COMMENTARY

Plastic Surgeons: The Rock Stars of Medicine?

Anthony S. Youn, MD

Disclosures

August 29, 2012

I once had a plastic surgeon tell me, "We are the rock stars of medicine. Plastic surgeons get all the action, all the glory, and all the money."

No, I don't really believe that, but the public does. Television shows like Dr. 90210 and Nip/Tuck have created a persona of plastic surgeons as slick, arrogant doctors who wear Armani suits and flirt with their 20-year-old patients.

The reality is far from this. The majority of plastic surgeons are earnest physicians who perform a wide variety of cosmetic and reconstructive surgery, ranging from cleft lip operations to complex tendon repairs to breast reconstruction after mastectomy. The field is truly vast in scope.

The term "plastic surgery" comes from the Greek word plastikos, which means "to mold." To become a plastic surgeon, you must complete 3-6 years of general surgery residency followed by 3 years of plastic surgery residency. Many plastic surgeons then complete a 1-year postgraduate fellowship in one of the following fields: hand surgery, craniofacial surgery, aesthetic surgery, microsurgery, burn surgery, or pediatric plastic surgery.

Plastic surgery is one of the most competitive fields of medicine to enter. In 2012, there were 300 applicants for only 121 open residency positions. To get into the field, you need to be one of the top students in your class and be willing to complete a long, arduous residency process.

My path to becoming a plastic surgeon had more ups and downs than Space Mountain. It began with my own appearance. During my last 2 years of high school my jaw began to grow. And grow. It enlarged to a monstrous size. With each horrifying millimeter that my jaw advanced, my self-esteem shrank in response. By the end of high school, my chin was bigger than Jay Leno's. I felt deformed.

Salvation came in the form of a jaw-reduction surgery. A maxillofacial surgeon broke my jaw in 2 places, set it back, and then wired it into place. My teeth were also wired shut. For 6 weeks. The operation, although incredibly painful, changed my ability to eat, my appearance, and my self-image. All for the better. I was a new man.

During college and most of medical school, I had the vague notion that I wanted to be a surgeon. I considered general surgery, but then I saw a 60-year-old man stumble out of a call room at 3 AM to attend to a trauma. Nope. General surgery was not for me. I like to sleep in my own bed at night.

My decision to pursue plastic surgery as a career was inspired by an 8-month-old boy who was mauled by a raccoon. I met him during my pediatrics rotation. His story horrified me more than anything I've ever encountered.

A young couple left their baby boy at home in his crib, while their pet raccoon inhabited a box next to him. Mom and dad went to the bar. Several hours later, they stumbled home and encountered a terrifying sight: The raccoon was hunched over the baby's crib eating his face.

By the time the boy arrived in the hospital, 60% of his face was missing. A plastic surgeon was consulted to evaluate him. As I watched him draw up possible reconstructive options, I was hooked. I discovered the fascinating field of plastic surgery.

My plastic surgery training took off from there. In Grand Rapids, Michigan, I learned how to perform postmastectomy reconstruction from some of the best breast surgeons in the country. I spent a month in Springfield, Illinois, replanting farmers' severed fingers and thumbs using state-of-the-art microsurgery. My training culminated at the mecca of plastic surgery, Beverly Hills, where I spent a year in one of the most prominent practices on Sunset Boulevard.

Today I have a private solo practice in Metro Detroit, Michigan. I perform both cosmetic and reconstructive surgery. The surgeries range from 1 to 6 hours long. Plastic surgeries are, on average, longer than the operations performed by other surgical subspecialists.

My typical week consists of 2 days in the office seeing patients and 3 days in the operating room. I don't work nights or weekends. I take call in the local emergency room, where I'm occasionally asked to repair dog bites or other facial injuries. In my spare time, I write for CNN.com and am preparing a sequel to In Stitches, my humorous memoir about becoming a doctor.

As a plastic surgeon, I enjoy many perks that other medical specialties don't. Because I perform a good amount of cosmetic surgery, my income is not as dependent on insurance as most medical practitioners. The threats of cuts to physician payments by Medicare don't affect me as much.

In addition, plastic surgery is a hot subject in the media. I'm often asked to present the newest breakthroughs on programs like The Dr. Oz Show and The Doctors. These breakthroughs now include face transplants and stem cell treatments. It's truly an exciting field.

Best of all, plastic surgery allows me the privilege of changing my patients' lives for the better. My experience with my jaw, over 20 years ago, taught me that changing a person's appearance can profoundly improve his or her life. Some may consider plastic surgery as frivolous, but the detractors don't understand the complex nature of this specialty. As a plastic surgeon, you can fix a child's cleft lip, save a burn patient's life, repair flexor tendon, and perform a facelift.

All in 1 day.

Anthony Youn, MD, is a board-certified plastic surgeon and author of In Stitches, an award-winning, humorous memoir about becoming a doctor.

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