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Plastic Surgery: The History, Definition and Characteristics, the Advancements

Abstract

Plastic surgery is a procedure, aimed at reshaping or reconstructing different body parts for medical or cosmetic purposes. The phenomenon appeared as a result of a constant desire of people to look better. The first techniques of improving the appearances are traced back to ancient times and became the basis for many types of modern technologies. However, today, there has been a significant development, which opened more opportunities for people to eliminate numerous defects and raise the level of satisfaction and the quality of life together with decreasing the risks for poor outcomes. Due to multiple advancements in this sphere, people receive possibilities for improving their health and coping with the early aging signs. However, there remain certain risks as these procedures involve surgical interference and serious medications, which may cause an unpredictable reaction of the organism.

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Introduction

Plastic surgery is a medical procedure aimed at eliminating defects or improving different parts of the human body for cosmetic or medical purposes. This process may be required in cases of serious trauma or injuries. However, it is also widely used for making people look better, and this option has become more popular during the last decades as science has gone through significant development. Today, surgeons all over the world offer a wide range of services for improving the appearance of people, including such procedures as facelift, lip augmentation, breast reconstruction, liposuction, and many others. Plastic surgery has seriously evolved since its initial appearance in ancient times and today, it offers numerous opportunities, lowering possible risks, connected with these types of operations.

The History of Plastic Surgery

Since the appearance of humanity, people have been constantly interested in various types of self-improvement, and plastic surgery is considered to be one of the world’s oldest medical procedures. There is documentation of physicians in ancient India using surgery for reconstructing a nose with a piece of cheek skin as early as 800 B.C. (Kita, 2020). However, further progress was slow and the next proof can be found in the Greco-Roman period. At that time, medical writer Aulus Cornelius Celsus wrote De Medicina, which described methods for surgical reconstruction of ears, lips, and noses (Kita, 2020). Then, during the early Byzantine period, Oribasius made a 70-volume medical encyclopedia, titled Synagogue Medicae, which contained much information about the techniques to repair facial defects (Kita, 2020). In the next period, the renaissance, a significant improvement of surgical protocols occurred. In the 15th century, the description of a technique for the treatment of gynecomastia appeared which is thought to be the basis of modern operation for breast reduction (Royal Centre of Plastic Surgery, n.d.). All these documentations prove that plastic surgery appeared in ancient times and part of the findings of those times is used up to the present.

The biggest improvements of plastic surgery, relevant for its history, are traced back to the years of the First World War. At that period, reconstructive surgery became a necessity as physicians had to treat multiple facial and head injuries. During that time, people realized that an individual’s appearance could have an influence on their success in life, which led to the appearance of more complex procedures, a greater understanding of anesthesia, and the importance of infection prevention. It became the time of the first procedures, which had cosmetic purposes: first rhinoplasty and breast augmentation (Kita, 2020). During the last few centuries, the development of plastic surgery has become especially rapid. In 1946, the first journal, devoted to reconstructive surgery appeared and this area of medicine became “fully integrated into the medical establishment by 1950” (Kita, 2020, para. 18). At that period, the first breast implant made from silicone appeared and the material became popular all over the world. Since then, there appeared multiple research, new materials, and better techniques, which made plastic surgery widely used by people all over the world for hiding visible signs of aging and improving defects and nuances of the appearance.

Definition and Characteristics of Plastic Surgery

Definition and Types of Plastic Surgery

Plastic surgery has become popular among people during the last century. According to the definition of Merriam-Webster dictionary, it is “a branch of concerned with improving the function or appearance of parts of the body through reconstructive or cosmetic medical procedures and a procedure performed for such a purpose” (2021). There are a few types of surgeries, working with different parts of the body. A big range of opportunities exist for the head, face, and eyes improvements, including facelift, eyelid or brow lift, ear pinning or reshaping, hair replacement, nasal surgery and nose reshaping, chin, cheek, or jaw facial implants, lip augmentation (Stanford Health Care, n.d.). For mouth and teeth, there are oral and maxillofacial surgeries and abdominoplasty, and liposuction for the abdomen. For breasts, surgeons offer operations of augmentation, reconstruction, lifting, and reduction in men with gynecomastia. A wide choice of services is also available for skin and includes such procedures as a chemical peel, dermabrasion or dermaplaning, collagen/fat injectable fillers, Botox or filler injections, glycolic and laser peels, scar revision, and tattoo removal (Stanford Health Care, n.d.). There are options for performing surgery on almost all the parts of the human body, allowing eliminating visible defects or making the appearance better.

Advantages of Plastic Surgery

Plastic surgery provides numerous opportunities for people with various disabilities and diseases. For example, it may help the person to restore an arm or leg, remove skin cancer or close an open wound. It has also become popular for cosmetic purposes as it provides numerous options for improving one’s appearance. There are many motives behind the surgery, such as removing birthmarks or scars, reshaping noses, cheeks, and other parts of the body. The main purpose of cosmetic plastic surgery is to enhance self-confidence and increase the quality of life. Moreover, an operation is often a way, which helps to improve the individual’s health. For example, rhinoplasty surgery can not only change the shape of the nose but may help with respiratory problems. In addition, another important advantage is that it is permanent and the result of the operation will remain with the person for a lifetime. From these perspectives, plastic surgery offers numerous opportunities for people to begin looking and feeling better. However, there are certain risks behind this interference, which may become an obstacle on the way to the desired result.

Risks of Plastic Surgery

One of the most important risks of plastic surgery is complications as any interference into the work of the organism can bring unpleasant consequences, including serious diseases and even death. There is also a chance of a mistake, even though today, medicine has shown serious progress in the area. For example, a facelift can lead to permanent nerve damage, which can result in facial paralysis. Another serious disadvantage of plastic surgery is that it can become an addiction and change the patient’s state of mind. In certain cases, people may develop Body Dysmorphic Disorder (BDD) which is characterized by a continuous search for flaws with the appearance (Flawless, 2019). Finally, there is also the risk of receiving bad results after the procedure as multiple side effects are individual and cannot be predicted. In many situations, a person may begin to look worse after the operation. A consultation with a good doctor before making the final decision about plastic surgery is necessary to learn about the possible outcomes. However, there is still a chance that the body of a certain person may react unpredictably to the used medications and materials.

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Statistics of Plastic Surgery

The popularity of plastic surgery for cosmetic purposes has been increasing for the past decades. According to the statistics of The International Society of Aesthetic Plastic Surgery (ISAPS), in 2019, there were 11,363,569 surgical procedures and 13,618,735 nonsurgical ones performed in the world (2019). Brazil was stated to be the country with the biggest number of surgical procedures, while the United States appeared to be on the top of the list with non-surgical operations (ISAPS, 2019). Among the leading surgical procedures are breast augmentation, liposuction, eyelid surgery, abdominoplasty, and rhinoplasty (ISAPS, 2019). The most popular non-surgical operations are botulinum toxin, hyaluronic acid, hair removal, non-surgical fat reduction, and photo rejuvenation (ISAPS, 2019). According to experts’ estimations, the popularity of plastic surgery continues to grow by approximately 7 percent each year. This increase is connected with the advancements the branch has made during the last decades, lowering the chances of complications development and providing people with multiple opportunities for health and appearance improvement.

The Advancements of Plastic Surgery

Neuromodulators for Facial Rejuvenation

The use of neuromodulators for facial rejuvenation has been rapidly growing in the past years due to its non-invasive nature. According to the estimations, it has increased by approximately 750 percent from 2000 to 2014 (American Society of Plastic Surgeons [ASPS], 2016a). Injections of a botulinum toxin, widely known as Botox, are one of the leading beauty procedures all over the world (Stewards, 2018). The substance was discovered in 1987 by two Canadian doctors, who found “the offbeat uses of toxins, which were generally used only in the case of severe spasms” (Stewards, 2018, para. 5). Their findings revealed that these toxins help to reduce the appearance of wrinkles when used in small quantities. Since then, beauty procedures involving Botox have gained popularity due to its effectiveness and non-invasive way of treatment. There are also two other products, used for the same purposes: abobotulinum toxin A (Dysport) and incobotulinum toxin A (Xeomin) (ASPS, 2016a). All three substances are officially approved for the treatment of “frown lines” and “crow’s feet” (ASPS, 2016a). From this perspective, fighting wrinkles is the main purpose of the neurotoxins’ use.

However, Botox injections are also used for treating multiple other conditions, which can cause serious problems for a person. They include neck spasms, excessive sweating (hyperhidrosis), an overactive bladder, and chronic migraines (Mayo Clinic, n.d.). When doctors began using the substance for medical purposes, there were originally many negative outcomes. However, modern technologies allow surgeons to focus on a single area when making injections with neuromodulators without causing side effects to closely situated parts of the body. A qualified plastic surgeon should have a good understanding of the facial muscles, the right dose of neurotoxin, and injection technique to make the procedure properly and receive the desired effect. Recently, the only risk from using Botox and other toxins is connected with the incorrect use, when performed by a non-qualified person, who does not possess the necessary skills and knowledge.

Dermal Fillers

Dermal fillers, also known as injectable implants, soft tissue fillers, or wrinkle fillers, are another popular procedure, which is proven to have a lasting effect and underwent significant development. This practice appeared in 1893 when a doctor named Neuber experimented with fat collected from his patient’s arms and used it to fill in gaps formed by facial defects (Stewards, 2018). In the middle of the 20th century, fat fillers were replaced with silicon-based ones. However, it was banned from use until 1992 due to serious complications, which were found in the patients. During the seventies, there also was a significant increase in the use of animal collagens in implants or injections (Stewards, 2018). Today, dermal fillers have been thoroughly tested and were approved by the U.S. Food & Drug Administration (FDA) for creating a smoother appearance in the face, including nasolabial folds, cheeks, chin, lips, and back of the hands (FDA, 2020). Thanks to this advancement of plastic surgery, it is now known as a convenient and relatively safe method of eliminating visible skin defects for a long period of time.

Tumescent and Ultrasound Liposuction

A serious development occurred in the area of liposuction, a procedure aimed at removing fat, which cannot be got rid of with the help of diet and exercise. This method can be used for treating thighs, hips, abdomen, waist, upper arms, back, chest area, cheeks, chin, calves, and neck. Liposuction appeared in 1985 and has undergone many changes to become safer for patients not to cause serious complications (Stewards, 2018). Among the advancement of this branch of plastic surgery is tumescent liposuction. This operation can be performed only with local anesthesia and during the procedure, the surgeon “injects specialized solution beneath the fat layers of the skin” (Stewards, 2018, para. 9). The technique requires special skill as there is a need for a targeted action to cut down fat as rapidly as possible. One of the most important advantages of this type of liposuction is minimal bruising.

Another advancement of liposuction is the use of high density focused ultrasound to remove fat and tighten tissue under the skin. The technology is characterized by the destruction of fat cells, which are “either metabolized as calories or processed through the liver as waste, along with normal dietary fats” (Aesthetic Reconstructive Center [ARC], n.d., para. 4). There are two different types of this procedure: internal and external ultrasonic liposuction (ASPS, 2016b). The first method is characterized by the insertion of a probe into the patient, which breaks up fat in problem areas with the help of vibrations. External type requires the use of a “paddle-like tool to emit sonic vibrations outside the body and through the skin” (ASPS, 2016b, para. 6). Both of the technologies, ultrasound and tumescent, allow eliminating extra fat with minimal risks of complications.

Another advancement, which made a revolution in the area of fat reduction, was recently approved by the FDA. It happened in 2010 when Zeltiq’s CoolSculpting device was permitted to be used for the procedure of cryolipolysis, also known as fat freezing (American Board of Cosmetic Surgery [ABCS], 2020). It is a non-surgical operation, which is now widely used throughout the world. According to the estimations, today, there are more than 350,000 patients receiving the procedure each year (ABCS, 2020). This method of fat reduction is convenient and has minimal risks for health, although, it takes months before the result can be seen as this procedure cannot shape the body as it does surgical liposuction. From this perspective, the advancements in the sphere of fat reduction made a serious contribution to the plastic surgery protocols, allowing doctors to help their patients fight with an extra weight with a relatively low risk of complications.

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Stem Cells

During the last few decades, there was a big interest in stem cells and their possible application in fat transfer and reconstructive surgery. This is the concept, which is supposedly opening new frontiers to plastic surgery. Stem cells can be “harvested to regenerate cells and tissues in the human body” (North Down Hospital, n.d., para. 7). Today, there are multiple types of research in such areas as burn care, for restoring skin layers after burn injury, breast reconstruction for breast cancer survivors, nerve regeneration after nerve injury, scar treatment, and hand and face transplantation (North Down Hospital, n.d.). Experts hope that in the future these technologies will be used in combination with tissue engineering to create new body parts for patients and will be able to restore shape and function. Due to the advancement of stem cells technologies, there are numerous opportunities, which are already available and more than can be revealed in the future to contribute to the health and appearance restoring of the human body.

Laser Therapy

Another important technology, which has undergone serious development, is lasers. This type of therapy is useful for a big variety of problems, from tattoos to varicose vein removal. The procedure is characterized by the use of short, concentrated beams of light (ARC, n.d.). One of the procedures, which has become possible due to the advancements in the sphere of laser technologies, is skin resurfacing, also known as a laser peel, laser vaporization, and lasabrasion (ASPS, n.d.). This method is used for reducing facial wrinkles, scars, and blemishes. The most advanced technologies allow surgeons to have more control during the procedure as it guarantees a high level of precision, which is important, especially for delicate areas.

Endoscopy

Endoscopy is another rapidly developing segment, which provides plastic surgeons with multiple opportunities in the procedures requiring especially high precision. This technology is represented by a small camera (endoscope), which is inserted through a small incision for the doctor to see the external tissue without completely opening the area (ARC, n.d.). This technique allows reducing the time for recovery, evades the appearance of big scars, and lowers the risks of incision-associated infections. Due to the appearance of endoscope and its application in plastic surgery, surgeons received an opportunity of controlling the process of multiple operations, which were previously done blindly.

Radiofrequency

Radiofrequency (RF) is a quickly developing sphere with high hopes of consumers and surgeons. This method promises skin tightening without surgery and is proven to increase collagen production (ABCS, 2020). The technology is also used in microneedling, which gained popularity in the 2010s (ABCS, 2020). This advancement increased the potential collagen-boosting effects of microneedling and provided such benefits as visible reduction of wrinkles and scars. The procedure became widely used due to its minimal invasiveness or completely non-surgical nature, depending on the method. The technology is beneficial for multiple problems from facial rejuvenation to body contouring and can help in treating such conditions as cellulite or acne. Radiofrequency energy was proven to be safe and effective, although, there is a slight chance of complications for patients with thin skin, autoimmune diseases, or those taking anti-inflammatory medications.

IPL

Another technology, which has been developing in the last decades, and gained popularity, is beneficial for people struggling with broken capillaries, acne, and severe wrinkles. The method is called intense pulsating light (IPL) and is widely known for being used for hair removal (Stewards, 2018). The procedure became popular due to its nature as it destroys the hair roots or hair follicles completely and permanently (Stewards, 2018). The method is characterized by a high price, although, it remains one of the leading beauty procedures due to its reliability and long-lasting effect. The technology is also useful for treating the skin. Such issues as hyperpigmentation as the result of skin being sensitive and damaged by the sun, liver spots, enlarged blood vessels, or pores can be healed with the help of IPL (Stewards, 2018). It should be made by a qualified doctor as well as all the other procedures as it requires special skill and knowledge. In this case, the technique will be beneficial and will not cause unnecessary complications.

Conclusion

Plastic surgery is an area, which appeared in ancient times as people were always interested in procedures, helping to change their appearance and eliminate defects. Today, the branch provides numerous options including such procedures as lip and breast augmentation, facelift, liposuction, reshaping of eyes, ears, cheeks, and other parts of the body, and many others. It helps people, who have defects due to various trauma or injuries, as well as those who want to change their appearance for cosmetic purposes. Plastic surgery is divided into two types: surgical and non-surgical and each of the existing procedures has its advantages and risks. Among the disadvantages are high costs, possible side effects and complications, a chance of Body Dysmorphic Disorder development, and the unpredictability of the outcome. However, it also provides numerous opportunities, often increasing the person’s self-esteem and quality of life.

The modern advancements in medicine and plastic surgery, in particular, have contributed to the reduction of potential risks from beauty procedures. Due to the development of such technologies as lasers, endoscope, and radiofrequency, the interference to the body became less damaging, involves fewer complications, makes the process of recovery quicker, and does not leave big scars. The advancements in such areas as liposuction and fillers permitted people to have serious improvements of their appearance without major risks. Modern technologies require skillful surgeons, who possess knowledge about the medications, correct doses, and methods of injection. In case the doctor is qualified for such beauty procedures, the chances for complications developments are low. From this perspective, plastic surgery can serve its purpose of improving the quality of life of millions of people all over the world. Moreover, new advancements in the sphere appear almost every year and, according to the experts’ expectations, technologies will be developing further and will lead to numerous opportunities such as creation of new body parts.

References

The American Board of Cosmetic Surgery. (2020). Top 6 cosmetic advancements of the last decade (and a hint of what’s to come). Web.

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American Society of Plastic Surgeons. (2016a). Experts demonstrate ‘advances and refinements’ in neuromodulators for facial rejuvenation. Web.

American Society of Plastic Surgeons. (2016b). Ultrasonic liposuction vs traditional liposuction. Web.

American Society of Plastic Surgeons. (n.d.). What is laser skin resurfacing? Web.

Aesthetic Reconstructive Center. (n.d.). Advances in cosmetic surgery. Web.

Flawless. (2019). Advantages and disadvantages of cosmetic surgery. Web.

Kita, N. (2020). The history of plastic surgery. Verywell health. Web.

Mayo Clinic. (n.d.). Botox injections. Web.

Merriam-Webster. (2012). Plastic surgery. In Merriam-Webster’s Advanced Learner’s English Dictionary. Merriam-Webster. Web.

North Down Hospital. (n.d.). The future of cosmetic surgery. Web.

Royal Centre of Plastic Surgery. (n.d.). A brief history of plastic surgery. Web.

Stanford Health Care. (n.d.). Types of plastic surgery. Web.

Stewards, M. (2018). The latest advances in plastic surgery. Technology Marketing Corporation. Web.

The International Society of Aesthetic Plastic Surgery. (2019). ISAPS international survey on aesthetic / cosmetic procedures performed in 2019. Web.

U.S. Food & Drug Administration. (2020). Dermal fillers (soft tissue fillers). Web.

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