The Difference Between Cosmetic and Reconstructive Surgery

Key Takeaways:

  1. Cosmetic surgery is an elective choice, while reconstructive surgery is medically necessary.
  2. Reconstructive surgery is often focused on restoring function or appearance, such as for breast cancer patients after a mastectomy.
  3. It is important to consider the costs and potential risks associated with cosmetic surgeries, as these are not usually covered by insurance.

This video features Jamie Hill, Practice Coordinator/Manager of Politis Plastic Surgery, who provides an explanation of the difference between cosmetic and reconstructive surgery. Jaime states that cosmetic surgery is an elective procedure that individuals opt for to enhance their aesthetics, such as breast augmentation or liposuction. These procedures are typically not covered by insurance and require payment in cash. On the other hand, reconstructive surgery is meant to treat medical conditions, birth defects, burns, or injuries, and it is usually covered by insurance as it is medically necessary. In their practice, breast reconstruction for breast cancer patients is a predominant reconstructive procedure.

Jaime Hill’s explanation is crucial in understanding the significant differences between the two types of plastic surgeries. Cosmetic surgery is a choice, a luxury, while reconstructive surgery is often a necessity. Cosmetic surgery is meant to enhance one’s appearance, while reconstructive surgery is meant to restore function or appearance, such as after a disease or injury.

Plastic surgery has become increasingly popular, and it is critical to understand the differences between the types of surgeries. Jaime Hill’s explanation helps to clear the confusion and misconception about the two surgeries. Jaime Hill’s distinction between the two types of plastic surgery highlights the essential nature of reconstructive surgery and its importance in restoring people’s lives.

It is important to note that while cosmetic surgeries are an elective choice, they also have their benefits. Cosmetic surgery can improve an individual’s self-esteem, enhance their self-image, and boost their confidence. Individuals may choose to undergo cosmetic surgery to help them feel better about themselves, and there is nothing wrong with this. However, it is important to consider the costs and potential risks associated with cosmetic surgeries, as these are not covered by insurance.

Reconstructive surgery, as highlighted by Jaime, is primarily focused on restoring function or appearance. One of the critical examples of reconstructive surgery is breast reconstruction, which is often performed for breast cancer patients who have undergone a mastectomy. This procedure not only restores the physical appearance of the breast, but it also helps patients regain their confidence and sense of femininity. Other examples of reconstructive surgery include repairing cleft lips, restoring damaged tissue after an injury, or reconstructing parts of the body after a disease.

In conclusion, plastic surgery plays an important role in society, and understanding the differences between cosmetic and reconstructive surgery is essential. While cosmetic surgery is a luxury, reconstructive surgery is often a medical necessity. Jaime Hill’s explanation helps to clarify the difference between the two types of plastic surgery, and how they can have a positive impact on individuals’ lives. It is important to consider the costs and potential risks associated with cosmetic surgeries, while reconstructive surgery can restore function, confidence, and appearance to patients who have suffered from diseases, birth defects, or injuries. Ultimately, it is up to the individual to decide whether they want to undergo plastic surgery, and it is essential to consult with a qualified plastic surgeon to make an informed decision.

TRANSCRIPTION:

My name is Jamie Hill and I’m with Politis Plastic Surgery.

A lot of people wonder what the difference is between cosmetic and reconstructive surgery.

We provide both at this practice.

The difference in cosmetic and reconstruction is cosmetic is usually an elective procedure

that you choose to have done to enhance your aesthetics.

Maybe you want to be just the best version of you that you can be and maybe that means

you have larger breasts or a flatter stomach.

So those are cosmetic surgeries.

Typically those are not covered by insurance.

Those are cash pay procedures versus reconstructive surgery is used to treat usually a disease

process or a birth defect or something, a burn, something that insurance is going to

cover because we’re fixing, you know, something medically indicated for you.

In our practice, the bulk of what we do when it comes to reconstruction is breast reconstruction

because of breast cancer.

Sources:

Reconstructive Surgery on Cutaneous Malignancies

 
 
 
 
 
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A post shared by Effie Politis, MD, FACS (@dreffiepolitis)


As plastic surgeons, dermatologists typically refer us cases involving skin cancers dealing with the head/neck which require advanced closure techniques to minimize scar burden and resulting deformities. ⁣⁣

We are trained in “cutaneous oncology” in terms of evaluation and treatment of skin cancers, as well as coverage of resulting defects. ⁣⁣
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Micrographic surgery (Mohs surgery) is performed by our dermatology colleagues and is a technique based on complete tumor excision with maximal normal tissue preservation. ⁣⁣
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We often work with Mohs trained dermatologists who remove skin cancers that meet requirements. ⁣⁣
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We assist them in covering the resulting defect after tumor excision with margin clearance. Mohs surgery ensures margin and tumor clearance in areas requiring maximal tissue preservation (nose, lips, eyelids). ⁣⁣
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In some cases, Mohs is not indicated and we are able to perform the oncologic portion as well as the reconstructive portion. ⁣⁣
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In this patient, I was able to visualize tumor margins and perform a margin analysis (to ensure negative margins) prior to central tumor removal. ⁣⁣
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Once the margins were deemed negative via a pathologist on site who performs frozen sections, the remaining tumor is removed and the defect can be closed in the same setting. ⁣⁣
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Please note this patient did not receive Mohs surgery. ⁣⁣
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I performed the excision, achieved margin control, and then also performed
the reconstruction with local tissue rearrangement.

 
 
 
 
 
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A post shared by Effie Politis, MD, FACS (@dreffiepolitis)

Previously, we presented an example of reconstructive surgery I perform for cutaneous malignancies (skin cancers) involving face, scalp, and neck. ⁣
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Removal of cancer in an aesthetic unit (with margins) and closure of the defect with scars in an inconspicuous location. ⁣
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Principal in replacing like tissue with like tissue (color match and tissue thickness are taken into consideration) and tissue is moved or rotated or advanced with its corresponding blood supply. ⁣
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This is where the art of plastic surgery comes into play. We are trained to respect aesthetic subunits and cover like tissue with like tissue to ensure minimal distortion, and best color match and thickness. ⁣
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When considering coverage options, we need to be aware of how to best rotate or re-arrange adjacent tissue to cover the defect with a design that respects blood flow or tissue perfusion to ensure healing. ⁣
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Sometimes adjunct procedures are needed to get the best results (eg. revisions including debulking, dermabrasion, etc). ⁣
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This lady underwent partial chin defect coverage with bilateral V-Y advancement flaps and a single revision. ⁣
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Healing time is 4-6 weeks. ⁣
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Revisions are small office procedures with minimal downtime and healing in 1-3 weeks. ⁣
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Additionally, I advise my patients on sun avoidance and scar maturation postoperatively. ⁣
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It can take 6-8 weeks for scars to regain most (but never all) of their tensile strength. Scars often look worse before they look better. ⁣
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We recommend sun avoidance or covering the scar for 1 year (physical block or sunblock and physical block).⁣
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No scar revisions prior to one year. It usually takes one year for scars to really settle and look as close to normal as possible. ⁣
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I also remind patients there is no “scarless” surgery but we try to optimize the size and placement of scars according to local and aesthetic units.

Dr. Effie Politis Instagram
View the Before/After Gallery

GalaFLEX Surgical Scaffold for Plastic or Reconstructive Surgery

 
 
 
 
 
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A post shared by Effie Politis, MD, FACS (@dreffiepolitis)

Another important technique to point out from the case that we’ve recently posted about(please see our grid @dreffiepolitis ), is the use of Galaflex Ravioli construct⁣⁣⁣⁣⁣.⁣⁣

The GalaFLEX Scaffold (Galatea Surgical, Inc., Lexington, MA) for plastic and reconstructive surgery belongs to a new generation of products for soft tissue reinforcement made from poly-4-hydroxybutyrate (P4HB)⁣. ⁣

It is comprised of high-strength, resorbable P4HB monofilament fibers. It is a knitted macroporous scaffold intended to elevate, reinforce, and repair soft tissue. The scaffold acts as a lattice for new tissue growth, which is rapidly vascularized and becomes fully integrated with adjacent tissue as the fibers resorb.⁣

The “ravioli” technique involves using 2 pieces of extra thick ADM to completely wrap the TE/implant. The 2 pieces of ADM are cut to the size of the TE/implant with 1 piece covering the anterior and the other covering the posterior surface of the TE/implant.⁣⁣

Acellular dermal matrix (ADM) is a soft connective tissue graft generated by a decellularization process that preserves the intact extracellular skin matrix. Upon implantation, this structure serves as a scaffold for donor-side cells to facilitate subsequent incorporation and revascularization. In breast reconstruction, ADM is used mainly for lower pole coverage and the shaping of a new breast. It helps control the positioning of the implant in the inframammary fold, and prevents the formation of contractile pseudocapsule around the breast implant.⁣⁣

The “ravioli” construct is something Dr. Stephen Sigalov came up with which involves performing a 360 degree wrap of the implant with Galaflex to stabilize the implant in the breast pocket given the normal landmarks are obliterated with the mastectomy. The Galaflex or P4HB totally resorbs (turns in CO2 and H20) in 18-24 months and is replaced by the patients own Type 1 collagen to provide long lasting implant support. Type 1 collagen is the strongest collagen in the body. This prevents issues such as stretch, bottoming out, malposition, implant flipping etc. ⁣⁣

Dr. Effie Politis Instagram
View the Before/After Gallery