Advances in Plastic Surgery follow advances in the basic and advanced research to do with wound healing, tissue regeneration and manipulation of wounds. More detailed understanding of anatomy leads to more precise and less problematic reconstructions

The pace of evolution of reconstructive surgery follows the scientific endeavours of many from basic scientists to clinicians with an enquiring mind.  

At the most basic and fundamental the research into manipulating the way wounds heal may transform the future of Plastic Surgery. In the knowledge that as we develop in the womb tissue joins together in, for example, forming the face, leaving no external mark scientists are attempting to manipulate scars so that they take on this scarless mending process.  If this is successful then imagine the prospects for those with bad and visible scars such as after burns or being born with a cleft lip.  

The British Association of Plastic, Reconstructive and Aesthetic Surgeons has taken part in a debate and contributed to a document produced by the College of Surgeons of England on the sensitive issue of Human Facial Transplantation.  The conclusion was that, although the anatomical and microsurgical knowledge is available there are still many issues to do with the psychological impact on the recipient and their family as well as the long term risks of immunosuppressive therapy to make this currently not advisable.   Research into tissue engineering may enable us to reconstruct tissues as composite grafts such as skin replacement with all the necessary constituents of normal skin.  Current techniques are yet to make the dermis (leathery part) as complete as normal to make the skin elastic, hairbearing and capable of sweat.  Cartillage which forms the foundations of the form of the ear and nose may be generated artificially as well as bone for reconstructive purposes.  

Microsurgery has transformed the ability to replace whole areas needed from either congenital absence, disease or trauma.  Research in this field continues to hone our reconstructive armamentarium enabling tailoring of donor site and minimising the morbidity to the patient whilst enhancing the reconstructive outcome.  Advances in perforator flaps and the new super-thin flaps are examples here.