Plastic Surgery 

sni“Reconstructive surgery not only restores the body but also one’s confidence”,sni

says Prof Dr Naheed Ahmed Choudhry, a plastic surgeon at Nishtar Medical College & Hospital Multan

SN: What does a plastic surgeon deal in?sni

A plastic surgeon deals in two major divisions of plastic surgery: cosmetic/aesthetic and reconstructive. In cosmetic surgery features are enhanced through procedures like face lift and tummy tuck etcetera. Whereas in reconstructive surgery damaged or deformed body parts are treated to give them a normal shape. This type is needed to live a normal life. It includes burn surgery and skin grafting etcetera.sni

SN: Why is it called plastic surgery? Some people believe plastic is used in this process. Is it true?sni

It is called plastic surgery because plastic means “to mold”. Unlike the common misconception of using plastic, we use body’s own tissues to reconstruct damaged parts and also enhance the individual’s appearance.sni

SN: What kind of cosmetic and reconstructive procedures are common in Pakistan?sni

Common cosmetic procedures are LASERS, hair transplant, nose jobs, liposuction, fat grafting, breast augmentation and abdominoplasty. On the other hand, common reconstructive procedures include burn surgery, nasal reconstruction, cleft lip and palate and flap coverage.sni

SN: What are the benefits and complications of reconstructive surgery?sni

Reconstructive surgery not only restores the body but also one’s comfort and confidence. Patients become capable of carrying out routine activities. Risks associated with it are infection, bleeding, loss of graft, abnormal scarring, blood clots and problems related to anesthesia.sni

SN: Do the scars acquired due to surgery go away with time?sni

It depends on the location, nature of scar and skin type. Usually scars fade and their volume decreases naturally with time. But in some cases they are very prominent. A surgeon can improve their condition and appearance to make them less noticeable.sni

SN: What are the possible reasons for a surgery to go wrong? To which extent damage is reversible?sni

Things can go wrong if proper preoperative planning or examination is not done. Other factors include uncontrolled comorbid conditions (presence of more than one disease at a time), smoking and unhealthy wounds etcetera. Reversal of damage depends on the nature of surgery.sni

SN: What is the difference between surgical and non-surgical techniques?sni

In surgical method body’s own tissue is taken to reconstruct the missing part. In non-surgical techniques LASERS, creams and prefilled injections are used.sni

SN: What is the difference between breast implant and flap surgery?sni

Both are major types of breast reconstruction surgeries. In implant, a medical prosthetic is placed inside breast to reconstruct or create the physical form of the breast. In flap surgery a woman’s own tissue is used to reconstruct the breast.sni

SN: How beneficial is plastic surgery for cancer patients?sni

Plastic surgery is highly beneficial for cancer patients. A plastic surgeon not only removes cancer but also reconstructs removed parts of the body. For example, in breast cancer surgery, tumor is removed and breast is reformed through flap surgery or implant. Another example is head and neck cancer surgery in which oral cavity, upper and lower jaws are reconstructed with flap tissue.sni

SN: What is the role of plastic surgery in treating burns?sni

It plays a vital role in treating burns especially acid burns. Initially patients need restoration and treatment of dead skin. Once all dead tissues are removed, the surgeon reconstructs wounds with skin grafting and flaps.sni

SN: What are other medical interventions to be expected for a burn patient?sni

Initially major burn patients need central venous line. It is a tube through which fluids, blood and medication is provided to affected part. Some patients need “tracheostomy” for air to enter in the lungs. For this purpose, a cut is made in the neck and tube is inserted in windpipe. Severe burn cases in which both skin layers are destroyed require surgical treatment called “escharotomy.”  Heparin (blood thinner) is used to prevent blood clotting. Some other components are also used to prevent bleeding.sni

SN: Is it a painful procedure? How long does the healing process take?sni

Plastic surgery is normally done under local or general anesthesia depending on the nature of surgery. Pain is bearable. If it exceeds it is controlled with pain killers. Healing process takes two to three weeks.sni

SN: What is the treatment for birth defects like cleft palate?sni

It is mainly treated through cleft lip and palate surgery. There are many other options as well.sni

SN: What are the sources of skin grafts? What happens to the spot from where graft is taken?sni

Skin grafts can be taken from almost any part of the patient’s body. Usually they are taken from hidden areas like thighs, outer ear and scalp. Other graft sources are animals, synthetically produced products and another person. The area from where graft is taken is called donor site. It can heal on its own with the help of essential skin appendages.sni

SN: What is microsurgery?sni

It is a surgery in which very small caliber arteries, veins, nerves are taken from one part of body and reconstructed at other areas. It ends with joining arteries and veins of local area. It can be performed on any body part and often used for complex cancer and trauma cases.sni

SN: What type of pre and post-surgery care is required?sni

Comorbid conditions must be controlled before surgery. One should stop smoking as it affects healing process by causing infection. It can cause heart attack too during or after surgery. Also take a few days’ rest pre and post-surgery. Most importantly follow your surgeon’s advice regarding which physical positions should be avoided.sni

SN: Do stitches or incisions go bad during summers because of sweating?sni

Sweating can sometimes cause problems in wound/stitch care. But there is no definitive connection between them.sni

SN: When does a patient require a prosthetic device?sni

When amputation and reconstruction is nearly impossible, then prosthetic device is used for functioning.sni

SN: Which unique surgeries have you performed?sni

I have treated many cases like total nasal reconstruction after amputation, hand re-plant, penile reconstruction, cleft lip and palate repair and hypospadias repair.sni

difference between reconstructive and cosmetic surgery, is plastic used in plastic surgery, surgery and scars