A dream will not become an innovation if there is no realization.
After a month and a half of eye-opening experiences traveling to various nations and cities to represent the Journal—Moscow, New Delhi, and Boston—the final stop on the 2015 PRS Global Open “World Tour” was Seoul, South Korea (Fig. 1). This was a unique stop in our tour and a fitting end, as we were holding our very first PRS Global Open Editorial Board meeting in Asia. It seems like an obvious decision to host a global journal’s meeting away from the confines of home and on other continents where new horizons are literally visible and a new group of people can join. Two years after the birth of our Journal, now in a rapid growth phase, we were excited to have our first internationally held Editorial Board meeting in Seoul and honored to be hosted by the Korean Society of Plastic and Reconstructive Surgeons at their annual meeting. But, as any weary traveler could attest, the last leg on a long travel schedule loses some of the steam, shine, and energy when compared with the first. We were definitely expecting great things from our editorial board—and we were not disappointed—but it was what we did not expect to find that was truly awe inspiring. As we reflect on this journey from over 1 year ago, the clarity of hindsight has truly helped us put this amazing experience in focus.
Just like the city of Seoul, the Korean Society of Plastic and Reconstructive Surgeons meeting and society were palpably excellent, as there were innovations in each session and welcoming people greeting and hosting us at each engagement, meeting, and course. Discussing PRS Global Open and plastic surgery in general here was like watching both come alive all over again. The people we worked with again—or for the first time—in the editorial board meeting, in the lectures we attended and led, and in the clinics we were invited to visit were all so open to innovation, open to learning, open to open access, and open to expanding the knowledge base of plastic surgery for all. This welcoming, fruitful, collaborative environment was emblematic of the reason for the American Society of Plastic Surgeons to be there with its official open access journal.
Korea does present a rare opportunity for a true visualization of history, juxtapositions, contrasts, and challenges. The 38th parallel—the Demilitarized Zone—provides a visible reminder of the stark contrast and a stark reality (Fig. 2). The South is booming with all the technology and construction and amenities you would expect from a world-class city, but at the 38th parallel, it seems as if time stood still. This is a palpable reminder to be thankful for all the opportunities we have and a reminder of our mission in plastic surgery: to help provide better lives for those who might be living in stark contrast to us in our very own cities. The 38th parallel is also a great reminder of what is possible despite incredible challenges. Just 50 km away, Seoul is representative of South Korea: a booming advanced city with dynamic and growing Asian culture and a thirst for innovation and intellectual curiosity.
Specifically, there was a lot to learn from our time there. Here are our top lessons we learned about plastic surgery while in Seoul:
- Microsurgery and supermicrosurgery seem to be the heart of university-based training in Seoul. The use of perforator flaps in breast reconstruction and in trauma and head and neck cancer surgery is certainly at the forefront in plastic surgery practice.
- Korea has a leading edge in innovation in aesthetic Asian surgery. Cosmetic surgery is booming in Korea and setting the standard for Asian plastic surgery aesthetics. Anecdotally, we heard that 30% of aesthetic plastic surgery practiced in Korea is from China, Singapore, and Japan. This is a testament to the high quality of aesthetic surgery done by the plastic surgeons in Korea.
- The most common/in demand/popular aesthetic procedures are double-eyelid Asian blepharoplasty and rhinoplasty. The use of silicone dorsal implants is popular, though cartilage grafts—both the dorsum and the tip—are increasingly being utilized. There may be a shift toward more autogenous cartilage, especially for the nasal tip.
- The biggest trend is from an increasing demand for surgical rejuvenation of the aging face. Although minimally invasive procedures such as string lifts and injectable fillers are quite popular, the demand by Korean plastic surgeons to learn surgical rejuvenation and modern facelift techniques is increasing. They have formed a subgroup within the Korean society for anatomic research and for instruction or teaching for anatomic research to develop technical procedures specific for facial rejuvenation in the Asian patient.
- After spending a day in an ultramodern aesthetic clinic in Seoul, we saw the intricacies of aesthetic surgery in Asian patients combined with concepts pioneered in the West: truly a fascinating combination of technical innovation with artistry. It seems to us that Seoul has become the bridge between East and West.
- Korea has a leading edge in innovations for modern hospital care. We saw the state of the art hospitals emphasizing efficiency and the use of technology in medical care enhancement for safety outcomes and efficiency. This is an alignment with the technological advances and innovations we saw everywhere we looked in Seoul, which is a truly modern mega-city.
- We saw how Korean plastic surgeons are aiming to set standards for improving scar management in Asian skin types (which have a tendency to have hyperpigmentation and keloid) using both early steroid injections and laser therapy postoperatively.
- We witnessed a passion for advancing education through innovative technology, innovative open access journals (such as PRS Global Open and our Korean International Partner, the Archives of Plastic Surgery) and using educational videos, such as the forthcoming PRS Global Open Operative Techniques video series.
- We also saw a passion to share that knowledge openly with each other.
- Finally, we witnessed incredible respect for teachers from their life-long students, which was met with an equally evident respect for students from teachers. Learning and education are not taken for granted; they are seen as one of the highest honors.
Based on our time in the city visiting with the reconstructive and aesthetic surgeons, Korea—and Seoul in particular—emerged in our experience as a major gateway to Asian plastic surgery…with the focus on innovation, passion, and excellence in both cosmetic and reconstructive surgery. What really struck us was the enthusiasm for learning, teaching, and sharing plastic surgery in Asia. The rumors of the incredible Korean hospitality are true—everyone was willing to share their culture, their kimchi, their barbeque, and soju with us. But that hospitality extends beyond being kind to visitors; it is embraced and enacted in lecture halls and clinics for plastic surgeons from near and far as well. Everyone we met was enthusiastic and willing to learn, change, innovate, and share (Fig. 3).
We found this spirit reflected eagerly in our PRS Global Open Editorial Board meeting as well. With tremendous representation from 8 countries—Korea, China, Egypt, Singapore, Sweden, Taiwan, and the United States—gathered in a conference room to discuss the demonstrated growth, strategic plans, and endless possibilities for the Journal. It was a highly collaborative meeting, where we quickly discovered a shared global vision for PRS Global Open. At this meeting, we were truly able to say that our friends entered the room as Associate Editors and Regional Editors…but left as true ambassadors for the mission of PRS Global Open. And it is no wonder—the mission parallels that of global plastic surgery itself: to expand plastic surgery knowledge to enrich patient safety, outcomes, and quality of care locally, regionally, and world wide.
In a place where there is will, there is a road.
The authors thank Aaron Weinstein, Managing Editor, for his assistance in copyediting the manuscript and providing photographs.