Plastic SurgeryPlastic Surgery

What is Plastic Surgery?What is Plastic Surgery?

the term plastic surgery comes from the term plastic surgery comes from the Greek word "plastikos," which the Greek word "plastikos," which means to mold or to shapemeans to mold or to shape

branch of surgery, dealing with the branch of surgery, dealing with the remodelling of any portion of the remodelling of any portion of the human body that has been damaged human body that has been damaged or deformed or deformed

Types of Plastic SurgeryTypes of Plastic Surgery

Cosmetic SurgeryCosmetic Surgery

Reconstructive SurgeryReconstructive Surgery

Cosmetic plastic surgery:Cosmetic plastic surgery: Surgery Surgery designed primarily to enhance or designed primarily to enhance or improve the looks of an individual who improve the looks of an individual who may not have a gross deformity or may not have a gross deformity or physical impairmentphysical impairment

Abdominoplasty (or "tummy tuck"): reshaping and firming of the abdomen

Blepharoplasty (or "eyelid surgery"): Blepharoplasty (or "eyelid surgery"): Reshaping of the eyelidsReshaping of the eyelids

Rhinoplasty (or "nose job"): Rhinoplasty (or "nose job"): Reshaping of the noseReshaping of the nose

Mammoplasty Mammoplasty Breast augmentation (or "breast Breast augmentation (or "breast enlargement" enlargement"

Breast reduction: Removal of skin and Breast reduction: Removal of skin and glandular tissue. glandular tissue.

Breast lift (Mastopexy): Lifting or Breast lift (Mastopexy): Lifting or reshaping of breasts to make them less reshaping of breasts to make them less saggy, often after weight losssaggy, often after weight loss

Reconstructive SurgeryReconstructive Surgery

involves the restoration of function to involves the restoration of function to a damaged body part and the a damaged body part and the rebuilding of normal physical contours rebuilding of normal physical contours when parts of the body—such as the when parts of the body—such as the nose, jaw, ears, or fingers—are nose, jaw, ears, or fingers—are missing or disfigured missing or disfigured

Obtaining A Fine-Line ScarObtaining A Fine-Line Scar

The final appearance of a scar is dependent The final appearance of a scar is dependent on many factors:on many factors:

(1) the type of skin and location on the body.(1) the type of skin and location on the body. (2) the tension on the closure.(2) the tension on the closure. (3) the direction of the wound.(3) the direction of the wound. (4) co-morbid conditions.(4) co-morbid conditions. (5) the technique used for closure. (5) the technique used for closure.

Minimizing damage to the skin edges with Minimizing damage to the skin edges with atraumatic technique, debridement of atraumatic technique, debridement of necrotic or foreign material.necrotic or foreign material.

Intrinsic FactorsIntrinsic Factors

1.Age. Loss of elasticity combined with changes in 1.Age. Loss of elasticity combined with changes in the subcutaneous tissue, produce wrinkling, which the subcutaneous tissue, produce wrinkling, which makes scars in older individuals less obvious and makes scars in older individuals less obvious and less prone to stretching. less prone to stretching.

2.Type of skin . Skin that is oily or pigmented, or 2.Type of skin . Skin that is oily or pigmented, or both, produces more unsightly scars.both, produces more unsightly scars.

3.Certain anatomic areas produce unfavorable scars 3.Certain anatomic areas produce unfavorable scars that tend to become hypertrophic or widened. The that tend to become hypertrophic or widened. The shoulder and sternal area are notable examples. shoulder and sternal area are notable examples. On the other hand, eyelid scars almost always On the other hand, eyelid scars almost always heal with a fine-line scar. heal with a fine-line scar.

4.Nutritional status can affect wound healing. 4.Nutritional status can affect wound healing. 5.Co-morbid conditions such as anemia can retard 5.Co-morbid conditions such as anemia can retard

wound healing. . wound healing. .

Factors determine the severity of Factors determine the severity of suture markerssuture markers

1.Time of removal of stitches . 1.Time of removal of stitches .

2.diameter of the suture .2.diameter of the suture .

3. Relation to wound edges.3. Relation to wound edges.

4. Region of the body.4. Region of the body.

5.Absence of infection.5.Absence of infection.

6. Propensity for keloid. 6. Propensity for keloid.

Features of good scarFeatures of good scar

1- Fine line scar 1- Fine line scar

2- absence of contour irregularities2- absence of contour irregularities

3- absence of pigmentary irregularities3- absence of pigmentary irregularities

4- no contracture or distortion 4- no contracture or distortion

Methods of ExcisionMethods of Excision

1.Simple Elliptical Excision1.Simple Elliptical Excision2.Wedge Excision 2.Wedge Excision Lesions located at or adjacent to free margins can be Lesions located at or adjacent to free margins can be

excised by wedge excisions. excised by wedge excisions. 3.Circular Excision 3.Circular Excision When preservation of the skin is required in areas When preservation of the skin is required in areas

such as the nose or the anterior surface of the such as the nose or the anterior surface of the auricle, the lesion can be excised in a circular auricle, the lesion can be excised in a circular manner and the defect closed with a skin graft or manner and the defect closed with a skin graft or skin flap . skin flap .

4.Multiple Excision Technique 4.Multiple Excision Technique Serial excision is frequently employed for large Serial excision is frequently employed for large

lesions lesions

Reconstructive Ladder

Secondary Intention

Primary Suturing

Delay Primary Suturing

Secondary Suturing

Skin Graft

Flap

-Local -regional -Distant -Free

Secondary Intention

Primary Suturing

Delay primary suturing

Skin Graft

Flap