Plastic and Reconstructive Surgery

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PRSonally Speaking
Monday, August 26, 2013
Innovation and Wellness: The Value Proposition of Plastic Surgery
By Henry C. Hsia, MD, FACS
Does our society need plastic surgeons?  In the August 2013 issue of PRS, Wang, Kotsis, and Chung write about applying business concepts of innovation strategies to plastic surgery.  The specialty has a long tradition of past surgical innovations including facial reconstruction and microsurgery, but the authors make the case that the continued ability to innovate will be necessary if plastic surgery as a specialty is to maintain its edge in the future.  To directly quote from their article, “Innovation makes plastic surgery different and distinctive, and will be key to the survival of the specialty.”
The article touches on an important existential question for plastic surgeons: What is so special about plastic surgery now as a surgical specialty in an age when its past technical innovations have gone mainstream and can be readily performed by other technically skilled surgeons? 
You can approach this question by considering what gives other specialties their value.  The easiest way to do this is to play this quick exercise in free association: Think of a medical specialty, and what’s the first word that pops into your head?  It’s likely you’ll quickly come up with a single word that captures its essence as well as its value, thereby justifying its existence: cardiology = heart, orthopedics = bone, pediatrics = kids. 
As a specialty that does not limit itself to any one particular anatomic area, physiologic process, or demographic group, plastic surgery defies this trend, thereby making it more difficult to define its value.  The general public tends to think of plastic surgery as the “cosmetic” specialty, but as any plastic surgeon knows, this definition is woefully incomplete, and unfortunately leads many people to trivialize the importance of plastic surgery to society.  This inability to easily define plastic surgery’s “portfolio” makes it understandable if our society wants to ask the existential business question: What is the value proposition of plastic surgery?
Wang, Kotsis, and Chung take the right approach in saying that plastic surgery as a specialty could do a better job at associating itself in the public’s mind with the concept of “Innovation” (with a capital ‘I’).  I would add that plastic surgery could further distinguish itself as a specialty by better emphasizing the unique perspective of its practitioners in being able to serve patients in the context of their respective medical and social circumstances to maximize their quality of life and sense of “Wellness” (with a capital ‘W’ of course!). 
This perspective is derived from a combination in breadth and style of training that is rare (if not unique) among medical specialties.  In addition to ranging over the spectra of anatomical areas and demographic groups, the training process in plastic surgery imbues a thoughtful openness to new and different approaches that make plastic surgeons well positioned not only to lead surgical innovation, but also to develop sophisticated treatment plans tailored to the diverse circumstances of individual patients. 
In an age when health care is increasingly emphasizing personalized and holistic care and medical students are being taught to view patients as more than the sum of their parts and organs, plastic surgeons should be seen as the embodiment and leading proponents of this philosophy.  Just as plastic surgeons had been pushing the envelope and innovating long before “Innovation” became a buzzword in business, plastic surgeons have also been improving the quality of patients’ lives and helping patients achieve a sense of well being long before “Wellness” became a buzzword in healthcare.  When viewed from this perspective, the value proposition to our society of plastic surgery as the specialty that promotes innovation and wellness to improve quality of life for patients becomes clear.  Hopefully those will become the first words that automatically and universally pop into people’s minds as the answer whenever someone asks: Why do we need the specialty of “plastic surgery”?

About the Blog

Plastic and Reconstructive Surgery

PRSonally Speaking is the official blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit our blog for exclusive previews of and discussions on hot topics in plastic surgery as well as insider-tips on open access content. PRSonally Speaking is now powered by frequent contributions from the American Society of Plastic Surgeons’ Young Plastic Surgeons Forum (YPS); these practicing plastic surgeons provide the personal side of the plastic surgery story, from daily challenges to unique insights. PRSonally Speaking is home to lively, civil debate on hot topics and great discussions pertaining to our field. So, bookmark us, subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your Journal; have fun, be respectful, get engaged and interact with the PRS community.

The views and recommendations of guest contributors do not necessarily indicate official endorsements or opinions of the Journal, PRS, or the ASPS. All views are those of the authors and the authors alone.


Anureet K. Bajaj, MD is a practicing plastic surgeon in Oklahoma City. She completed residency and fellowship in 2004, had a brief stint in academia at the University of Cincinnati, and then chose to join her father (Paramjit Bajaj MD, also a practicing plastic surgeon) in private practice in OKC, where she focuses on breast reconstruction and general cosmetic surgeries.

Devra B. Becker, MD, FACS, is an Assistant Professor of Plastic Surgery in the Department of Plastic Surgery at University Hospitals/Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed Plastic Surgery residency at Washington University School of Medicine in St. Louis, and completed fellowships with Daniel Marchac and with Bahman Guyuron. She currently has a primarily reconstructive practice.

Henry C. Hsia, MD, FACS is at Robert Wood Johnson Medical School of Rutgers University in New Brunswick, New Jersey and also holds an appointment at Princeton University.  When he’s not working hard trying to be a good father and husband, he runs a practice focused on reconstructive surgery and wound care as well as a research lab focused on wound biology and regenerative medicine.

Stephanie K. Rowen, MD is a senior physician at The Permanente Medical Group in San Jose, California.  She joined TPMG upon finishing residency and a hand surgery fellowship in 2005.  She has a primarily reconstructive practice, about 50% hand surgery.  Outside of work she enjoys participating in triathlons and spending time with her family.

Jon Ver Halen, MD is currently Chief of plastic surgery, Baptist Cancer Center; Research member, Vanderbilt- Ingram Cancer Center; Adjunct clinical faculty, St. Jude Children's Research Hospital. He also acts as Program Director for the plastic surgery microvascular surgery fellowship. His practice focuses on oncologic reconstruction.

Tech Talk Bloggers

Adrian Murphy is a plastic surgery trainee in London, England. He studied medicine in Dublin, Ireland and has trained in Ireland, Boston, MA and the United Kingdom. He is a self-confessed geek and gadget aficionado.

Ash Patel, MD is Assistant Professor of Plastic Surgery and Associate Program Director at Albany Medical College, in Albany NY. His practice is primarily reconstructive.