Plastic and reconstructive surgery is frequently mistaken for aesthetic and cosmetic surgery. At present, plastic surgery is a very broad discipline in which aesthetic surgery is an integral part. The majority of reconstructive operations, in particular on the body surface, include an aesthetic component. Their purpose is not only the restoration of function but also the achievement of optimal aesthetic results. The authors demonstrate examples on the vague borderline between functional and aesthetic reconstruction and present their views on the medical indication for these operations.