Written and maintained by CASRAI Editorial Board
Last updated
This page describes products and general use; it is not medical advice.
Plastic surgery instruments are the hand-held, non-powered tools used to cut, grasp, lift and suture tissue in reconstructive and cosmetic procedures. Most are familiar general-surgery designs (forceps, scissors, needle holders, retractors, scalpel handles) in finer, shorter or more delicate patterns. One way to see what the category contains is a real tray: a University of Iowa ophthalmology tutorial lists the instruments of an oculoplastic (eyelid, brow and orbit) tray with their sizes and stated uses, and the table below is built from it. FDA’s rule for general manual surgical instruments is covered under regulatory status.
Who uses them: surgeons and operating-room teams performing eyelid, brow and facial procedures, and the staff who assemble, count and reprocess those trays.
What plastic surgery instruments are
They are reusable or disposable manual instruments for delicate soft-tissue work. FDA does not define a separate “plastic surgery instrument” category: its regulation for a manual surgical instrument for general use (21 CFR 878.4800) covers a nonpowered, hand-held or hand-manipulated device, reusable or disposable, intended for various general surgical procedures. The listed examples include forceps, hemostats, retractors, curettes, elevators, scalpel blades and handles, suturing needles, calipers and a manual dermabrasion brush. The same regulation states that an instrument with specialized uses in a specific medical specialty is classified in separate regulations in parts 868 through 892.
How they are built
The tray tutorial describes construction details that matter for how an instrument is named and used: forceps with a “tying platform” (Paufique and Castroviejo suturing forceps), forceps with a wide, flat, serrated thumb platform and rows of teeth (Brown Adson), needle holders with a lock (Castroviejo) or ring handles (Webster), and jaws that are smooth or serrated. Catalogue-style names combine a maker or surgeon name, a length in inches, and tooth or tip configuration, for example “Adson tissue forceps 4.875 in with 1×2 teeth”.
Types and sizes in an oculoplastic tray
The table lists instruments from one published oculoplastic tray. Sizes are the lengths given in that tutorial and apply to that tray, not to plastic surgery as a whole. Related guides: surgical scissors types, surgical retractors, the Castroviejo needle holder and ophthalmic surgical instruments.
| Group | Instrument and listed size | Stated use |
|---|---|---|
| Tissue forceps | Adson tissue forceps, 4.875 in, 1×2 teeth | Grasping thick or heavy skin such as brow skin |
| Tissue forceps | Brown Adson forceps, 4.75 in | Holding and manipulating subcutaneous tissue; multiple rows of teeth |
| Suturing forceps | Paufique, 3.375 in, tying platform | Grasping delicate periocular tissues |
| Suturing forceps | Castroviejo, 4.25 in, 0.12, 0.3 and 0.5 mm teeth, tying platform | Finer tissue such as conjunctiva or eyelid skin |
| Scalpel handle | Bard-Parker handle no. 3 (3L left-handed); handle no. 9, 4.25 in | Used with no. 15 blades in browplasty and blepharoplasty, as listed in the tutorial |
| Scissors | Metzenbaum, curved, 5.5 in | Delicate cutting and blunt dissection with blunted tips |
| Scissors | Storz iris, curved, 3.25 in | Trimming skin and fashioning lateral tarsal strips |
| Scissors | Stevens tenotomy, curved, 4.5 in; Westcott tenotomy, 4.625 in | Fine cutting; the tutorial calls Westcott the workhorse in eyelid surgery |
| Needle holders | Castroviejo with lock, 5.625 in; Webster, 5 in (smooth or serrated jaws) | Webster is used when significant force is needed to pass a needle |
| Hooks | Tyrell iris sharp hook, 4.75 in, single prong | Undermining thin skin |
| Hooks | Two-prong skin hook, 5.125 in x 15 mm | Handling eyelid tissue without the crushing a forceps can cause |
| Hooks | Joseph double hook, 6.375 in x 7 mm | Elevating thicker tissue while minimizing crush damage |
| Retractors | Knapp 4-prong blunt, 5.5 in; Senn 3-prong sharp, 6.25 in | Senn is used for elevating malar tissue in midface lifts |
| Other | Freer periosteal elevator, 7.5 in; Frazier suction tip, 8 Fr; Baron ear suction, 5 Fr, 5.125 in; Lancaster speculum, 3.25 in; Jaffe lid retractor, 2.125 in | Listed in the same tray |
Handles and blades are covered in what is a scalpel.
How instruments are matched to tissue and task
The tray tutorial does not give a buying guide. It does list stated uses that show how the instruments differ:
- Forceps: Adson is listed for thick or heavy skin such as brow skin; Castroviejo and Paufique suturing forceps are listed for finer tissue such as conjunctiva or eyelid skin.
- Needle holders: the locking Castroviejo holder is described as the one used to pass most needles in the tray; the ring-handled Webster is listed for when significant force is needed.
- Check the manufacturer’s labelling and instructions for use for the exact instrument and size.
Safe use and handling basics
One caution the tutorial states: Metzenbaum scissors are not recommended for cutting sutures, drains or heavy tissue, so they are not a general-purpose scissor. Reprocessing and sterile handling follow the manufacturer’s instructions for use for each instrument. For related general-purpose instruments see what is a hemostat.
Common mistakes
- Treating one tray as the whole field. The sizes above come from an oculoplastic tray and should not be assumed for a facelift or other set.
- Using fine scissors on sutures or drains. The tutorial advises against Metzenbaum scissors for these.
- Assuming a plastic-surgery-specific FDA category. The regulation text for general manual instruments does not use the word “plastic”; specialty instruments are classified in parts 868 to 892.
Regulatory status
Under 21 CFR 878.4800(b), a manual surgical instrument for general use is Class I (general controls) and exempt from premarket notification, subject to the limitations in 21 CFR 878.9. Specialty-specific instruments fall under other regulations in parts 868 to 892, so the class of a given instrument depends on which regulation covers it.
Frequently asked questions
What are plastic surgery instruments?
Hand-held, non-powered instruments such as forceps, scissors, hooks, needle holders and retractors, used in finer patterns for delicate soft tissue.
Does FDA have a separate class for plastic surgery instruments?
No separate category appears in 21 CFR 878.4800. General manual surgical instruments are Class I (general controls) and exempt from premarket notification, subject to 21 CFR 878.9; specialty instruments are classified in parts 868 to 892.
Do the sizes on this page apply to all plastic surgery sets?
No. They are the lengths listed for one oculoplastic tray and should not be assumed for another set.
Sources
- University of Iowa Department of Ophthalmology, EyeRounds, “Oculoplastic Tray” instrument tutorial: https://eyerounds.org/tutorials/instruments/Oculoplastics/OculoplasticTray/ (checked 2026-10-30).
- eCFR, 21 CFR 878.4800, Manual surgical instrument for general use: https://www.ecfr.gov/current/title-21/part-878/section-878.4800 (checked 2026-10-30).
