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PRS Global Open in the Land Down Under

Ch’ng, Sydney, MBBS, PhD, FRACS*,†,‡

Plastic and Reconstructive Surgery – Global Open: November 2018 - Volume 6 - Issue 11 - p e1903
doi: 10.1097/GOX.0000000000001903

From the *Department of Plastic Surgery, Royal Prince Alfred Hospital, NSW, Australia

Department of Head & Neck Surgery, Chris O’Brien Lifehouse Cancer Centre, NSW, Australia

Institute of Academic Surgery at Royal Prince Alfred Hospital, University of Sydney, NSW, Australia.

Published online 21 November 2018.

Received for publication May 21, 2018; accepted June 19, 2018.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. Clickable URL citations appear in the text.

Sydney Ch’ng, MBBS, PhD, FRACS, Department of Plastic Surgery, Royal Prince Alfred Hospital, Missenden Road, CAMPERDOWN, NSW 2050 Australia, Email:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

“Down Under” by Men at Work:

Do you come from a land down under?

Where women glow and men plunder?

Can’t you hear, can’t you hear the thunder?

You better run, you better take cover

The PRS Global Open editorial team recently attended the Royal Australasian College of Surgeons (RACS) Annual Scientific Congress (ASC) in Sydney, Australia. Continuing a recent theme of establishing a global presence, this was the first opportunity for the journal to visit Australia, and the furthest trip for the US-based team. The Editor-in-chief, Rod J Rohrich, was the 2018 Australasian Foundation of Plastic Surgery BK Rank Lecturer, for which he presented “Fat Grafting: Efficacious but Safe? What is the Evidence?”. The annual lecture is held in honor of Sir Benjamin Keith Rank, a world leader in the field of Plastic Surgery, and considered by many to be the father of Plastic Surgery in Australia. The other overseas guest speakers for Plastic Surgery were David Chang, J.P. Hong, Peter C. Neligan and Julian Pribaz (Fig. 1).

Fig. 1

Fig. 1

The RACS ASC showcased some unique features for a surgical meeting. The meeting was combined with the annual scientific meeting of the Australian and New Zealand College of Anaesthetists, allowing for a number of multidisciplinary sessions, and emphasizing the importance of teamwork, communication, and collaboration in the operating room. The theme of the combined meeting was “Reflecting on What Really Matters”—paying special attention to the difficult topic of medical practitioner health and wellbeing. The broad program addressed scientific and technological advances, and nontechnical skills, education and training, subspecialty craft groups, medico-legal issues, and even surgical history. The meeting was also cobadged by the American College of Surgeons.

“We are set for the next 100 years of partnership, of mateship, of the commitment Australia and America have to each other’s shared values, shared vision, shared destiny.” – Malcolm Turnbull

There were plenary lectures, small group discussions, practical workshops (Figs. 2 and 3), and moderated poster presentations. There were sessions that catered specifically for trainees, retired practitioners, and women in surgery (Fig. 4).

Fig. 2

Fig. 2

Fig. 3

Fig. 3

The ASC featured heavily the RACS’ ongoing campaign “Operating with Respect”—to encourage surgeons to build respect and improve patient safety in surgery. It is part of a cultural shift to increase awareness of discrimination and address gender imbalance. The Australian Bureau of Statistics’ census revealed only 18% of surgeons in Australia are female (although the medical profession overall has better gender parity with 46% of doctors being female). The RACS now mandates proactive steps be taken toward achieving gender equity among invited speakers and in discussion panels. I champion for inclusiveness of women in positions of visibility and prestige but acknowledge the fine balance between tokenism and meritocracy. Left alone to survey the exquisite settings and lost in the luxurious atmosphere of the Foundation Hall, Museum of Contemporary Art in the last minutes leading up to the Plastic Surgery Section Dinner, I reflected on the challenges I have faced in establishing my own career as an overseas-born Asian female.

Surgery in Australia has until recently been seen as a white male dominated field, and therefore, I felt considerable expectation when I accepted the role of Plastic Surgery Section Convenor for the RACS ASC 2018. As a migrant, would I be Australian enough to represent the Australian Society of Plastic Surgeons? Only 13.4% of Australian Plastic Surgeons are female (and those born overseas make up an even smaller minority), although that figure has risen to 36.9% among Residents. Would I be able to attract high calibre overseas faculty and local industry sponsorship? Additionally, would my reconstructive interest have sufficient appeal to delegates with a predominantly aesthetic practice?

“If we cannot end now our differences, at least we can make the world safe for diversity.” – John F Kennedy

The presenters on the Plastic Surgery program were from a wide range of backgrounds. Topics reflected the diverse nature of the specialty, involving different regions of the body (head and neck, breast, lower limb, pelvis, and perineum), reconstructive and aesthetic, historical perspectives (eg, evolution of flap surgery in parallel with improved understanding of vasculature of the integument), and evolving techniques (eg, vascularized composite allograft transplantation and supermicrosurgery), and update on breast implant-associated anaplastic large cell lymphoma. In the spirit of collaboration that epitomizes our specialty, there were joint sessions with Craniofacial, Surgical Oncology and Melanoma, Head and Neck, and Breast.

PRS Global Open was established to give global insight into the different ways Plastic Surgery is performed around the world. Therefore, Rod Rohrich was delighted to meet Plastic Surgeons from a number of small nations in the Asia Pacific region and members of Interplast—a nonprofit organization dedicated to “repairing bodies and rebuilding lives” in developing countries for those who otherwise could not afford or access Plastic Surgery. More importantly, Interplast helps nurture local medical systems through training and mentoring so that they will become self-sufficient. PRS Global Open, open-access and peer-reviewed, will work with this group of Plastic Surgeons to further its goal of sharing updated patient safety and outcome information at no cost.

New friendships were formed and old ones renewed in many social events that dotted the Plastic Surgery program. We climbed to the summit of the Sydney Harbor Bridge, the largest steel arch bridge in the world, enthralled by commentary on its history and to a dramatic panorama of the Sydney harbor (see video, Supplemental Digital Content 1, which shows the summit of the Sydney Harbor Bridge, We learnt how prior to the era of steel welding, the bridge was assembled with 6 million rivets (for comparison, the Eiffel Tower has 3 million)—a cooker would throw a red-hot rivet fresh out of a coal-fuelled furnace to a catcher who would then insert it into the steel sheet before a riveter hammered and hot-forged it in place. We dined and wined in great company against the backdrop of yet another Sydney icon, the Opera House (Fig. 4). A couple of our American guests were disappointed that there were no crocodile, kangaroo or emu on offer in the menu, and they had had to contend with the delicacies of scampi, bay bug and barramundi instead!

Fig. 4

Fig. 4



It was a magnificent experience for me as Plastic Surgery Section Convenor, RACS ASC 2018, and I certainly look forward to a greater presence of PRS Global Open in this corner of the world!

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Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.