PLASTIC OR COSMETIC?

By Robbie Pangilinan


In the medical world, there is a long standing rivalry between plastic surgery and cosmetic surgery. The two terms are usually used interchangeably since there really are many similarities with the procedures, but there are also critical differences between them.

We usually equate cosmetic surgery with aesthetics and beauty. Face lift, nose lift, breast enhancement or reduction, liposuction, tummy tuck, and removal of moles or birthmarks, come to mind when the term cosmetic surgery is heard.

Plastic surgery, on the other hand, is associated with repairing skin damaged by injuries or accidents, or correcting congenital defects or illness. We hear of facial reconstruction or skin repair of burnt or scarred tissue, skin graft, transplants, reshaping of facial parts, and others, and think of plastic surgery. And, almost always, we think that cosmetic surgery is performed by dermatologists while plastic surgery is done by real surgeons.


In the strictest definition, plastic surgery “deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, crainomaxillofacial structure, hand extremities, breast and trunk and external genitalia.” Plastic surgery is generally used to correct, restore, or repair skin and tissue problems caused by congenital defects, illness or injury and usually involves invasive procedures.


According to the American Academy of Cosmetic Surgery (AACS), a professional medical society that represents cosmetic surgeons in the American Medical Association, “cosmetic surgery is a subspecialty that uniquely restricts itself to the enhancement of appearance through surgical and medical techniques. It is specifically concerned with maintaining normal appearance, restoring it, or enhancing it toward some aesthetic ideal.”


Of course, there are cases when plastic surgery is also considered cosmetic like when breast reduction is done not only to enhance the client’s appearance but also because the extra weight of the breast causes back or shoulder pain for the client.
Technically speaking, cosmetic surgery is one of the two categories that fall under plastic surgery (the other is reconstructive surgery). In cosmetic surgery, a body part that is most likely to be within normal range is enhanced or improved, while in reconstructive surgery, a body part that is not within normal range is made to look more normal such as in repairing a cleft lip.


Cosmetic surgeons, though always looked down upon by plastic surgeons, are required to have further training to achieve the adequate competency to perform cosmetic surgery. In the USA, board certification by the American Board of Plastic Surgery only shows a physician’s skill in plastic surgery and not aptitude in cosmetic surgery. Many clients are misled to believe that plastic and cosmetic surgeons have the same training. The AACS explains that surgeons from various disciplines practice cosmetic surgery. Dermatologists, general surgeons, oral and maxillofacial surgeons, ophthalmologists, otolaryngologists, plastic surgeons and physicians from other fields may all do cosmetic surgery learned through post residency training and experience. Many qualified cosmetic surgeons are not even board-certified in plastic surgery.


Plastic surgery is usually necessary for the health or well-being of the client so the decision to undergo the procedure is normally straightforward as the risks generally out-weigh the rewards. The decision to have cosmetic surgery is more elective. The client must decide to undergo the procedure for the right reasons and should have realistic expectations of the results.


In today’s society where beauty is given high importance and the media highlights enhancements and improvements as a choice, cosmetic surgery has been mainstreamed. Considered taboo in the past, cosmetic surgery is now accepted, fashionable even.

An AACS survey showed that 71 percent of respondents think society is less judgmental about cosmetic surgery than it was five years ago and 62 percent said society’s attitude toward cosmetic surgery made them feel more comfortable about getting a procedure. The survey likewise showed that the most accepted invasive procedures are breast augmentation, facelift and tummy tuck and the most accepted non-invasive procedures are laser hair removal and Botox.


Cosmetic surgery is usually costly, but many clients say that it’s worth it. Contours Advanced Face and Body Sculpting Institute, the first and only cosmetic surgery center in the Philippines certified to do VASER High Definition Liposculpture, offers its extensively studied and researched procedures in affordable rates than more famous dermatology centers around.


Dr. Claudine Roura, founder of Contours, believes that the right cosmetic surgery can boost self-esteem and increase confidence. “Because surgery is often permanent, clients should spend time comparing doctors and clinics before making a decision. Cost is not the only factor you should consider. The expertise of the doctor and the reputation of the center are important,” Dr. Roura says.


Cosmetic or plastic, surgery is a procedure that affects the well-being of a person. Terms are mere words, what is important is that the service addresses the requests of the clients without misleading them to undergo procedures they do not really need. The long standing rivalry between the two should once and for all be resolved, for the sake of the clients who trust the professionalism of both cosmetic and plastic surgeons. #