Plastic Surgery – It’s More Than Just Face-Lifts

Mention the words “plastic surgery,” and most people immediately think of face-lifts, nose jobs, tummy tucks and breast augmentation.  Popular TV shows such as “The Swan” and “Extreme Makeover” have helped create greater awareness of cosmetic surgery procedures.  In fact, an estimated $7.7 billion is spent on elective cosmetic surgery in the United States each year.

Yet there is far more to the practice of plastic surgery than enhancing someone’s appearance.  Plastic surgery encompasses both cosmetic and reconstructive procedures. Cosmetic surgery generally is performed to improve the patient’s appearance and sense of self-esteem.  Reconstructive surgery corrects abnormal structures of the face and body that may be caused by congenital defects, traumatic injury, infections, skin cancers or disease.  The main purpose of reconstructive surgery is to correct problems that affect body function, but reconstructive procedures also can improve a person’s appearance.

Cosmetic surgery is usually not covered by health insurance because it is considered elective.  Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures may vary.  For example, eyelid surgery is usually performed as a cosmetic improvement, but it may be covered by insurance if the patient’s eyelids are drooping severely and obscuring the patient’s vision.

George Wu, MD, a board-certified plastic surgeon at St. Luke’s Hospital, performs the entire spectrum of plastic surgery procedures – both cosmetic and reconstructive – but his primary focus is on reconstruction.  “It’s a challenging area that is rewarding because it helps improve people’s lives,” he says.  “Plastic surgeons sometimes lightheartedly claim that the scope of our work is the skin and its contents, meaning the entire body.  Our work requires not only skill, but also imagination and artistry.  Each procedure is different, and we must always seek creative solutions to produce the best outcomes.”

Some of the most common reconstructive procedures include:

• Congenital deformities such as cleft lip or cleft palate (when the left and right sides of a baby’s upper lip or the roof of the mouth do not grow together properly).
• Ear deformities.
• Correction of nasal septal deviation (when the wall of cartilage dividing the nose into two nasal cavities is severely twisted or shifted to one side).
• Breast reconstruction following mastectomy.
• Breast reduction to reduce problems such as neck and back pain caused by excessive weight of large breasts.
• Burns and traumatic scars. 
• Removal of skin cancers and soft-tissue tumors, including reconstruction of any resulting disfigurations.

Many plastic surgeons specialize in specific problems or techniques.  Wu, for example, has a subspecialty in hand and wrist surgery.  He often uses arthroscopic procedures to both diagnose and treat many hand and wrist problems.  Arthroscopy entails making very small incisions – approximately three millimeters – and then inserting a mini-camera that allows the surgeon to see things that might not even show up on an MRI. 

"One of the most frequent problems I treat these days is carpal tunnel syndrome, a rather common cause of hand numbness," he says.  " I also perform numerous surgical procedures for hand injuries, reconstruction of arthritic joints, and problems that develop over time such as the 'trigger finger,' which occurs when the tendon in the finger swells and catches, preventing proper bending of the finger.  Patients often assume ‘trigger finger’ is a joint problem, but it’s actually a problem in the tendons.”

Many hand problems are the result of burns.  Scars from a burn injury or other trauma can lead to permanent contractures of the hand that can be relieved through surgery.  Other hand problems stem from work-related or sports injuries, often to the ligaments and joints of the thumb or of the wrist.  And, unfortunately, many a child is rushed to the emergency room with problems such as fingers that have been smashed in a door and require surgical repair.

Patients are often referred to plastic surgeons and hand surgeons by their primary care physician or – in cases involving injuries – by workers compensation physicians, lawyers or insurance companies. Patients also might be referred to hand surgeons by orthopedic surgeons who don’t perform hand surgery procedures.

For more information about plastic surgery and hand surgery procedures at St. Luke’s Hospital, please call (415) 641-6657.