This is a summary if chapter 17, Plastic, Reconstructive and Aesthetic Surgery by Mr Peter Butler. He is a Consultant Plastic Surgeon and Honorary Senior Lecturer at the Royal Free and University College Hospitals, London and a Consultant in Plastic Surgery at the Massachusetts General Hospital, Boston, USA. He is a council member of the British Association of Plastic Surgeons (BAPS). He is also frequently seen on television discussing face transplants.
In this chapter he explains that plastic surgery specialty is adapting to the ever-changing healthcare environment. However, he discusses the concern over the lack of provision of adequate manpower. This has caused other surgical specialities to have to pick up this capacity shortfall, adopting plastic surgery techniques with variable standards and achieving mixed results. The inadequate numbers of plastic surgeons is in the face of an increasing demand for plastic surgery provision. This is in part related to medical advancements making plastic surgery possible, that previously would have been deemed untreatable. Demand is also compounded by an ageing population and increasing numbers needing plastic. Added to this is the demand for surgery for normalisation and improvement of appearance, partly related to increased patient demand and increased awareness due to television programmes such as ‘Extreme Makeover’. Increasingly, GPs refer patients to plastic surgery units for this type of surgery.
He believes that currently the provision of cosmetic surgery is not driven by evidence-based medicine but by subjective opinion.
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