Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.

Etymology[link]

In the term plastic surgery, the adjective plastic denotes sculpting, and derives from the Greek πλαστική (τέχνη), plastikē (tekhnē), “the art of modelling” of malleable flesh.^[2]

History[link]

Walter Yeo, a British sailor, is often cited as the first known person to have benefited from plastic surgery. The photograph shows him before the procedure (left) and after (right) receiving a skin flap performed by Sir Harold Gillies in 1917.

Reconstructive surgery techniques were being carried out in India by 800 BC.^[3] Sushruta, the father of Surgery,^[4] made important contributions to the field of plastic and cataract surgery in 6th century BC.^[4] The medical works of both Sushruta and Charak originally in Sanskrit were translated into Arabic language during the Abbasid Caliphate in 750 AD.^[5] The Arabic translations made their way into Europe via intermediaries.^[5] In Italy the Branca family^[6] of Sicily and Gaspare Tagliacozzi (Bologna) became familiar with the techniques of Sushruta.^[5]

British physicians traveled to India to see rhinoplasties being performed by native methods.^[7] Reports on Indian rhinoplasty performed by a Kumhar vaidya were published in the Gentleman's Magazine by 1794.^[7] Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods.^[7] Carpue was able to perform the first major surgery in the Western world by 1815.^[8] Instruments described in the Sushruta Samhita were further modified in the Western world.^[8]

Aulus Cornelius Celsus, who lived in the first century AD, described plastic surgery of the face, using skin from other parts of the body

The ancient Egyptians and Romans also performed plastic cosmetic surgery. The Romans were able to perform simple techniques, such as repairing damaged ears from around the 1st century BC. For religious reasons, they did not dissect either human beings or animals, thus their knowledge was based in its entirety on the texts of their Greek predecessors. Notwithstanding, Aulus Cornelius Celsus left some surprisingly accurate anatomical descriptions,^[9] some of which — for instance, his studies on the genitalia and the skeleton — are of special interest to plastic surgery.^[10]

In 1465, Sabuncuoglu's book, description, and classification of hypospadias was more informative and up to date. Localization of urethral meatus was described in detail. Sabuncuoglu also detailed the description and classification of ambiguous genitalia.^{[citation needed]} In mid-15th century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgery became common.

Up until the techniques of anesthesia became established, surgeries involving healthy tissues involved great pain. Infection from surgery was reduced by the introduction of sterile techniques and disinfectants. The invention and use of antibiotics, beginning with sulfonamide and penicillin, was another step in making elective surgery possible.

In 1792, Chopart performed operative procedure on a lip using a flap from the neck. In 1814, Joseph Carpue successfully performed operative procedure on a British military officer who had lost his nose to the toxic effects of mercury treatments. In 1818, German surgeon Carl Ferdinand von Graefe published his major work entitled Rhinoplastik. Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap.

The first American plastic surgeon was John Peter Mettauer, who, in 1827, performed the first cleft palate operation with instruments that he designed himself. In 1845, Johann Friedrich Dieffenbach wrote a comprehensive text on rhinoplasty, entitled Operative Chirurgie, and introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose.

In 1891, American otorhinolaryngologist John Roe presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892, Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896, James Israel, a urological surgeon from Germany, and in 1889 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects. In 1898, Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty. In 1928, Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik.

20th century[link]

In World War I, a New Zealand otolaryngologist working in London, Harold Gillies developed many of the techniques of modern facial surgery in caring for soldiers suffering from disfiguring facial injuries. Kazanjian and Blair, two men hired for plastic surgery by the United States army, learned from Gillies in England.^[11] His work was expanded upon during World War II by his cousin and former student Archibald McIndoe, who pioneered treatments for RAF aircrew suffering from severe burns. McIndoe's radical, experimental treatments, led to the formation of the Guinea Pig Club. In 1946, Gillies carried out the first female-to-male sex reassignment surgery.

Techniques and procedures[link]

In plastic surgery, the transfer of skin tissue (skin grafting) is a very common procedure. Skin grafts can be taken from the recipient or donors:

• Autografts are taken from the recipient. If absent or deficient of natural tissue, alternatives can be cultured sheets of epithelial cells in vitro or synthetic compounds, such as integra^{[disambiguation needed ]}, which consists of silicone and bovine tendon collagen with glycosaminoglycans.
• Allografts are taken from a donor of the same species.
• Xenografts are taken from a donor of a different species.

Usually, good results are expected from plastic surgery that emphasizes careful planning of incisions so that they fall in the line of natural skin folds or lines, appropriate choice of wound closure, use of best available suture materials, and early removal of exposed sutures so that the wound is held closed by buried sutures.

Reconstructive surgery[link]

Navy doctors perform reconstructive surgery on a 21-year-old patient

Reconstructive plastic surgery is performed to correct functional impairments caused by burns; traumatic injuries, such as facial bone fractures and breaks; congenital abnormalities, such as cleft palates or cleft lips; developmental abnormalities; infection and disease; and cancer or tumors. Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance.

The most common reconstructive procedures are tumor removal, laceration repair, scar repair, hand surgery, and breast reduction. According to the American Society of Plastic Surgeons, the number of reconstructive breast reductions for women increased in 2007 by 2 percent from the year before. Breast reduction in men also increased in 2007 by 7 percent. Some other common reconstructive surgical procedures include breast reconstruction after a mastectomy, cleft lip and palate surgery, contracture surgery for burn survivors, and creating a new outer ear when one is congenitally absent.

Plastic surgeons use microsurgery to transfer tissue for coverage of a defect when no local tissue is available. Free flaps of skin, muscle, bone, fat, or a combination may be removed from the body, moved to another site on the body, and reconnected to a blood supply by suturing arteries and veins as small as 1 to 2 millimeters in diameter.

Cosmetic surgery[link]

Rhinoplasty or Nose Surgery

Aesthetic plastic surgery can also be called as Medical aesthetics involves techniques intended for the "enhancement" of appearance through surgical and medical techniques, and is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal.

In 2006, nearly 11 million cosmetic procedures were performed in the United States alone. The number of cosmetic procedures performed in the United States has increased over 50 percent since the start of the century. Nearly 12 million cosmetic procedures were performed in 2007, with the five most common surgeries being breast augmentation, liposuction, nasal surgery, eyelid surgery and abdominoplasty. The American Society for Aesthetic Plastic Surgery looks at the statistics for thirty-four different cosmetic procedures. Nineteen of the procedures are surgical, such as rhinoplasty or facelift. The nonsurgical procedures include Botox and laser hair removal. In 2010, their survey revealed that there were 9,336,814 total procedures in the United States. Of those, 1,622,290 procedures were surgical (p. 5). They also found that a large majority, 81%, of the procedures were done on Caucasian people (p. 12).^[12] The increased use of cosmetic procedures crosses racial and ethnic lines in the U.S., with increases seen among African-Americans and Hispanic Americans as well as Caucasian Americans. In Europe, the second largest market for cosmetic procedures, cosmetic surgery is a $2.2 billion business.^[13] Cosmetic surgery is now very common in countries such as the United Kingdom, France, and Germany. In Asia, cosmetic surgery has become an accepted practice, and China, followed by India has become Asia's biggest comestic surgery markets.^[14] Children undergoing cosmetic eye surgery can be seen in Japan and South Korea.^[15][16]

The most prevalent aesthetic/cosmetic procedures include:

• Abdominoplasty ("tummy tuck"): reshaping and firming of the abdomen
• Blepharoplasty ("eyelid surgery"): reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty
• Phalloplasty ("penile liposuction") : construction (or reconstruction) of a penis or, sometimes, artificial modification of the penis by surgery, often for cosmetic purposes
• Mammoplasty:
  • Breast augmentations ("breast implant" or "boob job"): augmentation of the breasts by means of fat grafting, saline, or silicone gel prosthetics, which was initially performed to women with micromastia
  • Reduction mammoplasty ("breast reduction"): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with gigantomastia and/or for psychological benefit men with gynecomastia
  • Mastopexy ("breast lift"): Lifting or reshaping of breasts to make them less saggy, often after weight loss (after a pregnancy, for example). It involves removal of breast skin as opposed to glandular tissue
• Buttock augmentation ("butt implant"): enhancement of the buttocks using silicone implants or fat grafting ("Brazilian butt lift") and transfer from other areas of the body
  • Buttock lift: lifting, and tightening of the buttocks by excision of redundant skin
• Chemical peel: minimizing the appearance of acne, chicken pox, and other scars as well as wrinkles (depending on concentration and type of agent used, except for deep furrows), solar lentigines (age spots, freckles), and photodamage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid (AHA), or salicylic acid (BHA) as the active agent.
• Labiaplasty: surgical reduction and reshaping of the labia
• Lip enhancement: surgical improvement of lips' fullness through enlargement
• Rhinoplasty ("nose job"): reshaping of the nose
• Otoplasty ("ear surgery"/"ear pinning"): reshaping of the ear, most often done by pinning the protruding ear closer to the head.
• Rhytidectomy ("face lift"): removal of wrinkles and signs of aging from the face
  • Browplasty ("brow lift" or "forehead lift"): elevates eyebrows, smooths forehead skin
  • Midface lift ("cheek lift"): tightening of the cheeks
• Chin augmentation ("chin implant"): augmentation of the chin with an implant, usually silicone, by sliding genioplasty of the jawbone or by suture of the soft tissue
• Cheek augmentation ("cheek implant"): implants to the cheek
• Orthognathic Surgery: manipulation of the facial bones through controlled fracturing
• Fillers injections: collagen, fat, and other tissue filler injections, such as hyaluronic acid
• Laser skin resurfacing
• Liposuction ("suction lipectomy"): removal of fat deposits by traditional suction technique or ultrasonic energy to aid fat removal

Sub-specialties[link]

Plastic surgery is a broad field, and may be subdivided further. Plastic surgery training and approval by the American Board of Plastic Surgery includes mastery of the following as well:

Burn

Burn surgery generally takes place in two phases. Acute burn surgery is the treatment immediately after a burn. Reconstructive burn surgery takes place after the burn wounds have healed.

Cosmetic

Aesthetic surgery is an essential component of plastic surgery. Plastic surgeons use cosmetic surgical principles in all reconstructive surgical procedures as well as isolated operations to improve overall appearance.^[17]

Craniofacial

Craniofacial surgery is divided into pediatric and adult craniofacial surgery. Pediatric craniofacial surgery mostly revolves around the treatment of congenital anomalies of the craniofacial skeleton and soft tissues, such as cleft lip and palate, craniosynostosis, and pediatric fractures. Adult craniofacial surgery deals mostly with fractures and secondary surgeries (such as orbital reconstruction) along with orthognathic surgery. Craniofacial surgery is an important part of all plastic surgery training programs, further training and subspecialisation is obtained via a craniofacial fellowship.

Hand

Hand surgery is concerned with acute injuries and chronic diseases of the hand and wrist, correction of congenital malformations of the upper extremities, and peripheral nerve problems (such as brachial plexus injuries or carpal tunnel syndrome). Hand surgery is an important part of training in plastic surgery, as well as microsurgery, which is necessary to replant an amputated extremity. The Hand surgery field is also practiced by orthopedic surgeons and general surgeons (see Hand surgeon). Scar tissue formation after surgery can be problematic on the delicate hand, causing loss of dexterity and digit function if severe enough. Permanently erasing fingerprints can be done using plastic surgeries, especially criminals would do it on purpose to erase their criminal record. This can be done using a variety of ways, ranging from simply burning the fingertips using acids, to advanced techniques such as undergoing a plastic surgery^[18].^{[19][20][21][22]}. Some people might be born without any finger- or toe- prints, this is a rare medical condition termed as adermatoglyphia.

Micro

Microsurgery is generally concerned with the reconstruction of missing tissues by transferring a piece of tissue to the reconstruction site and reconnecting blood vessels. Popular subspecialty areas are breast reconstruction, head and neck reconstruction, hand surgery/replantation, and brachial plexus surgery.

Pediatric

Children often face medical issues very different from the experiences of an adult patient. Many birth defects or syndromes present at birth are best treated in childhood, and pediatric plastic surgeons specialize in treating these conditions in children. Conditions commonly treated by pediatric plastic surgeons include craniofacial anomalies, cleft lip and palate and congenital hand deformities.

Plastic surgery obsession[link]

With increased media attention on beauty and perfection, celebrities and those alike are turning to plastic surgery more and more. Some take out loans for this purpose; one woman spent over $83,000 for 14 surgeries.^[23]

Though media and advertising do play a large role in influencing many people's lives, researchers believe that plastic surgery obsession is linked to psychological disorders.^[24] Body dysmorphic disorder is seen as playing a large role in the lives of those who are obsessed with going under the knife in order to achieve physical perfection.

BDD is a disorder resulting in the sufferer becoming “preoccupied with what they regard as defects in their bodies or faces.” While 2% of people suffer from body dysmorphic disorder in the United States, 15% of patients seeing a dermatologist and cosmetic surgeons have the disorder.Half of the patients with the disorder who have cosmetic surgery preformed are not pleased with the aesthetic outcome. BDD can lead to suicide in some of its sufferers. While many with BDD seek cosmetic surgery, the procedures do not treat BDD, and can ultimately worsen the problem. The psychological root of the problem is usually unidentified; therefore causing the treatment to be even more difficult. Some say that the fixation or obsession with correction of the area could be a sub-disorder such as anorexia or muscle dysmorphia.^[25]

In some cases, people whose doctors refuse to perform any further surgeries, have turned to "do it yourself" plastic surgery, injecting themselves and running extreme safety risks.^[26]

See also[link]

• Biomaterial
• Body modification
• Botox
• Breast implant
• Breast lift
• Journal of Cutaneous and Aesthetic Surgery
• Laser Resurfacing
• Otolaryngology

References[link]

Further reading[link]

• Santoni-Rugiu, Paolo (2007). A History of Plastic Surgery. Springer. ISBN 3-540-46240-6. 
• Fraser, Suzanne (2003). Cosmetic surgery, gender and culture. Palgrave. ISBN 1-4039-1299-8. 
• Gilman, Sander (2005). Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery. Duke University Press. ISBN 0-8223-2144-0. 
• Haiken, Elizabeth (1997). Venus Envy: A History of Cosmetic Surgery. Johns Hopkins University Press. ISBN 0-8018-5763-5. 
• Abby Ellin, "Have Fat, Will Fight It," The New York Times

External links[link]

Media related to Plastic surgery at Wikimedia Commons

Heidi Montag
Montag attending the Girls Gone Wild Magazine second-issue party in Hollywood in June 2008.
Born	Heidi Blair Montag (1986-09-15) September 15, 1986 (age 25) Crested Butte, Colorado, United States[1]
Other names	Heidi Pratt (married name)
Occupation	Reality television personality, recording artist, fashion designer
Years active	2005–present
Television	The Hills (2006-2010) Famous Food (2011)
Spouse	Spencer Pratt (2009-present)
Relatives	Holly Montag (sister) Stephanie Pratt (sister in-law)

Heidi Blair Pratt (née Montag; born September 15, 1986) is an American media personality and singer. She came to prominence with her starring role on the MTV reality series The Hills from 2006 to 2010. In 2007, Montag began working on her debut album, Superficial, which was released in January 2010. She was featured in the second season of I'm a Celebrity... Get Me out of Here! in 2009 and later appeared in VH1's reality series Famous Food during 2011.

In November 2008, Montag and The Hills cast member Spencer Pratt eloped to Mexico. The couple later married in the United States in April 2009. In July 2010, Montag filed for divorce after fifteen months of marriage to Pratt, but called off the divorce in September 2010.

Early life[link]

Montag was born in Crested Butte, Colorado on September 15, 1986.^[1] Her parents, Darlene and Tim Egelhoff, owned a restaurant in Crested Butte, although it was closed after twenty-one years of operation.^[2] Reality television personality Holly Montag is her older sister by three years.^[3] After graduating from high school, Montag moved to California where she enrolled at the Academy of Art University in San Francisco.^[4]

Career[link]

[edit] 2005-2010: The Hills

During freshman orientation, Montag met Lauren Conrad, who at the time was a featured cast member on the MTV reality series Laguna Beach: The Real Orange County.^[5] After the two transferred to Fashion Institute of Design & Merchandising in Los Angeles,^[4] Conrad received her own spin-off series The Hills, which premiered on May 31, 2006.^[6] Montag eventually left the Fashion Institute in fall of 2005 when she was hired at Bolthouse Productions.^[7] According to Montag, she dropped out because she "did not find the school challenging."^[8] Within two years, she was promoted to event planner at Bolthouse.^[9]

Montag went on to star in all six seasons of The Hills, but last appeared on the series on the final season's fourth episode after her husband and fellow cast member, Spencer Pratt, had threatened to kill a series producer.^[10] He was due to return to the series after completing anger management training, although his behavior worsened which led to their being completely removed from the cast.^[11] Montag had also filed charges against The Hills creator Adam Divello, claiming sexual harassment.^[12]

[edit] 2007-2010: Superficial

In February 2007, Montag began working on an album with producer David Foster.^[13] In March 2009, Montag hired songwriter Cathy Dennis to work on her debut album.^[14] On the Billboard issue dated July 1, 2009, Montag's song "More Is More" debuted on the Hot Dance Club Songs chart at number fifty, becoming her first song to chart, despite not being released as a single.^[15] After five weeks on the chart, it peaked at number twenty-seven.^[16] On August 23, 2009, Montag performed "Body Language" during the Miss Universe 2009 pageant in the Bahamas.^[17] The performance received generally negative reviews from critics.^[18] Montag's debut album, Superficial, was digitally released on January 12, 2010.^[19] The album was self-funded and cost almost $2 million to record,^[20] and sold just over 1,000 copies in its first week of release.^[21] Montag released a video for "Superficial", the first and only single taken from the album.^[22]

2008-present: Other endeavors[link]

Montag was featured on the front cover of the February 2008 issue of Maxim.^[23][24] Montag debuted her fashion line, Heidiwood, at a fashion show at the Hollywood and Highland shopping center in Hollywood on April 11, 2008.^[25] In October 2008, it was confirmed that Anchor Blue, which had carried Montag’s line, would not be renewing her one-year contract, thus ending the line's run.^[26]

In November 2008, Montag and Pratt took part in scenes for an episode of the CBS sitcom How I Met Your Mother. The two appeared as themselves in an episode that premiered in January 2009.^[27] Montag, along with Pratt, also signed on to appear on the second season of the reality series I'm a Celebrity... Get Me out of Here! in April 2009.^[28] In early June 2009, it was reported that the couple had quit the show,^[29] although they later returned.^[30] The couple ultimately withdrew from appearing on the series after Montag suffered from a gastric ulcer which caused her to be hospitalized.^[31] Her appearance on the show, as well as Pratt's, was criticized after the couple claimed they were subject to torture.^[32][33]

In June 2009, it was confirmed that Montag would pose for Playboy.^[34] She appeared on the cover of the September 2009 issue of the magazine.^[35] In November 2009, Montag and Pratt released their first book, How To Be Famous: Our Guide to Looking the Part, Playing the Press and Becoming a Tabloid Fixture.^[36] In March 2010, Montag was cast in a cameo role in her first feature film, Just Go with It, which was released in February 2011.^[37][38] On April 10, 2010, Montag hosted the grand opening of the Liquid Pool in Las Vegas, Nevada.^[39]

In early 2011, Montag was confirmed to be one of seven celebrities to compete in the VH1 reality series, Famous Food, that premiered in the summer of 2011.^[40] Other cast members included Ashley Dupre, DJ Paul, Juicy J, Vincent Pastore, Danielle Staub, and Jake Pavelka.^[40] The cast members worked to open a Hollywood restaurant; the winner was given a partnership stake in the business.^[40] The series, which ran from July to September 2011, was won by DJ Paul.^[41] In October 2011, Montag announced that she is writing a memoir.^[42]

Personal life[link]

Montag in Las Vegas in December 2007

On March 3, 2008, Montag's stepbrother Eric O'Hara was killed in an accidental fall from an icy roof.^[43]

In 2006, she began dating Spencer Pratt. In May 2007, Montag and Pratt announced their engagement.^[44] On November 20, 2008, Montag and Pratt had a marriage ceremony in Mexico.^[45] No family members were present and the wedding ceremony lasted 15 minutes.^[46] Montag and Pratt married a second time on April 25, 2009 in Pasadena, California.^[47] On July 30, 2010, Montag filed for divorce, citing irreconcilable differences in the petition.^[48] However, the couple called off the divorce in September 2010.^[49] In November 2010, Montag and Pratt announced that the reason behind the couple's divorce was to help Montag's career.^[50] Later that November, Montag and Pratt renewed their wedding vows at a beachfront house in Carpinteria, California.^[51]

Plastic surgeries[link]

In April 2007, Montag had a breast augmentation and rhinoplasty. After much media speculation, Montag spoke to Us Weekly about her surgeries in September 2007.^[52] In January 2010, Montag revealed to People magazine that she had ten plastic surgery procedures in one day, performed by Dr. Frank Ryan on November 20, 2009. Among the procedures were brow-lifts, ear-pinnings, a chin reduction, as well as a second rhinoplasty and second breast augmentation. She revealed that she almost died from too much Demerol, reducing her breath rate to five breaths per minute, but said it was worth it.^[53]

In December 2010, Montag appeared on the cover of Life & Style magazine, revealing scars caused from her surgeries.^[54][55]

Filmography[link]

Published works[link]

• How To Be Famous: Our Guide to Looking the Part, Playing the Press and Becoming a Tabloid Fixture (with Spencer Pratt) (2009)

Discography[link]

Studio albums[link]

Extended plays[link]

Wherever I Am

1. "Your Love Found Me" – 3:52
2. "More Is More" – 3:06
3. "Party Is Wherever I Am" – 3:28
4. "Turn Ya Head" – 3:39
5. "Look How I'm Doing" – 3:39

Here She Is...

1. "No More" – 4:05
2. "Overdosin'" – 3:45
3. "Look How I'm Doing" – 3:29
4. "Turn Ya Head" – 3:39
5. "More Is More" – 3:06
6. "Blackout" – 3:31
7. "Your Love Found Me" – 3:52

Dreams Come True

1. "Your Love Found Me" – 3:53
2. "Party Is Wherever I Am" – 3:30
3. "No More" – 4:02
4. "Overdosin'" – 3:45

Singles[link]

Promotional singles[link]

Music videos[link]

References[link]