How can two disciplines
as different as aesthetic and reconstructive surgery be placed in the same
category? The reason is that the techniques used are the same, or at least
very similar. For example, the same technique of loosening and lifting the
skin is used in a face lift and in finding the nerves in facial paralysis.
Further, material such as silicone can be used to reconstruct a breast lost
to cancer, and similar methods are used in aesthetic surgery to enhance
small breasts. These two plastic surgery areas have been able to cross-fertilize
each other in numerous other ways. New discoveries and methods in aesthetic
surgery can often be used in reconstructive operations, and advances in
reconstructive surgery can often fuel developments in aesthetic surgery.
And even in purely reconstructive operations, some attention must be given
to the aesthetics of the result.
Until the turn of the last century plastic surgery was basically reconstructive,
mostly to repair injuries and congenital defects. The distinction between
reconstructive and aesthetic plastic surgery was made somewhat later. The
borderline between the two is not clear, and the distinction is more or
less academic.
Plastic surgeons work with many different tissues and organs. The specialty
can therefore be regarded as one of technique, whereas most other surgical
specialists usually work with organs or organ systems (brain surgeon, heart
surgeon etc.). As a specialist in techniques for handling and moving tissues,
the plastic surgeon is an important partner to other surgical specialists.
If an organ specialist removes a tumor in a tissue, leaving a hole or a
loss of function, a plastic surgeon is called in to reconstruct (repair)
it.
In most countries, there are doctors who, despite lacking training in plastic
surgery, nevertheless perform cosmetic surgery. Their
rationalizations are usually about the same: the untrained surgeon says
that there is no training for aesthetic surgery, and no such specialty.
This is both true and false. It is true that there is no surgical specialty
called aesthetic surgery. However, the subject is a part of plastic surgery
and is naturally included in the training of a plastic surgeon. There are
many internationally recognized plastic surgeons who assert that the chances
of becoming a successful reconstructive surgeon are poor without solid training
in aesthetic surgery. Likewise, it is difficult to be a good aesthetic surgeon
without training in reconstructive surgery.
Since the specialty is growing explosively, more and more doctors are being
forced to choose between aesthetic and reconstructive surgery. In some countries
there are even plastic surgeons who perform only one or two kinds of operations.
All these surgeons, however, have a common background: a solid training
in both reconstructive and aesthetic plastic surgery.
