All too often a difference is made between reconstructive and cosmetic surgery, most often to elevate the status of reconstructive surgery and lower the one of cosmetic surgery. I am a cosmetic surgeon and I do complex reconstrucive surgery. So I never could understand how someone could come up with something so artificial, neither based on science nor technique. I want my reconstructions to be cosmetically and aesthetically acceptable. A lot of cosmetic surgery technique has its roots in what used to be called reconstructive surgery, only the problem reconstructed is different. In cosmetic surgery I try to reconstruct how structure, shape and form were in youth, how they would be in an ideal if they are just normal or slightly below norm. So cosmetic surgery certainly is reconstructive surgery. So is reconstructive surgery “cosmetic” ? Most certainly if you imagine the appearance of a lady with only one breast after a cancer operation compared to her after reconstruction with one reshaped breast and one reconstructed breast say made from a TRAM (transverse rectus abdominis) flap.
I think the biggest difference for me personally between reconstructive and cosmetic surgery is the mind set. Cosmetic procedures are fairly routine, but have to be executed with a high degree of perfection without requiring much improvisation. Reconstructive procedures tend not to be routine, require often a fair amount of improvisation and thus a much more in depth knowledge of anatomy and plastic surgery principles and due to the limitations of what the patients literally bring to the (operating) table can at least by me never be executed with the same degree of perfection as a cosmetic procedure.