Plastic and reconstructive surgeons, plastic surgeons, train to diagnose and manage many aesthetic issues that patients may have. These may be issues with the appearance of the face and body, and many surgical techniques are used to augment any areas of concern to the patient. It's important to take note that plastic surgeons aren't only involved with aesthetic procedures, but they also perform reconstructive procedures on patients who have suffered severe trauma and burns to parts of the body, as well as birth defects such as cleft lip and/or palate. Plastic surgeons can also perform procedures that may otherwise result in bad scarring from the excision of masses on the skin, in order to give a better cosmetic result to the patient.
Training
Once a doctor has completed their undergraduate training and have completed their 1-2 year internship phase, they can proceed to apply for a post in plastic and reconstructive surgery. The residency programme of this discipline is 5-6 years, depending on the country you live in.
Doctors will be exposed to many aesthetic and reconstructive techniques that are available in this specialty, and they may decide to specialise further in the different sub-discipline that are available through fellowship training programmes. These include the following:
- Aesthetic surgery - this component of plastic surgery, as mentioned, concerns surgery of the face and body for aesthetic reasons, but also for good cosmetic results where bad scarring is possible after an operation.
- Burn surgery - this sub-specialty is usually performed in 2 stages. Namely, acute burn surgery immediately following a burn and reconstructive burn surgery that is performed after the burn wounds have healed.
- Craniofacial surgery - this discipline is divided into adult and paediatric craniofacial surgery. Adult craniofacial surgery deals mostly with fractures and secondary surgeries involving the craniofacial anatomy. Paediatric craniofacial surgery involves the management of congenital anomalies such as cleft lip and/or palate and paediatric fractures.
- Hand surgery - this discipline involves the treatment of issues such as peripheral nerve problems (carpal tunnel syndrome), correction of congenital abnormalities of the upper limbs and acute injuries and chronic diseases of the hand and wrist. Other doctors such as neurosurgeons and orthopaedic surgeons can also perform procedures on the hand, but a plastic surgeon may be consulted to preserve the cosmetic result.
- Microsurgery - this involves the reconstruction of missing tissues by transferring a piece of tissue to the reconstruction site and reconnecting blood vessels. Sub-specialty areas of microsurgey include head and neck reconstruction, breast reconstruction, brachial plexus surgery and hand surgery/replantation.
READ What a Plastic Surgeon Can Offer - Explore the Possibilities
Popular procedures
Skin grafting
- Autografts (taken form the patient themselves).
- Allografts (taken from a donor of the same species.
- Xenografts (taken from donors of a different species).
Reconstructive procedures
- Correcting functional impairments caused by: burns, congenital abnormalities (cleft palates or cleft lips), traumatic injuries (facial bone fractures and breaks), infection and disease, developmental abnormalities (missing outer ear) and cancers or tumours.
- Tumor removal.
- Laceration repair.
- Scar repair.
- Hand surgery.
- Breast reduction plasty and breast reconstruction after a mastectomy.
Aesthetic procedures
- Eye lift.
- Blepharoplasty (eyelid surgery).
- Face lift.
- Liposuction.
- Abdominoplasty (tummy-tuck).
- Lip enhancement.
- Rhinoplasty (nose-job)
- Otoplasty (ear-pinning).
- Mammoplasty (breast augmentation/implants, breast lift or breast reduction).
The Daily Schedule Of A Plastic And Reconstructive Surgeon
Plastic surgeons perform aesthetic surgical procedures that are usually done at a day-surgery clinic. These patients will be discharge to go home the same day and will be followed up by the specialist accordingly. Reconstructive procedures, though, are performed at acute hospital where the patients will be followed up 1-2 times a day by the specialist until they are discharged.
Plastic surgeons will provide on-call services for the hospitals they work at since emergency cases such as severe lacerations, tissue damage and burn cases may be managed by them. Depending on the amount of specialists that are available, these doctors may need to be on-call 3-4 times a week.
An issue plastic surgeons need to deal with is patients who suffer from body dysmophic disorder. These patients have a psychological problem where they are convinced that they have to change the appearance of part of their body, even though the "flaw" is hardly even noticeable to others. A plastic surgeon would then refer these patients for a psychologist's opinion before considering performing any major aesthetic procedures on them.
Mondays
Mondays are usually administrative days for most doctors. Here, surgical lists as well as patient appointments and meetings with surgical representatives and hospital management are confirmed.
The plastic surgeon will then consult with patients. They will be managed accordingly and this may include performing procedures such as Botox injections, fillers, etc. in the procedure room of the office. Patients who need bigger aesthetic and reconstructive work done on them will have surgical dates booked for day-surgery clinics or larger acute hospitals.
Tuesday
This day usually involves having a full surgical list and may include performing procedures in the hospital such as a superficial skin cancer excision with reconstructive skin flaps done, reconstructive burn surgeries, debridement of old scars or stumps of amputated limbs and reconstructing breast tissue after a mastectomy was done.
Wednesday
The plastic surgeon can also perform minor procedures, in the mornings, that can be done under local anaesthesia or conscious sedation, with the aid of an anaesthesiologist, in the procedure room of their office.
The afternoon can be reserved for consulting with new patients and following up post-surgical patients.
READ Breast Reduction Plastic Surgery Solves Many Physical Problems
Thursday
Thursdays can also be used to consult with patients, or perform surgeries at the day clinics where patients can be discharged after the procedure in concluded. These procedures are usually aesthetic ones such as those mentioned earlier in the article.
The afternoons can be used for duties such as academic training, further research, filling out motivation forms for medical insurance companies and giving feedback to referring physicians.
Friday
The plastic surgeon will either consult with new patients and perform minor procedures in their rooms, perform aesthetic or minor reconstructive procedures at the day-surgery clinics or perform a couple of larger aesthetic or reconstructive procedures at the acute hospitals.
The afternoons will then be used to finalise any unresolved administrative issues, and the plastic surgeon's work week will end if they are not on-call for the weekend. If they are working the weekend, they will provide care for their patients and any other colleague's patients that have been discussed with them.