Surgery, Plastic

(also reconstructive surgery), a branch of surgery devoted to the restoration of the function and shape of partially or completely detached organs, correction of congenital or acquired abnormalities and deformities, and elimination of cosmetic defects. The biological basis of plastic surgery is the ability of flap tissue (for example, skin and skin-muscle-bone) and organs (for example, a kidney) transplanted on a pedicle or free from their original base to grow in new sites. Besides the patient’s own tissues, tissues from another person or an animal, cadaver tissue, and various inorganic materials (plastic and metal) may be used.

In the broad sense of the term, plastic surgery is employed in all surgical specialties: heart surgery (for example, valve prosthesis), surgery on digestive organs (for example, repair of the esophagus with tissue from the small intestine), traumatology and orthopedics (for example, replacement of tendons, osteoplasty), urology (for example, restoration of the penis and urethra), maxillofacial surgery (for example, operations for congenital harelip and cleft palate), otorhinolaryngology (for example, operations to improve hearing in otosclerosis), and ophthalmology (for example, corneal transplant).

In the narrow sense of the term, plastic surgery refers to operations on the body surface involving the transplantation of skin flaps, the repair of skin with a free skin flap, or the construction of a circular skin pedicle (V. P. Filatov’s rope flap); such operations make it possible to cover tissue defects with skin flaps transplanted from another part of the body. Operations on the body surface usually have a cosmetic aim as well. Some operations are performed solely for cosmetic purposes, for example, removal of wrinkles from the face and neck, skin folds from the abdomen, pigment spots, and deformities due to scars. The shape of the nose, lips, and ears may also be altered for cosmetic purposes. Noncosmetic plastic surgery is performed in general surgical or specialized medical institutions, whereas cosmetic surgery is performed in specialized hospitals or institutes of cosmetic surgery.