Outside of our industry we hear a lot of misconceptions about what is and isn’t cosmetic, plastic, and reconstructive surgery. If you are an expert in this field, this would be the one post of ours that you can likely skip right over. For most of even the TSLMS members, however, this will be a highly educational piece.

 

What Is Plastic Surgery

Medicine.Net defines plastic surgery as, “A surgical specialty that is dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease. Plastic surgery is also involved with the enhancement of the appearance of a person through cosmetic surgery.” This definition is expanded on by Wikipedia:

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two categories. The first is reconstructive surgery which includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. The other is cosmetic or aesthetic surgery. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims at improving the appearance of it. Both of these techniques are used throughout the world… In the term “plastic surgery,” the adjective plastic implies sculpting and/or reshaping, which is derived from the Greek πλαστική (τέχνη), plastikē (tekhnē), “the art of modelling” of malleable flesh. This meaning in English is seen as early as 1598. 

The surgical definition of “plastic” first appeared in 1839, preceding the modern “engineering material made from petroleum” sense of plastic (coined by Leo Baekeland in 1909) by 70 years. The current semantic diversity of the word plastic has a long history of development. Essentially, there are two ways of using this term..  In its original sense plastic relates to formation or shaping of matter, i.e. to plastic art. Plastic can also be used figuratively in the meaning of formation of non-material things (e.g. writing a poem, creating a piece of music, and so on), i.e. in the meaning of the power to create. Both notions have been around for thousands of years. The origin of the dual history of the materialistic and philosophical use of plastic can be traced back to the ancient Greek craft of pottery and mythology, respectively. Wider textual use of the term plastic began with Pliny the Elder’s (23 – 79 AD) Plastice, a chapter in his Natural History. The semantic flourish of plastic started only at the end of the 18th century when Johann Gottfried Herder introduced the concept of “plastic sense” in his aesthetic essay Plastik (Sculpture) of 1778.

For more on the history of plastic surgery, see our piece “The History of Plastic Surger.“

The American Society of Plastic Surgeons points out that “The field of Plastic Surgery can be broken down into two main categories – reconstructive procedures and cosmetic procedures. Both are generally considered subspecialties of plastic surgery.” Each requires a different type of training and board certification. 

Below is a summary of each practice.

 

Cosmetic Surgery 

All cosmetic surgeons are plastic surgeons. The American Board of Cosmetic Surgery is the leading US authority on cosmetic surgery. This is their take on the topic:

While both cosmetic surgery and plastic surgery deal with improving a patient’s body, the overarching philosophies guiding the training, research, and goals for patient outcomes are different. 

Cosmetic Surgery: Focused on Enhancing Appearance. The procedures, techniques, and principles of cosmetic surgery are entirely focused on enhancing a patient’s appearance. Improving aesthetic appeal, symmetry, and proportion are the key goals. Cosmetic surgery can be performed on all areas of the head, neck, and body. Because the treated areas function properly, cosmetic surgery is elective. Cosmetic surgery is practiced by doctors from a variety of medical fields, including plastic surgeons. The scope of cosmetic surgery procedures includes:

• Breast Enhancement: Augmentation, Lift, Reduction
• Facial Contouring: Rhinoplasty, Chin, or Cheek Enhancement
• Facial Rejuvenation: Facelift, Eyelid Lift, Neck Lift, Brow Lift
• Body Contouring: Tummy Tuck, Liposuction, Gynecomastia Treatment
• Skin Rejuvenation: Laser Resurfacing, Botox®, Filler Treatments

Plastic Surgery [on the other hand] is focused on repairing defects to reconstruct a normal function and appearance. 

Clearly, even the experts have some confusion when it comes to this matter. 

 

Reconstructive Surgery Vs Cosmetic Surgery

Cosmetic surgery is generally elective, or something that someone chooses to get in order to enhance their looks. On the other hand, reconstructive surgery is typically considered medically necessary. For people who are getting reconstructive surgery, this frequently means an easier road with their insurance companies than those seeking out only cosmetic surgery. According to the National Cancer Institute Dictionary of Cancer Terms, reconstructive surgery is “Surgery that is done to reshape or rebuild (reconstruct) a part of the body changed by previous surgery.” However, the full definition extends well beyond just repairs from surgical procedures to cover repairs from accidents and birth defects as well. Frequently this intersects with cosmetic surgery in people’s minds as the end goal is frequently cosmetic in nature. However, this is not always true. Quite often, in fact, reconstructive surgery has an initial goal of restoring function with a secondary goal of perfecting the aesthetic to the area repaired.