Defining Scope of Plastic Surgery

Editorial

Plastic surgeons face lots of medicolegal issues, and one of the reason is absence of clarity on definition and scope of plastic surgery. If asked, most of the lay public and patients have no idea about what defines plastic surgery. Most of them think, some plastic will be used to treat him or her. To some plastic surgery means only beautification. Others feel some magic trick will be played to change shape of their body. This imaginative description confuses patients and leads to false hope & high possibility of legal issues. Not only patients, even among medicos, it is felt that they have no clarity about scope of plastic surgery. The term “plastic” is derived from the Greek word plasticos means “moldable” and defined as a branch of surgery which deals with treatment of deformities of integument and underlying musculoskeletal system [1,2]. It involves restoration, reconstruction, or alteration of the human body and includes cosmetic or aesthetic surgery, reconstructive surgery, craniofacial surgery, hand surgery, microsurgery, and the treatment of burns [3].

To simplify and easy to understand & remember, we proposed a definition which actually gives clear idea about scope of plastic surgery. We define plastic surgery as “Branch of surgery which deals with ‘5 Ds’ i.e., ‘Defect’, ‘Deformity’, ‘Dysfunction’, ‘Disability’ and ‘Disfigurement’””. ‘Defect’ means loss or breach in tissue continuity e.g., wounds, raw areas etc. ‘Deformity’ means alteration in shape and contour e.g., post burn deformity, post traumatic deformity, congenital deformity etc. ‘Dysfunction’ means abnormality and impairment of a bodily organ or system e.g., abnormal or impaired functions secondary to post burn deformity. ‘Disability’ means impairment, limitation of activity and participation e.g., impaired or limited activity due to post burn deformity. ‘Disfigurement’ means an aesthetically unacceptable surface abnormality that overlies normal contour e.g., scarring following burn injury, surgery, trauma, etc.

The ‘5 Ds’ concept of defining plastic surgery brings key elements of scope of plastic surgery into focus to explain to patients, and may help plastic surgeons to clearly understand patient’s problem and find solution effectively.

We have been practicing, teaching residents and published concept of ‘5 Ds’ of defining plastic surgery, and would like to disseminate this information to readers of this journal [4].

References

1. Mazzola RF, Mazzola IC. History of reconstructive and aesthetic surgery. In: Neligan PC, Gurtner GC, editors. Plastic Surgery. 3^rd ed. London: Elsevier. 2013: 11-29.
2. Converse JM. Introduction to Plastic Surgery. In: Converse JM, editor. Plastic Surgery. 2^nd ed. Philadelphia: WB Saunders. 1977: 1.
3. McCarthy JG. Introduction to Plastic Surgery. In: McCarthy JG, editor. Plastic Surgery. Philadelphia: WB Saunders. 1990: 20-22.
4. Babu P, Chittoria RK, Kumar SH, Marimuthu SK, Reddy KS, Chavan V, et al. Five “Ds” of plastic surgery. Plast Aesthet Res. 2017; 4: 13-14.