Despite its overwhelming media presence plastic surgery continues to be the most misunderstood surgical specialty. It is my contention that this is the case because plastic surgery does not claim any specific disease (e. g. coronary artery disease in case of cardiac surgery) as its own nor does it focus on any single organ system (e. g. nervous system in case of neurosurgery) or region of the body (e.g . ear, nose and throat). It is thus hard to pinpoint what plastic surgery actually is. As much as I hate to admit it though, there is a grain of truth in the “extreme makeover” TV shows. Plastic surgery deals with shapes and form. Frank Lloyd Wright opined that form follows function. I opine function and form is the same in plastic surgery. Or put differently – and I challenge all readers to find a better answer – what is the function of the human face for instance ? Very categorically I state that the function of the human face is to look like the human face. Form and function are one and the same. The function of the human face is to have human form and shape. A similar case can be made in most of what I do as a plastic surgeon. A fractured bone in the hand does not function any more because it has lost its intact shape and form. It is not anatomically correct. Its normal anatomy is destroyed. Restoration of the anatomy restores form and function.
Plastic surgery is shape surgery. It creates or recreates structure, form and shape. Structure is beauty. Correct anatomy is beauty. Correct anatomy is “ideal, beautiful, normal”. So that’s what I do most of my working hours. I deal with shapes, form, structure and function. Cosmetic surgery – adorn the form, shape, make it structurally correct, enhance it. Hand surgery – recreate structure, form and function if at all possible after massive destruction, aging, or in congenital malformations. Craniofacial surgery – the epitaph of creating structure, mostly of the facial skeleton. Burn surgery – restoration of shape and form. And so on and so forth.
And it is all technique – another word having its roots in ancient Greek. “Techne” means skill, craft, art. People always look somewhat obliquely at me when I say I am the technician, who is generally considered lower than the knowledgeable sage, but I really use it in the sense of “skilled artist”. I know a lot about the materials I work with above all human tissues and their anatomy, dynamics and mechanical characteristics and aging properties, implants, biomaterials, fracture fixation sets down to mundane sutures etc. If there is a single answer that spontaneously comes to my mind when mostly non plastic surgery colleagues ask me what a plastic surgeon is really an expert at it is “arcane, esoteric and advanced anatomy”. The structurally correct “ideal, beautiful, normal” anatomy – the ultimate plastic surgeon’s perspective.