If you typically use cosmetic surgery and plastic surgery interchangeably you’re not alone. Many people who hear the terms plastic, reconstructive, or cosmetic surgery assume the three are the same. There are fine distinctions, however, between the different types of surgery. It’s critical that you know these differences when looking for a surgeon.
Cosmetic Surgery
This is what most people think of when you say “plastic surgery.” But “plastic surgery” is not synonymous with “cosmetic surgery.” The term “cosmetic” refers to what is also called aesthetic surgery—it focuses on the appearance of the patient.
The American Board of Cosmetic Surgery defines cosmetic surgery as “entirely focused on enhancing a patient’s appearance. Improving symmetry, proportion and aesthetic appeal are the primary goals.”
As none of the procedures are meant to improve the function of the body, cosmetic surgery is considered completely elective.
Here are categories of surgery that fall under the cosmetic umbrella, plus a few examples:
- Facial Contouring: Nose jobs or cheek implants
- Facial Rejuvenation: Facelifts, eyelifts or neck lifts
- Body Contouring: Tummy tucks or liposuction
- Skin Rejuvenation: BOTOXâ, laser resurfacing or fillers and injections
Reconstructive Surgery
Reconstructive surgery is the opposite of cosmetic surgery. It is focused totally on reconstructing the form of the body after trauma or defect. It can also include body enhancement procedures designed to correct or improve the body’s function or overall health.
What many think of as cosmetic surgery could actually be classified as reconstructive procedures. A breast reduction, for example, might be seen as an entirely elective procedure, but as the reduction alleviates conditions such as back or mobility problems, it is actually considered reconstructive.
Similarly, surgery on the eyelids may be thought of as a cosmetic or elective procedure. But if it is done in order to improve eyesight, then it is a reconstructive procedure.
Reconstructive surgery deals both with defects the patient is born with, as well as those acquired through trauma or illness.
Some of the procedures considered reconstructive are:
- Cleft lip and palate
- Congenital facial deformities
- Breast reconstruction
- Ear reconstruction
- Burn repairs
- Scar revisions
- Hand surgery
Plastic Surgery
Plastic surgery is a catchall term and where things can get a little murky when it comes to definitions. The American Board of Plastic Surgery defines the practice as:
“[The] repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk, external genitalia or cosmetic enhancement of these areas of the body.”
The definition continues to define cosmetic surgery as a practice that falls within plastic surgery, as an essential component to their field of medicine.
The Difference Between Surgeons
You might think surgery is surgery, and all surgeons must be trained alike. But there are major differences between surgeons who specialize in cosmetic, plastic, or reconstructive surgery.
A Brief History
The term Plastic Surgery comes from the Greek word plastike (teckhne) or the art of modeling or sculpting. The profession dates back to approximately 800 BC in India where forehead flaps were utilized to reconstruct amputated noses. The ancient Egyptians and Romans also performed plastic surgery to restore defects in ears/lips and enhance the appearance of the skin. The American Board of Plastic Surgery (ABPS) was established in 1937 and given the status of a major specialty board by the American Board of Medical Specialties (ABMS) in 1941. This was well before the modern utilization of the industrial plastic products we utilize every day. Thus, the confusion between the everyday plastic items we use and plastic surgery.
The practice of plastic surgery encompasses the restoration, rejuvenation and the enhancement of the patient through the art of surgery. Plastic surgery can be divided into two main areas: reconstructive & aesthetic/cosmetic surgery.
Reconstructive plastic surgery is performed to correct functional impairments caused by burns, traumatic injuries such as facial bone fractures/breaks, congenital abnormalities such as cleft palates/cleft lips, developmental abnormalities, infection/disease and cancer/tumors. Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal form or appearance. Aesthetic or cosmetic plastic surgery involves techniques intended for the “enhancement” of an individual’s appearance through surgical and medical techniques, and is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal.
The surgical field of plastic surgery is quite voluminous and covers many surgical fields to include burn, breast, body contouring, cosmetic, craniofacial, hand, microsurgery, pediatric and occuloplastic surgery. The first kidney transplant was performed by a plastic surgeon who subsequently was awarded the Nobel Prize, Dr. Joseph Murray. Other notable advancements have included breast reconstruction with implants/autogenous tissue, toe to hand operations to reconstruct and restore hand function, hand transplants and face transplants. Plastic surgery is one of the most vast and complicated of the surgical professions. Training to become a plastic surgeon certified by the ABPS is time consuming and complicated.
Becoming a Plastic Surgeon
All ASPS plastic surgeons are first physicians. They must complete college and be a medical school graduate. While the family practitioner, pediatrician or radiologist completes three years of training to practice their craft after graduation from medical school, the plastic surgeon certified by the ASPS must complete a minimum of 5 years post-graduate surgical training. Additional residency or fellowship training is very common. Often ASPS plastic surgeons go on to study further into one of the many other specific fields of plastic surgery such as hand, craniofacial, microsurgery, cosmetic surgery, etc.
All ASPS plastic surgeons are well trained and experienced surgeons. The initial training of a plastic surgeon receives can occur in many areas of surgery to include urology, orthopedics, otolaryngology (ENT), general surgery and even neurosurgery. Completion of the craft requires a core curriculum of plastic surgery that can last from two to five years depending upon the training program and the candidates’ background/experience. The training process is extensive. Most ASPS members have completed around 14 to 16 years of higher education, passed three to five national certifying examinations in both written/oral forms and are in their mid to late 30’s at the time they begin their careers. It is the heavy price they pay to enter this surgical field that restores, rejuvenates and enhances the individual through the art of surgery. It all started so many years ago through the craft of modeling or sculpting the human form.