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PRSonally Speaking
Thursday, April 03, 2014
Why I go to meetings like the Plastic Surgery Research Council….

By Henry Hsia, MD

 

It had been two weeks now. Her implant was gone and she was looking at me from where she sat on the exam table.  Even though she had known it could happen, had signed the consent form indicating I’d told her that this could happen, I could tell from the look she was giving me that she never expected it would actually happen.

 

I knew better, but I admit I hadn’t expected it would happen either, especially to her and now.  Several months had passed since the implant was placed.  She didn’t smoke, never had radiation for her breast cancer, and had done everything I asked.  She’d been doing well and at her last routine visit a month ago I’d congratulated her on making it through the reconstruction gauntlet.  Back then, she had sat on that exam table looking at me with a smile of relief and gratitude.

 

But that was then.  Some time after that visit I got the call she had redness and some drainage.  During the ensuing flurry of evaluation and discussion, I had her focus on making sure the infection didn’t get worse and threaten her health.  And with that in mind, we decided the implant couldn’t be salvaged and had to come out.  The explantation had gone smoothly and she completed her antibiotics.  She was doing well, except….

 

“So what’s next?”  That’s what her look now seemed to ask me.  At her initial consultation, she’d been adamantly not interested in autologous reconstruction.  She didn’t want the added scars, the possible donor site morbidity, etc.  And the last few weeks hadn’t changed her mind about that.  But she also wasn’t willing to accept a bra prosthesis as a long-term solution.  She wanted to try the implant again.  I didn’t think that was a good idea without better tissue coverage.  We were at an impasse.

In the end pressed for time, I punted the question to a future visit, telling her we had to wait a few months anyway.  I’m sure it wasn’t the most satisfying answer for her and the lack of a clear plan left me in a frustrated mood.  I was still feeling that sour mood when a few days later I found myself at the Plastic Surgery Research Council meeting in New York City.  

 

"Having the opportunity to speak face-to-face with the surgeon and pick his brain about the flap made me feel a lot less sour about missing time with my family"

 

Even though I’ve always enjoyed going to these and other plastic surgery meetings, it’s been getting harder and harder each year to go, what with the squeeze of ever increasing expectations for clinical productivity and family commitments.  As I wandered among the scientific sessions, my phone was a constant distraction as it buzzed with photos of my young daughters that my loving wife was sending from their weekend trip away along with text messages like “Check out what you’re missing!”

 

Then, looking up from my wife’s latest salvo of guilt-laden cuteness, I saw a poster entitled “The Lateral Intercostal Artery Perforator (LICAP) Flap for Outpatient Total Breast Reconstruction”.  Forgetting my family (for just a moment), I immediately thought of my patient and went up and started chatting with the authors who were standing there.  This flap wasn’t something I’d thought of during my patient’s visit earlier that week, and it was wonderfully fortuitous and timely to come across this particular poster.  Having the opportunity to speak face-to-face with the surgeon and pick his brain about the flap made me feel a lot less sour about missing time with my family. 

We had a great discussion and I left the poster looking forward to seeing my patient again.  Even though I couldn’t be sure, at least I had a feasible option to offer that I thought she just might be willing to accept.  Whatever frustrations and qualms I had about coming to the meeting had melted away.  I stood there among the poster presentations and all the exciting and innovating work around me and felt a reinvigorated sense of optimism.  Now this is why I go to meetings like the PSRC! 

 

I took a selfie among the posters and shot it back to my bemused wife with the message “Hey, check out what YOU are missing!”

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.

Contributors

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 an Assistant Professor in the Department of Plastic Surgeryat the University of Tennessee Health Science Center, in Memphis. He also acts as Program Director for the plastic surgery residency. 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.