What is the Difference between Plastic, Cosmetic, Aesthetic, and Reconstructive Surgery?

Unfortunately, in the medical world there are many terms that can often have many different meanings. People often confuse elective surgery with plastic surgery, but this is not always true. Elective surgery actually refers to something that can be scheduled at the patient’s convenience, or should be done sooner than later. The opposite would be an emergency surgery that if not performed as soon as possible would result in significant negatives, including death. In the true sense, almost all plastic surgery is elective, and especially the surgeries that I perform.

When we look at these terms from an insurance perspective, elective is often used to mean the opposite of medically necessary. Elective surgeries in that sense are something that insurance companies often push back on to cover or fight to reimburse. This in in contrast to something medically necessary that insurance companies routinely cover without question.

Lastly, the difference between plastic and cosmetic or reconstructive surgery is a different discussion. Plastic surgery involves changing the appearance of something may appear normal, or function properly, just as the term “-plasty” is used in many surgical specialties and refers to changing something (e.g. rhinoplasty, arthroplasty, valvuloplasty, urethroplasty, etc.). On the other hand, reconstructive surgery contents taking something that is broken, functioning improperly, or appears deformed and striving to return it to its normal functioning state. As opposed to reconstructing something in an attempt to return it to its pre-trauma, cancer, or dysfunctional condition, plastic or cosmetic surgery most often has the goal of improving the appearance of something.

Is All Plastic Surgery Elective?

With the exception of very few medically necessary and emergent plastic surgical procedures (trauma, severe infection, etc.) almost every surgical procedure that is performed for a cosmetic purpose is elective. This is especially true in my practice, where nearly every plastic surgery procedure I performed is done in an outpatient surgery center and is completely elective. This means that surgery is scheduled at your convenience, and insurance companies will typically deem it not medically necessary, therefore Insurance reimbursement is not an option. Functional surgeries, including those for nasal obstruction, or vision deficiencies caused by excessive eyelid redundancy, can often be covered by insurance. These are in addition to trauma related issues that caused a visible deformity or functional issue.

How are Facial Plastic Surgeons, Dermatologists, and Plastic Surgeons Different?

Remember, all medical providers and especially medical doctors have committed to years and often decades of medical training. Dermatology is mostly considered a medical specialty, and includes four years of additional training following medical school. Surgical training almost always includes more hands-on practical experience than general medical training. Facial plastic and reconstructive surgeons spend six years of additional training (residency and fellowship) years following four years of medical school. Plastic surgeons spend a similar amount of time, typically six years, in their surgical training.

Plastic surgeons spread their years of surgical training working on all parts of the body with some exposure to the face. Facial plastic surgeons on the other hand spend their entire six years of surgical training focusing exclusively on the head, neck, and face. It is this difference in focused experience that separates facial plastic from plastic surgeons. Personally I feel that plastic surgeons are incredibly qualified to perform cosmetic procedures on the body, including body contouring, and breast surgery as well as facial surgery. However, I feel that facial plastic surgeons are uniquely qualified to focus exclusively on facial cosmetic surgery including facial rejuvenation, rhinoplasty, and reconstructive work.

What is Facial Rejuvenation Surgery?

Facial rejuvenation surgery, which is often referred to as “aging face surgery,” refers to procedures meant to lift sagging tissues, remove redundant fat or skin that ages the face, and tighten tissues to restore a more youthful appearance. The most often treated areas are the brow as it descends over the eyes, the upper and lower eyelids with excessive upper eyelid skin, and lower eyelid skin with pooching fat, midface hollowing and fat descent, and jawline and neck skin and soft tissue redundancy. Most procedures such as brow lift, facelift, neck lift, and eyelid lift (blepharoplasty) are intended reverse the effects of years of aging and gravity. Additionally, resurfacing procedures such as chemical peels and laser resurfacing that helps remove sun damage, age spots, and treat fine lines and wrinkles are considered facial rejuvenation surgery.

What Can Facial Rejuvenation Surgery Do For Me?

It all depends on what specifically bothers you. It is amazing to me how two patients with the exact same age related facial changes can be bothered by two totally different problem areas. In other words, if you’re interested in surgical correction for some age related facial concerns, it is definitely worth scheduling a surgical consultation to determine whether what bothers you is something that can even be addressed with surgery. Occasionally patients are bothered by something that is correctable, but the correction might make a more visible resulting problem. Or, their expectations are not appropriate, and they’re hoping for a miracle transformation that is just not obtainable whether it is due to their underlying anatomy, tissue quality, or medical well-being. Not surprisingly, some patients consult with me to discuss surgery, when in fact filler or neurotoxin is actually the best option for them. Even though I love being a surgeon, and love performing surgery, a surgical procedure is not always in the best interest of every patient.

At the end of the day what bothers you, bothers you… And I more than happy to discuss what is the best option available for treating your concerns.

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