On Friday, January 11, I had the privilege of interviewing medical students for the combined plastic surgery residency program at Columbia and Cornell.  One of the questions I always ask is “What made you decide to become a plastic surgeon?”

The answers are as varied as the students, but most point to a single moment, a single case, or a single surgeon who completely changed their perspective.  For most applicants, this “a-ha!” moment often occurs when seeing a cleft lip repair for the first time, when seemingly disparate elements come together to repair a devastating defect.  For others, watching a TRAM (transverse rectus abdominis muscle) flap, during which muscle, fat, and skin are transposed to the breast for reconstruction following mastectomy, is a minor miracle.  For me, the “ah-ha!” moment came during my first year of medical school, when I first watched my mentor Dr. Lloyd Hoffman reconstruct a patient’s nose following the excision of a large skin cancer.  I watched him make some unintelligible markings on the patient’s face, and then cut the surrounding skin prior to rotating and suturing it into place.  The result was a closed defect, a restored anatomical defect, and a very relieved patient.  I was so intrigued that I proceeded to skip pharmacology class every Monday to watch Dr. Hoffman perform every imaginable type of procedure.  (N.B. to med students: don’t skip your pharmacology classes.)  He would start the day with a breast reconstruction procedure using either implants or the patient’s own tissue, then follow with a muscle flap to cover exposed bone on a trauma patient’s leg, and finally would finish his day with a cosmetic eyelid lift.  In the next room, his colleague Dr. Greg LaTrenta would be performing a cleft lip repair on a six-month old baby.  It was the first time I had seen surgeons operating all over the body, using every type of tissue and technique, and – most importantly – having fun.  If a student can’t think of a good “a-ha” moment, or heaven forbid, refers to a television show, then I become a little wary.

So, what does it take anyways to become a plastic surgeon?  Aside from an obscene number of years of education and training and examinations, plastic surgeons have a certain sense of fearlessness.  That is, they must crave a challenge, whether it comes from their peers, their patients, or their teachers.  No case is ever routine, because a patient’s anatomy is never the same as it was for the last patient.

Second, they must be able to work hard and to be prepared for anything.  Complications never happen at 10 am on a Tuesday, they always happen at 2 am on a Saturday night.  Always.  Finally, plastic surgeons must be able to appreciate the artistry of surgery.  One could argue that all surgery is artistic, but what is beautiful in our eyes needs to be beautiful for the patient as well.  In cutting, reducing, enlarging, rotating, or suturing tissue, we are performing what the Greeks originally meant when they used the term “plastikos” – sculpting and molding living, breathing tissue.  I can’t think of anything else I would rather do for a living. 

On Friday, January 11, I had the privilege of interviewing medical students for the combined plastic surgery residency program at Columbia and Cornell.  One of the questions I always ask is “What made you decide to become a plastic surgeon?”

The answers are as varied as the students, but most point to a single moment, a single case, or a single surgeon who completely changed their perspective.  For most applicants, this “a-ha!” moment often occurs when seeing a cleft lip repair for the first time, when seemingly disparate elements come together to repair a devastating defect.  For others, watching a TRAM (transverse rectus abdominis muscle) flap, during which muscle, fat, and skin are transposed to the breast for reconstruction following mastectomy, is a minor miracle.  For me, the “ah-ha!” moment came during my first year of medical school, when I first watched my mentor Dr. Lloyd Hoffman reconstruct a patient’s nose following the excision of a large skin cancer.  I watched him make some unintelligible markings on the patient’s face, and then cut the surrounding skin prior to rotating and suturing it into place.  The result was a closed defect, a restored anatomical defect, and a very relieved patient.  I was so intrigued that I proceeded to skip pharmacology class every Monday to watch Dr. Hoffman perform every imaginable type of procedure.  (N.B. to med students: don’t skip your pharmacology classes.)  He would start the day with a breast reconstruction procedure using either implants or the patient’s own tissue, then follow with a muscle flap to cover exposed bone on a trauma patient’s leg, and finally would finish his day with a cosmetic eyelid lift.  In the next room, his colleague Dr. Greg LaTrenta would be performing a cleft lip repair on a six-month old baby.  It was the first time I had seen surgeons operating all over the body, using every type of tissue and technique, and – most importantly – having fun.  If a student can’t think of a good “a-ha” moment, or heaven forbid, refers to a television show, then I become a little wary.

So, what does it take anyways to become a plastic surgeon?  Aside from an obscene number of years of education and training and examinations, plastic surgeons have a certain sense of fearlessness.  That is, they must crave a challenge, whether it comes from their peers, their patients, or their teachers.  No case is ever routine, because a patient’s anatomy is never the same as it was for the last patient.

Second, they must be able to work hard and to be prepared for anything.  Complications never happen at 10 am on a Tuesday, they always happen at 2 am on a Saturday night.  Always.  Finally, plastic surgeons must be able to appreciate the artistry of surgery.  One could argue that all surgery is artistic, but what is beautiful in our eyes needs to be beautiful for the patient as well.  In cutting, reducing, enlarging, rotating, or suturing tissue, we are performing what the Greeks originally meant when they used the term “plastikos” – sculpting and molding living, breathing tissue.  I can’t think of anything else I would rather do for a living.