4^th Global Meeting on Plastic, Aesthetic and Reconstructive Surgery November 07-08, 2019 Frankfurt, Germany

A plastic surgeon creates an aesthetic, facially proportionate and functional nose by separating nasal skin and soft tissue from Osseo-cartilaginous nasal framework. In surgical procedures open and closed Rhinoplasty techniques are used. Various skin flap techniques are used in the surgical procedures such as Bilobed flap, mucosal flap, Septalflap and Paramedian Forehead flap. Ear surgery, Otoplasty, improves the shape, position, or proportion of ear. The surgery corrects the deformities and defects of the external ear .

• lap techniques in Rhinoplasty
• Nasal Analysis & reconstruction
• Open Rhinoplasty
• Closed Rhinoplasty
• Non-surgical Rhinoplasty
• Cleft lip and Palate

Rhinoplasty (RIE-no-plas-tee) is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, improve breathing or both.

The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve.

When planning rhinoplasty, your surgeon will consider your other facial features, the skin on your nose and what you would like to change. If you're a candidate for surgery, your surgeon will develop a customized plan for you.

Sometimes part or all of a rhinoplasty is covered by insurance.

Reconstructive surgery refers to plastic surgery which is performed on body parts which are abnormal, either in terms of their shape (disfigured) or function (dysfunctional). Such abnormalities may arise because of:

• Congenital defects (defects at birth);
• Development abnormalities;
• Trauma (e.g. burns);
• Infectious disease; and
• Tumours.

Reconstructive surgery is usually performed with the aim of improving the function of a body part. However, reconstructive surgery may improve functionality and the appearance of a body part at the same time. For example, blepharoplasty (eyelid surgery) is normally considered cosmetic, but can improve function where eyelids droop severely and obscure an individual’s vision.

Cosmetic surgery has increased dramatically in popularity over the past several years. People’s attitudes toward signs of aging have changed. More and more are accepting the cosmetic surgery alternative.

Cosmetic surgery has undergone significant technological and conceptual changes. Conceptual changes have altered the approaches to facial aging in the forehead, eyelids, and lower face. Technological changes include the use of lasers for facial cosmetic surgery, and minimally invasive techniques for face, breast, and body-contouring surgery.

Any elective surgical procedure carries some risk. But these advances mean faster patient recovery, less morbidity (illness), and natural-appearing results.

If your child needs surgery to fix a deformity caused by a birth defect, injury, illness, or tumor, a pediatric plastic surgeon has the experience and qualifications to treat your child. 

All children become ill or injured at one time or another. Most problems are simple and can be solved by your pediatrician. At times, however, special care from a pediatric plastic surgeon may be needed and may make the difference in achieving the best possible cosmetic result. If you think your child needs this kind of special care, request a visit with a pediatric plastic surgeon. 

Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption. Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic surgery).

Non-surgical medical procedures are used to diagnose, measure, monitor or treat problems such as diseases or injuries that don’t require surgery. They are generally not highly invasive and don’t involve cutting. Non-surgical procedures are carried out by a health professional such as a physician, general practitioner (GP), diagnostician or nurse. 

Knowing what to expect during and after a medical procedure can help you prepare, whether you go to hospital or to an outpatient clinic. All medical procedures have benefits, risks and possible side effects. Always ask your doctor for further information on any recommended procedure. If in doubt, seek a second opinion from another doctor.

Our hands serve many purposes.  Hands help us eat, dress, write, earn a living, create art and do many other activities. To accomplish these tasks and activities, our hands require sensation and movement, such as joint motion, tendon gliding and muscle contraction.

When a problem takes place in the hand, care must be given to all the different types of tissues that make function of the hand possible.  Hand surgeons are specifically trained to give that care:

• Hand surgery is the field of medicine that deals with problems of the hand, wrist and forearm.
• Hand surgeons care for these problems without surgery, and they are specially trained to operate when necessary.
• Many hand surgeons are also experts in diagnosing and caring for shoulder and elbow problems.
• Hand surgeons are orthopedic, plastic or general surgeons who have additional training in surgery of the hand.
• To become a member of the American Society for Surgery of the Hand, a hand surgeon must complete a full year of additional training and must pass a rigorous certifying examination.   

Genioplasty is a type of surgery done on the chin. Both plastic surgeons and maxillofacial surgeons (surgeons who work on the mouth and jaw) can perform this type of surgery. Genioplasty is most frequently a cosmetic surgery, meaning people choose to have it for looks and not because of a medical problem

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, with the subsequent development of the use of axial flaps, musculocutaneous flaps and neurosensory flaps. 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. Encouraging results have been reported in the treatment of nevus flammeus with argon lasers. In aesthetic surgical procedures, the aim is for safety and consistent long-lasting results. Improved understanding of the physiology and treatment of radionecrosis has evolved.

Laparoscopy invented by George Kelling in 1901, in Germany, is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.

Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, is a modern surgicaltechnique. There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. These include reduced pain due to smaller incisions, reduced hemorrhaging and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.

Ear surgery, also known as otoplasty, can improve the shape, position or proportion of the ear. A defect in the ear structure that is present at birth or that becomes apparent with development can be corrected by otoplasty. This procedure can also treat misshapen ears caused by injury.

Otoplasty creates a more natural shape while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self-esteem. If protruding or disfigured ears bother you or your child, you may consider plastic surgery.

Craniofacial surgery is a surgical subspecialty that deals with congenital and acquired deformities of the head, skull, face, neck, jaws and associated structures. Although craniofacial treatment often involves manipulation of bone, craniofacial surgery is not tissue-specific; craniofacial surgeons deal with bone, skin, nerve, muscle, teeth, and other related anatomy.

Defects typically treated by craniofacial surgeons include craniosynostosis (isolated and syndromic), rare craniofacial clefts, acute and chronic sequellae of facial fractures, cleft lip and palate, micrognathia, Treacher Collins Syndrome, Apert's Syndrome, Crouzon's Syndrome, Craniofacial microsomia, microtia and other congenital ear anomalies, and many others.

The procedures, techniques, and principles of cosmetic surgery are entirely focused on enhancing a patient’s appearance. Improving aesthetic appeal, symmetry, and proportion are the key goals. Cosmetic surgery can be performed on all areas of the head, neck, and body. Because the treated areas function properly, cosmetic surgery is elective. Cosmetic surgery is practiced by doctors from a variety of medical fields, including plastic surgeons.

The scope of cosmetic surgery procedures includes:

• Breast Enhancement: Augmentation, Lift, Reduction
• Facial Contouring: Rhinoplasty, Chin, or Cheek Enhancement
• Facial Rejuvenation: Facelift, Eyelid Lift, Neck Lift, Brow Lift
• Body Contouring: Tummy Tuck, Liposuction, Gynecomastia Treatment
• Skin Rejuvenation: Laser Resurfacing, Botox^®, Filler Treatments

Fortunately most burns are minor and require only first aid and a dressing.  However burns that affect a large area of the body are much more serious, can be life-threatening, involve intensive-care treatment and possibly several operations. Even some small burns, if they are deep, are treated with an operation. Usually the seriousness of a burn injury is determined by:

•  How much of the body is burned ( the “body surface area” or “BSA”),
•  How deeply the skin has been burned and
•  The general health and age of the person who has been burned.

A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast mound for post–mastectomy breast reconstruction patients or to correct congenital defects and deformities of the chest wall. They are also used cosmetically to enhance or enlarge the appearance of the breast through breast augmentation surgery.

There are three general types of breast implants, defined by their filler material: saline solution, silicone gel, and composite filler. The saline implant has an elastomer silicone shell filled with sterile saline solution during surgery; the silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, etc. Composite implants are typically not recommended for use anymore and, in fact, their use is banned in the United States and Europe due to associated health risks and complications.

Brachioplasty has become one of the most rapidly growing operations in plastic surgery. There are a variety of arm presentations, due to either weight loss or other reasons, and the extent of the defect can carry into the lateral chest wall and the back. In this featured operative technique article, the author describes indications, patient selection, and criteria for classifying brachioplasty, and illustrates the surgical techniques of this procedure. Markings, scar positioning, and the various operative steps are described along with the intricacies of postoperative care, including scar control. 

Abdominoplasty, one of the most commonly performed aesthetic procedures, has undergone a significant evolution over the past several decades. Kelly was one of the first surgeons to attempt to correct excess abdominal skin and fat.  Using a transverse incision, he was able to resect a 7450-g panniculus measuring 90 X 31 X 7 cm. Since that time, numerous variations have been suggested. Thorek was the first to devise a procedure that preserved the umbilicus. 

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two categories. The first is reconstructive surgery which includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. The other is cosmetic or aesthetic surgery. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims at improving the appearance of it. Both of these techniques are used throughout the world.