What is Plastic Surgery?
What is Cosmetic Surgery?
Do you need cosmetic surgery?
Who is best qualified to perform cosmetic surgery?
What are the Anesthesia choices for procedures?
What are the Risks & complications of plastic and cosmetic procedures?
What about the Cost of Plastic Surgery?

What is Plastic Surgery? What is Cosmetic Surgery?

Plastic Surgery is a branch of surgery concerned with the correction of defects and deformities which affect its appearance and function.
The word plastic is derived from the word ‘plastique’ which means to mould or shape. The word has no correlation with plastic the man made material. Yes, sometimes artificial materials are used to build up a defect but this is purely incidental. Unfortunately this semantic confusion has led to many false perceptions in the mind of lay public about how plastic surgery is carried out.
Plastic Surgery is not area specific unlike specialties like cardiac or neurosurgery but involves operations which are carried out from head to foot.

Plastic Surgery has two broad divisions-

  • Reconstructive Plastic Surgery
  • Cosmetic surgery

In layman terms Reconstructive Plastic surgery has become synonymous with Plastic Surgery and Cosmetic surgery is considered a separate specialty, but this is another misconception.

Reconstructive plastic surgery is performed to correct functional impairments caused by burns; injuries, congenital and developmental abnormalities; infection and diseases such as cancer Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance. Reconstructive plastic surgery has a very extensive range of operations. See details.

Cosmetic plastic surgery involves optional procedures that are performed on normal parts of the body with the only purpose of improving a person’s appearance to bring it close to a perceived ideal and/or removing signs of ageing. If one does not have a positive body image this can lead to serious psychological sequelae. Studies prove that this type of surgery plays an important role in restoration of a person’s self-esteem because the physical appearance is an important status equivalent to gender or race and by making changes to the body it contributes not only to the patient’s physical appearance but also to the mental health of the patient. Cosmetic surgery operations include a whole gamut of operations from head to foot. See details.
In short, reconstructive surgery aims to bring subnormal people to normal whereas cosmetic surgery aims to bring normal people to perfection.

Do you need cosmetic surgery?

The answer to this question is hidden in another question- What do you see, when you look at yourself in the mirror?

Each one of us has his or her perception of a perfect body. If what you see matches your perception, then you do not need us –at least for now!
If you feel dissatisfied about your body proportions, or shape and size of individual body parts, or about the quality of skin in general read on…
We have the expertise to offer to you customized cosmetic, anti ageing, body contouring, skin rejuvenation and Smile design solutions. They will enhance your body image and your self confidence.
Once the exclusive reserve of the rich and the famous, cosmetic surgery is now available for one and all. This sea change has been made possible by increasing range and safety of procedures, positive role played by media, more revealing clothes and the increasing affluence of the middle class as also greater emphasis on body aesthetics and female emancipation.

Strictly speaking, a person seeking cosmetic surgery is not a patient as he/she is not abnormal. Not every person seeks perfection so every person does not merit cosmetic surgery even if he/she can do with some improvement in appearance. So unlike other fields of medicine the opinion of the patient is very important in decision making since the only reason the surgery is being done is to satisfy a person’s desire to improve the body image. The best performed cosmetic procedure is a failure if it does not satisfy the patient.

For cosmetic surgery to be successful the following patient perquisites are important-

  1. A cosmetic problem which is technically correctable.
  2. Patient is physically healthy.
  3. The patient is mentally stable with realistic expectations.


The following patients are likely to remain dissatisfied after the cosmetic procedure-

  1. Patients with minimal deformity and out of proportion concern
  2. Inability to describe desired changes
  3. Family & friends[support system] opposition
  4. Bizarre/psychiatric behaviour
  5. Anxious/ depressed
  6. Unrealistic expectations
  7. Life crisis
  8. Frequent cosmetic procedures
  9. Dissatisfaction with earlier procedures/surgeons
  10. Gender sexual identity issues
  11. Body dysmorphic disorder [BDD] is a disorder in which the sufferer becomes preoccupied with imaginary as defects in their bodies. While 2% of people suffer from body dysmorphic disorder in the United States, 15% of patients seeing a dermatologist and cosmetic surgeons have the disorder. More than 50 percent of people with this disorder may have cosmetic surgery performed and are not pleased with the aesthetic outcome. BDD can lead to worsening of symptoms or suicides.


Who is best qualified to perform cosmetic surgery?
Reconstructive plastic surgery is performed by Plastic surgeons but cosmetic surgery is being performed by a number of specialists who develop an interest in the subject of cosmetic surgery.
Only a Plastic surgeon has the requisite training to achieve optimal results in cosmetic surgery since he is trained to handle tissues in a delicate way to produce optimal results. These skills are fundamental to all surgical procedures-cosmetic or reconstructive. A M.Ch. [Magister Chirurgiae] in Plastic surgery or an equivalent foreign degree entitles the surgeon to perform cosmetic surgery and achieve optimal results.
It is in your interest that you look at the qualifications of the surgeon who performs the procedure rather than hitch your faith in a self styled friendly neighbourhood cosmetic surgeon who is performing cosmetic procedures. Results in surgery whether good or bad- are irreversible! Choose wisely. In addition, there are some red flags which can warn a patient that he/ she may not at the right place for the procedure-

1. Those who are soliciting patients through advertisements in media are indulging in unethical behaviour. Such unholy practices can creep into their medical practice as well. Do not be knave to fall for such traps.

2. Trivialization of all procedures as ridiculously simple, one hundred per cent safe, get-in get-out, or day care can be at the cost of safety. Beware. A surgery is a surgery is a surgery and should be done after full work up and planning with zero compromise on safety. First rule of cosmetic surgery is – first do no harm.
3. Too much reliance on newer procedures which are not authenticated for example touting stem cells as cure for all maladies.

What are the Anesthesia choices for procedures?
Most procedures will require some anesthesia before the procedure can be carried out. Anesthesia can be-

1. Topical- a cream or gel for example Toplap can be used to numb the skin can be applied 1-2 hours before the surgery. The effect is often unpredictable and may be incomplete for suffices for minor procedures not likely to produce too much pain.
2. Local anesthesia– involves the use of local xylocaine or bupivacaine which is injected in and round the area to be treated to produce anesthetic effect. The effect lasts from half an hour to several hours depending upon the agent used.

3. Regional anesthesia-Is a method of anesthesia in which the nerves supplying the area of interest are temporarily knocked out by the use of drugs injected in precise location of the nerves.

4. General anesthesia means that the patient is completely unaware of the procedure and wakes up only after the procedure is over. It may be administered by the use of drugs given into intravenous line. Alternately it may involve the use of tubes which go into throat or windpipe and deliver anesthetic gases into lungs to produce anesthetic effect.

The topical and local anesthesia can be administered by the surgeon himself but regional and general anesthesia is generally administered by the anesthesiologist who is specially trained for this job.
Any anesthesia carries some risk but is necessary before a procedure can be carried out effectively. Your surgeon will brief you about the choice of anesthesia options for the particular procedure to be carried out as also the potential risks associated with it.

What are the Risks of plastic and cosmetic procedures?
All procedures carry some inherent risk. The final call about doing any procedure is taken after careful assessment of risk benefit ratio. A procedure is carried out if the risks are negligible and the benefits substantial.

The risks can arise from-

  1. Surgical procedure itself for example general problems like hematomas or infection and complications specific to the procedure
  2. Risks may be relates to anesthesia
  3. Risks because of drugs used after surgery e.g. antibiotics or painkillers
  4. Risks because of associated illnesses- diabetes, hypertension or heart disease
  5. Risks because of mental or psychological condition s of the patient e.g. anxiety attack, body dysmorphia.

Quantification of the risk
The risk of any procedure cannot be quantified precisely but an analogy will help. A doctor performing a surgery is like a person driving a car.
Now, all of us drive cars or other vehicles. One may go through your entire life without any serious accident but one can still have a serious or even fatal accident any time. The analogy can be carried out still further. The Surgeon is the driver; the patient is the car and the facility where the surgery is carried out is the road. The risks of accidents increase if –

A] The driver [read surgeon] is inexperienced
B] The car is rickety [read poor risk patient with pre existing diseases]
C] The road is bad [read poor facilities at the centre where surgery is carried out]
D] You drive long enough. So extensive procedures carry greater risk.

So the trick to minimize the risk is to choose a surgeon who is experienced and a surgical setup which is fully equipped. All preexisting diseases should be fully evaluated and controlled before procedures are undertaken.
Your surgeon will discuss in detail the possible complications associated with the procedure before it is actually done to make you aware of the potential risks. You may be asked to sign a consent form which mentions these facts.

What about the Cost of Plastic Surgery?
The cost of any surgery is a sum total of a number of components including surgeon’s professional fee, operation theater charges, anesthesiologist fee, room rent, cost of drugs, disposables, anesthetic gases and implants and sutures. The implants and Alloplastic materials can cost a bomb as they have to conform to stringent medical safety norms. Also many of them are imported and cost of duties and currency conversion hits them. For example, a pair of form stable breast implants from US FDA approved company can cost nearly 40,000/ rupees and some fillers can cost around 30,000/ for a single shot.

In general, surgery is cheaper in the developing world countries as compared to developed world countries due to prevalence of lower wages in developing world and lower cost of overheads.
In a surgery carried out in a hospital, the costs of operation are lower for lower categories of rooms like economy wards and rise steadily as you opt for single rooms, deluxe rooms and suites. The differences in extremes can be up to 300% for the same operation. The cheapest packages are available for economy category with daycare or single day stay- every other factor remaining constant.

Financial constraints may force a person to go shopping before a procedure but a word of caution is necessary. Too much emphasis on cost cutting and trying to look for the cheapest deal in the market may land you in soup as cost cutting at the cost of safety and quality can be disastrous and even fatal. Surgery done in established centers that have good operation theatres, trained anesthesia staff, optimal perioperative care and multi specialty support is always to be recommended even if costlier. Getting cosmetic surgery is not equivalent to buying a TV. Beware and choose wisely.