After 4 weeks, I am finally finished with plastic surgery and have completed exactly 2 elective cosmetic procedures. Neither of these were boob-jobs. I feel really comfortable with skin grafts, wound care, the basics of hand surgery, and flap theory. I had the privilege of helping several women regain their breasts after a mastectomy and help put hands back together. I assisted in helping rebuild half of a man's head and doing a lot of suturing. Plastics is a lot more than cosmetics and deserves a great deal more respect than it gets in the general population. The majority of the physicians I worked with spend a crazy number of hours providing life-changing surgeries to very needy people. I respect them a great deal. I also recognize that surgery is not a lifestyle that I am ever interested in. It demands more time away from a family than I can abide by and it is both physically and mentally draining. I am very thankful for those who choose it as their profession so I do not have to. They truly earn their money at the end of the day.
Let's share some nuggets of wisdom from the plastic surgery rotation.
#1 Every single day in clinic there will be someone who tries to scam free breast augmentation / abdominoplasty and/or breast lift. They will try to coerce the surgeons into insurance fraud. They will make a passionate plea and give examples of friends who were successful at their scams. These people are politely shot down and provided with an elective cosmetic price list. (surprisingly it really isn't as expensive as you would believe)
#2 People in Indianapolis (and likely many other major urban areas) get shot in the hand a lot. This always occurs while minding their own business, before/after bible study, and visiting a grandmother is usually involved. It is always "some dude" that does it every time. In greater than 50% of these cases they will have been shot previously. This proves several things:
A. People in Indy need a lot more target practice.
B. Never mind your own business
C. Never shoot someone with a caliber of bullet that is not start with at least a .4 or has magnum in the name.
D. There are a lot of grandmothers that live near dudes that like to shoot people. Avoid grandma at all costs.... your life may depend on it.
E. Some Dude is an asshole
#3 Plastic surgery is an art. It requires a great deal of skill, vision, and artistry. There are different kinds of artists. One is a sculptor chiseling David from marble. Another is a large, hairy, bearded man with no shirt that cuts large logs into bears. Plastic surgeons should strive to be the former rather than the latter.
#4 Many people (physicians included... yes they are people too) have a magical belief that plastic surgery is a mysterious cabal of flesh crafters that can create super-physiological results. This is totally untrue. A substantial amount of the modern view of plastics is based on a totally ridiculous fantasy perpetuated by the media. A cursory review of what plastic surgeons do will prove this. Yes, it is highly skilled. No, it is not at all magic.
#5 Fasciotomies when done well can save limbs. Fasciotomies done poorly make the initial surgeon look like Hannibal Lecter and piss off plastic surgeons when they have to cover them with skin grafts unnecessarily. I never ever ever ever ever want a fasciotomy..... ever...
Now it is on to anesthesia.... the land of milk and honey (diprivan and fentanyl).
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