“Most people want to be firemen or astronauts when they are 5 years old, the only thing I have ever wanted to be was a surgeon, but I wanted to be a brain surgeon first then I wanted to be an ENT surgeon because my dad had a lot of surgeries, but I have always wanted to be a surgeon. My parents used to buy ‘readers digest’ and I would read all the medical stuff. When I was 12 years old I was given this book about a plastic surgeon and I read that book and said to myself ‘man, this is the coolest business in the whole world!’ and from then on plastic surgery was the only thing I wanted to do. When I was asked at medical school why I wanted to be a doctor I said it is so that I can become a plastic surgeon. So I didn’t stumble upon it, this is the only thing I have ever wanted to do and it’s still the only thing I want to do.”
How do you navigate the complexity of the psychological motivations for cosmetic surgery?
“After a while you develop a ‘crazy-filter’, you sort of have a quotient – the patient wants something and they have some kind of real expectation and then they have got like a crazy fantasy and everyone has a little bit of both because when you come in for a procedure you’re expecting it to change your life, make you a better person or get you a date. So you go through your crazy-filter and determine if the patient’s crazy quotient is okay, but sometimes patients have psychological problems such as dysmorphic disorder or some patients are completely unrealistic then I refer them to a psychiatrist or psychologist to assist me and I inform them that I won’t do the surgery until they have had a psychiatric evaluation. Sometimes the crazy only comes out later then you ask another surgeon to see your patient for a second opinion because sometimes it’s easier for a patient to accept that this is a really good result if they hear it from another surgeon. So it’s good to have some senior colleagues with really grey hair to say ‘this is a great result!’”
Is it frustrating working plastics in the public sector? Resource limitations?
“I don’t work in the public sector, I only do private. And it’s frustrating everywhere, but the frustrations in private are way less. The frustrations are very different for example private sector frustrations are medical aids, tons of admin, writing letters for stuff and the cost of procedures, whereas in the public sector the only frustration is resources, stuff being too expensive/ not available. Availability of resources in private sector doesn’t make it stress-free there’s a lot more stress when it comes to dealing with money.”
Personal fears when going into surgery?
“The fear of failure. You want every case to be the best one you have ever done. That’s how you go in – you go in saying ‘this is going to be the best breast augmentation I have ever done.’ Otherwise, how are you going to get any better if you say you’re going to do it how you always do it. You only get better if you continue to strive for the best. The anxiety of every surgeon is that we want the best possible results for our patients and for ourselves to go home thinking today we did well.”
What can you say to students for them to consider plastics as a potential speciality? What kind of characteristics do you think one needs to become a plastic surgeon?
“It’s a really long road, but then so is everything else. Medicine is a long road, an undergraduate degree is 6 years, 2 years community service and 2 years internship. Plastics is a really long road, but it’s an awesome speciality. I’m biased I think plastics is the best speciality there is. If you want to do plastics it’s hard to get into and it’s the hardest speciality because it has the textbook with the greatest number of pages on any medical subject in the history of the world ever published, 9000 pages! It’s hard, but if you love it it’s not that hard because it becomes easier to read when you actually want to read it.”
What would you change/improve in the medical school educational system?
“Medical students come to me for electives, I only get to see what I teach, we chat and some things are good other things are bad, but overall the students are the same or better than when I was a student. The impression that I get from students is that the education is the same or better in some regard. The good students are going to be the good students no matter what they do and the bad students are still going to be terrible students, the average student is the same or a tiny bit better. So I think the medical school education system is still good.”
What is your favourite thing about your job?
“Other than operating? Other than getting a thrill when you operate? It’s narcissistic but when a patient says ‘you’re so good.’ It sounds terribly narcissistic but I like that a lot. I like what I do, I like helping people and I like seeing a great result, but when a patient says thank you in that way that says I’m so good I like it a lot.”
Do you have any special pre/post-surgery traditions?
“I have a whole bunch of cool hats and I hate it when I don’t have a cool hat. If I have to wear a paper hat I’m unhappy, I feel under-dressed. And a pair of comfy shoes – I like my Crocs. I don’t have any special traditions, there’s the ritual of washing up, but everyone has to scrub the same way. We have coffee before surgery, but that’s a social thing, not a tradition. It’s all about my hats, if I’m not wearing one of my hats then I don’t feel like I’m up for the game.”