A range of medical conditions or trauma can lead to external manifestations which subsequently can affect the mental and physical state of patients. In recent years, there has also been an increase in demand for elective cosmetic procedures due to celebrity and media influences. Both these situations warrant the need for plastic surgeons.

The pioneers of plastic surgery date back to 600BC when a surgeon called Sushruta reconstructed a nose with a piece of cheek. In the 16th century, Gaspare Tagliacozzi became well known for treating saddle nose deformities using skin flaps from the upper arm.

Since then, modern medicine has refined and standardised these methods with an increase in tools for precision. Especially with the introduction of anesthesia and antiseptics in the 19th century, this field has benefited in terms of safety and simplicity.

A highly skilled specialisation

Playing a key role in the treatment of many patients, the daily task of plastic surgeons calls for a great deal of patience and perfectionism. Developing these characteristics aside from learning the specialised skills required to carry out their tasks takes an excessive amount of training and time.

Dr Lilli Cooper, a plastic surgery trainee at the Queen Victoria Hospital in England, states that she spends three full days out of a week in the operation theatre to sharpen her skills.

“Operations can last from around 20 minutes for something straightforward to between six and eight hours for more complex microsurgery, for example where someone has lost a finger.”

Apart from the vastly publicised cosmetic surgery, this field offers a multitude of subspecialties to venture into such as cranio-maxillofacial, hands, burns and trauma, skin and breast cancers, congenital malformations, tissue degenerative diseases etc. Evidently, this begs an expertise of the entire human body and the ability to work with various other surgeons to perform complex surgeries.

“I really love the breadth of work in plastic surgery and the fact that you see people of all ages from babies to elderly people. Plastic surgeons treat the whole body and also have an interesting mix of emergency and non life-threatening operations,” added Cooper.

“I enjoy working as part of an MDT [multi-disciplinary team] with different colleagues and using different skills when operating on soft tissue, blood vessels, bone and tendons.”

Managing patient expectations amidst quest for perfection

Arguably, a large chunk of a plastic surgeon’s daily struggle lies in the balance between managing patients’ expectations and providing a healthy and functional form. Plastic surgeons need to be frequently updated on new transplantation and tissue regeneration research to better their techniques in this competitive field.

“Plastic surgery is often technically difficult and challenging, and there may be difficult clinical decisions to make. However, there are always senior colleagues available to help,” Cooper elaborated on the downsides of her career.

As the final outcome of plastic surgery usually involves modifying the external appearance of the patient, perfection is necessary. The quality of work can easily be criticised by just about anyone as the external results are widely thought to be the determining factor of a good plastic surgeon. With that being said, the main goal of plastic surgery should be to holistically improve patients’ quality of life and wellbeing.

“A really rewarding part of our work is being able to operate on patients who have cancer. Through surgery we hope not only to make them well, but also restore function to the affected area and make it appear as if the cancer was never there,” explains Dr Joy Odili, a consultant plastic surgeon in England.

A booming billion dollar industry in Asia

In the Medscape Plastic Surgeon Compensation Report 2017, second to orthopedic surgeons, plastic surgeons are the most highly paid in the US with an increase in compensation since 2016.As of January this year, theInternational Master Course on Ageing Science revealed that the aesthetics market has grown a further 8.3% in 2016 as compared to the previous year.

With the US taking the lead at 46% of the global market share, Europe, Asia-Pacific and Latin America are following closely behind. This billion dollar industry even greatly affects medical tourism as patients meticulously source out well-experienced doctors or even ‘high-profile’ ones spread across the world.

In 2014, medical tours were found to attract up to five Malaysians a month looking to improve mainly their facial features at one of the numerous cosmetic centres in South Korea.

Dr Woffles Wu, a plastic surgeon in Singapore, also affirmed the growth in medical tourism as he now receives 30 to 40 clients from China a month as opposed to less than 10 a year previously.

“Some patients come with no financial limit and just want to achieve the best possible results they can. They are willing to fly back and forth again and again,” he added. MIMS

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