As a child, I was convinced that I wanted to become a pediatric surgeon. While studying under a plastic surgeon at Dartmouth, my eyes widened as I was exposed to the world of reconstruction. I watched with amazement as the floor of the patient’s mouth was reconstructed using the skin and muscle from his chest after a tumor resection. Following reconstruction, the patient could again eat and communicate—basic necessities of human life. In many ways, plastic surgery is a field that capitalizes on a surgeon’s creativity and innovation to solve the problems left untouched by other disciples, restoring form and often function. In medical school, I choose to become a plastic surgeon admiring a surgical field that had no anatomical borders, operating on all parts of the body and on any age group.
The ayurvedic physician Sushruta first developed the field of reconstructive surgery in ancient India (c. 800 BC). Secondary to religious, criminal or military punishment, Sushruta treated many patients with amputated noses, genitalia and earlobes. It was during this era that he developed techniques to reconstruct the nose using skin from the forehead or an earlobe using the cheek. Wartime atrocities lead to developments in plastic surgery during the Roman Empire, the 16th Century, and World War I. Harold Gilles of the British Army was instrumental in advancing the field of plastic surgery by repairing disfiguring facial wounds of soldiers injured by shrapnel during trench warfare.
Over the last century, techniques have improved leading to more realistic reconstructions. We have entered the age of microsurgery, allowing plastic surgeons to utilize tissue from a distant location by reattaching it to a new artery and vein. The word reconstruction means to build something that was damaged or destroyed. In plastic surgery the damage is often due to an accident or cancer.
While training as a general surgeon at Columbia University and the University of California, San Francisco, I learned to save patients from life threatening accidents and advanced cancers. Now as a plastic surgeon, I have the privilege of restoring their bodies and their lives. Some of the most exciting and challenging cases that I perform are breast reconstruction after mastectomy and facial reconstruction after MOH’s excision. I have been challenged by many secondary rhinoplasties (nose jobs) due to difficulty breathing or collapse of the nose. Each patient has a unique set of deficits and goals, making this aspect of my practice constantly challenging and rewarding.