Modern Plastic Surgery is represented by 4 divisions:

• Aesthetic surgery
• Plastic-reconstructive surgery
• Hand surgery
• Burn surgery

None of the divisions is expendable. They complement one another methodically and build up in their entirety the foundation for innovation within the specialty of plastic surgery.

In all of the four divisions, operative techniques like microsurgery, laser surgery and endoscopic procedures are used. The specialty lives from the continuous creation of new and development of established techniques.

Aesthetic Surgery

The aim of aesthetic surgery is to enhance a patient’s appearance, without necessarily curing an illness. The main medical challenge of a plastic surgeon is to give professional advice to his patients. He has to evaluate whether a desired operation can be done by weighing up the benefits with the expected risk of complications. Because the patient’s decision for an operation is very much a personal one, detailed informed consent is important. Occasionally it is necessary to advice against a desired operation. High moral standing is of utmost importance for the German association for plastic reconstructive and aesthetic surgery (DGPRÄC), requesting also an outstanding qualification of their members. The aesthetic aspect when restoring form and function unites the aesthetic division with plastic-reconstructive surgery. Every medically indicated operation, be it for reconstructive-, handsurgical or burns reasons should result in an aesthetically satisfying result.

zur Ästhetischen Chirurgie

Reconstructive Surgery

As the second division of Plastic Surgery, reconstructive plastic surgery deals with the restoration of form and function after soft tissue injuries, tumour operations, severe infections, chronic wounds and the correction of congenital malformations. For each indication there are different ways to perform reconstructive procedures that are tailored to each patient depending on size, location and type of defect. We as reconstructive surgeons deal with the correction of form and function of skin and soft tissue, the reconstruction of muscles and tendons, bone and cartilage as well as procedures for peripheral nerve damage. Microsurgical techniques for tissue transfer have substantially extended the spectrum to restore form and function after severe injuries and extensive soft tissue excisions. This includes also the replantation of severed digits.
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Burns Surgery

The primary aim after burn injuries is to ensure the patient’s survival. Next to supportive measures to keep the organs functioning, fluid replacement and minimising the risk of infection, early and radical debridement of all burnt tissue is essential.  This is often followed by operations replacing the excised skin with skin grafts or skin substitutes. After the initial phase, the recovery and convalescence phase is characterized by progressively reconstructing form and function, intensive physiotherapy, and adjuvant therapy like fitting of pressure garments to limit the extent of scaring. Much later, scar revision surgery forms an important part in allowing the patient to regain much of his daily routines by achieving cosmetic and functional reconstructions.
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Hand Surgery

A very important discipline of Plastic Surgery is the surgery of hands. The intricacies and finesse of Plastic Surgery are expressed in restoring a hand, which acts as a link between thoughts and the environment through its elaborate functions. From the enormous acts of strength seen in sports people or workers, to the detailed movements to allow great dexterity when playing a musical instrument. Microsurgical techniques have allowed to expand the possibilities, allowing the replantation of severed digits and extremities. Other areas involve the transplantation of muscles in order to restore movement in paralysed limbs, which in combination with nerve transplantation can be made into functioning units. This is made possible only through special education and intensive training of a plastic surgical hand surgeon.
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