What is the Difference Between Cosmetic and Reconstructive Surgery?

If you have always thought of “plastic surgery” as being the cosmetic procedures associated with enhanced physical features, know that you’re not alone. Plastic surgeons often offer procedures and treatments that fall into both the cosmetic and reconstructive surgery categories, making it a bit difficult to know which type of subspecialty you need. 

To make it easy, cosmetic is all about enhancing, while reconstructive is all about repairing. Let’s dive into the differences between these two sub-categories.

A mature woman getting cosmetic or reconstructive surgery at a plastic surgeons practice in Orlando Florida

Defining Plastic Surgery & Two Sub-specialties: Cosmetic & Reconstructive  

The medical specialty of plastic surgery focuses on repairing bodily defects in order to reconstruct appearance or restore normal function that has been diminished or removed due to trauma, birth disorders, burns, or disease. Since plastic surgery encompasses both cosmetic surgery and reconstructive surgery as sub-categories, there is often a lot of overlap that exists between the two, which leads to confusion.  This is why a lot of people think “cosmetic” when they hear “plastic surgery” since this sub-category is one that we hear a lot about (think Botox, Tummy Tucks, and Breast Augmentation). However, there are significant differences between cosmetic and reconstructive surgery. 

1. Cosmetic Surgery:  this type of surgery is done for purely aesthetic reasons. Its aim is to improve or enhance the appearance of a patient’s physical features, such as their nose, face, or breasts by reshaping or adjusting the normal structures of the body.  While the end goal with cosmetic plastic surgery is mostly visual, the patient often benefits from improved self-esteem, and boosted confidence.  Examples of cosmetic procedures include

    • Breast Enhancement: like breast augmentation, breast lifts, or breast reductions.
    • Facial Contouring: like rhinoplasty or cheek enhancements.
    • Facial Rejuvenation: like facelifts, eyelid lifts, neck lifts, or brow lifts.
    • Body Contouring: tummy tucks, liposuction, and gynecomastia treatment are common in this category.
    • Skin Rejuvenation: microdermabrasion, Botox, filler treatments (Juvederm), and laser resurfacing. 

The techniques used in cosmetic plastic surgery are solely for improving proportion, aesthetic appeal, and symmetry. Since these procedures enhance already functional portions of the body, the procedures are considered “elective” and are normally not covered by insurance. 

2. Reconstructive Surgery: this type of surgery is aimed towards repairing the abnormal structures of the body that are caused by things like disease, infections, trauma, developmental abnormalities, and congenital defects.  The focus here is to improve or restore normal function to the body part, but it may also include restoring the normal appearance as well.  Reconstructive surgery is often done at the same time as general surgery in response to treating medical conditions, which is why it is often covered under health insurance policies. Examples of reconstructive procedures include

    • Repairing lost tissue or skin from burn injuries.
    • Reconstructing breasts after a mastectomy due to cancer. 
    • Repairing a congenital defect such as a cleft palate or lip.
    • Reconstructing lower extremities after severe injuries (thighs, legs, feet, or toes). 
    • Completing hand surgery to remove tumors or cysts.
    • Providing scar revision surgery. 
    • Trauma surgery.

Since plastic surgery encompasses both cosmetic surgery and reconstructive surgery as sub-categories, there is often a lot of overlap that exists between the two, which leads to confusion.

Board Certification Requirements: A Difference in Training

When looking at plastic surgeons in cosmetic and reconstructive subspecialties, you’ll see a major difference in training and certification.  In order to become a board certified plastic surgeon, one must either complete an integrated residency training that combines three years of general surgery and three years in plastic surgery, or an independent five-year residency program in general surgery that is followed up by a three-year plastic surgery residency [1].  

While residency programs for plastic surgery may include a component of cosmetic surgery, it does not include training in all cosmetic procedures. On the other hand, to become a board certified cosmetic surgery surgeon, you must have training in three hundred cosmetic surgery procedures in order to sit for your exam [2]. 

Can Cosmetic and Reconstructive Surgery Overlap?

There is significant overlap between the two, and many plastic surgeons will offer both types of services.  An example of an overlap would be a rhinoplasty (nose surgery), which is often done to help the patient breathe better. Prior to the procedure, the patient may request that the nose is reconstructed in such a way that its original appearance is enhanced. Another example would be eyelid surgery to fix drooping eyelids; this not only improves the patient’s vision, but it can benefit their appearance as well. 

Wrapping It Up  

The confusion between cosmetic and reconstructive surgery is understandable since it is common for one practitioner to offer services that fall within both subspecialties. If you’d like to learn more about available cosmetic surgery procedures, please visit contact us to book a consultation. 

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