Summary: From coast to coast, there seems to be a divide based on the difference between reconstructive and cosmetic plastic surgery. It’s not clear whether this segmentation began with the surgeons themselves or with the public—but cosmetic plastic surgery seems to get the short end of the stick when it comes to social respectability, and I’m not sure I agree with that. For example, if you look at the website of the Minneapolis breast surgery experts at Minneapolis Plastic Surgery, you can see they perform transgender breast surgery—does that fall under reconstructive or cosmetic?

How We Think of the Difference Between Reconstructive and Cosmetic Plastic Surgery

We’re used to thinking of plastic surgery as something to make you look better, as an elective procedure. So when we talk about plastic surgery, then, we don’t usually talk about (also), the fact that plastic surgery is often reconstructive in nature. And by that we mean it’s not necessarily elective. To be sure, cosmetic plastic surgery is more popular. In 2012, 14.6 million people in the United States underwent a cosmetic procedure of some kind, compared to only 5.6 million people who underwent reconstructive plastic surgery. But there are a couple of reasons for this that might be worth considering.

First and foremost, you generally only get reconstructive plastic surgery when something bad happens to you. Among the most widely known types of reconstructive plastic surgery is that performed during treatment of breast cancer. As many already know, treatment of breast cancer often begins aggressively with the removal of breast tissue, a procedure known as mastectomy. Often during or shortly following the mastectomy, reconstructive plastic surgeons will begin the reconstruction process, placing a tissue expander beneath the remaining tissue and breast muscle.

Reconstructing Hopes and Dreams

Essentially, surgeons attempt to reconstruct the breast to look as natural as possible. They often use donor material (muscle, for example) from the abdomen to accomplish that. And in most cases, that’s the best solution. This isn’t altogether different from what surgeons do for patients who have suffered from, for example, nose cancer, skin cancer, or other ailments that then require some reconstruction. For those patients, the procedure is about reclaiming a normal life, a normal appearance.

But there are many reasons people want reconstructive surgery other than as part of treating cancer. Many people want scars removed (or made less noticeable), carpal tunnel symptoms diminished, and congenital defects repaired. These are all quite understandable treatments. In fact, in 2012, 27,000 patients had reconstructive surgery to repair damage caused by dog bites. And that’s just dog bites– pretty specific injury to repair.

Changing the Way You Look

And yet, the more I think about the difference between cosmetic reconstructive and cosmetic plastic surgery, the more I question that difference. Both sets of procedures, at their core, aim to help people feel better about the way they look—aim to make people feel more comfortable in their own skins. In many ways, breast reconstruction isn’t all that different from breast augmentation. At least, from an impartial point of view.

But life isn’t terribly impartial. It’s clouded with all kinds of social stigmas and social values and society mores. Which means that, essentially, breast augmentation is perceived as being quite trivial—the kind of thing only a shallow, selfish person would do (not to mention, when it comes to breast augmentation, all the sexual connotations that get wrapped up in that). In other words, breast augmentation is looked at as self indulgent.

Making You Feel More Comfortable in Your Own Skin

Breast reconstruction, on the other hand, is perceived as being all about healing. And that’s true. And I don’t want to conflate the journey of the breast reconstruction patient with the journey of the breast augmentation patient. The journeys aren’t all that similar. What I’m saying is similar is the goal: both patients want to feel good about her breasts, about the way she looks, about her femininity. And of course, the satisfaction with both procedures is quite high, so it becomes no surprise that both are considered to be quite successful.

And while women may not necessary shout from the rooftops about their breast reconstruction—it seems much more likely to be a topic of discussion than breast augmentation, which must be kept secret. I guess what I’m advocating for is not that reconstructive surgery be trivialized, but rather that cosmetic plastic surgery be granted the social space to come out of the shadows. Despite how it is often portrayed in the media or in popular imagination, cosmetic plastic surgery is not something that is taken upon lightly by most patients. Rather, any procedure is the end of a long journey that involves research, consultation, and a lot of reflection and thought.

So the difference between reconstructive and plastic surgery isn’t quite as wide as most people tend to think it is. What gets people to the point of going under the knife might be pretty disparate, yes, but the end goal (and often, the end results) are quite similar. At the end of the day, everyone deserves to feel comfortable in his or her own skin, no matter where the cause of that discomfort may originate from. After all, everyone deserves to be happy.

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