I know that faces can change in my years of nursing, but not only by scalpels or syringes. I have witnessed expressions on people when a burn victim looks at her healing skin for the first time. I have witnessed a boy born with a cleft lip being trained on how to smile confidently. I have witnessed souls being transformed not only physically, but emotionally and spiritually. This is why, whenever I hear someone disregard plastic surgery as a shallow or unnecessary practice, I want to tell them about the entirety of the situation. It is not all about beauty; plastic surgery is a matter of healing, restoring, and in many cases, survival.
Regrettably, most of the population is familiar with plastic surgery because of the outrageous tabloid headlines or celebrity news. They connect it with the vanity, failed operations, and unneighbourly risks. Those stories are out there, and they are valuable lessons, but they are not the entire truth. I am a nurse, and I have witnessed how much plastic surgery can produce good, sometimes with the help of qualified specialists and accompanied by good aftercare (American Society of Plastic Surgeons [ASPS]), 2022).
In this article I introduce you to see beyond the headlines and perceive plastic surgery as it is a medicine in all its diversifications; a combination of science, art and care.
What Is Plastic Surgery, Really?
Plastic surgery is a branch of surgery named in the Greek language plastikos (to mold or shape), and it entails the restoration, reconstruction, or modification of the human body (Nagarkar et al., 2021). It is widely divided into two broad categories; reconstructive and cosmetic plastic surgery.
Reconstructive plastic surgery is done to bring back the form and functionality of the areas of the body that were born with defects, trauma, illness, or surgery (National Institutes of Health [NIH], 2020). Conversely, cosmetic plastic surgery is done to improve appearance, self-confidence or to boost physical appearance with identity.
The history of plastic surgery is long and rooted in the ancient India and Egypt. It however took off tremendously in the early 20th century when surgeons attended to soldiers who had suffered facial injuries in World War I (Haiken, 1997). The field has changed a lot since that time, with the use of improved technology, anaesthesia as well as surgical procedures.
Reconstructive Plastic Surgery: Healing After Harm
Most individuals associate plastic surgery with lip fillers and tummy tucks. But I usually remember Rehema, a teenage girl, who got third-degree burns in a house fire. She was not able to close her eyelids well. Scar tissue had her left arm frozen at an odd position. The burns went up to her legs and she had difficulties walking. Plastic surgery helped her regain a functioning ability, dignity and hope.
1. Burns and Trauma
A very typical procedure in reconstructive plastic surgery is skin grafts. Patients with burns, trauma, and individuals with large wounds will have their conditions improved through grafting mechanisms, where healthy skin in another area of the body is used to cover the damaged sections (Peck, 2011). With time, patients become mobile, pain-free, and less apprehensive.
2. Breast Reconstruction
Breast reconstruction is chosen by a lot of women after mastectomy because of breast cancer. It is not the matter of appearance but of feeling complete again (Jagsi et al., 2014). In some individuals, reconstructive surgery enables them to overcome trauma and repossess their bodies. The role of nurses is extremely important in this situation as they have to take care of wound treatment, offer emotional support, and motivation at all steps of the healing process.
3. Congenital Abnormalities
One of the most life-transforming procedures is repair of cleft lip and palate. Children born with them are likely to experience feeding problems, speech disorders and social stigma. These children do well with timely surgery and multidisciplinary care which involves nursing, speech therapy, and counselling (Mossey et al., 2009).
Reconstructive surgery also repairs other born conditions, such as craniosynostosis or syndactyly (WEBBED fingers). Every success story reinstates the fact that modern medicine can be very strong.
4. Skid Grafting and Diabetic Ulcers
Wounds, particularly foot wounds, can become threatening to diabetic patients very fast. I have attended to patients that had ulcers that needed surgical debridement and grafting. Otherwise, numerous individuals would lose their limbs or have infections that are life-threatening (Lipsky et al., 2012). In such instances, reconstructive plastic surgery is literally lifesaving.
Cosmetic Plastic Surgery: More than Skin Deep
Cosmetic procedures have earned a bad rap and here is the reality about it: not all people who do cosmetic surgery are vain and superficial. I know some women who have opted to have breast reductions because they were experiencing constant back pain. I have witnessed men choose rhinoplasty, as they were involved in an accident that deformed their nose during childhood. And, yes, there are individuals who want to get an improvement to feel better, particularly following massive weight reduction or old age (Sarwer et al., 2005).
1. Popular Cosmetic Surgeries
A few of the most common cosmetic surgeries are:
• Rhinoplasty (nose reshaping)
• Liposuction (fat removal)
• Breast enlargement or reduction
• Facelifts
• Eyelid surgery
• Non-surgical (Botox and dermal fillers)
When conducted by qualified surgeons, these operations can provide satisfaction rates of high levels (ASPS, 2023). The patients usually complain of the enhancement of self-esteem, body image, and even social relations (Cash et al., 2004).
2. When Cosmetic Surgery Goes Bad
However, there is a darker side to cosmetic surgery- particularly when patients wake the services of unlicensed people offering cheap unregulated surgeries. People share the stories of botched surgeries, infections, disfigurement, and even death (Tessler et al., 2020).
I, as a nurse, once had a patient who had gone to an overseas country to get a cheap tummy tuck. She returned with a terrible abdominal infection and sepsis. Her convalescence was protracted, torturous and costly. It was a reality check: cosmetic surgery is surgery and as such is risky and should not be taken lightly.
3. Substitutes and Psychology Factors
The good clinics will examine the physical and mental preparedness of a patient before surgery. In some cases body image can be a result of more serious mental health problems such as Body Dysmorphic Disorder (Phillips, 2005). There are other cases in which surgery may fail to address the underlying issue.
In other cases, lifestyle interventions, such as exercise or therapy can provide safer, more long-lasting outcomes. Ethical practitioners will never compromise patient safety by putting profit first.
The Role of the Medical Team: Where Nurses Make a Difference
Plastic surgery is not a one-man show, involving just the surgeon, it is a team work. I am a nurse, and fellow nurses are at the forefront to provide care to patients prior to, during, and after surgery.
We inform patients on what to expect. We handle hurting and healing. We observe possible complications such as infections, blood clots or poor healing (White et al., 2015). However, it is not just physical support, we also provide emotional support. I have held hands pre-op and heard concerns post-op. I have celebrated milestones, however minimal they may be, such as a patient, standing up for the first time or lastly, taking off their bandages.
We do not only want to recover, we want to be empowered. It is our desire that any given patient leaves our premises stronger than he or she entered.
Changing the Narrative: A Call for Compassion and Perspective
Plastic surgery, as any other sphere of medicine, is good and dangerous. But when we strip it down to gossip or ridicule we wound the people who require it the most. Just consider, you are a mother and your child was born with a deformity. Or a woman who has lost her breasts to cancer. Or a man who lost his face in an accident on the road. To such individuals, plastic surgery is not vanity, it is victory ( Haiken, 1997).
Yes, we need to speak against unethical practice and avoid unnecessary harm. But shall we also elevate the accounts of healing and change. Okay, then, let us rejoice in the science that heals scarred skin and makes it smooth, that shuts visible and invisible wounds.
Final Reflections
After all, there is one thing I have learned taking care of plastic surgery patients and that is this: healing is never skin-deep.
Regardless of whether one arrives to fix a cleft lip or to straighten his/her nose, his/her path should be met with respect, understanding and competent service. I have seen suffering, bravery, remorse and gladness- all in one hospital bed. And so, before we judge, or before we make jokes, we have to keep in mind that there is a human story behind every surgery.
Plastic surgery is not all about cosmetic alterations. It is life changing.
References
American Society of Plastic Surgeons. (2022). Plastic surgery statistics report 2021. https://www.plasticsurgery.org
American Society of Plastic Surgeons. (2023). Top 5 cosmetic surgical procedures. https://www.plasticsurgery.org/news/press-releases
Cash, T. F., Duel, L. A., & Perkins, L. L. (2004). Women’s psychosocial outcomes of breast augmentation with silicone gel-filled implants: A 2-year prospective study. Plastic and Reconstructive Surgery, 114(3), 909–916. https://doi.org/10.1097/01.PRS.0000131053.19689.63
Haiken, E. (1997). Venus envy: A history of cosmetic surgery. Johns Hopkins University Press.
Jagsi, R., Jiang, J., Momoh, A. O., Alderman, A., Giordano, S. H., & Buchholz, T. A. (2014). Complications after mastectomy and immediate breast reconstruction for breast cancer: A claims-based analysis. Annals of Surgical Oncology, 21(10), 3233–3240. https://doi.org/10.1245/s10434-014-3856-3
Lipsky, B. A., Berendt, A. R., Cornia, P. B., Pile, J. C., Peters, E. J., Armstrong, D. G., & Warren, S. (2012). 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clinical Infectious Diseases, 54(12), e132–e173. https://doi.org/10.1093/cid/cis346
Mossey, P., Little, J., Munger, R. G., Dixon, M. J., & Shaw, W. C. (2009). Cleft lip and palate. The Lancet, 374(9703), 1773–1785. https://doi.org/10.1016/S0140-6736(09)60695-4
Nagarkar, P., Janis, J. E., & Kanchwala, S. K. (2021). What is plastic surgery? Defining a specialty in an era of marketing and misperception. Plastic and Reconstructive Surgery, 148(3), 709–714. https://doi.org/10.1097/PRS.0000000000008227
National Institutes of Health. (2020). Reconstructive surgery. MedlinePlus. https://medlineplus.gov/reconstructivesurgery.html
Phillips, K. A. (2005). The broken mirror: Understanding and treating body dysmorphic disorder (Rev. ed.). Oxford University Press.
Peck, M. D. (2011). Epidemiology of burns throughout the world. Part I: Distribution and risk factors. Burns, 37(7), 1087–1100. https://doi.org/10.1016/j.burns.2011.06.005
Sarwer, D. B., Cash, T. F., Magee, L., Williams, E. F., Thompson, J. K., Roehrig, M., … & Anderson, D. A. (2005). Female college students and cosmetic surgery: An investigation of experiences, attitudes, and body image. Plastic and Reconstructive Surgery, 115(3), 931–938. https://doi.org/10.1097/01.PRS.0000153211.15036.C9
Tessler, O., Nunley, R. M., & Goldman, M. P. (2020). Complications of cosmetic surgery: Risk factors, prevention, and management. Clinics in Plastic Surgery, 47(2), 219–228. https://doi.org/10.1016/j.cps.2019.12.003
White, C. P., Muir, I. F., & Kay, A. R. (2015). Wound healing in surgery: A review. British Journal of Surgery, 102(e3), 3–12. https://doi.org/10.1002/bjs.9700
