Plastic surgery

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The plastic surgery (of "plastic", from the Greek πλαστική τέχνη , plastiki Techni , "[by kneading] Fine art, sculpture [for a clay model], plastic ," by the Greek πλάσσω Plasso , German , form of soft mass, making, erdichte ' , originally in relation to spreading or clapping the sound flat) is a surgery that deals with interventions on organs or tissue parts that change or restore shape for functional or aesthetic / cosmetic reasons . Mainly it deals with the visible part of the body . The aim of plastic surgery is to restore or improve body shape and visibly impaired body functions.

Main directions

In plastic surgery, interventions are carried out for purely aesthetic as well as purely functional reasons. Or both aspects come into play at the same time. Accordingly, there are different main directions in plastic surgery:

This includes interventions that change shape, the indications of which are not determined medically, but exclusively by the wishes of the patient. They are also known colloquially as "cosmetic surgery" and aim to improve the appearance. Aesthetic surgery is not a reinvention of the 20th century, but has been known for at least 1400 years and had significant successes in the Middle Ages and early modern times, but did not experience its boom until the 19th century.
restores lost functions of the body, e.g. B. as a result of injuries, tumor removal or malformations , surgically restored. Typical operations are defect coverage by tissue displacement or grafting, nerve grafting or tendon relocations. Nowadays microsurgery is the essential basis for these measures ; Reconstructive measures in plastic surgery have been known for over 1500 years. One of the earliest reconstructive interventions was facial plastic surgery such as the restoration of the nose . Celsus described corresponding operations as early as the first century .
deals with the acute and intensive treatment of burns in specialized burn centers and the treatment of the consequences of burns. Here come v. a. Methods of reconstructive surgery used.
is its own (interdisciplinary) specialty in plastic surgery, trauma surgery and orthopedics . She mainly deals with the treatment of injuries, malformations and diseases of the hand and forearm. In addition, microsurgery is used here, e.g. B. It is an essential part of replantation .

Specialist competence

In order for a medicine study in Germany as a Specialist for Plastic, Reconstructive and Aesthetic Surgery to act, it requires a six-year training period (72 months). The respective state medical association is responsible for the exact mode of specialist training. The further training comprises at least four years (48 months) in the field of plastic, reconstructive and aesthetic surgery. Furthermore, six months each must be completed in the emergency department and intensive care medicine; the following can also be taken into account:

• Twelve months of competence acquisition in other areas, such as ENT and maxillofacial surgery.

In the meantime, all German federal states have specialist expertise in plastic and aesthetic surgery (with the new (sample) training regulations of the German Medical Association from November 2018, specialist in plastic, reconstructive and aesthetic surgery ) . In Switzerland the field exists Plastic, Reconstructive and Aesthetic Surgery , in Austria the special compartment plastic, aesthetic and reconstructive surgery .

Cosmetic surgeon is not a term that is defined in medical training law. Contrary to popular belief, the plastic surgeon is not just a cosmetic surgeon from his training. His training is mainly in the field of reconstructive surgery (e.g. congenital deformities, accidental injuries , burns). Aesthetic surgery is part of his training. Other specialist areas also include special aspects of cosmetic surgery, although these are not provided for in the training regulations: z. B. Breast operations by gynecologists , face operations by oral and maxillofacial surgeons and ear, nose and throat doctors, skin operations , liposuction and laser treatments by dermatologists . For years there have been controversial discussions between these specialist groups about expanding the term specialist or the additional title “plastic surgery” to include the term “aesthetic”. Because of the advertising character of this term, all specialist groups try to demonstrate their aesthetic-surgical competence by appropriating the term. For the specialist areas ENT and MGK surgery, there is a 24-month additional training course in plastic and aesthetic operations.

In recent years the German Medical Association and many state medical associations have changed the name of the plastic surgeon to "Plastic and Aesthetic Surgeon", while in Mecklenburg-Western Pomerania , for example , with the change in the further training regulations of September 7, 2007, the name continues to be "Plastic surgeon " called.


The operative shaping of organs or tissue parts, including their restoration (reconstruction), is called plastic . Sculptures are not made exclusively in the field of "plastic surgery", but in all operative specialties. Here are some examples:

Orthopedics and trauma surgery

Visceral surgery



Ear, nose and throat medicine

Assumption of costs

With the exception of cosmetic surgery, which is carried out at the patient's request for aesthetic improvement, the costs are covered by statutory or private health insurance companies . In cosmetic surgery cases, the total cost, including loss of earnings, must be borne by the patient . Statutory insured persons who have undergone a medically not indicated measure, such as cosmetic surgery , a tattoo or a piercing , also have to contribute appropriately to the costs of a complication resulting therefrom, including the daily sickness allowance. Doctors and hospitals are obliged to notify them of secondary illnesses of medically unnecessary treatments .

More examples of plastic surgery


Pioneer of plastic surgery


  • Alfred Berger, Robert Hierner: Plastic Surgery. Basics, principles, techniques: Vol. 1. Springer-Verlag, Berlin a. a., 2003. 413 pages. ISBN 3-540-42591-8 .
  • Gundolf Keil : On the history of plastic surgery. In: Laryngologie Rhinologie Otologie. Volume 57, 1978, pp. 581-591.
  • Gundolf Keil: Heinrich von Pfalzpaint and the plastic surgery of the skin. In: Günter Burg et al. (Ed.): Oncological Dermatology: New Aspects - Age-Related Features. Berlin et al. 1992, pp. 3-11.
  • Lemperle , von Heimburg (editor): Aesthetic surgery, Ecomed-Verlag, 2003.
  • Christoph Weißer: Plastic Surgery. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1165-1167.
  • Birgit von Essen, Marian Stefan Mackowski :: Plastic Surgery - Aesthetic Surgery , in: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller and Rüdiger Döhler (eds.): OP manual. Basics, instruments, operating procedures , 6th, updated and expanded edition. Springer, Berlin Heidelberg New York 2016, ISBN 978-3-662-49280-2 , pp. 727-747.

Web links

Individual evidence

  1. ^ Franz Dornseiff: The Greek words in German. Walter de Gruyter & Co, Berlin 1950, p. 97.
  2. ^ Johann Baptist Hofmann : Etymological dictionary of the Greek. Published by R. Oldenbourg, Munich 1950, p. 273.
  3. German Society of Plastic, Reconstructive and Aesthetic Surgeons: The Four Pillars of Plastic Surgery ( Memento of the original from June 8, 2011 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. . @1@ 2Template: Webachiv / IABot /
  4. Peter Proff: Possibilities of plastic-reconstructive and tumor surgery in early Byzantine medicine. In: light of nature. Medicine in specialist literature and poetry. Festschrift for Gundolf Keil on the occasion of his 60th birthday (= Göppingen work on German studies. No. 585). Kümmerle, Göppingen 1994, ISBN 3-87452-829-4 , pp. 307-328.
  5. Ralf Vollmuth and Peter Proff: "Because the face is a special ornament and wellbeing of the people ..." Comments on the question of aesthetics in oral and maxillofacial surgery in the Middle Ages and early modern times. In: Dominik Groß and Monika Reininger (eds.): Medicine in history, philology and ethnology: Festschrift for Gundolf Keil. Königshausen & Neumann, Würzburg 2003, pp. 159–175
  6. Ernst Kern : Seeing - Thinking - Acting of a surgeon in the 20th century. ecomed, Landsberg am Lech 2000, ISBN 3-609-20149-5 , p. 179.
  7. Patrick B. Adamson: Comments on cosmetic surgery in the ancient Near East. In: Würzburg medical history reports. Volume 8, 1990, pp. 85-89, here: p. 88.
  8. Retrieved on: February 4, 2019
  9. Retrieved on: February 4, 2019
  10. Retrieved on: February 4, 2019
  11. Plastik (Med.) In: Duden - German Universal Dictionary , 6th edition, Bibliographisches Institut & FA Brockhaus AG, Mannheim 2007.
  12. ^ V. Schumpelick: Surgery atlas . Georg Thieme Verlag, Stuttgart 2006, ISBN 3-13-140632-1 , p. 172 ( online ).
  13. Manfred Kaufmann , Serban-Dan Costa , Anton Scharl: Die Gynäkologie . Springer Verlag, Heidelberg 2005, ISBN 3-540-25664-4 , pp. 611 ff . ( online ).