KATHMANDU, July 16: When someone suffers from burns, injuries, or deep wounds, plastic surgeons play a crucial role in healing and reconstructing damaged or misaligned body parts. Yet, plastic surgeons in Nepal say they face neglect from the state, despite their essential contributions. On the occasion of World Plastic Surgery Day in Kathmandu on Tuesday, they voiced their concerns.
Doctors say the public still lacks full awareness about plastic surgery services. Plastic surgeons perform reconstructive surgeries for injuries, burns, cancer-related damage, and congenital deformities. They say the service in Nepal has improved significantly, benefiting many patients.
Orthopedic specialist Dr. Anurag Singh Thapa from the National Trauma Center emphasized that complex bone injuries often require plastic surgeons. “Without plastic surgery, trauma care is incomplete,” he said. Thapa also said that it is the plastic surgeons who reconstruct the body when the scalp is lost due to injury, when flesh and skin from other parts are damaged, when a hand or fingers are severed, or when the flesh is exposed and the back or leg is misaligned.
Dr. Niraj Maharjan, burn and plastic surgeons at Teaching University Teaching Hospital (TUTH), Maharajgunj, noted that plastic surgeons reconstruct severely burned body parts. Major centers providing such services include Kirtipur Hospital, TUTH, Bir Hospital, Sushma Koirala Memorial Trust Hospital, and Patan Hospital. He advised against applying tomato or aloevera on burns, recommending clean water instead and removing cloths above the burned part, which prevents internal damage.
Another plastic surgeon from Tribhuvan University Teaching Hospital, Dr. Samit Sharma, presented that plastic surgery is being used in cancer treatment. He said that any body part damaged due to cancer tumors is being reconstructed through plastic surgery to restore it to a normal state.
He shared that plastic surgery is being performed in cases of cancer affecting the head, spine, face, nose, mouth, and breasts. “Since there is a risk of infection after cancer surgery, tissue or skin from other parts of the body is transplanted to cover the wounds,” he said.
Dr. Bishal Karki, chief plastic surgeon at the Nepal Cleft and Burn Sector Department in Kirtipur, stated that plastic surgery is also necessary to correct congenital deformities in body structures. He explained that plastic surgery is being used to repair conditions such as cleft lips, misaligned noses, fused fingers, deformed ears, cleft palates, and split chins.
Dr. Sangam Rayamajhi, a plastic surgeon at TUTH, stated that plastic surgeons also perform cosmetic procedures to restore beauty in people whose body parts are misshapen. According to him, plastic surgeons remove sagging belly fat caused by obesity, correct asymmetrical facial features, revise surgical scars, reshape eyes, create dimples on cheeks, remove moles, straighten crooked noses, correct ears, and reshape breasts.
Neglect from the State
Doctors also criticized the government for ignoring the field. Dr. Piyush Dahal from National Academy of Medical Sciences (NAMS) said the government has failed to create sufficient posts for plastic surgeons—only two positions have been added in the past 10 years. As a result, students studying this subject are losing affection and interest.
“We currently have a system in which one can pursue M.Ch in plastic surgery only after completing general surgery, but such a requirement is unnecessary,” he said. “As an alternative, a shorter and more direct pathway should be introduced through appropriate policy reforms.”
He noted that plastic surgery demands a lot of commitment, but lack of adequate positions and facilities has made the field less attractive. As the production of skilled manpower declines, he warned, it could pose challenges in advancing plastic surgery, which is essential across multiple sectors.
Dr. Ishwor Lohani, a burn and plastic surgeon at the TUTH, expressed concern that the government has not paid adequate attention to plastic surgery. He stated that due to the government’s failure to properly manage doctors trained in this field, new medical professionals have shown little interest in pursuing it.
"Those who have completed M.Ch have started burn wards, but the continuity of such services depends on the level of commitment from the ministry," he said. Dr. Lohani pointed out that the state still lacks understanding of plastic surgery, which has led to problems in utilizing, managing, and expanding the workforce. "Plastic surgery is not just cosmetic medicine—it is essential for the treatment of various medical conditions," he added.
Although plastic surgery began in Nepal in 1973, it was formally recognized as a distinct specialty only from the year 2000.