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Babu et al. Plast Aesthet Res 2017;4:13-4 Plastic and
DOI: 10.20517/2347-9264.2016.104
Aesthetic Research

www.parjournal.net
Letter to Editor Open Access

Five “Ds” of plastic surgery

Preethitha Babu, Ravi Kumar Chittoria, Sudhanva Hemanth Kumar, Senthil Kumaran Marimuthu, Elan Kumar
Subbarayan, Konda Sireesha Reddy, Vinayak Chavan, Devi Prasad Mohapatra, Meethale Thiruvoth Friji, Dinesh
Kumar Sivakumar

Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Correspondence to: Dr. Ravi Kumar Chittoria, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and
Research, Pondicherry 605006, India. E-mail: drchittoria@yahoo.com

How to cite this article: Babu P, Chittoria RK, Kumar SH, Marimuthu SK, Subbarayan EK, Reddy KS, Chavan V, Mohapatra DP, Friji MT,
Sivakumar DK. Five “Ds” of plastic surgery. Plast Aesthet Res 2017;4:13-4.
Article history: Received: 05-12-2016 Accepted: 09-12-2016 Published: 19-01-2017

Dr. Ravi Kumar Chittoria is born and brought up in Delhi, India. He completed his post graduation (MCh plastic surgery
from Mumbai), post doctorate (PhD in plastic surgery) and MBA (hospital administration) in India. He received higher
training in laser surgery from Boston Medical Centre, Boston University, USA, and endoscopic plastic surgery from
Emory University, Atlanta, Georgia, USA. He is recipient of 29 awards including BMJ Award, author of 3 textbooks, 5
chapters, chief editor of 3 journals, more than 120 publications with 1 patent. At present he is the Professor and Head
of Department of Plastic Surgery, JIPMER, Pondicherry, India.

Although there are a variety of definitions that alteration of the human body and includes cosmetic or
describe plastic surgery, confusion persists in the aesthetic surgery, reconstructive surgery, craniofacial
minds of both the lay public and doctors. A common surgery, hand surgery, microsurgery, and the treatment
[2]
lay misconception is that actual pieces of plastic are of burns. The term “plastic” is derived from the Greek
used to repair injured tissues or placed over defects to word plasticos that means “mouldable”. [3]
make them appear better. On the other hand, resident
doctors from specialities such as ear-nose-throat From a practical perspective, it is imperative that every
and general surgery fail to appreciate the vast scope practising plastic surgeon has a clear reconstructive
that plastic surgery specialty entails. In recognition plan for every case that is salient and easily recalled.
of this, trainee plastic surgeons are often asked to To this end, we have distilled this into five categories
briefly define our specialty in their final exams, so that represented by the following five “Ds”:
subsequent misconceptions are minimized. 1. Defect - Loss or breach in tissue continuity;
2. Deformity - Alteration in shape and contour;
Plastic surgery is a specialised branch of surgery that is 3. Dysfunction - Abnormality and impairment of a bodily
primarily concerned with deformities of the integument organ or system;
[1]
and underlying musculoskeletal system. It is a surgical 4. Disability - Impairment, limitation of activity and
specialty involving the restoration, reconstruction, or participation;

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