Appearance
is an important aspect of modern life as both women and men want to look as
good as they feel. To achieve this end, more than 13 million million cosmetic
procedures were performed last year in the United States. The results are often
dramatic and permanent, so it is important that the patient knows what to
expect and that he or she chooses a surgeon certified by the American Board of
Plastic Surgery (ABPS). The American Society of Plastic Surgeons (ASPS) has
prepared the following reference to assist primary care physicians and others
to help counsel their patients who are considering cosmetic (or reconstructive)
surgery.
It is a
common misunderstanding that the word plastic in plastic surgery means
artificial. Rather, the word originated from the ancient Greek word plastikos,
which means to mold or give form. Plastic surgery is a surgical specialty
involved with both the improvement in a person's appearance and the
reconstruction of facial and body tissue defects due to illness, trauma, or
birth disorders.
Plastic
surgery restores and improves function, as well as appearance. It can involve
surgery on any part of the anatomy, except the central nervous system,
including, but not limited to, the following:
- Skin (including skin cancer, scars, burns, birthmarks, and tattoo removal)
- Maxillofacial (the facial skeleton)
- Congenital anomalies (including deformed ears, cleft palate, and cleft lip)
Doctors who perform plastic surgery
It is
important to select a doctor who is certified in plastic surgery by the
American Board of Plastic Surgery. Generally, a surgeon who is board-certified
in plastic surgery has graduated from an accredited medical school and has
completed at least 5 years of graduate medical education--usually 3 years
of general surgery and 2 years of plastic surgery. In addition, the
surgeon must practice plastic surgery for 2 years and pass comprehensive
written and oral exams to become board-certified. Board certification is
renewed every 10 years to ensure ongoing competency in the specialty.
Cosmetic and Reconstructive Surgery: The Differences
Although
the outward effects may be similar or even identical, the terms cosmetic and
reconstructive surgery are not interchangeable. The plastic surgeon performs
cosmetic surgery to reshape normal structures of the face or body in order to
enhance the patient's appearance and self-esteem. Reconstructive surgery is
performed to correct abnormalities of facial or body structures caused by
congenital defects, developmental abnormalities, injuries, previous or
concurrent surgeries, infection, tumors, or other disease. The purpose of
reconstructive surgery is generally to improve function, but it may also be
used to restore a normal appearance.
These
distinctions have implications for insurance coverage. Nearly all insurance
carriers cover reconstructive procedures for functional restoration but not
those performed purely for cosmetic reasons. In general, the classification as
cosmetic or reconstructive depends on the reason that the surgery is performed.
For example, rhinoplasty to change the shape of the nose is considered
cosmetic. However, rhinoplasty to restore the shape of the nose following
traumatic deformity is reconstructive.
Corrective
surgery to remove or minimize the effects of scarring usually provides cosmetic
improvement. Insurance carriers, however, may recognize these procedures as
reconstructive in nature because scars are abnormal formations that develop on
the body as a result of injury or illness.
People with
good self-images tend to function effectively in their work, feel secure in
their relationships and interact positively with others. Self-image has other
components, but one of the most important is appearance. Sometimes the
correction of even a minor cosmetic defect can result in a major positive
change, substantially increasing feelings of well-being and self-worth.
Many people hold jobs where appearance is important in the
workplace, even if the person is not a public figure. In any job that involves
interaction with others, people are apt to be judged to some degree by the
way they look. Encounters are often fleeting, so first impressions count. At
times of tenuous job security, people struggle to maintain whatever edge they
can. For some, retaining a youthful and pleasing appearance may be their means
of remaining competitive in a crowded marketplace.
