When congenital anomalies (birth defects) are severe, or when trauma has caused obvious deformity, then surgical improvement of appearance is not called cosmetic surgery, but is classed as a reconstructive procedure. In many countries, reconstructive surgery will be covered by private insurance or government health plans. Cosmetic surgery, on the other hand, is generally considered a luxury that requires payment out of pocket.
Although an improved appearance is often the result of recontructive surgery, Among surgeons doing plastic work, the reconstructive surgeon hold a place of honor and the performance of reconstructive surgery holds a place of pride. (Menick FJ. "If you've got the money, honey, I've got the time--if you've got no more money, honey, I've got no more time". [Editorial] Plastic & Reconstructive Surgery. 118(2):549-50, 2006 Aug. UI: 16874234)