Plastic Surgery in India: Where Are We Now?

Dear Editor,

Plastic surgery is a specialized subject that defies categorization, lacks a particular organ system, and is more concerned with concepts than procedures.¹ The first detailed explanation of plastic surgical operations may be found in the ‘Sushruta Samhita,’ a clinical book on Indian surgery (circa 600 B.C.). After World War II, India began to practice modern plastic surgery. There was no such thing as plastic surgery as a recognized specialty in the nation. In 1958, the M.C. Hospital in Nagpur established the country's first autonomous Department of Plastic Surgery. In 2018, 895,896 plastic surgery treatments were done in India, including 390,793 surgical procedures and 505,103 nonsurgical procedures, ranking India fifth in the world for the total number of plastic surgery procedures performed.²

In the same year, we ranked fourth, sixth and fifth in the world in terms of the number of surgical operations performed on the face and head, breast, body, and extremities respectively.² India has performed most number of hair removal treatments in the globe, accounting for 18.9 % of all hair removal procedures performed worldwide.² Our country has a total of 2300 plastic surgeons and is sixth in the world in terms of a total number of plastic surgeons. The US ranks first with a total of 7009 plastic surgeons. India has 5% of the world's plastic surgeons compared to 15.1 % in the US.²

In India, 64.3 % of all cosmetic surgery operations are performed in a hospital, with just 17.3 % performed in an office setting. While 28.2 % of all operations performed worldwide are performed in an office setting, 55.55 % of procedures performed in the US are performed in a private environment, with 19.2 % performed in a hospital. Medical tourists account for 12.2 % of all treatments performed.² The top three nations from which medical tourists come to India for plastic surgery procedures are the US, Australia, and Iraq, with the majority of them coming from the US.² There are 285 M. Ch. seats, as well as 37 DNB seats in Plastic and Reconstructive surgery, and only 6 M. Ch. spots in Burns and Plastic surgery.%^3,4

Panse et al., studied Health Workers’ Awareness and Perceptions of Plastic Surgery and discovered that there is a lack of awareness of Plastic Surgery among members of the medical community¹ which is very disheartening. According to a study done in a deemed university, it was found that undergraduate students are poorly exposed to the contents of plastic surgery.⁵ A similar pattern may be seen among students from the United States.⁶ The present undergraduate medical curriculum does not adequately expose students to super-specialty issues.⁷

Individuals and national-level groups should make concerted efforts to educate healthcare consumers and providers, as well as to popularise the specialty of plastic surgery through campaigns and projects. More interdisciplinary meetings and interdepartmental conversations might help us become more aware of our medical colleagues. In conclusion, we recommend that plastic surgery should be taught to MBBS students in their clinical rotations, which will create awareness about the noble practice of plastic surgery in young budding doctors. Plastic surgery enrichment classes should be conducted. These courses should be taught by plastic surgery department faculty to broaden students’ education outside their course of study. The author proposes that these courses be taught in clinical rotations for final-year medical students in each relevant specialization of plastic surgery. The practice of contemporary plastic surgery in India may be in its infancy in terms of popularity, but it has a very promising future.

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