The term “plastic surgery” was in use in the late 1700s; long before the material “plastic” was invented in 1907 and came into common daily use. The name comes from the greek word fo for ‘grow’ or ‘form’ which is “plastikos” and has come to mean malleable.
Plastic Surgery has come to be associated with cosmetic or aesthetic surgery to rejuvenate or change appearance, but most of what plastic surgeons do is reconstruction of form and function after one of the accidents of birth or life (such as trauma, burn injury, or surgery to remove tumours or correct other problems) leaves a defect that needs to be ‘filled’.
Reconstructive surgery is what drew me to my specialty and it is the fundamental techniques of reconstructive surgery that I apply and modify every day in both my reconstructive and aesthetic surgery practices.
Reconstruction after skin cancer surgery
In New Zealand, a great deal of what a plastic surgeon does revolves around reconstructing the defects left after removing melanoma, basal and squamous cell skin cancer. One of the advantages that plastic surgeons have when removing cancer is that our skill set allows us to reconstruct large defects without tension and with minimal cosmetic disturbance and so this allows us to comfortably excise large tumours with comfortable and safe margins without hesitation and generally, therefore, without the need to return for further surgery if the pathologist who examines the tumour sample finds a cancer has been incompletely excised.
Reconstruction after trauma
Trauma arrives unexpectedly in multiple forms: scalding water after a moment’s inattention; a fall; a road traffic accident; or an inflicted wound. Reconstruction of any traumatic wound involves the same fundamental skills, applied in the same methodical and meticulous way, but individualised to the person suffering the trauma, the circumstances of the injury and the tissues injured. A sharp wound from a grown man slipping and cutting a finger with a chisel while wood-working requires very different care than does a bite from a large dog to a elderly woman’s shin. The tissues involved, the age and health and healing capabilities and the mode of injury and degree of damage are all different between these two examples.
Generally speaking, acute injuries are treated by the DHB system, so what I am asked to treat is scars that have healed in an unsightly way, or wounds which have failed to heal. There is usually something that can be done to improve the appearance of any wound, but it is critical that I match my skill set to a patient’s realistic goals after we have discussed all the options and agreed on what should be done.
Whatever it is you would like to discuss revising, rejuvenating or reconstructing after a change from whatever mechanism, I will be happy to discuss with you whether there is anything I can do to help you. Please feel free to make an appointment.