Usually referred to as cosmetic surgery, this is a small but integral part of plastic surgery.

Operations which are primarily reconstructive also have an aesthetic or cosmetic component, with plastic surgeons concerned to normalize and improve appearance along with function. Other operations are entirely cosmetic. These include plastic surgery to reshape drooping eyelids, crooked or large noses, protruding ears, abnormal or asymmetrical body contours (including breasts of very different sizes and shapes), and deal with facial aging, loss of abdominal tone after childbirth, or birth marks. While physical functioning is not at issue in these instances, social and psychological functioning may be. For instance a birth mark on the cheek which is resulting in constant teasing at school can have lasting detrimental effects on a child's social development. At present such a case may or may not meet the criteria for public funding - or may face a long delay. The fourteen year old suffering from constant teasing because of prominent ears, or excessive over-development of the breasts, may be referred to a plastic surgery unit by a general practitioner and booked for surgery. But insufficient theatre time and staff make it likely the procedure will not be done within the six months now allowable to remain on a waiting list for surgery. The focus on acute surgery, coupled with the shortage of resources, leaves little theatre time and space for elective surgery. The teenager is likely to be referred back to the GP, then back to the hospital to again go on a six month waiting list.

There needs to be a debate about where to draw the line for public funding of 'cosmetic' surgery. There can be major psychological benefits, with procedures considerably improving a person's quality of life. People should be given access to plastic surgery where significant psychological and social benefits will result, as well as physical benefits.

Although only a relatively small part of plastic Surgery, cosmetic or aesthetic surgery is becoming increasingly important. Worldwide, the field is growing at a rate of 10-15% per annum. The growth and development of techniques in both surgery and anaesthesia has made Cosmetic Surgery safer and increasingly a mainstream option for people who are dissatisfied with some aspect of their appearance. From minor "nips and tucks", through body contouring and aesthetic breast surgery to a wide variety of facial restorative and enhancing procedures, this is an exacting and highly specialised branch of Plastic Surgery. In a sense, reconstructive and aesthetic Plastic surgery are two sides of the same coin and most practitioners would utilize elements of both sub-disciplines in tackling a given case. Although Plastic surgery is one of the few surgical specialties which has a specific training curriculum, which is examinable at the specialist level, in Cosmetic Surgery, most plastic Surgeons who become involved in this field will have sought further, super-specialized training, usually by a six to twelve month post-graduate fellowship attachment to a centre of excellence, in the craft. Within the private sector, every major centre in New Zealand, as well as most secondary centres, have access to well-trained Plastic Surgeons, offering a full range of Cosmetic Surgical procedures. For economic reasons, most cosmetic Plastic Surgical procedures are not available in the public sector.

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