Plastic surgery is a wide field. It is not easy to describe it in few words. The word plastic is derived from the Greek word plastikos, meaning, "to mold" or "give form". Although the precise date is disputed by historians, the first recorded description of actual reconstructive plastic surgery may be traced back over 2600 years to the Sanskrit texts of ancient India. In his Samhita, or encyclopedia, the Hindu author Sushruta first described both a reconstruction of the earlobe using skin from the cheek and a traditional method of reconstructing the nose, commonly referred to since as the "Indian" or "Hindu" method.

The specialty has been forged slowly since ancient times into its present-day structure. It has evolved into an extremely diverse specialty with a breadth and depth that blur its boundaries with other fields. Its sheer scope in modern times is truly a testament to the contributions of many individuals from varying backgrounds and medical specialties that have come together to form and refine it.

To a layman plastic surgery is synonymous with cosmetic surgery. Cosmetic Surgery is a subspecialty of medicine and surgery 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 beyond the average level toward some aesthetic ideal. Cosmetic Surgery is a multi-disciplinary and comprehensive approach directed to all areas of the head, neck and body.

It is a general term and relates with improving the aesthetics. Cosmetic surgery and aesthetic surgery are sometimes used as interchangeable terms but aesthetic surgery is broader. Various cosmetic procedures e.g. rhinoplasty, breast surgeries, liposuctions, face-lifts and congenital anomalies like cleft lip and palate are included in this.

In contrast with purely cosmetic surgery, the field of reconstructive surgery seeks to restore functionality to damaged body areas. Equally so, reconstructive surgery repairs and in parallel enhances a return to normalcy for the person injured or scarred from accidents or birth defects. Reconstructive surgery in itself is a broad term. It encompasses various areas in plastic surgery, which in themselves are being considered separate branches. Reconstructive work is slowly being recognized as the reconstruction following limb trauma and post tumour excision.

Compared with other natural disasters, burns exert a catastrophic influence on people in terms of human life, suffering, disability, and financial loss. Burn injuries are extremely complex and elicit physiologic and metabolic interactions involving all major organ systems. These pathophysiologic changes occur in a time-dependent manner. Burns can be thermal, electrical, chemical etc.

Craniofacial Surgery is an upcoming branch so far practiced in highly specialized centers and it involves close cooperation between neurosurgeon, paediatrician and plastic surgeon. It involves various birth defects e. g. cleft lip and palate, different types of congenital syndromes like Treachers Collins syndrome. Orthognathic surgery has come out of the shadow of craniofacial surgery to evolve as a separate branch.

Orthognathic surgery refers to the surgical repositioning of the maxilla, mandible, and the dentoalveolar segments to achieve facial and occlusal balance. One or more segments of the jaw(s) can be simultaneously repositioned to treat various types of malocclusions and jaw deformities. Preoperative diagnosis and planning for patients with jaw asymmetries and deformities includes a photographic analysis and a complete orthognathic work-up involving cephalometric and panorex radiographs, dental impressions, and models. This is done by the Pedodontist/Orthodontist in coordination with the craniofacial surgeon. Usually, pre-surgical orthodontics are necessary to straighten the teeth and align the arches so that a stable occlusion can be obtained post-operatively, while orthodontics following surgery are frequently required to revise minor occlusal discrepancies. Orthognathic surgery is often delayed until after all of the permanent teeth have erupted unless medical conditions necessitate that the surgery be performed earlier. In adult patients, orthognathic surgery can be combined with soft tissue contouring to improve the aesthetic results.

Facio maxillary surgery is another interesting field of plastic surgery. It includes facio maxillary trauma including soft tissue injuries and facial fractures and temporomandibular joint dysfunctions.

Oculoplastic surgery, or plastic and reconstructive surgery of the eye, encompasses eyelid surgery to change the structure and function of the lids, the tear duct system and the eye socket. A wide array of surgical procedures is included in this area, but among the most common conditions treated are loose, droopy or baggy eyelids, tear duct blockages, and eyelid damage from injuries.

Microsurgical reconstruction is used for complex reconstructive surgery problems when other options such as primary closure, healing by secondary intention, skin grafting, local flap transfer, and distant flap transfer are not adequate. Microsurgery may not be the best solution for all reconstructive dilemmas and certainly is not the first choice in the reconstructive ladder. However, it can offer the reconstructive surgeon a wide range of possibilities for complex reconstruction. In specific cases, such as mandibular reconstruction, free tissue transfer may be the best option

Free flap reconstruction has several advantages over other methods, particularly in the head and neck. Free tissue transfers are usually designed as a single-stage procedure, as opposed to many of the pedicled reconstructions. Pedicled flaps require a less efficient use of tissue as entire muscles are defunctionalized in order to safely transfer enough tissue to fill the defect. Free transfers allow the harvest of exactly tailored grafts, minimizing donor morbidity. Similarly, free tissue transfers are usually associated with less postoperative atrophy, eliminating the need to overcorrect. The principal disadvantage in free tissue transfer is the technical demands required by the technique. A great deal of additional expertise and equipment (including microscope) is required intraoperatively, as well as perioperatively.

Hand surgery is a highly specialized area of plastic surgery and unfortunately is treated very casually by general surgeons and sometimes even by orthopaedic surgeons. It is purely the domain of plastic surgeons and includes all congenital hand anomalies, fracture tendon injuries, various upper limb nerve palsies etc.

Slowly slowly various urologic and genital reconstructive procedures are evolving into a separate branch. Still there is overlapping with urologist, paediatric surgeons and gynaecologists in some areas. This includes various urogenital congenital anomalies e.g. hypospadias, vaginal atresias. The scope includes reversal of sterilization procedures, infertility, genital reconstruction following trauma e.g. penile reconstruction, scrotal reconstruction.

Lastly plastic surgery is head to toe. It involves close cooperation between various other specialties. The need is for the general practioners to come out of the illusion of plastic surgery being only cosmetic work.