Plastic surgery as a specialty encompasses both cosmetic as well as reconstructive surgery. The definition of cosmetic surgery is surgery “to improve on the normal” whereas reconstructive surgery is surgery ” to restore to normal form and function”. In some cases it is clear – repair of a cleft lip is clearly reconstructive surgery and liposuction of small amounts of fat that one just does not like is cosmetic surgery. In other situations it is more difficult. An upper eyelid lift to improve one’s appearance is cosmetic while an upper eye lift to remove excessive skin which is blocking one’s vision is reconstructive. Breast reconstruction after cancer treatment is unusual in that there is a Federal Law signed into effect by Bill Clinton mandating that breast reconstruction and surgical treatment of the opposite breast (if needed) is covered by insurance. Thank you Mr. Clinton!