Plastic Surgery Overview

What Is Plastic Surgery?
The Scope of Plastic Surgery

Plastic Surgery deals with the repair and reconstruction of physical defects of form or function involving the skin, musculoskeletal system, cranio-maxillofacial structures, hand, extremities, breast and trunk, and external genitalia. It involves the blending of surgical principles and aesthetic artistry, not only to cosmetically improve undesirable qualities of normal structures, but to restore normal form and function in reconstructive procedures as well.

Special knowledge and skill in the design and surgery of grafts, flaps, and free tissue transfer and re-plantation is necessary. Competence in the management of complex wounds, the use of implantable materials, and tumor surgery is required. Plastic Surgery has been prominent in the development of innovative techniques, such as micro-vascular and cranio-maxillofacial surgery, liposuction, and free tissue transfer. The foundation of surgical anatomy, physiology, pathology, and other basic sciences are fundamental to this specialty.

Competency in Plastic Surgery implies a special combination of basic knowledge, surgical judgment, technical expertise, ethics, and interpersonal skills in order to achieve satisfactory patient relationships and problem resolution.1

Plastic Surgeries Two Components: Reconstructive Surgery and Cosmetic (Aesthetic) Surgery

Plastic Surgery procedures generally fall into one of two categories – reconstructive or cosmetic.

Cosmetic Surgery is performed to reshape normal structures of the body in order to improve the patient’s appearance.2

Reconstructive Surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma and burns, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a restoration of normal appearance.2

Reconstructive procedures commonly performed by plastic surgeons include: correction of congenital anomalies (such as cleft lip and palate), maxillofacial and craniofacial surgery, hand surgery, breast reconstruction following mastectomy, breast reduction for hyperplasia, burn care, trauma care (such as repair of lacerations and facial fractures), excision of tumors and reconstruction following various types of cancer treatment.

Commonly performed cosmetic procedures include Face Lifts, Eyelid Lifts, Breast Enlargement, some Nasal Surgery, Body Contouring, and Liposuction.

Sometimes the overlap between reconstructive and cosmetic surgery leads to confusion. For example, similar techniques may be utilized for reconstruction of nasal deformity after trauma (reconstructive rhinoplasty) as well as for cosmetic alteration of a normal nose (cosmetic rhinoplasty). The technique and procedural coding may be the same, but the reason for surgery is the key factor to be considered in determining whether the procedure is reconstructive or cosmetic.

A number of position papers identifying criteria for determining coverage of various procedures are available from the American Society of Plastic Surgeons. Additionally, the Society has developed clinical guidelines for a number of Plastic Surgery procedures. Contact the American Society of Plastic Surgeons at (800) 766-4955, or on the web at American Society of Plastic Surgeons.

References:
1. Adopted by the American Board of Plastic Surgery, April 30, 1994.
2. Approved by the American Medical Association, June 1989. American Medical Association Policy Compendium, 1994 edition, 475.992.