Plastic Surgery is a surprisingly broad field, and there are actually sub-specialties within plastic surgery. The general public thinks of plastic surgeons as aesthetic, or cosmetic surgeons. However, there is a huge amount of reconstructive surgery that goes into plastic surgery.
Historically, Plastic Surgery has been a field where the greatest advances have been made during times of war. World War I, World War Ii, the Korean War, the Vietnam War, and even the current wars in Iraq and Afghanistan have resulted in stunning advances in reconstructive techniques. With the ability to repair reconstructive defects, this knowledge can be applied to aesthetic issues as well.
Hand and Microvascular Surgery is one of the few separate sub-specialty boards recognized by the ABMS, the American Board of Medical Specialties. This is an intensive year long training program, in addition to plastic surgery, that focuses only on the hand and upper extremity. Orthopedic and general surgeons can also do this fellowship training.
Microvascular surgery is a field where a muscle, along with the artery, vein, and nerve that is associated with the muscle, is detached from the body, and then re-attached somewhere else in the body. If you have a defect with poor blood flow, it may not heal. If you have a muscle and skin flap that is attached is a distant blood supply, and then this muscle and skin flap covers your open wound, then your wound should heal. This field has been literally a life saving procedure in patients with significant wounds, such as after trauma, burns, cancer, and other medical problems.
Craniofacial and/or Pediatric Plastic Surgery is focused on congenital, or birth defects. Common problems include cleft lift and cleft palate, but this field also encompasses defects with facial skeleton growth, developmental problems elsewhere in the body, and reconstructive surgery in children. This fellowship training program is typically a year long as well.
Aesthetic Plastic Surgery training generally lasts 6-12 months, and is concentrated on aesthetic, or cosmetic, procedures. Since a lot of plastic surgery training already touches aesthetic surgery, many plastic surgeons choose not to do this fellowship. However, the number of training slots has slowly been increasing over time.
Burn Surgery is generally a year long, and is focused on immediate burn care, and the reconstructive burn care to obtain function. Skin grafts, including skin grown in a laboratory, have been the major advances in this field.
Breast Surgery is usually 6-12 months in training length, and is focused on breast reconstruction after breast cancer surgery, and breast surgery in relation to aesthetics, including breast augmentation, breast lift, and breast reduction. Many programs are associated with large surgical oncology, or surgical cancer, hospitals.
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For further information about the organizations related to these specialties, here are their websites.
American Board of Medical Specialties- www.abms.org
American Board of Plastic Surgery- www.abplsurg.org
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