What’s Plastic About Plastic Surgery? Actually, quite a bit. But do you know why plastic surgery is called
“plastic"? While most people think that it’s because plastic materials (like
silicone) are used in plastic surgery, the term was in use long before implants
made of plastic were developed. Plastic actually refers to the strict definition
of the word: “capable of being molded or of receiving form." Used in the sense
of changing the position of skin and moving skin and tissue from one part of the
body to another, this meaning of plastic came to be used for the materials we
now call plastics, not the other way around. Plastic surgery itself is plastic:
new developments, technologies, and techniques emerge on a regular basis. This
first issue of the newsletter article will document and discuss five of the most
significant trends in plastic surgery.
1) More surgery through
smaller incisions, which means less scarring. Liposuction is the best
example of this trend. Virtually unknown thirty years ago, liposuction is now
the most commonly performed cosmetic surgery in the United States. Using
incisions that typically measure half an inch or less, nearly every part of the
body can be re-contoured. While the most common areas are the stomach, hips, and
thighs for women, and the chest, stomach, and love handles for men (and the
chin/neck for both!), it is also used on many other areas. Dramatic changes can
be effected with only minimal “evidence" being left behind. Another example is
the “transconjunctional lower lid blepharoplast," which is the removal of fat
bags under the eyes using small incisions placed inside the lower eyelid itself,
leaving nothing visible on the skin. This procedure is often combined with laser
resurfacing to tighten the skin. A third example is saline-filled breast
implants. This implant is inserted empty and then filled once it’s in place.
Compared with silicone implants, which come pre-filled, a similarly sized saline
implant can be inserted through a smaller incision, thereby leaving a smaller
scar.
2) Younger patients having smaller procedures, and dividing one
big procedure into several smaller ones. Instead of waiting until there
would be the most dramatic changes, patients are undergoing procedures at an
earlier age (i.e., a Maintenance philosophy). Aside from there being “less to
do" on younger patients, the recovery tends to be easier. Less time is therefore
lost from work and one’s regular routine. Similarly, instead of combining
several procedures into one big session, patients are more likely to have a
long-range plan for what they want to do, and have things done as they “arise".
Typically, this might be eyelid surgery in one’s thirties or forties and a
facelift in one’s forties or early fifties, with liposuction of the chin, BOTOX
and Collagen injections in between.
3) The diminished role of the
doctor as teacher It used to be that the doctor was the patient’s
primary – if not only – source of medical information. While the doctor remains
a key resource, the explosion of information available in books and magazine
articles and particularly on the Internet has changed the way information is
obtained. Patients routinely arrive at a consultation already knowing a lot
about the procedure(s) they’re interested in. This is really to everyone’s
advantage. Patients get a lot more out of a consultation when they already know
the basics. That way, they can use the time they spend with the doctor to see
how the generalities apply to them, to ask any specific questions they have,
and, in another function of the Consultation, to better assess the doctor and
his or her office staff. In brief, Sy Syms has it right: the ideal – for all
involved – is the “educated consumer".
4) Newer anesthetics that
facilitate outpatient procedures In the past few years a new group of
intravenous anesthetic agents have changed the way anesthesia can be
administered. While typically described as deep intravenous sedation, these
powerful but short-acting preparations allow people to be sedated to an
appropriately deep level for the procedure itself but then to wake up relatively
quickly. As an added benefit, they are associated with fewer side effects (such
as nausea). Traditional general anesthesia is still an excellent – and often the
best – choice, but the new anesthetics have facilitated another trend: more
outpatient and ambulatory procedures in a hospital, surgicenter, or in a
doctor’s office. While there are advantages and disadvantages with all
facilities in which plastic surgery is performed, the unmistakable trend is
toward outpatient procedures. Smaller, outpatient facilities, including doctor’s
offices, offer a level of privacy and personalized attentive care that can be
difficult for larger facilities, such as hospitals, to provide. The changes in
health care in general and the way hospitals are staffed and reimbursed have
also contributed to this phenomenon.
5) Increased Safety Advances in surgical technique and instrumentation as well as in monitoring
capabilities and anesthesia have combined to make plastic surgery safer then
ever before. For example, liposuction is now performed by first infusing a
wetting solution that contains lidocaine (a local anesthetic that decreases the
amount of anesthesia required) and epinephrine (which constricts the blood
vessels and decreases bleeding). The combination allows more fat to be removed
more safely than could be done previously when little or no fluid was injected
before the surgery. At the same time, new anesthesia equipment allows more
precise and careful monitoring of the patient during and after the surgery. An
example is the pulse oximeter which, through a clip placed on a finger, uses
light spectrometry to measure the oxygen concentration in the blood. This
sensitive instrument allows the anesthesia, particularly, the type that is used
commonly in plastic surgery, to be delivered more safely.
The plastic
nature of plastic surgery has made the procedures safer and more effective then
ever before. Like the lasers themselves, we can expect that plastic surgery will
continue to evolve “at the speed of light".
Located in New
York and serving the Upper East Side, Manhattan - NYC, and Long Island NY
areas, Board Certified Plastic Surgeon, Dr. Alan M. Engler, utilizes the latest
surgical techniques in his practice of Breast Augmentation, Breast Implants, and
Breast Enhancement surgery.
Disclaimer: All information on this site is provided for informational purposes only! By no means is any
information presented herein intended to substitute for the advice provided to you by any health care or other professional
or organization.
