needed|date=September 2018}}</ref>

'''Middle Ages to Early Modern Period (500–1800 CE)'''

Surgical practices continued to develop during the [[Abbasid Caliphate|Abbasid]] Caliphate from 750 CE,<ref name="locka">Lock, Stephen etc. (200ĞďéĠĊ1). ''The Oxford Illustrated Companion to Medicine''. US: Oxford University Press. {{ISBN|0-19-262950-6}}. ''(page 607)''</ref> where physicians preserved and expanded earlier medical knowledge through Arabic translations.<ref name="locka" /> 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<ref>{{Cite journal |last1=Amr |first1=Samir S. |last2=Tbakhi |first2=Abdelghani |date=2007 |title=Abu Al Qasim Al Zahrawi (Albucasis): pioneer of modern surgery |journal=Annals of Saudi Medicine |volume=27 |issue=3 |pages=220–221 |doi=10.5144/0256-4947.2007.220 |issn=0256-4947 |pmc=6077085 |pmid=17575478}}</ref> 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.<ref>{{cite journal | url=https://onlinelibrary.wiley.com/doi/10.1111/j.1445-2197.2007.04130_8.x | doi=10.1111/j.1445-2197.2007.04130_8.x | title=Sh08Al-Zahrawi – the Father of Surgery | date=2007 | last1=Ahmad | first1=Z. | journal=ANZ Journal of Surgery | volume=77 | s2cid=57308997 | url-access=subscription }}</ref> The Arabic translations made their way into [[Europe]] via intermediaries.<ref name="locka" />

In [[Italy]], the Branca family<ref>{{cite journal | vauthors = Maniglia AJ | title = Reconstructive rhinoplasty | journal = The Laryngoscope | volume = 99 | issue = 8 Pt 1 | pages = 865–7 | date = August 1989 | pmid = 2666806 | doi = 10.1288/00005537-198908000-00017 | s2cid = 5730172 }}</ref> of [[Sicily]] and [[Gaspare Tagliacozzi]] of [[Bologna]] (1545–1599) became familiar with the techniques of Sushruta.<ref name="locka" /> Tagliacozzi was a Bolognese surgeon who popularized<ref>{{Cite journal |last=Cock |first=E. |date=2015-02-01 |title='Lead[ing] 'em by the Nose into Publick Shame and Derision': Gaspare Tagliacozzi, Alexander Read and the Lost History of Plastic Surgery, 1600-1800 |url=https://academic.oup.com/shm/article-lookup/doi/10.1093/shm/hku070 |journal=Social History of Medicine |language=en |volume=28 |issue=1 |pages=1–21 |doi=10.1093/shm/hku070 |issn=0951-631X}}</ref> a rhinoplasty procedure involving the use of a skin flap from the patient's upper arm to reconstruct the nose.<ref>{{Cite journal |last1=Greig |first1=Aina |last2=Gohritz |first2=Andreas |last3=Geishauser |first3=Max |last4=Mühlbauer |first4=Wolfgang |date=June 2015 |title=Heinrich von Pfalzpaint, Pioneer of Arm Flap Nasal Reconstruction in 1460, More Than a Century Before Tagliacozzi |journal=The Journal of Craniofacial Surgery |volume=26 |issue=4 |pages=1165–1168 |doi=10.1097/SCS.0000000000001625 |issn=1536-3732 |pmid=26080150}}</ref><ref>{{Cite book |last=Cock |first=Emily |url=https://www.jstor.org/stable/jj.21996031 |title=Rhinoplasty and the nose in early modern British medicine and culture |date=2019 |publisher=Manchester University Press |isbn=978-1-5261-6074-4 |volume=25}}</ref> 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.<ref>{{Cite journal |last1=Santoni-Rugiu |first1=Paolo |last2=Massei |first2=Allesandro |date=July 1982 |title=The legend and the truth about the nose of Federico, Duke of Urbino |url=https://linkinghub.elsevier.com/retrieve/pii/S0007122682901102 |journal=British Journal of Plastic Surgery |volume=35 |issue=3 |pages=251–257 |doi=10.1016/S0007-1226(82)90110-2 |pmid=6758899 |issn=0007-1226}}</ref>

In 1465, Ottoman surgeon, [[Sabuncuoğlu Şerafeddin]] (1385–1468) provided detailed descriptions and classifications of certain congenital conditions such as [[hypospadias]] and ambiguous genitalia. Sabuncuoğlu's book, Cerrahiyyet'ul Haniye (Imperial Surgery), an illustrated surgical manual covering a range of medical and congenital conditions, provided an informative and up to date description of [[hypospadias]], a congenital condition where the urethral opening is located on the underside of the penis.<ref>{{Citation |last1=Donaire |first1=Alvaro E. |title=Hypospadias |date=2026 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK482122/ |access-date=2026-04-28 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29489236 |last2=Mendez |first2=Magda D.}}</ref> Localization of the [[urethral meatus]] was described in detail.[[File:Indian method of nose reconstruction, illustrated in the Gentleman's Magazine, 1794.png|thumb|Illustration of an 18th-century nose reconstruction method from Poona performed by an Indian potter, from ''[[The Gentleman's Magazine]]'', 1794]]{{More citations needed|date=July 2024}}

'''Modern Period (1800–present)'''

In the 18th century, [[England|British]] physicians travelled to India to observe [[Rhinoplasty|rhinoplasties]] being performed by Indian methods.<sup><ref name="Lock651">Lock, Stephen etc. (2001). ''The Oxford Illustrated Companion to Medicine''. US: Oxford University Press. {{ISBN|0-19-262950-6}}. ''(page 651)''</ref><ref>{{Cite journal |last1=Mukherjee |first1=Nayana Sharma |last2=Majudar |first2=Susmita Basu |last3=Majumdar |first3=Susmita Basu |date=2011 |title=A Nose Lost and Honour Regained: The Indian Method of Rhinoplasty Revisited |journal=Proceedings of the Indian History Congress |volume=72 |pages=968–977 |jstor=44146788 |issn=2249-1937}}</ref></sup> Reports on rhinoplasties performed by a [[Kumhar]] (potter) [[Vaidya]] were published in the ''[[Gentleman's Magazine]]'' by 1794<sup><ref name="Lock651" /></sup>, which brought wider attention to these techniques in Europe. [[Joseph Constantine Carpue]] spent 20 years in India studying local plastic surgery methods.<ref name="Lock651" /> Carpue later applied these methods in England, performing one of the first major rhinoplasty procedures in the [[Western world]] in the year 1815.<ref name="Lock652">Lock, Stephen etc. (2001). ''The Oxford Illustrated Companion to Medicine''. US: Oxford University Press. {{ISBN|0-19-262950-6}}. ''(page 652)''</ref> Instruments described in the ''Sushruta Samhita'' were further modified in the Western world.<ref name="Lock652" />

In 1814, Joseph Carpue successfully performed an operative procedure on a [[British Armed Forces|British military]] officer who had lost his nose to the toxic effects of [[mercury (element)|mercury]] treatments.<ref>{{Cite web |title=Britain's first nose job |url=https://www.bl.uk/stories/blogs/posts/britains-first-nose-job |access-date=2026-02-09 |website=www.bl.uk |language=en}}</ref> In 1818, German surgeon [[Carl Ferdinand von Graefe]] published his major work entitled ''[[Rhinoplasty|Rhinoplastik]]''.<ref>{{Cite journal |last1=Goel |first1=Aakanksha |last2=Goel |first2=Arun |date=December 2024 |title=From Quackery to Super-Specialization: A Brief History of Aesthetic Surgery |journal=Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India |volume=57 |issue=6 |pages=486–491 |doi=10.1055/s-0044-1789271 |issn=0970-0358 |pmc=11679177 |pmid=39734372}}</ref> Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap.

The first American plastic surgeon was [[John Peter Mettauer]], who, in 1827, performed the first [[cleft lip and palate|cleft palate]] operation with instruments that he designed himself.<ref>{{Cite web |title=History of ASPS |url=https://www.plasticsurgery.org/about-asps/history-of-asps |access-date=2026-02-09 |website=American Society of Plastic Surgeons |language=en}}</ref>

[[File:Johann Friedrich Dieffenbach.jpg|thumb|170px|left|[[Johann Friedrich Dieffenbach]] established many modern techniques of [[reconstructive surgery]].]] [[Johann Friedrich Dieffenbach]] specialized in [[skin transplantation]] and early plastic surgery. His work in [[rhinoplasty|rhinoplastic]] and [[maxillofacial]] surgery established many modern techniques of [[reconstructive surgery]]. In 1845, Dieffenbach wrote a comprehensive text on rhinoplasty, titled ''Operative Chirurgie'', and introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. Dieffenbach has been called the "father of plastic surgery".<ref>{{cite web | url=https://prezi.com/-sixyzg8uyhf/plastic-surgery/ | title=Plastic Surgery }}</ref><ref>{{Cite web|url=https://medway.am/news/Here%E2%80%99s-Everything-You-Need-to-Know-about-hair-transplant|title=MedWay|website=MedWay}}</ref>

Another case of plastic surgery for nose reconstruction from 1884 at [[Bellevue Hospital]] was described in ''[[Scientific American]]''.<ref>{{Cite book|url=https://books.google.com/books?id=K4M9AQAAIAAJ|title=Scientific American|date=1884-06-07|publisher=Munn & Company|page=354|language=en}}</ref>

In 1891, American [[Otorhinolaryngology|otorhinolaryngologist]] John Roe presented an example of his work: a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896, [[James Israel]], a [[Urology|urological]] surgeon from Germany, and in 1889 George Monks of the United States each described the successful use of [[Homogeneity and heterogeneity|heterogeneous]] free-bone grafting to reconstruct saddle nose defects. In 1898, Jacques Joseph, the German [[Orthopedic surgery|orthopaedic]]-trained [[surgeon]], published his first account of reduction rhinoplasty. In 1910, [[Alexander Ostroumov]], the Russian [[pharmacist]], and perfume and cosmetics manufacturer, founded a unique plastic surgery department in his Moscow Institute of Medical Cosmetics.<ref>{{cite journal | last = Stochik | first = A. A | title = Bulletin of Semashko National Research Institute of Public Health, The first large-scale productions of parfumes and cosmetics in Russia and the establishment of The Institute of Medical Cosmetics by pharmacist A. M. Ostroumov, Part I | journal = №1 (2020) | publisher = The National Research Institute of Public Health, Moskow | year = 2020 | issue = 1 | pages = 76–79 | doi = 10.25742/NRIPH.2020.01.0013 | url = http://bulleten-nriph.ru/journal/article/view/1468}}</ref> In 1928, Jacques Joseph published {{Lang|de|Nasenplastik und Sonstige Gesichtsplastik}}.<ref>{{cite journal | vauthors = Bhattacharya S | title = Jacques Joseph: Father of modern aesthetic surgery | journal = Indian Journal of Plastic Surgery | volume = 41 | issue = Suppl | pages = S3–S8 | date = October 2008 | pmid = 20174541 | pmc = 2825133 }}</ref>

==Nascency of maxillofacial surgery== {{More citations needed section|date=May 2023}} The development of weapons such as [[machine gun]]s and [[explosive shell]]s during [[World War I]] led to a rapid increase in the number of mutilations to the faces and the heads of soldiers. Improved techniques for preventing and treating infections also meant that previously fatal injuries became survivable. This combination led to never-before seen rates of soldiers with facial injuries, alive but without noses, chins, cheekbones, or even eyes.<ref>{{Cite web | vauthors = Klein C |title=Innovative Cosmetic Surgery Restored WWI Vets' Ravaged Faces—And Lives |url=https://www.history.com/news/world-war-i-plastic-surgery-innovations-gillies |access-date=2022-12-15 |website=HISTORY |date=26 October 2018 |language=en}}</ref><ref>{{cite journal | vauthors = Zola M | title = World War I maxillofacial fracture splints | journal = Journal of Oral and Maxillofacial Surgery | volume = 62 | issue = 5 | page = 643 | date = May 2004 | pmid = 15141677 | doi = 10.1016/j.joms.2004.02.005 }}</ref>

Battlefield surgeons had to quickly stabilize soldiers, often without the time to consider aesthetic results, further increasing the number of disfigured survivors. [[Harold Gillies]], observing the number of new facial injuries and the lack of adequate surgical techniques to address them, dedicated an entire hospital to the study and reconstruction of facial injuries. Crucially, he recognized that facial disfigurement often resulted in psychological trauma, and sought to develop techniques that restored form as well as function in his patients.<ref>{{cite journal | vauthors = Alotaibi A, Aljabab A, Althubaiti G | title = Predictors of Oral Function and Facial Aesthetics Post Maxillofacial Reconstruction with Free Fibula Flap | journal = Plastic and Reconstructive Surgery. Global Open | volume = 6 | issue = 11 | article-number = e1787 | date = November 2018 | pmid = 30881773 | pmc = 6414127 | doi = 10.1097/GOX.0000000000001787 }}</ref><ref>{{cite journal | vauthors = Stathopoulos P | title = Maxillofacial surgery: the impact of the Great War on both sides of the trenches | journal = Oral and Maxillofacial Surgery | volume = 22 | issue = 1 | pages = 21–24 | date = March 2018 | pmid = 29067543 | doi = 10.1007/s10006-017-0659-5 | s2cid = 3418182 }}</ref><ref>{{Cite web |title=The birth of plastic surgery {{!}} National Army Museum |url=https://www.nam.ac.uk/explore/birth-plastic-surgery |access-date=2022-12-15 |website=www.nam.ac.uk |language=en}}</ref>

Gillies developed a new technique using rotational and transposition flaps, as well as bone grafts from the ribs and tibia, to reconstruct facial defects. One of the most important advances developed at Gillies' hospital was the pedicle flap, which involved cutting a flap of skin from a donor site but leaving it connected at one end. The flap of skin, still connected to the donor site, would then be swung over the site of the wound, allowing the maintenance of physical connection and ensuring blood supply, lowering the risk of tissue rejection.

==Development of modern techniques== {{More citations needed section|date=February 2024}} [[File:Walter Yeo skin graft.jpg|thumb|[[Walter Yeo]], a sailor injured at the [[Battle of Jutland]], is assumed to have received plastic surgery in 1917. The photograph shows him immediately following (right) the [[flap surgery]] by [[Sir]] [[Harold Gillies]], and after healing (left).{{citation needed|date=November 2024}}]] [[File:The Work of Major Harold Gillies in the Field of Plastic Surgery During the First World War - IWM HU 110801.jpg|thumb|A patient after receiving plastic surgery from Harold Gillies, during World War I]]

The father of modern plastic surgery is generally considered to have been Sir [[Harold Gillies]]. A New Zealand [[Otorhinolaryngology|otolaryngologist]] working in London, he developed many of the techniques of modern facial surgery in caring for soldiers with disfiguring facial injuries during the [[First World War]].<ref>{{cite journal | vauthors = Chambers JA, Ray PD | title = Achieving growth and excellence in medicine: the case history of armed conflict and modern reconstructive surgery | journal = Annals of Plastic Surgery | volume = 63 | issue = 5 | pages = 473–8 | date = November 2009 | pmid = 20431512 | doi = 10.1097/SAP.0b013e3181bc327a }}</ref>

During [[World War I]], he worked as a medical minder with the [[Royal Army Medical Corps]]. After working with the French [[oral and maxillofacial surgeon]] [[Hippolyte Morestin]] on skin grafts, he persuaded the army's chief surgeon, [[William Arbuthnot-Lane|Arbuthnot-Lane]], to establish a facial injury ward at the [[Cambridge Military Hospital]], [[Aldershot]], later upgraded to a new hospital for facial repairs at [[Queen Mary's Hospital, Sidcup|Sidcup]] in 1917. There, Gillies and his colleagues developed many techniques of plastic surgery; more than 11,000 operations were performed on more than 5,000 men (mostly soldiers with facial injuries, usually from gunshot wounds).<ref>{{Cite web |last=Roxburgh |first=Tracey |date=2017-04-11 |title=Pupil speeches honour soldiers |url=https://www.odt.co.nz/regions/queenstown/pupil-speeches-honour-soldiers |access-date=2024-09-14 |website=[[Otago Daily Times]] |language=en}}</ref> After the war, Gillies developed a private practice with [[Arthur Rainsford Mowlem|Rainsford Mowlem]], including many famous patients, and travelled extensively to promote his advanced techniques worldwide.

In 1930, Gillies' cousin, [[Archibald McIndoe]], joined the practice and became committed to plastic surgery. When [[World War II]] broke out, plastic surgery provision was largely divided between the different services of the [[British armed forces|armed forces]], and Gillies and his team were split up. Gillies himself was sent to [[Park Prewett|Rooksdown House]] near [[Basingstoke]], which became the principal army plastic surgery unit; Tommy Kilner (who had worked with Gillies during the First World War, and who now has a surgical instrument named after him, the kilner cheek retractor) went to Queen Mary's Hospital, Roehampton; and Mowlem went to St Albans. McIndoe, consultant to the RAF, moved to the recently rebuilt [[Queen Victoria Hospital]] in [[East Grinstead]], [[Sussex]], and founded a Centre for Plastic and Jaw Surgery. There, he treated very deep burns and serious facial disfigurement, such as loss of eyelids, typical of those caused to aircrew by burning fuel.<ref>{{cite journal|title=Albert Ross Tilley: The legacy of a Canadian plastic surgeon|year=2013 |pmc=3891087 |last1=Mowbrey |first1=K. |journal=The Canadian Journal of Plastic Surgery |volume=21 |issue=2 |pages=102–106 |doi=10.1177/229255031302100202 |pmid=24431953 }}</ref>

McIndoe is often recognized for not only developing new techniques for treating badly burned faces and hands but also for recognising the importance of the [[Rehabilitation (penology)|rehabilitation]] of the casualties and particularly of social reintegration back into normal life. He disposed of the "convalescent uniforms" and let the patients use their service uniforms instead. With the help of two friends, Neville and Elaine Blond, he also convinced the locals to support the patients and invite them to their homes. McIndoe kept referring to them as "his boys" and the staff called him "The Boss" or "The Maestro".<ref>{{Cite news |last=Furness |first=Hannah |date=2017-05-21 |title=Story of maverick WW2 'Guinea pig' surgeon to be told on big screen for first time |url=https://www.telegraph.co.uk/news/2017/05/21/story-maverick-ww2-guinea-pig-surgeon-told-big-screen-first/ |access-date=2024-09-14 |work=The Telegraph |language=en-GB |issn=0307-1235}}</ref>

His other important work included the development of the [[walking-stalk skin graft]], and the discovery that immersion in [[Saline (medicine)|saline]] promoted healing as well as improving survival rates for patients with extensive burns—this was a [[Serendipity|serendipitous]] discovery drawn from observation of differential healing rates in pilots who had come down on land and in the sea. His radical, experimental treatments led to the formation of the [[Guinea Pig Club]] at [[Queen Victoria Hospital]], Sussex. Among the better-known members of his "club" were [[Richard Hillary]], [[Bill Foxley]] and [[Jimmy Edwards]].<ref>{{Cite news |last=Kennedy |first=Maev |date=2013-04-04 |title=War surgeon Sir Archibald McIndoe and his 'Guinea Pigs' honoured |url=https://www.theguardian.com/world/2013/apr/05/wartime-surgeon-archibald-mcindoe-honoured |access-date=2024-09-14 |work=[[The Guardian]] |language=en-GB |issn=0261-3077}}</ref>

==Sub-specialties== {{Merge portions from|Cosmetic_surgery_in_Australia#Types of cosmetic surgery available|date=April 2020}} {{More citations needed section|date=February 2024}} Plastic surgery is a broad field and may be subdivided further. In the United States, plastic surgeons are board certified by [[American Board of Plastic Surgery]].<ref>{{cite web |url=https://www.abplsurg.org/ModDefault.aspx?section=AboutIntro |title=Introduction |date=2013 |publisher=American Board of Plastic Surgery |access-date=4 April 2013 |archive-url=https://web.archive.org/web/20140202180933/https://www.abplsurg.org/ModDefault.aspx?section=AboutIntro |archive-date=2 February 2014 }}</ref> Subdisciplines of plastic surgery may include:

===Aesthetic surgery=== Aesthetic surgery is a central component of plastic surgery and includes facial and body aesthetic surgery. Plastic surgeons use cosmetic surgical principles in all reconstructive surgical procedures as well as isolated operations to improve overall appearance.<ref>Description of Plastic Surgery [https://www.abplsurg.org/ModDefault.aspx?section=AboutDPS American Board of Plastic Surgery] {{webarchive|url=https://web.archive.org/web/20101015000138/https://abplsurg.org/ModDefault.aspx?section=AboutDPS |date=15 October 2010 }}</ref>

===Burn surgery=== Burn 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.<ref>{{Cite web |title=Reconstructive Burn Surgery {{!}} University of Michigan Health |url=https://www.uofmhealth.org/conditions-treatments/surgery/plastic/burn-reconstructive |access-date=2024-03-03 |website=www.uofmhealth.org}}</ref>

===Craniofacial surgery=== {{Main|Craniofacial surgery}}

[[Craniofacial surgery]] is divided into pediatric and adult craniofacial surgery. Pediatric craniofacial surgery mostly revolves around the treatment of congenital anomalies of the craniofacial skeleton and soft tissues, such as cleft lip and palate, microtia, craniosynostosis, and pediatric fractures. Adult craniofacial surgery deals mostly with reconstructive surgeries after trauma or cancer and revision surgeries, along with orthognathic surgery and facial feminization surgery. Craniofacial surgery is an important part of all plastic surgery training programs. Further training and subspecialisation are obtained via a craniofacial fellowship. Craniofacial surgery is also practiced by [[Oral and maxillofacial surgery|maxillofacial surgeons]].

===Ethnic plastic surgery=== {{Main|Ethnic plastic surgery}}

[[Ethnic plastic surgery]] is plastic surgery performed to change ethnic attributes, often considered used as a way of "passing".

===Facial plastic surgery=== Facial plastic surgery is a subspecialty of plastic surgery focused on cosmetic and reconstructive procedures of the face, head, and neck. It includes both aesthetic procedures, such as [[Rhytidectomy|facelifts]], [[rhinoplasty]], and [[blepharoplasty]], and reconstructive procedures following trauma, cancer, or congenital abnormalities.<ref>{{Cite journal |last=Chuang |first=Jessica |last2=Barnes |first2=Christian |last3=Wong |first3=Brian J. F. |date=March 2016 |title=Overview of Facial Plastic Surgery and Current Developments |url=https://pubmed.ncbi.nlm.nih.gov/28824978 |journal=Surgery Journal (New York, N.Y.) |volume=2 |issue=1 |pages=e17–e28 |doi=10.1055/s-0036-1572360 |issn=2378-5128 |pmc=5553462 |pmid=28824978}}</ref>

Facial plastic surgery emphasizes detailed knowledge of facial anatomy, including the skin, underlying musculature such as the [[Superficial muscular aponeurotic system|superficial musculoaponeurotic system]] (SMAS) and platysma, fat compartments, and skeletal structure.<ref>{{Cite journal |last=Dibernardo |first=Barry E. |date=April 2013 |title=The aging neck: a diagnostic approach to surgical and nonsurgical options |url=https://pubmed.ncbi.nlm.nih.gov/23464846 |journal=Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology |volume=15 |issue=2 |pages=56–64 |doi=10.3109/14764172.2012.758383 |issn=1476-4180 |pmid=23464846}}</ref> Modern approaches often address multiple anatomical layers to restore both function and appearance.

[https://www.aafprs.org/404.aspx?aspxerrorpath=/iMIS_prod/404.aspx Training in facial plastic surgery] may occur through plastic surgery residency programs or via additional fellowship training, particularly through pathways associated with [[Otorhinolaryngology|otolaryngology]]–head and neck surgery. Board certification in the United States may be obtained through organizations such as the [https://www.abfprs.org/about/ American Board of Facial Plastic and Reconstructive Surgery].<ref>{{Cite journal |last=Chen |first=Shirley |last2=Lineaweaver |first2=William C. |date=2024-09-01 |title=Evaluating Board Certification Within the Aesthetic Marketplace |url=https://pubmed.ncbi.nlm.nih.gov/39230296 |journal=Annals of Plastic Surgery |volume=93 |issue=3S Suppl 2 |pages=S119–S122 |doi=10.1097/SAP.0000000000004056 |issn=1536-3708 |pmid=39230296}}</ref>

===Hand surgery=== {{Main|Hand surgery}}

[[Hand surgery]] is concerned with acute injuries and chronic diseases of the hand and wrist, correction of congenital malformations of the upper extremities, and peripheral nerve problems (such as brachial plexus injuries or carpal tunnel syndrome). Hand surgery is an important part of training in plastic surgery, as well as microsurgery, which is necessary to replant an amputated extremity. The hand surgery field is also practiced by [[orthopedic surgery|orthopedic surgeons]] and [[general surgery|general surgeons]]. Scar tissue formation after surgery can be problematic on the delicate hand, causing loss of dexterity and digit function if severe enough. There have been cases of surgery on women's hands in order to correct perceived flaws to create the perfect engagement ring photo.<ref>{{cite web|url=https://abcnews.go.com/blogs/lifestyle/2014/08/hand-surgery-for-better-engagement-ring-selfies-before-and-after-shots/|title=Hand Rejuvenation for Better Engagement Ring Selfies|website=ABC News|access-date=12 September 2015}}</ref>

===Microsurgery=== {{Main|Microsurgery}}

[[Microsurgery]] is generally concerned with the reconstruction of missing tissues by transferring a piece of 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.

===Pediatric plastic surgery=== {{Main|Pediatric plastic surgery}}

Children often face medical issues very different from the experiences of an adult patient. Pediatric plastic surgery serves to restore function to optimize growth and development. Many [[birth defects]] or syndromes present at birth are best treated in childhood, and [[pediatric]] plastic surgeons specialize in treating these conditions in children. Conditions commonly treated by pediatric plastic surgeons include [[craniofacial team|craniofacial anomalies]], Syndactyly<ref>{{EMedicine|article|1244420|Syndactyly}}</ref> (webbing of the fingers and toes), Polydactyly (excess fingers and toes at birth), cleft lip and palate, and congenital hand deformities.

===Prison plastic surgery=== {{Main|Prison plastic surgery}}

Plastic surgery was performed on an incarcerated population in order to affect their [[recidivism]] rate, a practice instituted in the early 20th century that lasted until the mid-1990s. Separate from surgery performed for medical need.

==Techniques and procedures== In plastic surgery, the transfer of skin tissue ([[skin graft]]ing) is a very common procedure. Skin grafts can be derived from the recipient or donors: * [[Autograft]]s are taken from the recipient. If absent or deficient of natural tissue, alternatives can be cultured sheets of [[epithelial cell]]s ''in vitro'' or synthetic compounds, such as integra, which consists of [[silicone]] and bovine tendon collagen with [[glycosaminoglycan]]s. * [[Allograft]]s are taken from a donor of the same species. Kidney transplants are an example of allograft transfer. [[Joseph Murray]] is credited for completing the first successful kidney transplantation in 1954. * [[Xenograft]]s are taken from a donor of a different species.

Usually, good results would be expected from plastic surgery that emphasize careful planning of incisions so that they fall within the line of natural skin folds or lines, appropriate choice of [[wound closure]], use of best available suture materials, and early removal of exposed sutures so that the wound is held closed by buried sutures.{{original research inline|date=July 2017}}<ref>{{cite web | url = http://www.thieme.com/media/samples/pubid1143527561.pdf | title = Reconstructive Plastic Surgery of the Face | access-date = 2 September 2020 | archive-date = 25 June 2021 | archive-url = https://web.archive.org/web/20210625115129/http://www.thieme.com/media/samples/pubid1143527561.pdf | url-status = dead }}</ref>

==Cosmetic surgery procedures{{anchor|Cosmetic surgery}}==  {{more citations needed section|date=December 2025}} {{multiple image | direction = vertical | width = 221 | image1 = | caption1 = [[Rhinoplasty]] or Nose Surgery | image2 = | caption2 = [[Blepharoplasty]] or Cosmetic Eyelid Surgery }}Cosmetic surgery is a voluntary or elective surgery that is performed on normal parts of the body with the sole purpose of improving a person's appearance or removing signs of aging. Some cosmetic surgeries such as breast reduction are also functional and can help to relieve symptoms of discomfort such as back ache or neck ache. Cosmetic surgeries are also undertaken following breast cancer and mastectomy to recreate the natural breast shape which has been lost during the process of removing the cancer. In 2014, nearly 16 million cosmetic procedures were performed in the United States alone. The number of cosmetic procedures performed in the United States has almost doubled since the start of the century. In 2014, 92% of cosmetic procedures were performed on women, up from 88% in 2001. Approximately 15.6 million cosmetic procedures were performed in 2020, with the five most common surgeries being [[Rhinoplasty|rhinoplasties]], [[Blepharoplasty|blepharoplasties]], [[Rhytidectomy|rhytidectomies]], [[liposuction]]s, and [[breast augmentation]]. Breast augmentation continues to be one of the top 5 cosmetic surgical procedures and has been since 2006. [[Silicone]] implants were used in 84% and saline implants in 16% of all breast augmentations in 2020. The [[American Society for Aesthetic Plastic Surgery]] looked at the statistics for 34 different cosmetic procedures. Nineteen of the procedures were surgical, such as rhinoplasties or rhytidectomies. The nonsurgical procedures included [[Botulinum toxin|botox]] and [[laser hair removal]]. In 2010, their survey revealed that there were 9,336,814 total procedures in the United States. Of those, 1,622,290 procedures were surgical (p. 5). They also found that a large majority, 81%, of the procedures were done on Caucasian people (p. 12).

Tenth-century Spanish physician [[Al-Zahrawi|Abu Alkasem Al-Zahrawi]] published one of the first medical textbooks with strictly cosmetic (non-reconstructive) surgical procedures, the [[Al-Tasrif|Kitab al-Tasrif]].<ref name=":02">{{Cite journal |last1=Atiyeh|first1=Bishara|last2=Habal|first2=Mutaz B.|date=2023-01-19|title=Forgotten Pioneers of Plastic and Reconstructive Surgery During the Medieval Period|url=https://doi.org/10.1097/scs.0000000000009176|journal=Journal of Craniofacial Surgery|volume=34|issue=3|pages=1144–1146|doi=10.1097/scs.0000000000009176|pmid=36727967 |issn=1049-2275}}</ref> He was thought to have been inspired by the 7th-century work of [[Paul of Aegina|Paulus Aeginata]].<ref name=":3">{{Cite book |last1=Santoni-Rugiu|first1=Paolo|title=A history of plastic surgery|last2=Sykes|first2=Philip J.|date=2007|publisher=Springer|isbn=978-3-540-46240-8|location=Berlin}}</ref> This seminal text instructed on the removal of male [[gynecomastia]] growths, an early example of a gender-affirming [[breast augmentation]] procedure.<ref name=":02" /> Similarly, one of the earliest documented cosmetic breast reduction surgeries performed on a woman was recorded in 1560.<ref>{{Cite book |last=Davis|first=Kathy|url=https://www.taylorfrancis.com/books/9781135207014|title=Reshaping the Female Body|date=2013-10-15|publisher=Routledge|isbn=978-1-135-20701-4|edition=0|language=en|doi=10.4324/9780203700129}}</ref> The earliest attention devoted to the concept of the cosmetic includes the work of philosopher [[Francis Bacon]]. He was the first English-language writer to define the term in book II of his 1605 text [[The Advancement of Learning]], coining it the 'art of decoration'.<ref>{{Citation |last=Karim-Cooper|first=Farah|title=Early Modern Cosmetic Culture|date=2006-07-06|work=Cosmetics in Shakespearean and Renaissance Drama|pages=34–63|url=https://doi.org/10.3366/edinburgh/9780748619931.003.0002|access-date=2026-03-29|publisher=Edinburgh University Press |doi=10.3366/edinburgh/9780748619931.003.0002 |isbn=978-0-7486-1993-1 }}</ref> This word is believed to have originated in the [[Public bathing|public baths]] culture of the [[Roman people|ancient Romans]], which featured female slaves called ''cosmetae,'' who performed aesthetic treatments on visitors.<ref name=":4">{{Cite journal |last=Blanco-Davila|first=Feliciano|date=March 2000|title=Beauty and the Body: The Origins of Cosmetics|url=https://doi.org/10.1097/00006534-200003000-00058|journal=Plastic & Reconstructive Surgery|volume=105|issue=3|pages=1196–1204|doi=10.1097/00006534-200003000-00058|pmid=10724281 |issn=0032-1052}}</ref> ''Cosmetae'' is rooted in the Greek term ''cosmetikos'', signifying to order or adorn.<ref name=":4" />

It was not until the [[Renaissance]] period that cosmetic or "beauty" surgery was clearly distinguished from [[reconstructive surgery]], which strictly aimed to repair function.<ref name=":12">{{Cite book |last=Gilman|first=Sander L.|url=https://doi.org/10.2307/j.ctv21r3pwv|title=Making the Body Beautiful|date=2021-12-07|publisher=Princeton University Press|doi=10.2307/j.ctv21r3pwv |isbn=978-0-691-24021-3}}</ref> This term began to intertwine with aesthetic considerations as a result of the defects caused by the 16th-century [[syphilis]] epidemic.<ref name=":12" /> The Renaissance label "beauty surgery" as a direct juxtaposition with reconstructive surgery was popularized by German surgeon [[Johann Friedrich Dieffenbach]], who is largely considered the father of plastic surgery.<ref name=":12" /> Common surgeries of the Renaissance included cosmetic [[Labiaplasty|labiaplasties]] to augment the appearance of the [[clitoris]] or [[labia minora]] through reduction or removal, related to concerns surrounding the intersection between female sexual organs and gender identity/sexual orientation.<ref name=":22">{{Cite book |last=Burke|first=Jill|title=How to be a Renaissance woman: the untold history of beauty & female creativity|date=2024|publisher=Pegasus Books|isbn=978-1-63936-590-6|edition=First Pegasus Books cloth edition January 2024|location=New York}}</ref> These procedures were depicted in writing and illustrations as early as the 7th century, in texts such as the Byzantine physician [[Paul of Aegina|Paul of Aegina's]] [[Medical Compendium in Seven Books|Medical Compendium]], as well as [[Lanfranc of Milan|Lanfranc da Milano's]] 13th century text Great Surgery.<ref name=":22" /> Furthermore, Renaissance physicians were also beginning to pioneer interventions to reduce the appearance of aging through operations such as the [[blepharoplasty]], exemplified in the work of [[Lorenz Heister]].<ref name=":3" /> Early works of medical research and instruction such as the aforementioned documents were often republished in the Renaissance period due to the rise in print culture that allowed for the mass dissemination of ideas, brought about by the invention of the [[Printing press|Gutenberg press]].<ref name=":22" /> These early discoveries set the stage for the technological and social advancements of the 20th century that solidified cosmetic plastic surgery as a successful and lucrative discipline, distinct from reconstructive plastic surgery.

In 1949, 15,000 Americans underwent cosmetic surgery procedures and by 1969 this number rose to almost half a million people.<ref>{{Cite news |date=1971-09-27 |title=Plastic Surgery |url=https://www.nytimes.com/1971/09/27/archives/its-no-longer-reserved-for-the-vain-and-rich.html |access-date=2026-04-27 |work=The New York Times |language=en-US |issn=0362-4331}}</ref><ref name=":03">{{Cite web |date=2018 |title=2018 Cosmetic Surgery Age Distribution |url=https://ghostarchive.org/archive/sIU3F |access-date=2026-04-27 |website=ghostarchive.org}}</ref> The [[American Society of Plastic Surgeons]] estimates that more than 333,000 cosmetic procedures were performed on patients 18 years of age or younger in the US in 2005 compared to approx. 14,000 in 1996.<ref name=":03" /> In 2018, more than 226,994 patients between the ages of 13 and 19 underwent plastic surgery compared to just over 218,900 patients in the same age group in 2010. Concerns about young people undergoing plastic surgery include the financial burden of additional surgical procedures needed to correct problems after the initial cosmetic surgery, long-term health complications from plastic surgery, and unaddressed mental health issues that may have led to surgery.<ref>{{Cite journal |last1=Zuckerman |first1=Diana |last2=Abraham |first2=Anisha |date=October 2008 |title=Teenagers and Cosmetic Surgery: Focus on Breast Augmentation and Liposuction |url=https://doi.org/10.1016/j.jadohealth.2008.04.018 |journal=Journal of Adolescent Health |volume=43 |issue=4 |pages=318–324 |doi=10.1016/j.jadohealth.2008.04.018 |pmid=18809128 |issn=1054-139X}}</ref> The increased use of cosmetic procedures crosses racial and ethnic lines in the U.S., with increases seen among African-Americans, Asian Americans and Hispanic Americans as well as Caucasian Americans. In Asia, cosmetic surgery has become more popular, and countries such as China and India have become Asia's biggest cosmetic surgery markets. South Korea is also rising in popularity in Asian and Western countries due to their expertise in facial bone surgeries (see [[cosmetic surgery in South Korea]]).

Plastic surgery is increasing slowly, rising 115% from 2000 to 2015. "According to the annual plastic surgery procedural statistics, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2015, a 2 percent increase over 2014."<ref>{{cite web|url=https://www.plasticsurgery.org/news/press-releases/new-statistics-reflect-the-changing-face-of-plastic-surgery|title=New Statistics Reflect the Changing Face of Plastic Surgery|date=25 February 2015|access-date=15 November 2017}}</ref> A study from 2021 found that requests for cosmetic procedures had increased significantly since the beginning of the COVID-19 pandemic, possibly due to the increase in [[Videotelephony|videoconferencing]];<ref>{{cite journal | vauthors = Padley RH, Di Pace B | title = Touch-ups, Rejuvenation, Re-dos and Revisions: Remote Communication and Cosmetic Surgery on the Rise | journal = Aesthetic Plastic Surgery | date = April 2021 | volume = 45 | issue = 6 | pages = 3078–3080 | pmid = 33797578 | pmc = 8018227 | doi = 10.1007/s00266-021-02235-1 }}</ref> cited estimates include a 10% increase in the United States and a 20% increase in France.<ref>{{Cite news|date=2021-04-11|title=Covid-19 is fuelling a Zoom-boom in cosmetic surgery|newspaper=[[The Economist]] |url=https://www.economist.com/international/2021/04/11/covid-19-is-fuelling-a-zoom-boom-in-cosmetic-surgery|access-date=2021-06-18|issn=0013-0613}}</ref>

The most popular aesthetic/cosmetic procedures include: * [[Abdominoplasty]] ("tummy tuck"): reshaping and firming of the [[abdomen]] * [[Blepharoplasty]] ("eyelid surgery"): reshaping of upper/lower eyelids including [[Asian blepharoplasty]] ** While blepharoplasty remains the most common procedure for modifying eyelid shape, non-surgical alternatives are increasingly sought after, especially in East Asia. ** Methods such as double eyelid tape, eyelid glue, and structured eyelid training systems allow individuals to temporarily or semi-permanently create a double eyelid crease without surgery. Some of these products use mechanical reinforcement to 'encourage crease retention over time. ** Unlike traditional adhesive-based tapes, structured eyelid training tapes aim to replicate mechanotransduction — a biological process where skin tension encourages crease formation. Studies on long-term non-surgical crease retention remain limited, but anecdotal evidence suggests some users achieve lasting results after sustained use. * [[Phalloplasty]] ("penile surgery"): construction (or reconstruction) of a penis or, sometimes, artificial modification of the penis by surgery, often for cosmetic purposes * [[Mammoplasty]]: ** [[Breast augmentation]]s ("[[breast implant]]" or "boob job"): augmentation of the [[breast]]s by means of fat grafting, saline, or silicone gel prosthetics, which was initially performed for women with [[micromastia]] ** [[Reduction mammoplasty]] ("breast reduction"): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with [[gigantomastia]] and for men with [[gynecomastia]] ** [[Mastopexy]] ("breast lift"): Lifting or reshaping of breasts to make them less saggy, often after weight loss (after a pregnancy, for example). It involves the removal of breast skin as opposed to glandular tissue *** Augmentation mastopexy ("breast lift with breast implants"): Lifting breasts to make them less saggy, repositioning the nipple to a higher location, and increasing breast size with saline or silicone gel implants. Recent studies of a newer technique for simultaneous augmentation mastopexy (SAM) indicate that it is a safe surgical procedure with minimal medical complications.<ref>{{cite journal | vauthors = Stevens WG, Macias LH, Spring M, Stoker DA, Chacón CO, Eberlin SA | title = One-Stage Augmentation Mastopexy: A Review of 1192 Simultaneous Breast Augmentation and Mastopexy Procedures in 615 Consecutive Patients | journal = Aesthetic Surgery Journal | volume = 34 | issue = 5 | pages = 723–732 | date = July 2014 | pmid = 24792479 | doi = 10.1177/1090820X14531434 | doi-access = free }}</ref> The SAM technique involves invaginating and tacking the tissues first, in order to previsualize the result, before making any surgical incisions to the breast.<ref name="r8">{{cite journal | vauthors = Eisenberg T | title = Simultaneous augmentation mastopexy: a technique for maximum en bloc skin resection using the inverted-T pattern regardless of implant size, asymmetry, or ptosis | journal = Aesthetic Plastic Surgery | volume = 36 | issue = 2 | pages = 349–54 | date = April 2012 | pmid = 21853404 | doi = 10.1007/s00266-011-9796-7 | s2cid = 19402937 }}</ref> * [[Buttock augmentation]] ("butt implant"): enhancement of the [[buttock]]s using silicone implants or fat grafting ("Brazilian butt lift") where fat is transferred from other areas of the body * [[Cryolipolysis]]: refers to a medical device used to destroy fat cells. Its principle relies on controlled cooling for the non-invasive local reduction of fat deposits to reshape body contours. * [[Cryoneuromodulation]]: Treatment of superficial and subcutaneous tissue structures using gaseous [[nitrous oxide]], including temporary wrinkle reduction, temporary pain reduction, treatment of dermatologic conditions, and focal cryo-treatment of tissue * Calf augmentation: done by silicone implants or fat transfer to add bulk to calf muscles * [[Labiaplasty]]: surgical reduction and reshaping of the [[labia (genitalia)|labia]] * [[Lip augmentation]]: alters the appearance of the lips by increasing their fullness through surgical enlargement with lip implants or nonsurgical enhancement with injectable fillers * [[Cheiloplasty]]: surgical reconstruction of the lip * [[Rhinoplasty]] ("nose job"): reshaping of the [[human nose|nose]] sometimes used to correct breathing impaired by structural defects. * [[Otoplasty]] ("ear surgery"/"ear pinning"): reshaping of the [[ear]], most often done by pinning the protruding ear closer to the head. * [[Rhytidectomy]] ("face lift"): removal of wrinkles and signs of aging from the face ** [[Platysmaplasty|Neck lift]]: tightening of lax tissues in the neck. This procedure is often combined with a facelift for lower face rejuvenation. ** [[Browplasty]] ("brow lift" or "forehead lift"): elevates eyebrows, smoothens forehead skin ** Midface lift ("cheek lift"): tightening of the cheeks * [[Genioplasty]]: augmentation of the [[chin]] with an individual's bones or with the use of an implant, usually silicone, by suture of the soft tissue<ref name=":0">{{Cite book |title=Facial bone contouring surgery: a practical guide |vauthors=Park S |date=2017 |publisher=Springer |isbn=978-981-10-2726-0 |location=Singapore |oclc=1004601615}}{{page needed|date=September 2018}}</ref> ** [[Mentoplasty]]: surgery to the chin. This can involve either enhancing or reducing the size of the chin. Enhancements are achieved with the use of facial implants. Reduction of the chin involves reducing the size of the chin bone.<ref>{{cite web | title = What is chin surgery? | url = https://www.plasticsurgery.org/cosmetic-procedures/chin-surgery | publisher = American Society of Plastic Surgeons }}</ref> * [[Cheek augmentation]] ("cheek implant"): implants to the cheek * [[Orthognathic surgery]]: altering the upper and lower jaw bones (through osteotomy) to correct jaw alignment issues and correct the teeth alignment * Fillers injections: [[collagen]], [[fat]], and other tissue filler injections, such as [[hyaluronic acid]] * [[Brachioplasty]] ("Arm lift"): reducing excess skin and fat between the underarm and the elbow * [[Laser]] skin rejuvenation or [[laser resurfacing]]: the lessening of the depth of facial pores and exfoliation of dead or damaged skin cells * [[Liposuction]] ("suction lipectomy"): removal of fat deposits by traditional suction technique or ultrasonic energy to aid fat removal * [[Zygoma reduction plasty]]: reducing the facial width by performing osteotomy and resecting part of the zygomatic bone and arch<ref name=":0" /> * [[Jaw reduction]]: reduction of the mandible angle to smooth out an angular jaw and creating a slim jaw<ref name=":0" /> * [[Buccal fat pad#Clinical uses|Buccal fat extraction]]: extraction of the buccal pads * [[Body contouring]]: the removal of this excess skin and fat from numerous areas of the body, restoring the appearance of skin elasticity of the remaining skin. The surgery is prominent in those who have undergone significant [[weight loss]], resulting in excess sagging skin being present around areas of the body. The skin loses [[elasticity (physics)|elasticity]] (a condition called [[elastosis]]<ref>{{Cite book|title = Fast Living Slow Ageing: How to age less, look great, live longer, get more| vauthors = Marie K, Thomas MC |publisher = Health Inform Pty Ltd|year = 2013|isbn = 978-0-9806339-2-4|location = Strawberry Hills, Australia|pages = 229–311|chapter = 33|edition = 4th}}</ref>) once it has been stretched past capacity and is unable to recoil back to its standard position against the body and also with age.<ref>{{cite web | title = What is body contouring? | url = https://www.plasticsurgery.org/cosmetic-procedures/body-contouring | publisher = American Society of Plastic Surgeons }}</ref> * [[Sclerotherapy]]: removing visible '[[Telangiectasia|spider veins]]' (Telangiectasia), which appear on the surface of the skin.<ref>{{cite web | title = Spider Vein Treatment | url = https://www.plasticsurgery.org/cosmetic-procedures/spider-vein-treatment | publisher = American Society of Plastic Surgeons }}</ref> * [[Dermal filler]]s: Dermal fillers are injected below the skin to give a more fuller, more youthful appearance of a feature or section of the face. One type of dermal filler is hyaluronic acid. Hyaluronic acid is naturally found throughout the human body. It plays a vital role in moving [[nutrient]]s to the cells of the skin from the blood. It is also commonly used in patients with [[arthritis]] as it acts like a cushion to the bones which have depleted the [[Hyaline cartilage|articular cartilage]] casing. Development within this field has occurred over time with synthetic forms of hyaluronic acid is being created, playing roles in other forms of cosmetic surgery such as facial augmentation.<ref>{{cite web | title = What are dermal fillers? | url = https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers | publisher = American Society of Plastic Surgeons }}</ref> * [[Micropigmentation]]: is the creation of permanent makeup using natural pigments to places such as the eyes to create the effect of eye shadow, lips creating lipstick and cheek bones to create a blush like look. The pigment is inserted beneath the skin using a machine which injects a small needle at a very fast rate carrying pigment into the skin, creating a lasting colouration of the desired area.

In 2015, the most popular surgeries were botox, liposuction, blepharoplasties, breast implants, rhynoplasties, and rhytidectomies.<ref>{{cite web|url=http://www.webmd.com/beauty/treatments/most-popular-cosmetic-procedures|title=The Most Popular Cosmetic Procedures|website=WebMD|access-date=12 September 2015|archive-url=https://web.archive.org/web/20150910172447/http://www.webmd.com/beauty/treatments/most-popular-cosmetic-procedures|archive-date=10 September 2015}}</ref> According to the 2020 Plastic Surgery Statistics Report, which is published by the American Society of Plastic Surgeons, the most surgical procedure performed in the U.S. was rhinoplasty (nose reshaping) accounting for 15.2% of all cosmetic surgical procedures that year, followed by blepharoplasty (eyelid surgery), which accounted for 14% of all procedures. The third most populous procedure was rhytidectomy (facelift) (10% of all procedures), then liposuction (9.1% of all procedures).<ref>{{Cite web |last=The American Board of Plastic Surgery |date=2021 |title=2020 Plastic Surgery Statistics {{!}} Cosmetic Procedure Trends |url=https://www.plasticsurgery.org/documents/News/Statistics/2020/cosmetic-procedure-trends-2020.pdf}}</ref>

==Complications, risks, and reversals== All surgery has risks. Common complications of cosmetic surgery includes [[hematoma]], [[nerve injury]], [[infection]], [[scar]]ring, [[implant failure]] and [[end organ damage]].<ref>{{cite web|url=http://www.nhs.uk/Conditions/Plastic-surgery/Pages/Complications.aspx|title=Plastic surgery – Complications – NHS Choices |website=www.nhs.uk|date=23 October 2017}}</ref><ref>{{cite web|url=http://www.mayoclinic.org/tests-procedures/cosmetic-surgery/basics/risks/prc-20022389|title=Cosmetic surgery Risks – Mayo Clinic|website=[[Mayo Clinic]]}}</ref> [[Breast implants]] can have many [[Breast implant#Complications|complications]], including rupture. In a study of his 4761 augmentation mammaplasty patients, Eisenberg reported that overfilling saline breast implants 10–13% significantly reduced the rupture-deflation rate to 1.83% at 8-years post-implantation.<ref name="Eisenberg 2021">{{cite journal | vauthors = Eisenberg T | title = Does Overfilling Smooth Inflatable Saline-Filled Breast Implants Decrease the Deflation Rate? Experience with 4761 Augmentation Mammaplasty Patients | journal = Aesthetic Plastic Surgery | date = March 2021 | volume = 45 | issue = 5 | pages = 1991–1999 | pmid = 33712871 | doi = 10.1007/s00266-021-02198-3|pmc=8481168 | doi-access = free }}</ref> In 2011 FDA stated that one in five patients who received implants for breast augmentation will need them removed within 10 years of implantation.<ref>{{cite web | title = FDA Update on the Safety of Silicone Gel-Filled Breast Implants | date = June 2011 | work = Center for Devices and Radiological Health U.S. Food and Drug Administration | url = https://www.fda.gov/media/80685/download }}</ref>

==Psychological disorders== Although media and advertising do play a large role in influencing many people's lives, such as by making people believe plastic surgery to be an acceptable course to change one's identity to their liking,<ref>{{cite journal |doi=10.1177/1749975510391583 |title='I Want to Look Like That!': Cosmetic Surgery and Celebrity Culture |journal=Cultural Sociology |volume=5 |issue=4 |pages=463–477 |year=2011 | vauthors = Elliott A |citeseerx=10.1.1.1028.8768 |s2cid=145370171 }}</ref> researchers believe that plastic surgery obsession is linked to psychological disorders such as [[body dysmorphic disorder]].<ref>{{cite journal | vauthors = Ribeiro RV | title = Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis | journal = Aesthetic Plastic Surgery | volume = 41 | issue = 4 | pages = 964–970 | date = August 2017 | pmid = 28411353 | doi = 10.1007/s00266-017-0869-0 | s2cid = 29619456 }}</ref> There exists a correlation between those with BDD and the predilection toward cosmetic plastic surgery in order to correct a perceived defect in their appearance.<ref name=PMJBDD>{{cite journal | vauthors = Veale D | title = Body dysmorphic disorder | journal = Postgraduate Medical Journal | volume = 80 | issue = 940 | pages = 67–71 | date = February 2004 | pmid = 14970291 | pmc = 1742928 | doi = 10.1136/pmj.2003.015289 }}</ref>

BDD is a disorder resulting in the individual becoming "preoccupied with what they regard as defects in their bodies or faces". Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive.<ref name=PMJBDD /> While 2% of people have body dysmorphic disorder in the United States, 15% of patients seeing a dermatologist and cosmetic surgeons have the disorder. Half of the patients with the disorder who have cosmetic surgery performed are not pleased with the aesthetic outcome. BDD can lead to suicide in some people with the condition. While many with BDD seek cosmetic surgery, the procedures do not treat BDD, and can ultimately worsen the problem. The psychological root of the problem is usually unidentified; therefore causing the treatment to be even more difficult. Some say that the fixation or obsession with correction of the area could be a sub-disorder such as anorexia or muscle dysmorphia.<ref>{{cite journal | vauthors = Miller MC | title = What is body dysmorphic disorder? | journal = The Harvard Mental Health Letter | volume = 22 | issue = 1 | page = 8 | date = July 2005 | pmid = 16193565 }}</ref> The increased use of body and facial reshaping applications such as [[Snapchat]] and [[Facetune]] have been identified as potential triggers of BDD. Recently, a phenomenon referred to as '[[Snapchat dysmorphia]]' has appeared to describe people who request surgery to resemble the edited version of themselves as they appear through Snapchat filters.<ref>{{cite press release |publisher=Boston Medical Center |title=A new reality for beauty standards: How selfies and filters affect body image |url=https://www.eurekalert.org/pub_releases/2018-08/bmc-anr080118.php |website=EurekAlert! |access-date=4 February 2019 |archive-date=9 November 2020 |archive-url=https://web.archive.org/web/20201109012840/https://www.eurekalert.org/pub_releases/2018-08/bmc-anr080118.php |url-status=dead }}</ref> In response to the detrimental trend, Instagram banned all augmented reality (AR) filters that depict or promote cosmetic surgery.<ref>{{Cite web|url=https://www.bbc.com/news/business-50152053|title=Instagram bans 'cosmetic surgery' filters|date=23 October 2019|website=[[BBC News]] }}</ref>

In some cases, people whose physicians refuse to perform any further surgeries, have turned to "[[self-surgery|do it yourself]]" plastic surgery, injecting themselves and facing extreme safety risks.<ref>{{Cite news| vauthors = Canning A | title = Woman's DIY Plastic Surgery 'Nightmare' | newspaper = ABC News | date = 20 July 2009 | url = https://abcnews.go.com/GMA/story?id=8080723&page=1 }}</ref>

==See also== * [[Biomaterial]] * [[Body modification]] * [[Cosmetic surgery in Australia]] * [[Dental trauma]] * [[Dermatologic surgical procedure]] * [[Ethnic plastic surgery]] * [[List of plastic surgery flaps]] * ''[[Plastic and Reconstructive Surgery (journal)|Plastic and Reconstructive Surgery]]'' * [[Scalp reconstruction]] * [[Serdev suture]] * [[Rejuvenation]]

==References== {{Reflist}}

==Further reading== * {{cite journal | vauthors = Atkinson M |doi=10.1177/1357034X07087531 |title=Exploring Male Femininity in the 'Crisis': Men and Cosmetic Surgery |journal=Body & Society |volume=14 |pages=67–87 |year=2008 |s2cid=143604536 }} * {{Cite book | vauthors = Fraser S | title=Cosmetic surgery, gender and culture | date=2003 | publisher=Palgrave | isbn=978-1-4039-1299-2}} * {{Cite book | vauthors = Gilman S | author-link=Sander L. Gilman | title=Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery | date=2005 | publisher=Duke University Press | isbn=978-0-8223-2144-6}} * {{Cite book | vauthors = Haiken E | title=Venus Envy: A History of Cosmetic Surgery | date=1997 | publisher=Johns Hopkins University Press | isbn=978-0-8018-5763-8 | url-access=registration | url=https://europesurgery.co.uk}} * {{Cite book | vauthors = Kolle FS | title=Plastic and Cosmetic Surgery | date=1911 | publisher=D. Appleton and Company | url=https://gutenberg.org/ebooks/73452}} * {{Cite book | last1=Ghali | first1=Shadi | veditors = Kalaskar D, Butler P, Ghali S | title=Textbook of Plastic and Reconstructive Surgery | date=2016 | publisher=UCL Press | doi=10.14324/111.978191063394 | isbn=978-1-910634-39-4 | url=https://uclpress.co.uk/book/textbook-of-plastic-and-reconstructive-surgery/}}

==External links== {{Commons category}} * ''[https://www.statista.com/statistics/293356/leading-countries-by-total-number-of-cosmetic-procedures/ Countries with the largest total number of cosmetic procedures]'', [[Statista]], 2019 * ''[https://www.cosmeticassociation.org/cosmetic-surgeries-procedures-statistics/ Cosmetic Surgery Statistics]'', [[American Cosmetic Association]], 2023

[[Category:Plastic surgery| ]] [[Category:Cosmetic surgery]] [[Category:Cosmetic industry]] [[Category:Surgical specialties]]