Plastic Surgery1
PLASTIC SURGERYPresented byFiza NadeemPlastic Surgery2
SCOPE• What is Plastic Surgery?• Origin• Islamic Perspective• Evolution in Pakistan• Comparison with Advanced Countries• P...
INTRODUCTION4Plastic Surgery
• Derived from Greek word• Art of Modeling• Medical specialty• Correction and restoration of form and function• Physical d...
• Broad classification:PLASTIC SURGERYcont’dPLASTICSURGERYCosmeticEnhancementsReconstructiveOperationsPlastic Surgery6
– Medical Aesthetics– Enhancement of appearance– Maintaining normal appearanceCosmetic Plastic SurgeryPlastic SurgeryPLAST...
TYPES OF COSMETIC SURGERYTummy tuck (Abdominoplasty)Eyelid surgery (Blepharoplasty)Chemical peelNose job (Rhinoplasty)Ear ...
Tummy tuck (Abdominoplasty)• Abdomen is reshaped and firmed• Removal of excess skin and fat• Abdomen is reshaped and firme...
Eyelid surgery (Blepharoplasty)• Eyelids are reshaped• A permanent eyeliner is applied• The aim is to reshape the upper or...
Before & After Eyelid SurgeryPlastic Surgery11
Chemical Peel• Popular among people with acne, scars and wrinkles• Involves• TypesTYPES OF COSMETIC SURGERYcont’dLight/Med...
Before & After Wrinkles Before & After PoresBefore & After Acne ScarsPlastic Surgery13
Nose job (Rhinoplasty)• Nose is reshaped• Done by otolaryngologist• Aim is to improve the appearance of the nose, andsomet...
Ear surgery (Otoplasty)• Involves pining the ear closer to the head• May involve reducing the size of very large ears, orr...
Before & After Ear SurgeryPlastic Surgery16
Facelift (Rhytidectomy)• To remove wrinkles surgically• The aim is to make the patients facelook younger• Done in many way...
Before & After FaceliftPlastic Surgery18
Liposuction• Also known as fat modeling, lipo sculpturesuction, lipectomy or lipo• Fat removed from various parts of the b...
Before & After LiposuctionPlastic Surgery20
• To correct functional impairments caused by:• Burns• Traumatic Injuries (Facial bone fractures & breaks)• Congenital Abn...
Tumor Removal• Procedure to remove an abnormal growth• Can either be a benign or a malignant tumor• Benign tumors are easy...
Laceration Repair• Wound caused by sharp object• Mends a tear in the skin or other tissue• GoalsTYPES OF RECONSTRUCTIVESUR...
Scar Revision• Improve or reduce the appearance of scars• Restores function, and corrects skin changes causedby an injury,...
Cleft Lip or Palate• Fissure or opening or a gap• Caused by abnormal facial development duringgestation• Can be successful...
Cleft Lip Scar RevisionTumor Removal Laceration RepairPlastic Surgery26
TECHNIQUES AND PROCEDURESEndoscopic surgerySkin GraftsFlap surgeryLaser technologyTissue ExpansionPlastic Surgery27
Plastic Surgery28
ORIGIN• As far as 2000 B.C.• Egyptian nose reconstruction• Indian doctor Acharya Sushrut• Romans• Cornelius Celsus “De Med...
ORIGINcont’d• End of third century A.D.• Middle ages and Renaissance• Late 1500s- a breakthrough• Italian Gasparo Tagliaco...
• Outbreak of world war I• Soldiers with extensive trauma wounds• An independent medical service• ASPRS created in 1931• A...
• Past 100 years• ASPRS changed to ABPS• Lawful recognition• Mid 2000s• Growing multi-billionindustry• Liposuction – mostc...
Plastic SurgeryISLAMIC PERSPECTIVE33
PLASTIC SURGERY IN THE LIGHTOF VARIOUS RELIGIONS• Muslim: It is understood that surgery isn’t allowed, onthe basis that it...
• Maslah or Manfa’h• Benefit or Utility• Seeking of benefit and preventing of harm• In Arabic, we sayISLAMIC PERSPECTIVEco...
“And spend of your substance in the cause of Allah, andmake not your own hands contribute to (your) destruction;but do goo...
ISLAMIC PERSPECTIVEcont’dPLASTICSURGERY (Types)For TreatingDeformityAimed atBeautificationPlastic Surgery37
Allah Almighty mentions in Surah al-Nisa the words ofShaytan, when he said :“I will mislead them and I will order them to ...
“Allah has cursed women who tattoo or havethemselves tattooed, who pluck eyebrows or havethem plucked, and women who separ...
ISLAMIC PERSPECTIVEcont’dCosmetic and plastic surgery for the purpose of beautifyingand adornment is impermissible. Howeve...
EVOLUTION IN PAKISTAN41Plastic Surgery
EVOLUTION IN PAKISTAN• Plastic surgery procedures - foreign word for manyPakistanis just 10 to 15 years ago• Hair transpla...
• Specialty unit in teaching started at Dow MedicalCollege & Civil Hospital, Karachi by Prof. K.M.Durrani in 1965• In 1976...
EVOLUTION IN PAKISTANcont’d• In early nineties Units were established in teachinginstitutes at Hyderabad, Faisalabad, Mult...
MAIN OBJECTIVE OF PAPSTo promote and advance medical and surgical training andresearch pertaining to Plastic Surgery. To d...
• Most common surgery procedures in PakistanincludeEVOLUTION IN PAKISTANcont’dNose ReshapingLiposuctionTummy TuckFace Upli...
ADVANCES IN PLASTIC SURGERYPlastic Surgery47
ADVANCES IN OTHERCOUNTRIES• Rapid progress with development of new techniques• Better understanding of anatomy of blood su...
Fractional Laser Resurfacing• Prolonged skin healing, skin redness, and risks ofclassic laser resurfacing minimized• Has s...
Combination Liposuction Technologies• Combination of laser and ultrasound technology withold liposuction techniques provid...
Pain Pumps For Cosmetic Surgery• Patient controlled analgesia• Introduction of devices to provide pain relief right tothe ...
Increasing Variety of Dermal Fillers• Around since the 1980s but early fillers didn’t lastlong• Increase in longevity of t...
Hair Cloning Research• Not a commercially available procedure• Technology has come a long way in the last tenyearsADVANCES...
Laser Vein Therapy• Days of pain recovery to get rid of pesky leg veinslong gone• Laser technology has allowed many patien...
Plastic SurgeryPROS AND CONS55
PROS AND CONS• PROSPhysical benefitsHigher self esteemGreater self confidenceSocial confidencePlastic Surgery56
PROS OF PLASTIC SURGERYPhysical Benefits• Extremely helpful for those with physical deformity• Improves health• ExamplesPl...
PROS OF PLASTIC SURGERYcont’dHigher Self Esteem• Gives patients higher self-esteem• Greater confidence• Positive effect on...
• Reshapes natural contours• Removes fat which cant be done through diet• Dramatic results• Successful in life and more op...
Cons– Causes undue stress on the body– Swelling or bruising– Risk of infection, blood clotting etc– No guarantee of result...
CONCLUSION61Plastic Surgery
BIBLIOGRAPHY62Plastic Surgery
 Plastic Surgery by Natasha Skvorc and Rudolf Gregurek Plastic and Reconstructive Surgery Associate Prof.Vichai Chichare...
64Plastic Surgery
65Plastic Surgery
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  • In the term plastic surgery, the adjective plastic denotes and is derived from a greek word plastikos which means TO FORM OR TO MOLD. Plastic surgery is “the art of modelling” of malleable flesh.Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. For people with physical deformities and skin burns, plastic surgery has proved to be a blessing. But today’s fashion conscious world, has broadened the scope of this field as well, and more people are turning to it to reshape and improve their physical features. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic it also includes many types of reconstructive surgery
  • Plastic surgery is broadly classified into two categories: cosmetic enhancements and functionally reconstructive operations. 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 which includehand surgery, microsurgery, and the treatment of burns
  • Cosmetic or aesthetic plastic surgery also called 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 this type of cosmetic surgery, the abdomen is reshaped and firmed. During this surgical procedure excess skin and fat is removed from the middle and lower abdomen, with the aim of tightening the muscle and fascia of the abdominal wall. Tummy tucks are more popular among people who have lost a great deal of weight and do not like the sagging that sometimes results from this. This procedure may also improve the appearance of stretch marks, especially those located below the navel.
  • During Blepharoplasty,the eyelids are reshaped, or a permanent eyeliner is applied. This procedure may be either functional or cosmetic, and sometimes both. The aim is to reshape the upper or lower eyelid by removing or repositioning excess tissue. It may also involve reinforcing surrounding muscles and tendons
  • This type of cosmetic surgery is popular among people with acne or pock, as well as those with scars and wrinkles. The procedure involves using Phenol (carbolic acid), TCA (trichloroacetic acid), AHA (glycolic acid) or BHA (salicylic acid) as the active ingredient. There are two types of chemical peel: Deep (phenol) peel - also known as a deep chemical peel. This is for patients with deep wrinkles, usually from exposure to the sun, as well as the skin that wrinkles around the lips and chin. This treatment reduces the appearance of skin damage and imperfections. Light to medium chemical peel - more suitable for patients with finely wrinkled faces, as well as sun-damaged skin, and uneven pigmentation. All chemical peels peel away the top layers of the skin.
  • InRhinoplasty, the surgeon reshapes the patient's nose. It is usually done by an otolaryngologist (head and neck surgeon, ear/nose and throat specialist), maxillofacial surgeon or plastic surgeon. The aim is to improve the appearance of the nose, and sometimes its function as well if the patient has breathing problems. Surgeon's say patients should wait until they are at least 15 years of age (boys perhaps even older). Sometimes rhinoplasty is carried out in conjunction with a facelift.
  • Ear surgery (otoplasty) - generally this involves pining the ear closer to the head. However, surgery may involve reducing the size of very large ears, or reshaping various bends in the cartilage. Most commonly, otoplasty is used for patients with: Protruding ears (ears that stick out) Large earsEars that have an abnormal shapeEar surgery can be performed on children because the ears reach their near total development when the child is 5 or 6. A study revealed that cosmetic ear surgery has the youngest age of patients.
  • Rhytidectomy means to remove wrinkles surgically. The aim is to make the patient's face look younger. Excess facial skin is removed without tightening underlying tissue - the skin is then redraped on the patient's face and/or neck. Face lifts may be done in many ways, however, the most popular one is to make an incision in front of the ear which extends into the hairline and also curves around the bottom of the ear and then behind it. The skin is then separated from the deeper tissues with a scalpel or scissors over the cheeks and neck. The deeper tissues are then tightened with sutures (stitches) - sometimes the excess deeper tissues are removed. The skin is then redraped and some excess skin is removed. The incisions are then sutured or stapled. Facelift procedures are continuously evolving.
  • Liposuction (suction-assisted lipectomy) - also known as fat modeling, liposculpture suction lipectomy, or lipo. Fat is surgically removed from various parts of the body - usually the abdomen, thighs, buttocks, hips, backs of the arms, and neck. It is crucial for the patient to be told that liposuction is not a weight loss method. If there is a lot of fat, the surgeon cannot remove it all in one go. How much fat is removed depends on what method is being used, as well as certain aspects relating to the patient - usually the most that can be taken out is about 5 kg (a little over 10 lbs). If too much fat is removed there is a significantly greater risk of complications for the patient. The fat is removed via a cannula (a hollow metal tube) that is passed through the fatty tissue. A pump is attached, generating a vacuum, so that the fat is literally sucked out (suction assisted liposuction). A motor may be attached which makes the cannula vibrate (vacillate back and forth). An ultrasonic generator may also be used - this produces sound waves that break the fat cells which are then removed. Prior to removal the fat cells may also be broken down with laser. Although complications are uncommon, they can occur, including the accumulation of blood under the skin (hematoma), infection, changes in sensation, allergic reactions, damage to underling structures, and unsatisfactory results. It is important that the patient is aware of the risks and has talked about them with a doctor. Smokers are advised to give up well in advance of the operation and not to resume for at a least a few weeks afterwards. Smoking can significantly undermine recovery.
  • 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 and hand surgery. Some other common reconstructive surgical procedures includecleft 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.
  • Tumor removal is a surgical procedure to remove an abnormal growth. A tumor can be either benign, like a wart, or malignant, in which case it is a cancer. Benign tumors are well circumscribed and generally are easy to remove completely. In contrast, cancers pose some of the most difficult problems in all of surgery. They may metastasize to other parts of the body and will ultimately result in death if not successfully treated by surgery and/or other methods.Surgical removal is one of four main ways that tumors are treated. Chemotherapy, radiation therapy, and biological therapy are other treatment options
  • A laceration is a wound caused by a sharp object producing edges that may be jagged, dirty, or bleeding. Lacerations most often affect the skin, but any tissue may be lacerated, including subcutaneous fat, tendon, muscle, or bone.A laceration should be repaired if it:Continues to bleed after application of pressure for ten to fifteen minutesIs more than one-eighth to one-fourth inch deepExposes fat, muscle, tendon, or boneCauses a change in function surrounding the area of the lacerationIs dirty or has visible debris in itIs located in an area where an unsightly scar is undesirable.Laceration repair mends a tear in the skin or other tissue. The procedure is similar to repairing a tear in clothing. Primary care physicians, emergency room physicians, and surgeons usually repair lacerations. The four goals of laceration repair are to stop bleeding, prevent infection, preserve function, and restore appearance. Before repairing the laceration, the physician thoroughly examines the wound and the underlying tendons or nerves. If nerves or tendons have been injured, a surgeon may be needed to complete the repair. The laceration is cleaned by removing any foreign material or debris. The wound is then irrigated with saline solution and a disinfectant. Once the wound has been cleansed, the physician anesthetizes the area of the repair. The physician may trim edges that are jagged or extremely uneven. Tissue that is too damaged to heal must be removed (debridement) to prevent infection. If the laceration is deep, several absorbable stitches (sutures) are placed in the tissue under the skin to help bring the tissue layers together. Suturing also helps eliminate any pockets where tissue fluid or blood can accumulate. The skin wound is closed with sutures. Suture material used on the surface of a wound is usually non-absorbable and will have to be removed later. A light dressing or an adhesive bandage is applied for 24-48 hours. In areas where a dressing is not feasible, an antibiotic ointment can be applied.
  • Scar revision is surgery to improve or reduce the appearance of scars. It also restores function, and corrects skin changes (disfigurement) caused by an injury, wound, or previous surgery. Scar tissue forms as skin heals after an injury (such as an accident) or surgery. Depending on the the extent of the surgery, scar revision can be done while you are awake (local anesthesia), sleeping (sedated), or deep asleep and pain-free (general anesthesia). There are several ways to improve the appearance of scars: The scar may be removed completely and the new wound closed very carefullyDermabrasion involves removing the upper layers of the skin with a special wire brush called a burr or fraise. New skin grows over this area. Dermabrasion can be used to soften the surface of the skin or reduce irregularities. Skin grafting involves taking a thin (partial, or "split thickness") layer of skin from another part of the body and placing it over the injured area Skin flap surgery involves moving an entire, full thickness of skin, fat, nerves, blood vessels, and muscle from a healthy part of the body to the injured site.
  • A cleft is a fissure or opening—a gap. Cleft lip (cheiloschisis) and cleft palate (palatoschisis), which can also occur together as cleft lip and palate, are variations of a type of clefting congenital deformity caused by abnormal facial development during gestation. A cleft lip or palate can be successfully treated with surgery, especially so if conducted soon after birth or in early childhood. however, the kind of treatment depends on the type and severity of the cleft.
  • Techniques and Procedures involved in Plastic urgery are:Endoscopic surgery. Endoscopic surgery is performed with an endoscope, a tubular probe that has a tiny camera and a bright light, which is inserted into a small cut in the skin. Images from the camera are transmitted back to a screen, which the surgeon watches while manipulating the endoscope inside the body. The endoscope is a device to assist the surgeon during surgical procedures. Instruments to actually perform the surgery are inserted through a different incision.Flap surgery. Flap surgery involves moving healthy, live tissue from one location of the body to another--often to areas that have lost skin, fat, muscle movement, and/or skeletal support.Laser technology. Lasers used in plastic surgery often provide for minimal bleeding, bruising, and scarring. There are many different types of lasers that may be used, depending on the purpose and location of the surgery to be performed. Tissue expansion. A tissue expansion is a surgical procedure that involves inserting a balloon-like device (called an expander) under the skin. The expander is then slowly filled with liquid to actually stretch and expand the skin over time. This serves the function of "growing" extra skin to repair nearby lost or damaged skin.Skin grafts. A skin graft may be used to cover skin that has been damaged and/or is missing. This surgical procedure involves removing healthy portions of skin from one part of the body to restore normal appearance and/or function to another part of the same body. 
  • The history of plastic surgery goes as far back as 2000 B.C. In India and Egypt, ancient physicians practiced some of the most rudimentary forms of plastic surgery. Reeds were used in Egyptian nose reconstruction to keep the nostrils open as the nose healed. In 600 B.C., the Indian doctor AcharyaSushrut published a collection of medical texts about plastic surgery, the first of its kind in ancient history.Around the first century B.C., Roman physicians practiced early beginnings of surgical methods to alter the body. With a culture that highly valued the physique and beauty of the natural human body, ancient Roman doctors operated on former gladiators whose bodies and faces had become severely damaged. At this time, Roman medical writer Cornelius Celsus wrote "De Medicina,” which outlined some of the methods used in thereconstruction of the ears, lips and noses – another important early text for plastic surgery.
  • After the fall of Rome at the end of the third century A.D., the progress of plastic surgery appears to have stalled for several hundred years. During the Middle Ages and the Renaissance, the spread of Christianity forbade any kind of surgical changes to the body.Then, in the late 1500s, a breakthrough in plastic surgery occurred. InItaly, GasparoTagliacozzi experimented with skin grafts for nose reconstructive surgery. However, Tagliacozzi’s progress was hindered by the influence of the Church. In addition, the technology of general anesthesia was still in its earliest stages at this time, which made any plastic surgery attempts extremely painful.For centuries, plastic surgery continued to struggle without much progress; plastic surgeries were performed sparingly with mixed results. In 1907, the first text pertaining specifically to cosmetic surgery, “The Correction of Featural Imperfection,” was published but disregarded by the medical community.
  • However, the outbreak of World War I would change the course of plastic surgery history forever. As the history of the American Board of Plastic and Reconstructive Surgery (ASPRS) describes, trench warfare caused thousands of WWI soldiers to receive extensive trauma wounds on their faces, necks, throats, and arms. This resulted in plastic surgery quickly becoming an independent medical practice that varied greatly across the nation. In order to regulate the profession, the American Board of Plastic and Reconstructive Surgery abbreviated as ASPRS was created in 1931. With the establishment of an authoritative institution, plastic surgery began a new age of enlightenment.
  • Within the past 100 years, the field of plastic surgery has experienced tremendous progress. The first medical journal for plastic surgery saw its first publication in 1946, which increased communication about new developments in the medical community. In response to the rapid growth of plastic surgery, the ASPRS eventually changed its title to its present name, the American Board of Plastic Surgery (ABPS). Virtually all types of plastic surgery have undergone considerable technological advancement, and many have received lawful recognition. In the mid 2000s, interest in plastic surgery skyrocketed. Popular shows such as Extreme Makeover, Dr. 90210, and Nip/Tuck gave the plastic surgery industry a new and familiar look to the public.Despite its rocky historical past, plastic surgery is a growing multi-billion industry. Of all plastic surgeriesliposuction are the most common, with women usually accounting for 91 percent of the patients.Today, modern technology continues to expand the horizons of plastic surgery. From its earliest beginnings to its most recent developments, the world and history of plastic surgery continues to evolve.
  • Plastic surgery has become one of the calamities of this time. The madness that haunts us regarding the culture of beautification and beauty treatments is undoubtedly imported and is not at all compatible with our traditions and values. The amount of money spent on such operations all over the world may well exceed the budgets of several developing countries, in which people die of hunger and are unable to sustain life.Currently, it may seem natural that cosmetic surgery should be perceived as permissible, and in our modern liberal age, it seems strange to attempt justifying certain surgical acts in the light of a particular cultural or religious tradition. Yet every day, cruel realities demonstrate that although the foremost intention of any scripture or tradition has been mainly to promote religious and moral values, most religions, including Christianity, Islam, and Judaism, invariably affect human behavior and attitude deeply, dictating some rigid positions regarding critical health issues. To justify plastic surgery in the eyes of islam therefore needs some logical explanations and authentic references
  • Saving of life or improving quality of life is necessary so long there is Maslah or Manfa’h. In its literal meaning, they mean BENEFIT or UTILITY. In other words Maslah or Manfa’h. in other words it means seeking of benefit and preventing of harm. In arabic we say …
  • Beautification is permissible in Islam so long it causes no harm to the subject or object. Hence Allah says“And spend of your substance in the cause of Allah, and make not your own hands contribute to (your) destruction; but do good; for Allah loves those who do good.” (2:195)Hence beautification is permissible if it doesn’t go contrary to the Islamic teachings. In Islam, Human body is not a personal property and therefore cant be possessed and be free disposed. Instead it is a divine trust from Allah which we are obliged to preserve.
  • There are two main kinds of plastic surgery,The first kind is used for treating a deformity, whether it is present from birth or caused by an accident. This may include procedures like removing extra fingers or treating deformities of the face or other parts of the body, where these deformities may cause social embarrassment, psychological trauma or physical pain. Hence, this kind of plastic surgery is legally prescribed and urged by Islam.The second kind is the product of media obsession with exploitation of women, Almighty Allah honored women, and the Prophet (peace and blessings be upon him) urged us to be merciful towards them and feel compassion for them. However, we have turned them into a cheap commodity to be bought and sold, as though we are still in the time of slavery. A husband may ask his wife to change her appearance to be more appealing to him. For example, he may want her to be thinner and, thus, she subjects herself to a series of painful operations such as liposuction. fter a while her husband may become bored with her new look and again he may ask her to change her appearance! He is like a child who becomes bored with a new toy and wants to change it quickly. Many women resort to such operations in order to lure others, preoccupy people with falsehood, render them insensible to the dangers around, spread adultery and destroy families through divorce. All contemporary scholars have unanimously agreed on the permissibility of the first kind of plastic surgery and the impermissibility of the second.
  • Mutilation of ones body has been clearly prohibited in Islam. Allah Almighty mentions in Surah al-Nisa the words of Shaytan, when he said : I will mislead them and I will order them to slit the ears of cattle, and to deface the (fair) natural creation of Allah.To deface the fair nature created by Allah, both physically and spiritually is what Shaytan likes and orders to practice. 
  • `Abdullah ibnMas`ud narrates that Prophet (peace and blessings be upon him) said“Allah has cursed women who tattoo or have themselves tattooed, who pluck eyebrows or have them plucked, and women who separate their front teeth for beauty, altering what Allah has created.” (Al-Bukhari)Ibn `Abbas narrates that Prophet (peace and blessings be upon him) said“The woman who supplies false hair and the one who asks for it, the woman who pluck eyebrows or have them plucked, the woman who tattoos and the one who has it done where there is no disease to justify it have been cursed.” In addition there are the hadiths in which the Prophet (peace and blessings be upon him) forbade women from imitating men, and men from imitating women as well as the texts, which prohibit the imitation of other non-Muslim peoples or those known for immoral and sinful behavior.
  • In conclusion, cosmetic and plastic surgery for the purpose of beautifying and adornment is impermissible. However, if there is a genuine need due to something being abnormal or deformed, then there is a dispensation of permissibility
  • Liposuction, tummy tuck, Hair transplantation, nose reshaping and face lifting were foreign words for many Pakistanis just 10 to 15 years ago. Hair transplantation clinics have sprouted up like mushrooms in major cities and even in some smaller towns across the nation. Cosmetic surgery although not as popular as in the United States, Europe or South America, nonetheless many clinics particularly in Karachi, Lahore and Islamabad are offering these services. The field of plastic surgery is in its infancy in Pakistan.
  • In Pakistan this specialty unit in teaching hospital was started at Dow Medical College & Civil Hospital, Karachi by Prof.K.M.Durrani in 1965. In 1973 Dr. GoolTalati joined this unit as Honorary Senior Registrar. In 1976 Prof.Faiz Mohammad Khan Started Unit at JPMC. In mid eighties Prof. Shaista joined the dept. and at same time plastic surgery unit were established at King Edward, Lahore and PIMS, Islamabad. In early nineties Units were established in teaching institutes at Hyderabad, Faisalabad , Multan, Peshawar and Quetta.
  • In Pakistan this specialty unit in teaching hospital was started at Dow Medical College & Civil Hospital, Karachi by Prof.K.M.Durrani in 1965. In. In early nineties Units were established in teaching institutes at Hyderabad, Faisalabad , Multan, Peshawar and Quetta. The Pakistan Association of Plastic Surgeons was established in 1993 which aimed at promoting the art and science to Plastic Surgery. Currently there are around 70 plastic surgeons working in PAPS and scope for future surgeons is even brighter,
  • The objective of Pakistan Association of Plastic Surgeons is:- * To promote and advance medical and surgical training and research pertaining to Plastic Surgery. To disseminate information regarding clinical and scientific progress in Plastic Surgery. * To promote the art and science of plastic Surgery and to communicate to the members and the general public, the advancements and improvements made in the field of Plastic Surgery To promote the highest standards of professional skill and competence among Plastic Surgeons. * To promote the opportunity for the exchange of experiences and opinion through discussion, study, meetings, seminars, and publication. To take effective measures to project the correct image of the specialty and Plastic Surgeons, as is consistent with the public interest.
  • The most common surgery procedures in Pakistan are nose reshaping, liposuction and tummy tuck in women
  • Recent progress in plastic surgery has been rapid and many new techniques have been developed. Reconstructive procedures have been advanced by a better understanding of the anatomy of the blood supply to skin and muscle. Burn treatment has advanced greatly, making it possible to successfully treat larger and more complicated burns. The development of microsurgery has made possible free-flap transfer and replantation of amputated parts. Advances in surgical procedures on the hands include a realization that primary repair of lacerated tendons and nerves will give good results. Replacement joints have been developed that can be used in hands for joints destroyed by arthritis or trauma. Craniofacial surgery is a new field of endeavor in plastic surgery, involving new techniques that can be used to treat exophthalmos of Graves' disease and the facial deformities resulting from gigantism and acromegaly. Head and neck procedures have advanced, with the emphasis on immediate reconstruction using new flaps. Techniques for treating cleft lip and palate have been refined.
  • Fractional laser resurfacingThe introduction of fractional laser resurfacing at the turn of the century meant that the prolonged skin healing, prolonged skin redness, and risks of classic laser resurfacing have been minimized without minimizing results. The technology started with lasers designed to treat age spots and has spread to lasers which also treat wrinkles. Unlike older laser technologies, fractional treatments can be completed with topical anesthesia alone. “There has been a long search for a technology which produces the same results for wrinkle improvement as the carbon dioxide laser without the complications or long recovery. The fractional technology applied to carbon dioxide lasers is the answer to that search,” according to facial plastic surgeon Dr. Matthew Kienstra.
  • Combination liposuction technologiesThe combination of laser and ultrasound technology with old liposuction techniques provides some new possibilities for decreased recovery and improved liposuction results. Though the scientific evidence is still mixed, continued development means this is a very promising innovation. “There is a lot of art involved with the application of the technology and it appears to be the first technology which will allow true sculpting of the body,” says Dr. Ed Khoury
  • Pain pumps for cosmetic surgeryPatient controlled analgesia has been used for years in surgery to allow patients to give medications through the vein to control pain. Recently, devices have been introduced which allow patients to provide pain relief at their own discretion right to the site of pain. Dr Sorokin comments, “Pain pumps have greatly decreased hospital stays and decreased recovery times for both our cosmetic and reconstructive surgery patients.”
  • Increasing variety of dermal fillersFor people who do not like the lines on their face, there are options for treatment including skin, or dermal, fillers. Dermal fillers have been around since the 1980s but unfortunately early fillers didn’t last that long. Recent introductions into the market have seen an increase in longevity of the results (sometimes several years), an increase in use, and an increasing number of areas in which they are used. Plastic surgeon Dr. Ronald Friedman notes, “Dermal fillers and botulinum toxin products enable patients to undergo chemical browlifts and liquid facelifts, frequently delaying or obviating the need for surgery.” According to the American Society for Aesthetic Plastic Surgery survey, there were over 1.5 million dermal fillers injections in 2008, up from just half a million in 2000.
  • Hair cloning researchThough hair cloning is not a commercially available procedure, the technology has come a long way in the last ten years with several companies currently performing clinical trials. “Once the technology becomes commercially available, surgeons will no longer be limited by a finite donor site. The dream of a full head of hair will become a reality,” says Dr. Verret.
  • Laser Vein TherapyDays of pain and days of recovery to get rid of pesky leg veins are long goneLaser technology have allowed many patients to undergo very successful leg vein removal Stem cell harvesting from fat acquired during liposuctionWhile there is a considerable controversy about embryonic stem cells, recent technology has allowed extraction of stem cells from the fat removed during liposuction procedures. These cells hold promise for future scientific research and as yet unthinkable medical discoveries.
  • Plastic surgery has become one of the calamities of this time. The madness that haunts us regarding the culture of beautification and beauty treatments is undoubtedly imported and is not at all compatible with our traditions and values. The amount of money spent on such operations all over the world may well exceed the budgets of several developing countries, in which people die of hunger and are unable to sustain life.Currently, it may seem natural that cosmetic surgery should be perceived as permissible, and in our modern liberal age, it seems strange to attempt justifying certain surgical acts in the light of a particular cultural or religious tradition. Yet every day, cruel realities demonstrate that although the foremost intention of any scripture or tradition has been mainly to promote religious and moral values, most religions, including Christianity, Islam, and Judaism, invariably affect human behavior and attitude deeply, dictating some rigid positions regarding critical health issues. To justify plastic surgery in the eyes of islam therefore needs some logical explanations and authentic references
  • Physical benefitsFor those with a physical deformity, plastic surgery is extremely helpful. It helps improve health. Examples of individuals who need plastic surgery due to a physical deformity include children born with a cleft lip and individuals with scarring. It also helps people who are not physically deformed, but who have a problem with specific body parts by correcting their perceived flaws.
  • Plastic surgery gives patients higher self-esteem. By fixing body issues, patients have greater confidence in themselves. Patients who like their body have a higher self-confidence. Social confidence leads to the person making contact with others, which is a very positive effect of plastic surgery. This makes it much easier for people to interact with others socially if they were introverted due to their physical appearance before.
  • Cosmetic surgery reshapes the natural contours of the body and this is what you want if you're extremely unhappy about your current body or some flaw that you have.A pro to liposuction is that it can remove those last few stubborn fat deposits that you can't seem to shed with any amount of diet or exercise.An important pro to cosmetic surgery is that you may receive your dramatic results and be happier than you have ever dreamed possible. It may lead to more opportunities in life followed by success. Society accepts the individual and he feels comfortable in company. Overall it has a positive effect of person’s psychological health
  • Before undergoing any surgery, weigh the pros and cons of cosmetic surgery. Because it is surgery after all, there is always the possibility that complications can arise.Plastic surgery causes un due stress on the body. Similarly , reshapingleads to swelling and bruising. Moreover there is always a risk of infection and blood clotting and there is positively no guarantee that the final results will be exactly what you desire. It is sometimes invasive and painful. Results may not even be evident for a year and recovery can take from one day to six months.Anothercon to plastic surgery is that while a plastic surgeon can do his best to give you the physical look you have always imagined, they cannot fix who you are on the inside.
  • Plastic surgery

    1. 1. Plastic Surgery1
    2. 2. PLASTIC SURGERYPresented byFiza NadeemPlastic Surgery2
    3. 3. SCOPE• What is Plastic Surgery?• Origin• Islamic Perspective• Evolution in Pakistan• Comparison with Advanced Countries• Pros and Cons• AnalysisPlastic Surgery3
    4. 4. INTRODUCTION4Plastic Surgery
    5. 5. • Derived from Greek word• Art of Modeling• Medical specialty• Correction and restoration of form and function• Physical deformities and skin burns• Improve physical featuresPLASTIC SURGERYPLASTIKOS To Form or to MoldPlastic Surgery5
    6. 6. • Broad classification:PLASTIC SURGERYcont’dPLASTICSURGERYCosmeticEnhancementsReconstructiveOperationsPlastic Surgery6
    7. 7. – Medical Aesthetics– Enhancement of appearance– Maintaining normal appearanceCosmetic Plastic SurgeryPlastic SurgeryPLASTIC SURGERYcont’d7
    8. 8. TYPES OF COSMETIC SURGERYTummy tuck (Abdominoplasty)Eyelid surgery (Blepharoplasty)Chemical peelNose job (Rhinoplasty)Ear surgery (Otoplasty)Face Lift/Brow Lift/Chin LiftLiposuction (Suction-assisted lipectomy)Hair TransplantationPlastic Surgery8
    9. 9. Tummy tuck (Abdominoplasty)• Abdomen is reshaped and firmed• Removal of excess skin and fat• Abdomen is reshaped and firmedTYPES OF COSMETIC SURGERYcont’d9Plastic Surgery
    10. 10. Eyelid surgery (Blepharoplasty)• Eyelids are reshaped• A permanent eyeliner is applied• The aim is to reshape the upper or lower eyelid byremoving or repositioning excess tissueTYPES OF COSMETIC SURGERYcont’dPlastic Surgery10
    11. 11. Before & After Eyelid SurgeryPlastic Surgery11
    12. 12. Chemical Peel• Popular among people with acne, scars and wrinkles• Involves• TypesTYPES OF COSMETIC SURGERYcont’dLight/Medium PeelDeep PeelPhenol (Carbolic acid) TCA (Trichloroacetic acid)AHA (Glycolic acid) BHA (Salicylic acid)Plastic Surgery12
    13. 13. Before & After Wrinkles Before & After PoresBefore & After Acne ScarsPlastic Surgery13
    14. 14. Nose job (Rhinoplasty)• Nose is reshaped• Done by otolaryngologist• Aim is to improve the appearance of the nose, andsometimes its function as well if the patient hasbreathing problems• Carried out in conjunction with faceliftTYPES OF COSMETIC SURGERYcont’dPlastic Surgery14
    15. 15. Ear surgery (Otoplasty)• Involves pining the ear closer to the head• May involve reducing the size of very large ears, orreshaping various bends in the cartilage• Can be performed on children• Has the youngest age of patientsTYPES OF COSMETIC SURGERYcont’dPlastic Surgery15
    16. 16. Before & After Ear SurgeryPlastic Surgery16
    17. 17. Facelift (Rhytidectomy)• To remove wrinkles surgically• The aim is to make the patients facelook younger• Done in many waysTYPES OF COSMETIC SURGERYcont’dPlastic Surgery17
    18. 18. Before & After FaceliftPlastic Surgery18
    19. 19. Liposuction• Also known as fat modeling, lipo sculpturesuction, lipectomy or lipo• Fat removed from various parts of the body• Not a weight loss method• Most that can be taken out at one time is 5kg• Procedure• Complications may occurTYPES OF COSMETIC SURGERYcont’d19Plastic Surgery19
    20. 20. Before & After LiposuctionPlastic Surgery20
    21. 21. • To correct functional impairments caused by:• Burns• Traumatic Injuries (Facial bone fractures & breaks)• Congenital Abnormalities• Infection• Cancer• Tumors• Most common reconstructive procedures• Microsurgery to transfer tissuePLASTIC SURGERYcont’dReconstructive Plastic SurgeryPlastic Surgery21
    22. 22. Tumor Removal• Procedure to remove an abnormal growth• Can either be a benign or a malignant tumor• Benign tumors are easy to remove completely• Malignant tumor pose most difficult problems• May result in death if not successfully treatedTYPES OF RECONSTRUCTIVESURGERY cont’dPlastic Surgery22
    23. 23. Laceration Repair• Wound caused by sharp object• Mends a tear in the skin or other tissue• GoalsTYPES OF RECONSTRUCTIVESURGERY cont’dStop Bleeding Prevent InfectionPreserve Function Restore AppearancePlastic Surgery23
    24. 24. Scar Revision• Improve or reduce the appearance of scars• Restores function, and corrects skin changes causedby an injury, wound, or previous surgery• Ways to improve appearanceTYPES OF RECONSTRUCTIVESURGERY cont’dComplete RemovalSkin GraftingDermabrasionSkin Flap SurgeryPlastic Surgery24
    25. 25. Cleft Lip or Palate• Fissure or opening or a gap• Caused by abnormal facial development duringgestation• Can be successfully treated with surgeryTYPES OF RECONSTRUCTIVESURGERY cont’dCleft Lip & PalatePlastic Surgery25
    26. 26. Cleft Lip Scar RevisionTumor Removal Laceration RepairPlastic Surgery26
    27. 27. TECHNIQUES AND PROCEDURESEndoscopic surgerySkin GraftsFlap surgeryLaser technologyTissue ExpansionPlastic Surgery27
    28. 28. Plastic Surgery28
    29. 29. ORIGIN• As far as 2000 B.C.• Egyptian nose reconstruction• Indian doctor Acharya Sushrut• Romans• Cornelius Celsus “De Medicina”Plastic Surgery29
    30. 30. ORIGINcont’d• End of third century A.D.• Middle ages and Renaissance• Late 1500s- a breakthrough• Italian Gasparo Tagliacozzi• Struggle without progress• First text of cosmetic surgeryPlastic Surgery30
    31. 31. • Outbreak of world war I• Soldiers with extensive trauma wounds• An independent medical service• ASPRS created in 1931• A new age of enlightenmentORIGINcont’dPlastic Surgery31
    32. 32. • Past 100 years• ASPRS changed to ABPS• Lawful recognition• Mid 2000s• Growing multi-billionindustry• Liposuction – mostcommon surgeryORIGINcont’d32Plastic Surgery
    33. 33. Plastic SurgeryISLAMIC PERSPECTIVE33
    34. 34. PLASTIC SURGERY IN THE LIGHTOF VARIOUS RELIGIONS• Muslim: It is understood that surgery isn’t allowed, onthe basis that it permanently changes the body Godcreated and gave as a “trust.”• Catholic: doesn’t directly address the subject. If theprocedure is not for something considered immoralby the Church (such as gender-reassignmentsurgery), then “elective plastic surgery is left to theprudent choice of those involved”• Buddhist: see plastic surgery as an “offense”Plastic Surgery34
    35. 35. • Maslah or Manfa’h• Benefit or Utility• Seeking of benefit and preventing of harm• In Arabic, we sayISLAMIC PERSPECTIVEcont’dPlastic Surgery35
    36. 36. “And spend of your substance in the cause of Allah, andmake not your own hands contribute to (your) destruction;but do good; for Allah loves those who do good.” (2:195)ISLAMIC PERSPECTIVEcont’dPlastic Surgery36
    37. 37. ISLAMIC PERSPECTIVEcont’dPLASTICSURGERY (Types)For TreatingDeformityAimed atBeautificationPlastic Surgery37
    38. 38. Allah Almighty mentions in Surah al-Nisa the words ofShaytan, when he said :“I will mislead them and I will order them to slit the ears ofcattle, and to deface the (fair) natural creation of Allah.”ISLAMIC PERSPECTIVEcont’dPlastic Surgery38
    39. 39. “Allah has cursed women who tattoo or havethemselves tattooed, who pluck eyebrows or havethem plucked, and women who separate their frontteeth for beauty, altering what Allah has created.”(Al-Bukhari)“The woman who supplies false hair and the one whoasks for it, the woman who pluck eyebrows or havethem plucked, the woman who tattoos and the onewho has it done where there is no disease to justify ithave been cursed.”(Abu Dawud)Plastic Surgery39
    40. 40. ISLAMIC PERSPECTIVEcont’dCosmetic and plastic surgery for the purpose of beautifyingand adornment is impermissible. However, if there is agenuine need due to something being abnormal ordeformed, then there is a dispensation of permissibilityPlastic Surgery40
    41. 41. EVOLUTION IN PAKISTAN41Plastic Surgery
    42. 42. EVOLUTION IN PAKISTAN• Plastic surgery procedures - foreign word for manyPakistanis just 10 to 15 years ago• Hair transplantation clinics have sprouted up likemushrooms• Not as popular as in other countries• Field of plastic surgery is in its infancy in PakistanPlastic Surgery42
    43. 43. • Specialty unit in teaching started at Dow MedicalCollege & Civil Hospital, Karachi by Prof. K.M.Durrani in 1965• In 1976 Prof. Faiz Mohammad Khan Started Unit atJPMC• In mid eighties Prof. Shaista joined the dept. and atsame time plastic surgery unit were established atKing Edward, Lahore and PIMS, IslamabadEVOLUTION IN PAKISTANcont’dPlastic Surgery43
    44. 44. EVOLUTION IN PAKISTANcont’d• In early nineties Units were established in teachinginstitutes at Hyderabad, Faisalabad, Multan, Peshawar and Quetta• The Pakistan Association of Plastic Surgeons wasestablished in 1993Plastic Surgery44
    45. 45. MAIN OBJECTIVE OF PAPSTo promote and advance medical and surgical training andresearch pertaining to Plastic Surgery. To disseminateinformation regarding clinical and scientific progress inPlastic SurgeryTo promote the art and science of Plastic Surgery and tocommunicate to the members and the general public, theadvancements and improvements made in the field ofPlastic Surgery To promote the highest standards ofprofessional skill and competence among PlasticSurgeonsPlastic Surgery45
    46. 46. • Most common surgery procedures in PakistanincludeEVOLUTION IN PAKISTANcont’dNose ReshapingLiposuctionTummy TuckFace UpliftBurns/ Wounds SurgerySkin GraftsHair TransplantationPlastic Surgery46
    47. 47. ADVANCES IN PLASTIC SURGERYPlastic Surgery47
    48. 48. ADVANCES IN OTHERCOUNTRIES• Rapid progress with development of new techniques• Better understanding of anatomy of blood supply andmuscle• Advancement in burn treatment• Development of microsurgery• Craniofacial surgery• Cleft lip and palate treatmentPlastic Surgery48
    49. 49. Fractional Laser Resurfacing• Prolonged skin healing, skin redness, and risks ofclassic laser resurfacing minimized• Has spread to lasers which also treat wrinkles• Can be completed with topical anesthesia alone“There has been a long search for a technology whichproduces the same results for wrinkle improvement as thecarbon dioxide laser without the complications or longrecovery. The fractional technology applied to carbon dioxidelasers is the answer to that search,” Dr. Matthew Kienstra.ADVANCES IN OTHERCOUNTRIES cont’dPlastic Surgery49
    50. 50. Combination Liposuction Technologies• Combination of laser and ultrasound technology withold liposuction techniques provides some newpossibilities for decreased recovery• Though the scientific evidence is stillmixed, continued development means this is a verypromising innovation“There is a lot of art involved with the application of thetechnology and it appears to be the first technology which willallow true sculpting of the body,”Dr. Ed KhouryADVANCES IN OTHERCOUNTRIES cont’dPlastic Surgery50
    51. 51. Pain Pumps For Cosmetic Surgery• Patient controlled analgesia• Introduction of devices to provide pain relief right tothe site of pain“Pain pumps have greatly decreased hospital stays anddecreased recovery times for both our cosmetic andreconstructive surgery patients.”Dr SorokinADVANCES IN OTHERCOUNTRIES cont’dPlastic Surgery51
    52. 52. Increasing Variety of Dermal Fillers• Around since the 1980s but early fillers didn’t lastlong• Increase in longevity of the results• Over 1.5 million dermal fillers injections in 2008, upfrom just half a million in 2000“Dermal fillers and botulinum toxin products enablepatients to undergo chemical browlifts and liquidfacelifts, frequently delaying or obviating the need forsurgery.” Dr.Ronald FriedmanADVANCES IN OTHERCOUNTRIES cont’dPlastic Surgery52
    53. 53. Hair Cloning Research• Not a commercially available procedure• Technology has come a long way in the last tenyearsADVANCES IN OTHERCOUNTRIES cont’d“Once the technology becomes commerciallyavailable, surgeons will no longer be limited by a finitedonor site. The dream of a full head of hair will become areality,”Dr. VerretPlastic Surgery53
    54. 54. Laser Vein Therapy• Days of pain recovery to get rid of pesky leg veinslong gone• Laser technology has allowed many patients toundergo very successful leg vein removalStem Cell Harvesting from Fat acquired duringLiposuction• Extraction of stem cells from the fat removed duringliposuction• Hold promise for future scientific researchADVANCES IN OTHERCOUNTRIES cont’dPlastic Surgery54
    55. 55. Plastic SurgeryPROS AND CONS55
    56. 56. PROS AND CONS• PROSPhysical benefitsHigher self esteemGreater self confidenceSocial confidencePlastic Surgery56
    57. 57. PROS OF PLASTIC SURGERYPhysical Benefits• Extremely helpful for those with physical deformity• Improves health• ExamplesPlastic Surgery57
    58. 58. PROS OF PLASTIC SURGERYcont’dHigher Self Esteem• Gives patients higher self-esteem• Greater confidence• Positive effect on behaviorPlastic Surgery58
    59. 59. • Reshapes natural contours• Removes fat which cant be done through diet• Dramatic results• Successful in life and more opportunities• Accepted by society• Feel comfortable in company• Positive effect of person’s psychological healthPROS OF PLASTIC SURGERYcont’dPlastic Surgery59
    60. 60. Cons– Causes undue stress on the body– Swelling or bruising– Risk of infection, blood clotting etc– No guarantee of results– Invasive and painful– Long recovery– Cannot fix your insideCONS OF PLASTIC SURGERYPlastic Surgery60
    61. 61. CONCLUSION61Plastic Surgery
    62. 62. BIBLIOGRAPHY62Plastic Surgery
    63. 63.  Plastic Surgery by Natasha Skvorc and Rudolf Gregurek Plastic and Reconstructive Surgery Associate Prof.Vichai Chichareon Advances in Plastic Surgery by Harold D. Mcdonald Top Ten Plastic Surgery Advances by Dr. D.J. Verret www.wikipedia.com www.google.com www.slideshare.com www.powershow.com www.paps.com.pkBIBLIOGRAPHY63Plastic Surgery
    64. 64. 64Plastic Surgery
    65. 65. 65Plastic Surgery
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