Innovation in Plastic Surgery: A Call for Re-Emergence of the Surgeon-Scientist
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Abstract:
The very existence of plastic and reconstructive surgery, perhaps more than any other surgical specialty, is reliant upon innovation. Unlike other surgical specialties, plastic and reconstructive surgery does not “own” any one organ system or region of the body. Instead, plastic surgeons are experts in restoring form and function in all body regions and tissue types, relying on their expert knowledge of anatomy and creative use of the principles that define our specialty.1 In the wake of numerous medical and surgical subspecialties adopting techniques and practices developed by and originally unique to the field of plastic and reconstructive surgery, there are many who question the need for the specialty to exist as a separate entity. As margins have decreased across the healthcare industry, specialties such as ear, nose, and throat and oncologic breast surgery have begun to couple ablative and reconstructive surgery under the auspice of a single team (i.e., excising tumors in the head and neck and performing microvascular free tissue transfer without the presence of a reconstructive microsurgeon; placing implants after mastectomy without consulting the plastic surgery service), raising concerns regarding the future of plastic surgery as a specialty service.2 Despite being the pioneers of head and neck oncologic surgery, orthognathic surgery, nasal reconstructive surgery, upper and lower extremity reconstructive surgery, and complex pelvic and abdominal wall reconstructive surgery, in many centers around the world, plastic surgeons are rarely consulted for such cases. While the scope of practice remains extremely broad and diverse for plastic and reconstructive surgery, there has been a gradual loss of previously commonplace referrals as other specialties expand their own scope. The specialty of plastic and reconstructive surgery has thrived and survived beyond such challenges due to the drive toward innovation and research ever-present in the individuals and academic communities comprising our field.1,3 Ongoing and future innovation in plastic surgery is unlikely to be predominantly clinical; rather, innovation is more likely to be on the research forefront, as plastic surgeon-scientists lead the way in regenerative medicine and surgery.1,4 Combating the encroachment of other specialties on the procedures and technology created by plastic surgeons, the field has relied on plastic surgeon-scientists to constantly identify novel solutions within the realm of practice of the specialty.4,5 Unfortunately, the current era of practicing surgeons now suffers from a lack of individuals and institutions motivated to bolster the training of plastic surgeon-scientists. While we recognize the reality of the challenges in balancing a busy clinical plastic surgery practice with meaningful scientific investigation and innovation in the laboratory, we are compelled to encourage the rising generation to consider the impact they may have should they embark on a career aimed toward innovation in plastic surgery. The future of our specialty remains nebulous given recent decades of shift in clinical practice patterns. By securing our impact in scientific innovation applied toward clinical translation and patient care in plastic surgery, we will in turn secure the safety and prosperity of plastic and reconstructive surgery as a whole. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.Keywords:
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Summary: The main purpose of this article is to provide the reader with an easily searchable online index of the first 1976 videos published in Plastic and Reconstructive Surgery and Plastic and Reconstructive Surgery Global Open to facilitate access to readers. The authors also describe the history and evolution of video articles in the first journal to provide a large offline video library of plastic surgery. The importance of videos in plastic surgery education is explored.
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AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK
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AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK
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As a service to our readers, Plastic and Reconstructive Surgery® reviews books, DVDs, practice management software, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The Journal actively solicits information in digital format (e.g., CD-ROM and Internet offerings) for review. Reviewers are selected on the basis of relevant interest. Reviews are solely the opinion of the reviewer; they are usually published as submitted, with only copy editing. Plastic and Reconstructive Surgery® does not endorse or recommend any review so published. Send books, DVDs, and any other material for consideration to: Ronald P. Gruber, M.D., Review Editor, Plastic and Reconstructive Surgery, Brookriver Executive Center, 8150 Brookriver Drive, Suite S-415, Dallas, Texas 75247. Ronald P. Gruber, M.D. Review EditorFigureThaller and Panthaki provide a unique and comprehensive text on breast surgery, with a focus on clinically relevant and practical concepts for surgeons of all levels. This shelf-worthy book provides a concise, readable reference to help guide surgeons starting out in practice, and a refresher for managing challenging patients or difficult complications for the more experienced surgeon. For residents, it represents a great introduction to the anatomic and radiographic consideration and assessment of the breast, as well as an overview of reconstruction and aesthetic principles central to any experienced plastic surgeon’s armamentarium. The book is well organized, with a good foundation from which a detailed overview of the critical functional and anatomic features of the breast is built. The authors systematically build on this framework, introducing other dimensions and considerations, such as aesthetic principles, reconstructive techniques, anticipation of complications, treating and managing complications, optimizing patient selection and expectation, and accurate billing. The abundance of preoperative patient photographs, descriptions of marking techniques, and practical intraoperative pictures make this book a highly useful clinical text. Furthermore, the consistent and comprehensive nature of individual chapters allows one to read chapters independent of one another. The book covers more than just aesthetic and reconstructive surgery of the breast, providing a strong foundation of knowledge on anatomy and oncologic considerations in treating breast cancer patients. The breast reconstruction chapters are particularly well-written and formatted to provide excellent foundational knowledge for comprehensive preoperative evaluation and counseling, intraoperative techniques, and the complications and pitfalls that can unfortunately happen. Unique to this book, and particularly the breast reconstruction chapters, is an organized and methodological approach to recognizing, minimizing, and treating perioperative complications in breast reconstruction, exemplified in the “Tissue Expansion Reconstruction” chapter by Drs. Sheri Slezak and Tripp Holton. This text also offers a relevant chapter on coding and reimbursement in breast reconstruction for surgeons starting out in practice. In summary, this text is a very concise and powerful book on a challenging topic. It has been tailored to meet the needs of virtually all levels of surgeons. It deserves to be on the shelves of all those who practice surgery of the breast, and is sure to be a fixture in many offices. John P. Fischer, M.D.
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AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK
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AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK
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AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC & RECONSTRUCTIVE SURGERY PRS GLOBAL OPEN ASPS EDUCATION NETWORK
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The European Society for Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) is the overarching organization for Plastic Surgery which pursues the interests of all the affiliated national societies for plastic surgery throughout Europe. ESPRAS is dedicated to providing patients with the best possible treatment by highly trained and skilled board-certified Plastic Surgeons in all the subspecialty areas of Plastic Surgery, including reconstructive, aesthetic, hand and burns surgery.
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