This document provides an overview of plastic surgery. It begins by defining plastic surgery as a special type of surgery that improves a person's appearance and ability to function through reconstructive and cosmetic procedures. The document then discusses the history of plastic surgery from ancient times through modern developments. It notes key contributors and advances in both reconstructive and cosmetic plastic surgery techniques over time.

1. PLASTIC AND RECONTRUCTIVE SURGERYPLASTIC AND RECONTRUCTIVE SURGERY
Dr Sumer YadavDr Sumer Yadav
Mch plastic and reconstructive surgeonMch plastic and reconstructive surgeon

2. What Is Plastic Surgery?What Is Plastic Surgery?
 The name is taken from the Greek wordThe name is taken from the Greek word
“plastikos”, which means to form or mold!“plastikos”, which means to form or mold!
 Plastic surgery is a special type of surgery thatPlastic surgery is a special type of surgery that
involves both a person's appearance and his orinvolves both a person's appearance and his or
her ability to function.her ability to function.
 It intends to improve patients' appearance, self-It intends to improve patients' appearance, self-
image, and confidence through bothimage, and confidence through both
reconstructive and cosmetic procedures.reconstructive and cosmetic procedures.

3.  Broad classification:Broad classification:
PLASTIC SURGERYPLASTIC SURGERY
cont’dcont’d
Plastic Surgery
3

4. There are two main kinds of plasticThere are two main kinds of plastic
surgery:surgery:
1.1. Reconstructive surgeryReconstructive surgery - is usually employed for medical- is usually employed for medical
purposes, and some common examples include:purposes, and some common examples include:
* cleft lip surgery* cleft lip surgery
* breast reconstruction surgery for those who have had* breast reconstruction surgery for those who have had
mastectomymastectomy
* contracture surgery for burn survivors* contracture surgery for burn survivors
2.2. Cosmetic surgery -Cosmetic surgery - is done mostly for aestheticis done mostly for aesthetic
enhancement and includes:enhancement and includes:
-- Different types of cosmetic surgery include: *Different types of cosmetic surgery include: *
Tummy tuck (abdominoplasty)Tummy tuck (abdominoplasty)
* Liposuction* Liposuction
* Breast lift* Breast lift
* Cheek augmentation* Cheek augmentation
* Breast reduction/enlargement (augmentation* Breast reduction/enlargement (augmentation
mammaplasty)mammaplasty)

5. Why do people get PlasticWhy do people get Plastic
Surgery?Surgery?
1.1. To improve the appearance.To improve the appearance.
2.2. Some people ore addicted to cosmeticSome people ore addicted to cosmetic
surgerysurgery
3.3. To correct a physical defect or to alter aTo correct a physical defect or to alter a
part of the body that makes them feelpart of the body that makes them feel
uncomfortableuncomfortable
4.4. To feel better about the way they lookTo feel better about the way they look

6. • To correct functional impairments caused by:To correct functional impairments caused by:
• BurnsBurns
• Traumatic Injuries (Facial bone fractures & breaks)Traumatic Injuries (Facial bone fractures & breaks)
• Congenital AbnormalitiesCongenital Abnormalities
• InfectionInfection
• CancerCancer
• TumorsTumors
• Most common reconstructive proceduresMost common reconstructive procedures
• Microsurgery to transfer tissueMicrosurgery to transfer tissue
PLASTIC SURGERY
cont’d
Plastic Surgery
6

7. Plastic Surgery
7

8. TECHNIQUES AND PROCEDURESTECHNIQUES AND PROCEDURES
Plastic Surgery
8

9. HISTORY OFHISTORY OF
PLASTIC SURGERYPLASTIC SURGERY

10. FIRST DESCRIPTIONSFIRST DESCRIPTIONS
 Description of replantation in Vedic times.Description of replantation in Vedic times.
 Sushruta Samhita, compiled in 600 BC describesSushruta Samhita, compiled in 600 BC describes
Indian rhinoplasty. Also a tilemaker method.Indian rhinoplasty. Also a tilemaker method.
 Indian rhinoplasty brought to attention in 1794,Indian rhinoplasty brought to attention in 1794,
B.L., Letter to Editor, Gentleman’s Magazine.B.L., Letter to Editor, Gentleman’s Magazine.
 Nicolo Manuzzi probably described IndianNicolo Manuzzi probably described Indian
rhinoplasty in early 18rhinoplasty in early 18thth
century but it was notcentury but it was not
published until 1907.published until 1907.

11. FATHER OF INDIAN PLASTICFATHER OF INDIAN PLASTIC
SURGERYSURGERY

13. SUSHRUTA’S CONTRIBUTIONS TOSUSHRUTA’S CONTRIBUTIONS TO
PLASTIC SURGERYPLASTIC SURGERY
 RhinoplastyRhinoplasty
 Classification of mutilated ear lobe defects andClassification of mutilated ear lobe defects and
techniques for repair of torn ear lobes (15techniques for repair of torn ear lobes (15
different types of otoplasties)different types of otoplasties)
 Cheek flap for reconstruction of absent ear lobe.Cheek flap for reconstruction of absent ear lobe.
 Repair of accidental lip injuries and congenitalRepair of accidental lip injuries and congenital
cleft lip.cleft lip.
 Skin grafting.Skin grafting.

14. SUSHRUTA’S CONTRIBUTIONS TOSUSHRUTA’S CONTRIBUTIONS TO
PLASTIC SURGERYPLASTIC SURGERY
 Piercing children’s ear lobe with a needle or awl.Piercing children’s ear lobe with a needle or awl.
 Classification of burns into four degrees and explainingClassification of burns into four degrees and explaining
the effect of heat stroke, frostbite, and lightningthe effect of heat stroke, frostbite, and lightning
injuries.injuries.
 Fourteen types of bandaging capable of coveringFourteen types of bandaging capable of covering
almost all the regions of the body and differentalmost all the regions of the body and different
methods of dressings with various medicaments.methods of dressings with various medicaments.
 Use of leeches to keep wounds free of blood clotsUse of leeches to keep wounds free of blood clots..

15. PERIOD OF CELSUSPERIOD OF CELSUS
 First century AD.First century AD.
 Compiled The Eight Books of Medicine, or DeCompiled The Eight Books of Medicine, or De
medicina octo libri.medicina octo libri.
 Plastic surgery for repair of nose, lips and ears.Plastic surgery for repair of nose, lips and ears.
 Double pedicled advancement flap and a formDouble pedicled advancement flap and a form
of subcutaneous island flap.of subcutaneous island flap.
 Washing wounds with vinegar, removal of partWashing wounds with vinegar, removal of part
of skull.of skull.

16. 1414thth
– 15– 15thth
CENTURIESCENTURIES
 1414thth
century Flemish surgeon Jehan Yperman:century Flemish surgeon Jehan Yperman:
repair of harelips.repair of harelips.
 Serafeddin Sabuncuoglu: first illustrated surgicalSerafeddin Sabuncuoglu: first illustrated surgical
textbook in Turkish-Islamic literature – eyelidtextbook in Turkish-Islamic literature – eyelid
problems, facial fractures, reductionproblems, facial fractures, reduction
mammoplasty (gynecomastia).mammoplasty (gynecomastia).
 Branca: cheek flaps for nasal reconstruction.Branca: cheek flaps for nasal reconstruction.

17. 1616thth
CENTURYCENTURY
 Tagliacozzi of Bologna: author of De CurtorumTagliacozzi of Bologna: author of De Curtorum
Chirurgia per Insitionem – delayed arm flap forChirurgia per Insitionem – delayed arm flap for
nasal, ear and lip reconstruction.nasal, ear and lip reconstruction.
 Antonio, son of Branca: upper arm flaps forAntonio, son of Branca: upper arm flaps for
nose, ear and lips.nose, ear and lips.
 Vianeo family from Calabria: reconstruction ofVianeo family from Calabria: reconstruction of
facial fractures.facial fractures.

18. TAGLIACOZZI OF BOLOGNATAGLIACOZZI OF BOLOGNA

19. 1717thth
– 18– 18thth
CENTURIESCENTURIES
 Art of facial restoration was in much disreputeArt of facial restoration was in much disrepute
following false ideas and perceptions.following false ideas and perceptions.
 Reemergence from India: article published inReemergence from India: article published in
Gentleman’s Magazine in October 1794 inGentleman’s Magazine in October 1794 in
London.London.

20. 1919thth
CENTURYCENTURY
 Joseph Carpue: reconstructed 2 noses using theJoseph Carpue: reconstructed 2 noses using the
Indian technique.Indian technique.
 von Graefe: “Rhinoplastik” – reconstructedvon Graefe: “Rhinoplastik” – reconstructed
noses using 3 different methods; lower eyelidnoses using 3 different methods; lower eyelid
reconstruction, cleft soft palate repair.reconstruction, cleft soft palate repair.
 Dieffenbach: leeches in nose reconstruction,Dieffenbach: leeches in nose reconstruction,
bone flaps for cleft hard palate, “nose” creationbone flaps for cleft hard palate, “nose” creation
in patient’s arm & transfer –in patient’s arm & transfer – Die OperativeDie Operative
ChirurgieChirurgie..

21. 1919thth
CENTURYCENTURY
 von Langenbeck: principles of modern cleft lipvon Langenbeck: principles of modern cleft lip
& palate surgeries.& palate surgeries.
 Serre: advancement flap – French method ofSerre: advancement flap – French method of
nasal reconstruction.nasal reconstruction.
 Dupuytren: palmar fibromatosis, burnDupuytren: palmar fibromatosis, burn
classification (6 degrees according to depth),classification (6 degrees according to depth),
removal of lower jaw, wry neck treatment.removal of lower jaw, wry neck treatment.

22. 1919thth
CENTURYCENTURY
 Z plasty: Denonvilliers – lower lid ectropion.Z plasty: Denonvilliers – lower lid ectropion.
 Sir Astley Cooper: first human skin graft.Sir Astley Cooper: first human skin graft.
 Jacques Reverdin: detached pinch grafts (STSG).Jacques Reverdin: detached pinch grafts (STSG).
 Wolfe, Krause: full thickness grafts.Wolfe, Krause: full thickness grafts.

23. 2020thth
CENTURYCENTURY
 Morestin: French army surgeon-reconstruction,Morestin: French army surgeon-reconstruction,
ear protrusion.ear protrusion.
 Harold Gillies: NZ ENT surgeon-Father ofHarold Gillies: NZ ENT surgeon-Father of
Modern Plastic Surgery; tubed pedicle flaps forModern Plastic Surgery; tubed pedicle flaps for
facial reconstruction (done earlier by Filatov),facial reconstruction (done earlier by Filatov),
epithelial outlay technique, intranasal skin graft,epithelial outlay technique, intranasal skin graft,
replantation, cosmetic surgery, sex reassignment.replantation, cosmetic surgery, sex reassignment.
 Kazanjian: IMF, facial clefts, bone grafting forKazanjian: IMF, facial clefts, bone grafting for
facial bone loss, prosthetic devices.facial bone loss, prosthetic devices.

24. SIR HAROLD GILLIESSIR HAROLD GILLIES

25. SEPARATE SPECIALTY (USA)
 Education not standardized.Education not standardized.
 Resistance from traditional surgeons.Resistance from traditional surgeons.
 1921: American Association of Oral & Plastic1921: American Association of Oral & Plastic
Surgeons.Surgeons.
 1931: American Society of Plastic &1931: American Society of Plastic &
Reconstructive Surgeons.Reconstructive Surgeons.
 1937: American Board of Plastic Surgery-efforts1937: American Board of Plastic Surgery-efforts
of Blair.of Blair.

26. WORLD WAR IIWORLD WAR II
 Refinement in plastic surgery.Refinement in plastic surgery.
 McIndoe: early skin grafting for burns.McIndoe: early skin grafting for burns.
 Sterling Bunnell: reconstructive hand surgery.Sterling Bunnell: reconstructive hand surgery.
 Converse: scalping flap.Converse: scalping flap.

27. DEVELOPMENTSDEVELOPMENTS
 Earl Padgett & George Hood: development ofEarl Padgett & George Hood: development of
dermatome.dermatome.
 Work on transplantation: Joseph MurrayWork on transplantation: Joseph Murray
received Noble Prize - work on kidneyreceived Noble Prize - work on kidney
transplants.transplants.
 Millard & Marks: better approach to cleft lip andMillard & Marks: better approach to cleft lip and
cleft palate repairs.cleft palate repairs.
 Paul Tessier et al: development of craniofacialPaul Tessier et al: development of craniofacial
surgery.surgery.

28. CONTINUEDCONTINUED
DEVELOPMENTSDEVELOPMENTS
 McGregor’s groin flap, Bakamjian’sMcGregor’s groin flap, Bakamjian’s
deltopectoral flap.deltopectoral flap.
 Ralph Ger: muscle flaps.Ralph Ger: muscle flaps.
 Malt (1962): reattached an amputated arm.Malt (1962): reattached an amputated arm.
 Komatsu & Tamai (1968): digital replantation.Komatsu & Tamai (1968): digital replantation.
 McClean & Buncke (1972): microvascularMcClean & Buncke (1972): microvascular
omental transfer.omental transfer.

29. DEVELOPMENTS INDEVELOPMENTS IN
AESTHETIC SURGERYAESTHETIC SURGERY
 Sheen: improvements in rhinoplasty.Sheen: improvements in rhinoplasty.
 Cronin & Gerow: silicone gel.Cronin & Gerow: silicone gel.
 Botswick: LD for breast reconstruction.Botswick: LD for breast reconstruction.
 Hartrampf: RA for breast reconstruction.Hartrampf: RA for breast reconstruction.
 Illouz: fat aspiration through hollow cannulas.Illouz: fat aspiration through hollow cannulas.

30. PLASTIC SURGERY IN INDIAPLASTIC SURGERY IN INDIA
 Sushruta Samhita & tilemaker method.Sushruta Samhita & tilemaker method.
 Maharishi Atreya & modification to classicalMaharishi Atreya & modification to classical
forehead flap.forehead flap.
 Description of rhinoplasty by Tribhovan &Description of rhinoplasty by Tribhovan &
Keegan in late 19Keegan in late 19thth
century.century.
 !945: maxillofacial surgical units at Kirkee &!945: maxillofacial surgical units at Kirkee &
Secunderabad.Secunderabad.
 1950: Plastic surgery dept at Patna & Nagpur.1950: Plastic surgery dept at Patna & Nagpur.

31. PLASTIC SURGERY IN INDIAPLASTIC SURGERY IN INDIA
 1957: Plastic Surgery section of ASI: Sir Gillies.1957: Plastic Surgery section of ASI: Sir Gillies.
 1960: MS degree in plastic surgery at Nagpur.1960: MS degree in plastic surgery at Nagpur.
“Nagpur classification” of cleft lip & palate by“Nagpur classification” of cleft lip & palate by
Dr. Balakrishnan.Dr. Balakrishnan.
 1966: first microvascular surgery in humans in1966: first microvascular surgery in humans in
the world done by Dr. Antia & Dr. Buch.the world done by Dr. Antia & Dr. Buch.
 1961: KEM Hospital, Dr. Pinto; “Hole-in-one”1961: KEM Hospital, Dr. Pinto; “Hole-in-one”
procedure for cleft lip & palate.procedure for cleft lip & palate.

32. FORMATION OF ASSOCIATIONSFORMATION OF ASSOCIATIONS
 1971: Burns Association of India.1971: Burns Association of India.
 1974: Indian Society for Surgery of the Hand.1974: Indian Society for Surgery of the Hand.
 1992: Indian Society for Reconstructive1992: Indian Society for Reconstructive
Microsurgery.Microsurgery.

33. ““Through all of Sushruta’s flowery language,Through all of Sushruta’s flowery language,
incantations and irrelevancies, there shinesincantations and irrelevancies, there shines
the unmistakable picture of a great surgeon.the unmistakable picture of a great surgeon.
Undaunted by his failures, unimpressed byUndaunted by his failures, unimpressed by
his successes, he sought the truth unceasinglyhis successes, he sought the truth unceasingly
and passed it on to those who followed. Heand passed it on to those who followed. He
attacked disease and deformity definitively,attacked disease and deformity definitively,
with reasoned and logical methods. When thewith reasoned and logical methods. When the
path did not exist, he made one.”path did not exist, he made one.”
Frank McDowellFrank McDowell

35. Plastic SurgeryPlastic Surgery

36. Megan Fox O.oMegan Fox O.o

37. THANKSTHANKS