Medical professionals are driven by a deep desire to improve their patients’ lives, and plastic surgeons are no exception.
We asked ten plastic surgeons to describe defining moments in their careers – epiphanies that will forever remind them of the positive impact their work can have on patients’ lives. They answered our questions with humility and grace, recalling many cases where patients overcame severe injuries and underwent deep transformations. These are their stories.
I have been a plastic surgeon on my own for less than a decade.
While I am certainly not mature enough in my profession or in age to have had a single “career defining moment,” I have had many moving experiences which have affirmed my decision to be in this profession. Such experiences continue to inspire me to grow as a professional and as a person. Here is one:
A college-bound young man severed his thumb off in a freak accident at his part-time job. He was a stellar student and his aspiration was to ultimately become a doctor. I was on replant call at the hospital that night, meaning that I was on stand-by for emergencies involving severed body parts, which generally involve the fingers or an entire hand.
It was therefore my responsibility to determine if his thumb could be saved, and if possible reattach it using microsurgery. In such cases not only are the bones, tendons, and skin reattached – the blood vessels and nerves are also reconnected under a microscope using stitches with a diameter thinner than a single hair.
As soon as I saw the patient and learned of his predicament, the weight of my responsibility hit me. The thumb is the most important digit – it accounts for 40-50 percent of proper hand function. I was the only surgeon in the city at that moment who could help this kid.
The operation took many hours, but it was successful. Just as important was the follow up care, which was as intense as the arduous, technical operation that came before. During my time treating this young man, I grew close to him and his family. Their trust in me was humbling. It was an honor to have had such a deep impact on his life.
When I was the chief of plastic surgery at Denver Health Medical Center, I took care of a badly injured woman who, while riding mountain bikes with her 15 year old son, had quite a crash and sustained severe trauma to her face.
They were all alone in the mountains, but her son’s quick thinking kept her alive long enough for rescue workers to come get her and transport her to a local hospital. She was stabilized and then flown down to our Level 1 trauma center.
I performed a number of reconstructive surgeries on her face to give it a semblance of its pre-injury appearance and function, calling on all of my facial trauma training to take care of her in the best way possible.
What struck me the most was how calm and supportive her family remained throughout the process – especially her son. It’s because of this case that I came to specialize in facial surgery. It also inspired her son to look towards medicine as a career, which I thought was really amazing.
It’s very difficult for me to pick one surgery that I enjoy doing more than others. However, if pressed on the issue, I would have to say that I enjoy treating babies with craniosynostosis. This condition causes the skull bones to become fused during infancy, resulting in very abnormally shaped heads. Along with a neurosurgeon, I actually remove parts of the skull, reshape it on the side table, and put it back on in a more normal position using plates and screws that dissolve over time.
It’s a very rewarding procedure because it’s technically challenging, but also because it provides instant, visual gratification. Parents are usually terrified before the surgery, but extremely impressed and grateful afterwards. There is no feeling quite like making a difference in a child’s life.
Just like most surgeons, I am a Type A perfectionist. This proves to be a blessing and a curse. I think it’s the attention to detail that constantly encourages me to be better and to do as much for my patients as I can. While this can be a positive thing, it also at times has its challenges. Some (or should I say most) procedures can’t be done perfectly, nor do they have perfect outcomes. Accepting what is less than perfect or dealing with complications is very difficult.
While I do have many excellent outcomes and happy patients, I have also had a few tough cases with suboptimal outcomes that cause me to lose sleep. Even when these outcomes are out of my control, I tend to take things personally. This is extremely motivating, and makes me continue to aim for perfect.
During my training in 2012 we performed a total nasal reconstruction on a 54 year-old woman with a massive basal cell cancer on her nose. She had avoided getting any treatment because she was scared of the consequences and risks. The cancer had also eroded most of her skin and obstructed her breathing.
After bravely coming into the office, she spent nearly an hour listening to us explain what the procedure would involve – excision of the cancer, then forehead flap and rib cartilage grafting. It would take at least three procedures. Despite her anxiety, we proceeded.
The surgery went well, but she struggled with the recovery process and her cosmetic expectations. Counseling and reassurance were the hardest things to provide post-surgery. However, week by week her confidence grew. After her third and final procedure she could breathe out of her nose, and esthetically her confidence was restored. She could finally go out in public again! This special experience inspired me to pursue my profession and continue to make a difference in my patients’ lives.
As a plastic surgeon, you hope that you will have a lasting impression on someone’s life. After all, we train so long and so hard to do what we do, we hope that it is all worthwhile and that we can benefit the lives of those we help. Patients appreciate us all the time; but how long will they remember our names or the details of that experience? One patient comes to mind regarding this question.
While checking in at a charity event in our community, the woman behind the desk said “I bet you don’t remember me?” She was right – I didn’t. After practicing in the same community for 20+ years, it’s hard to remember each and every patient. She began to tell me every detail of what had happened 10 years prior to that moment.
After a motor vehicle crash had left her with severe facial trauma, she had been transported to the trauma center where I happened to be on call that night. She was frightened at the thought of being deformed or scarred for life. As her plastic surgeon, I spent hours reconstructing the complex fractures and lacerations.
As she described all of this, the images of that evening began to appear in my mind. I started to remember her. Her face showed more and more excitement while telling her story – she wanted to show me how great it all turned out. She began calling her friends over and introducing me as the plastic surgeon who kept her looking beautiful. It’s in such moments that you realize how deeply you’ve affected someone’s life.
Throughout my career as a cosmetic surgeon, I have experienced countless cases that have inspired and motivated me to continue doing the work that I do. My practice performs all kinds of cosmetic procedures, but the surgery that impacts the lives of my patients the most is breast reconstruction for breast cancer survivors.
Earlier this year, the procedure became personal. One of my two sisters was diagnosed with early stage breast cancer at 34 years old. She had recently gotten engaged and was looking forward to marriage. The last thing on her mind was gearing up to fight this disease. Needless to say, I was there for her every step of the way; through the pain of undergoing a double mastectomy and then the reconstructive surgery, which I personally performed. Witnessing the kind of trauma a mastectomy can trigger – not only on the physical body, but also on a woman’s psyche – and addressing that distress with fat grafting made me realize intimately the value of breast reconstruction.
I believe that fat grafting is God’s gift to plastic surgery because it is a tool that provides an optimal result in any part of the body. The procedure allows women to use their own natural tissue to reconstruct their breasts in a natural and safe way. One company offering this technique is Puregraft, which I have used for five years – as long as I’ve been in practice. It is a product that consistently performs admirably. Puregraft’s amazing technology makes it especially useful for face and breast reconstructions, where details matter. More plastic surgeons ought to be using this wonderful product.
After my sister’s reconstructive surgery, I gained a whole new perspective. I strive every day to help women regain a sense of self, confidence and femininity after beating the disease. As for my sister, just a few weeks after her surgery she was running around a water park in a bikini – imagine that!
As surgeons, we spend our days performing procedures that we learned in medical school, at conferences or courses in continuing education, or by adding our personal touches to our surgeries.
On June 13 2016 at 11:30 a.m., while driving from Manhattan to rural Connecticut to visit a very well-known facial plastic surgeon, I had an epiphany. At that moment, I visualized how plasma energy could be used to address skin laxity in our micro facelift procedure.
I had purchased the J-plasma unit (Bovie) to perform skin resurfacing for my patients. After seeing the procedure’s tightening effects and its incredible precision for general surgery, I attempted the world’s first plasma blepharoplasty. The patient was a 60-year old female patient with severe skin laxity on the upper and lower lids. Passing the needle through each end of the blepharoplasty incision was like nothing I’d ever seen before. The tissue was spectacular – it looked untouched. But I was unprepared for the amazing amount of contraction that occurred after applying the plasma energy with the resurfacing parameters on the orbicularis side of the skin excision.
Recovery was much faster than expected. Unlike other lasers that create thermal spread, the plasma energy was precise and focused, allowing a faster healing time around the delicate eye area. I knew that this energy would change face lifts and body shaping forever.
Near the beginning of my private practice I performed a rhinoplasty on a 15-year-old who didn’t like her large nose. Now, some people might say, ‘Why are you doing plastic surgery on someone so young?’ It’s true that you should be able to accept yourself for who you are, but for younger people that can be very hard in this day and age. After the procedure was done and the patient healed, the result was very nice and I didn’t think anything special about it.
After a month, both the patient and her mother described how incredibly happy and confident she had become. She was making new friends and was increasingly active socially – she really came out of her shell. It gave me a great sense of satisfaction to see how I could positively affect someone’s life over and above just changing the appearance of their face.
My most inspiring moment as a plastic surgeon took place in Vietnam. Every year, we bring our resources and skill set to Hanoi to provide complex reconstructive surgery to those in need. Don’t get me wrong – the hospitals there have everything you need to perform the most complex surgery, and the surgeons are very gifted. A unique collaboration occurs each year that tests both American and Vietnamese surgeons through challenging reconstructive cases.
Patients from across southeast Asia are eligible for surgery through this program. In 2014, I was assigned to several complex cases, including toe-to-thumb transfer, jaw reconstruction using the leg for bone and skin, and ear reconstruction using the forearm. One case, however, stands out.
The patient was a young Malaysian man who had a tumor in his sinus removed in Singapore. The deep structures of his mid-face were not reconstructed, so over the next year the tissues under his left eye and the bridge of his nose began to sink in. He was also having difficulty breathing on the left side of his nose.
In short, the man presented with a nose full of scar, a depressed nasal bridge without support, and a hollowed mid-face without support. I would need to rebuild his mid-face, nasal lining, and nasal dorsum. Bulky tissue from the leg or thigh would further obstruct his nose. But he was a thin man, and so it occurred to me to use his forearm for bone with a blood supply, bone graft for the nose, and thin pliable skin to re-line the nasal cavity. The forearm would provide generous tissue for all of this. I had never performed, or read about, any operation like this – but I was unfazed nevertheless.
Here’s why: I had already learned the principles – this was just the time to apply them. I designed a flap that included bleeding bone and skin, and took another strut of bone to rebuild the nose. Using a screw, the nose framework came together easily, like pitching a tent. The other piece of bone was used to rebuild his left mid-face and was secured with fine wires. The skin attached to the bone perfectly lined the defect after all the scar was cut out. The blood vessels were connected to a matching set of vessels over his jaw through a small counter-incision.
The operation was not technically challenging, but reminded me of how plastic surgeons operate more based on principle than experience, and why I chose a career in plastic surgery in the first place.
As I tend to focus my practice on mommy makeovers, one story of a memorable mom comes to mind.
This was a 41 year-old woman who had four children. She was embarrassed to go to the swimming pool with her kids because of her body. She was depressed and mad at herself because her kids were suffering due to her concerns – even though they lived across the street from the neighborhood pool, this mom still refused to take the kids over, and when she did, she hid in the shade.
When I saw her in the office, she tried to hug herself into non-existence. She was so embarrassed about her breasts after having breast fed all four of her children that she couldn’t even look at me in the eye when she had her robe on, even before the exam. During the exam – which she prevented her husband from being in the room for – she started crying. She told me she didn’t understand how her husband could still have any interest in her.
She said she was disgusted at herself for gaining so much weight with her pregnancies. She just couldn’t get back to her pre-baby weight or to her pre-baby body. Her supportive husband told me he just wanted his wife back… not in the physical sense, but the emotional and mental aspect, and inquired if I thought surgery could help with that.
I suggested a tummy tuck and breast lift with augmentation, to which they agreed. I made sure they understood: this wouldn’t replace any confidence she didn’t have, just uncover the confidence that was hidden within. Just like I would remove the extra layer of fat, I was hopeful to remove the barrier that was preventing her confidence from shining through.
She went through with the mommy makeover surgery and healed beautifully. About one month post-operatively, she was beaming and bounced into the office, as light as a feather. She went on and on about how great she felt. When I took her to the photo room, she was disrobing before I could even shut the door. When I asked her to hold on before removing her gown, she told me in her sweet southern accent, “Oh honey, half of Nashville has seen these beauties.” My jaw hit the floor.
Accompanying her to this visit were her husband and one of her daughters. He repeatedly thanked me for all that I’d done. Upon hearing this, the teenage daughter chimed in too: “Yeah, Mom is just so happy all the time now. It’s sickening.”
This is why I love to perform mommy makeovers. I not only have the opportunity to help out an individual, but it’s great to see the ripple effects that restoring a mom’s confidence can have on the entire family unit.