Plastic surgery

Plastic Surgery Overview

  • Presenter: Pavlovics Gábor

  • Institution: University of Pécs, Department of Surgery

Fields of Plastic Surgery

  • Reconstructive: Restoration of lost tissues after injuries or cancer surgeries.

  • Burns: Treatment and correction following severe burn injuries.

  • Correction: Addressing congenital deformities (e.g., cleft lip, syndactyly).

  • Aesthetic (Cosmetic) Procedures: Enhancements for aesthetic purposes.

Historical Approaches

Indian and Italian Flaps

  • Indian Flap (Forehead Flap): Used historically for reconstructive purposes dating back to 2000 B.C.

  • Italian Flap: Gasparo Tagliacozzi notably advanced techniques in the late 1500s.

World Wars Era

  • The period of 1900-1960 marks significant advancements in plastic surgery, particularly during World War I-II.

Basic Techniques in Plastic Surgery

  • Tissue Transfer: Involves moving skin, cartilage, fascia, or bones for reconstruction.

  • Flap Types:

    • Random Flaps

    • Tubed Flaps

    • Axial Pattern Flaps

Principles of Plastic Surgery

  • Optimal Incision Lines: Important for healing and aesthetic outcomes.

  • Tissue Handling: Atraumatic techniques to minimize damage.

  • Incision Perception: Natural skin features (Langer’s lines) play a crucial role in incision placement.

Wound Closure Techniques

  • Closure should be atraumatic, layered, and minimize tension.

  • Suture Types:

    • Single Interrupted Sutures

    • Transdermal Running

    • Intradermal Running

Methods of Soft Tissue Reconstruction

  • Free Grafts: Detached tissue moved to a new location.

  • Tissue Expansion: Stretching tissue for more coverage, with no donor site morbidity.

  • Flaps: Local or distant flaps moved to cover defects.

Selecting Reconstruction Techniques

  • Considerations include:

    • Size and depth of defect

    • Blood supply conditions

    • Previous surgical history

Specific Techniques Overview

  • Skin Grafts: For burns and skin cancer.

  • Tissue Expansion: Used for congenital or traumatic defects, enhancing surrounding tissue before reconstruction.

  • Local Flaps: Transferring tissue with its blood supply from a nearby area (e.g., rotational and V-Y flaps).

Aesthetic Surgery Statistics (2015)

  • Top Surgical Procedures:

    • Breast Augmentation: 279,143 procedures

    • Liposuction: 222,051 procedures

    • Rhinoplasty: 217,979 procedures

  • Top Non-Surgical Procedures:

    • Botox: 6.7 million treatments

    • Soft Tissue Fillers: 2.4 million treatments

Procedure Examples

  • Abdominoplasty: Skin incision following swimwear lines.

  • Blepharoplasty: Correcting eyelid excess, usually under local anesthesia.

  • Otoplasty: Surgical correction for protruding ears, also performed under local anesthesia.