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Plastic surgery

NHS Direct Online Health Encyclopaedia


Plastic surgery is surgery to repair and restore defects of the skin and the underlying tissue, whether they are present from birth (congenital) or caused by disease or injury.

The function of plastic surgery is to restore the maximum possible functional capacity and the best possible appearance to people with obvious defects. Cosmetic surgery is concerned with altering appearance for purely cosmetic reasons.

The cosmetic branch of plastic surgery is concerned with:

removing or improving the appearance of birthmarks, moles, scars, tattoos, warts, cholesterol skin deposition (xanthelasmas) and other blemishes,
correcting disfiguring congenital defects, and
correcting defects of appearance at the request of the patient (elective cosmetic surgery).
Examples of elective surgery include a face lift (rhytidectomy), nose reshaping (rhinoplasty), correction of ear defects (otoplasty) and removal of redundant eyelid skin (blepharoplasty).

The body shape is determined by the skeleton, the muscle bulk and the amount and distribution of the layer of fat immediately under the skin (subcutaneous fat or superficial fascia).

These are procedures not to be undertaken lightly, for they carry a small but not negligible risk of complications. There is even, as with all major surgery, some risk to life.

Body-contour surgery does not necessarily involve such extreme intervention. Suction lipectomy is a form of plastic surgery in which an attempt is made to improve the contours of the body by removing fat through suction. Small incisions are made in the skin and a blunt-ended metal sucker is passed through and moved around under the skin.

Why is it necessary?
Plastic surgical treatment is most commonly used to repair tissue damage from burning (see the article on burns and scalds), after mechanical injury, cancer or mutilating surgery. It is often, in the first instance, concerned with providing cover for areas of skin loss.

To achieve this, a wide variety of techniques of skin transfer are used, including:

split-skin or full-thickness skin grafting,
z-plasty to lengthen an area of skin at the expense of width,
skin-flap transfer of many different types, and
pedicle grafts (skin tubes fashioned for transfer as a two-stage procedure).
Various methods of skin expansion may also be used.

© Queen's Printer and Controller of HMSO, 2005

Crown copyright material is reproduced with the permission of the controller of HMSO and the Queens Printer for Scotland.



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