"Hey, you're not an a--h---!"

One of things I like most about being a plastic surgeon is that I get to meet such an interesting variety of people. I think people often and incorrectly assume an identity for plastic surgeons based on movies or TV shows or other stereotypes. Similarily - many people have the wrong idea about who undergoes plastic surgery -(only those driving around town in Lamborghinis and fur coats). We are just as likely provide care for the person working behind the deli counter as well as the person buying the produce. So I was a bit surprised when the husband of one of my patient's said, "Hey, you're not an a--h---, you're a regular guy." I'm sure it was intended as a compliment of sort because some people have the wrong idea about plastic surgeons. We are all wired differently. I can't imagine ever forgetting what it was like working as a clerk behind the admissions counter at a local hospital for years before I became a plastic surgeon - a rather humble beginning. Don't get me wrong - I have met many surgeons who are - well - not always pleasant to work with. So I guess that we continue to re-learn that we can't make assumptions about people until we get to know them. Sometimes the least expected compliments can come from unlikely sources. Just today, after I removed some dressings off a big, professional fighter - he said , "Hey, I think I love you man." Better to love me than hate me - because after all - I'm not just your ordinary "a--h---".

Plastic Surgery is More Acceptable

I was happy to come across an article this week by the American Academy of Cosmetic Surgery that reported on a shift in perception that plastic surgery is more acceptable today that even five years ago. I found this news encouraging because I still meet patient that feel that having surgery on themselves is too "vain". Never mind the fact that people spend their discretionary money on a lot of other things that are equally discretionary - and some don't seem to process the same type of guilt about other discretionary purchases as vanity (think new car, boat, snowmobile, cabin, bigger house, vacations, etc.).
Orthodontist have been well positioned with many teenagers and more adults with braces being quite acceptable for a long time. They are improving both appearance and function - like a lot of plastic surgery does. For those of you who don't know - I finally got my braces off. I can't say that I ever got totally used to having them. I was just so aware of my teeth and smile every time I met a new person or patient because I thought people would think I was trying to look like I was 17 at age 50. It didn't seem to help when people would say, "I can hardly notice" which means that they did notice. Every time I ate out was distressing because there was always something clinging for dear life onto my braces after every meal. SO - I get that changing your appearance comes with some slow improvements and that most people were quite encouraging of the decision.
So the good news seems to be that plastic surgery is becoming more acceptable and just like wearing braces, people are increasingly comfortable with changing the way that they look. Cosmetic surgery increased almost a hundred percent over the last decade. I can only hope that the 20% of people who responded to the survey who were considering plastic surgery in the future - don't wait too long. I'm also hoping that the robust start of 2010 continues not just in our industry - but across the country.

The Littlest Loser

Truth be told - I was a big New Year's resolution type of guy. For a couple decades I took the time to write out numerous, annual resolutions on multiple pages. This year and last year - I simplified this process by reducing the number of goals to something more manageable: "Don't give up." In a review of past goals it would appear that I haven't made much progress because the areas I struggle with have been surprisingly similar over the years - balancing my life, eating right, losing weight, making better choices with my time, and living with more intention. I imagine that the appeal of the popular TV program, "The Biggest Loser" (www.nbc.com/the-biggest-loser/) is the life changing dedication and hard work that results in such dramatic changes. I seem to have a number of patients that have made regular (daily?) resolutions to wake up and commit to improving each day. They consult for those areas that do not respond to diet and exercise. Some people even name these little unwanted fat pockets ("my little friend", "Fred", "my other butt" etc.) and many patients are surprised at the dramatic improvements they see with even the littlest 2-5 pounds of fat removal. That's not to say that these unwanted fat deposits are not noticeable - because they are - but my observation is more that the biggest rewards sometimes come to the littlest losers.

Confessions

First confession: I love transformation stories. I love the old movie classic, "Rocky", remakes of old classics like "Sabrina" and even quirky Australian movies such as "Babe" or "Strictly Ballroom." Truthfully, I even enjoy cartoon versions of transformations such as "Shrek"or the classic "Beauty and the Beast". Although in the case of Fiona and the ogre - beauty can be in the eyes of the beholder. It is easy for me to see why so many people enjoy reality TV and the transformation stories of Susan Boyle or Legacy on "So You Think You Can Dance." Even the most physically transformative stories seen on "The Biggest Loser" are compelling in both the emotional and physical scope for most people. As viewers we get to see a very shortened portion of life altering changes.
Second confession: One of my favorite job benefits is to participate in transformations. The old saying, "Sticks and stones may break my bones, but words will never hurt me," is simply untrue. I have been impressed with the impact that a critical comment made by a family member, a friend or even a total stranger can have on some people's self-image. An off-handed comment about the size of a nose or the protrusion of ears or the _______(you can fill in the blank), can leave some people with emotional scars that can be often forgiven, but not easily forgotten. It has been my privilege to have been a frequent witness to physical changes and emotional healing that are accomplished as a result of surgery. Some people would like to think of plastic surgery as just "vanity," but my most typical patients are really attempting to normalize appearance or restore proportions that has been changed or lost with time, age, pregnancy, trauma or even cancer. In this century to say, "Well, you were born that way - and that's how you should stay," is also just untrue.
Third confessoin: I have kept a box of thank you notes from grateful patients who have allowed me the privilege of listening to their concerns, working with them to develop a treatment plan based on appropriate expectations and caring for them during their recovery and eventual transformations. Sometimes I do think, "Wow, I get to help people in unique ways - both visibly and emotionally." While my 13 years of medical training were critically important, maybe my undergraduate major in Psychology from Bethel was better than calculus after all.

If Plastic Surgeons Were Professional Athletes...

This past week I was reading an article about coaching and the fact that most professional athletes have coaches all of the time - even someone as accomplished as Tiger Woods. These are highly compensated professionals that are still in need of professional coaches. Even with the best coaches and the best athletes the Twins or Vikings can still lose. The best player on the Twins gets on base less than half of the time they are up to bat and completely strike out - often. The Viking's "new" and well-seasoned quarterback, Brett Favre, still fumbles or has his passes intercepted. So if plastic surgeons were more like professional atheletes - would we have coaches and would the public be "fans" even if our passes were interecepted, the ball was fumbled or we simply struck out when it was our turn at bat? Unlikely - well - let's just say - no.
Our speciality is especially vulnerable to criticism given the visual nature of what we do. If an appendix removal or knee surgery is imperfect - most patients would never know. If a cosmetic procedure is less than perfect - say - we got a new first down or we got a great hit and got to second or third base - a patient will usually be quite happy but sometimes they can feel disappointed it wasn't a touch down or home run. Fortunatley - many of us have great mentors that we resource for difficult problems or other solutions. Even wihout a professional coach - many of us constantly strive to improve our skills and outcomes. We are required to take at least 50 hours per year of continued education (aka - coaching). So, do I ever dream of being a professional athlete? Not really. Would I like to have a paid coach looking over my shoulder every day in surgery? No. Do I like having adoring fans - well - of course.
I am so thankful to have the opportunity to do what I do and to work with such a great team! To all of my "fans" - it is my privilege to share this bit of life with you. I hope the Coach continues to keep me at the top of my game!

Moving Forward

Toyota: "It's a great way to keep 'moving forward.'" I love that Toyota tag line and I have been heard to repeat it - somewhat frequently - just ask my staff. I seem to have one gear - forward. It just doesn't seem to do any good to try and reclaim the past. It has been recently reported that a lot of the elective plastic surgery business has been affected during this recession, although even during the Great Depression of the 30's - many people still found money to spend on beauty products and self-improvements. This has been true for us too - where patients want to maintain their appearance, but may not want to splurge on a bigger surgical procedure. We have an opportunity to refocus our efforts and priorities. Our goals can change with the times. We are happy to help people work within their budgets, to get their maximal benefit. It might not be a Mercedes for everyone - but a great looking appearance with a plan for extending the mileage is - after all - still a great goal. So as long as the recession lasts - let's keep moving forward with our self-care and care of others.

On a personal note, I am moving forward tomorrow (10-10-09) with the priviledge of traveling with a team of Rotaplast volunteers to China where I can use my surgical talents to care for children with cleft lips and palates. I am so thankful for this opportunity to give back a small portion of what I have been given. More when I return....

My First Blog

This is my first blog posting and I feel a little like I am sending this out to some unknown internet server in the middle of Arizona or maybe Dubai - and who knows where it goes from there. I was talking today with an old friend, Steve, about the whole social media and networking thing. We have not given in and we are trying to keep up. We both purchased IPhones last year and absolutley love them. We both just recently signed up for Facebook with the fastest growing demographic (over45). I do not have any plans to Twitter or send Tweets. I have been told the email is "so last year" and I am committing myself to staying on the information superhighway and trying to stay connected - and also I am trying to stay socially relevant - if that is even a worthy goal. So there it is. My first blog. I promise that the next one will actually be about plastic surgery and starting over in a new community during an economic recession. It is a true test of one's resolve, optimism and perseverance.