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The Aesthetics and the Wonders of Surgery
Plastic surgery encompasses both cosmetic and reconstructive surgery. Stepping onto the
coarse road of this profession first hits an intersection. While cosmetic surgery is performed to
reshape normal structures of the body in order to improve the patient’s self-esteem,
reconstructive surgery starts off from abnormal structures- whether caused by congenital defects,
developmental abnormalities, disease or trauma- to improve functions or to approximate a
normal appearance. Cosmetic surgery lies more within aesthetics and an elective operation while
reconstructive surgery is a mandatory surgery that may deeply affect the health or safety of the
client. Looking down the road of plastic surgery, it involves not only hard work and
determination, but also the mindset and desire to heal and perfect, not for wealth and affluence.
Cosmetic surgery often involves rejuvenation and body sculpting. Some major surgeries
considering the face include the facelift, eyelid surgeries, brow lifts, nose surgeries, facial
implants and fillers. Facelift, also known as rhytidectomy, is a surgical procedure to improve
visible signs of aging in the face and neck. It may include sagging in the midface, creases
between the nose and mouth, displaced fat, loss of muscle tone and excess fatty deposits. The
procedure typically beings with incisions within the hairline, it starts at the temple and continues
along just around the ear. (“New Facial Injectables”) This incision allows the underlying tissue
to tighten, removes excess fat and reduces sagging skin. Secondly, an incision under the chin is
made to assist with removal of fat deposits utilizing liposuction techniques. Swelling and
bruising will subside within 2-4 weeks and final results will be apparent in 1-2 months while
incision lines will require another year to refine and fade. (“Learn About Procedures”) Cosmetic
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eyelid surgery or blepharoplasty is to restore firmness around the upper and lower eyelids.
Incisions will be made around the creases of the eyelids in order to remove excess skin, muscle
and fatty tissue. Lasers may be used to resurface the lid skins and reduce scarring and bruising.
Nose surgery is a more commonly performed surgery also for reconstruction due to impaired
breathing. Incisions are made at the nostril base to allow access to reshape underlying cartilage
to lower humps, narrow nasal bones and shape the nasal tip. Structural irregularities may also
cause breathing difficulties but these results are not fully predictable and induce a great risk.
(“Learn About Procedures”) Finally, the brow lift is a smaller more focused version of the face
lift. It is performed through multiple limited incisions hidden within the hairline or in the natural
creases of the eyelids. Most procedures described above are used by clients of older ages since
they consider signs of aging. However, facial implants and injectable fillers are more commonly
used by the youthful age group. Facial implants are used to change the contours of the face and
to improve proportion and profiles. Implants are inserted through incisions in the mouth and
subtly positioned for support between the soft tissues. (“Learn About Procedures”) This
procedure is performed under local anesthesia or even general anesthesia. Fillers are also applied
to restore facial contours either to plump thin lips or enhance shallow contours. Other surgeries
focusing more on the body like breast augmentation, tummy tuck, or liposuction is popular
within both age crowds. Breast augmentations are mainly to enhance self-image and confidence.
Augmentation mammaplasty involves implants inserted beneath the chest wall muscle or behind
breast tissues to create fullness and balance. This procedure requires annual examinations and
implants may need to be replaced. Tummy tucks are often desired after pregnancies since the
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muscles around the abdominal profile has been weakened and separated. This surgery involves
the tightening of the abdominal wall and the removal of excess abdominal fat. Exercises are
ineffective for shedding abdominal fat entwined with the inner muscles and surgery may be the
only solution. (“Plastic Surgery”) Tummy tucks often accomplice liposuction which deals with
disproportionate contours. Liposuction can be applied in several ways. Traditional liposuction is
the suctioning of fat deposits, the super-wet technique involves infusions of saline solution with
adrenaline to remove fat. Lastly, ultrasound lipoplasty liquefies the excess fat prior to surgical
conditioning. (“Plastic Surgery”) Clients have to be aware that liposuction does not prevent from
further weight gain as significant weight gain causes recurrence of fatty deposits.
Reconstructive surgeries involve procedures that give a normal structure back to the
patient. Many times, patients are impaired with irregularities due to birth defects, scarring or
congenital roots. Skin resurfacing and nose surgeries are performed to improve results of
heredity or scarring. Skin resurfacing can reduce fine lines, uneven pigmentation and skin
damage. This procedure utilizes a variety of lasers and pulsated light device to achieve clearer
skin. (“Plastic Surgery”) Chemical solutions are also applied to peel the skin surface and new
skin will form- also called mechanical resurfacing and dermabrasion- these processes are used to
improve irregular surfaces. Gynecomastia also known as enlarged male breasts is a medical
disorder that is a combination of excess fat and glandular tissue. This disorder may greatly
impair self confidence and cause emotional discomfort. This procedure involves a
pharmaceutical filler substance that is injected below the skin to fill hollow areas. Fat is usually
taken from the abdomen or inner thighs to create a more natural effect. (Burki) This procedure
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only produces temporary results but some products may be permanent. Other reconstructive
surgeries involve craniofacial surgeries which are treatments of disorders of the soft and hard
tissues of the face and cranial areas. Treatments are for facial palates like cleft palates or lip
palates that generally result from birth defects. Reconstructive surgeries are often long term
surgeries in which each procedure improves the damage phase by phase.
Another considerable aspect of plastic surgery is anesthesia. The actual surgery has less
risk than the anesthesia treatment since it has to be carefully monitored so the correct sedation
can be applied for the specific surgical plan. Plastic surgeons often work alongside
anesthesiologists to determine the best course of treatment for each unique patient. Anesthesia is
categorized into general, regional and local. General anesthesia offers the highest degree of
sedation and is recommended for full body procedures and side effects may be nausea and
grogginess after awakening. Regional anesthesia is anesthesia on a major area like upper or
lower body so the patient may be conscious thereby increasing security for the patient. Local
anesthesia is used to focus on smaller areas of the body. This is very effective for treatments that
isolate certain parts of the body like Botox, a facial injectable, but this may also lead to
heightened anxiety. Often, patients may get converted in the middle of a procedure because
conscious sedation may agitate the patient. Converting from local to general anesthesia will
prolong the procedure and work against the client. Although “Anesthesia today is safer than it
has ever been due to advances in technology and pharmacology” there are still risks involved
that will require “stringent practice standards and educational requirements”. (AANA)
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Altogether, the overall surgery consists of the surgeon’s fee, anesthesia fee, operating
room fee, and implant fee. Generally, extensive surgeries range from $2,000-$10,000 while
regional surgeries like chemical peels or Botox will range from $200-$2,000. (Burki) Plastic
surgery involves days of consultation and only two to three days of actual procedure. Surgeons
are usually required to be certified by the American Board of Plastic Surgery. Beyond the
educational concerns and the experience, concerns also regard the environment and whether the
doctor provides realistic predictions, post operation processes and meetings and the full thorough
analysis of possible risks and side effects. Surgery also involves legal matters in the case that
patients are not satisfied with their results. A trusted lawyer should be employed from the start of
the practice and revision surgery may also be offered at a 15-20% rate. (Burki) However, plastic
surgery is not only the responsibility of the surgeon, it involves the full cooperation of the patient
and the doctor-patient relationship should be trusting and any medical cautions should be
addressed before the operation.
Plastic surgery is a long road that requires years of education and after obtaining medical
degrees, the years of residency to gain experience outside of the textbooks and lecture halls. Dr.
George Sun outlines his undying hard work not only with his educational and professional career
but in his life as well. Attending the private high school Webb and consecutively obtaining
undergraduate degree at UCLA then the medical degree at USC, he described his educational
pursuit as an unending cycle of learning and practicing. He interned at New Jersey for three
years before taking the last, and the most difficult, test for the Board of Certification. In his
professional career, his hardest lesson was to balance business medicine and science. Throughout
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his journey of becoming a plastic surgeon, he lost perspective of plastic surgery as a business as
he was so engulfed in the practice of the medicine. A quick timeline would involve
undergraduate school, medical school, the MCAT, the internships and finally residency and
fellowship. After outlining his treacherous road to plastic surgery, he highlights to me the most
important skills of any profession. Talent, hard work, sales and marketing, profit, and
connections. (Sun)
Talent is simple and user friendly. It is just as it seems- the talent to learn, the talent to
stay in school, and the talent to have passion for the subject.
Hard work is perhaps a talent, but he considers it a mere skill. A skill honed from years
work starting from ninth grade. However, he stresses that hard work is not just for a career, it is
intertwined in profession, in education, and most importantly in life.
Sales and marketing seems odd but every company, every business- including a practiceinvolves the full package of sales. Plastic surgeons need not only their skills and knowledge but
the ability to present your work and thoughts effectively. Furthermore, plastic surgery, like any
other field, is competitive and requires strategies to promote and enhance the practice. He
stresses that the best advertisement is word of mouth. Not television advertisements, or paper
flyers, but merely the best regards by past patients to their friends and family.
Profit, undeniably is a consideration of every man. Without endeavor, you will not
succeed and a surgeon must always consider the assets and the liabilities. Plastic surgery is more
than the medicine it is also about financial literacy, it is the ability to determine the costs and
expenditures of every procedure in order to make a profit. (Sun) However, Dr. Sun stresses that
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if wealth is your only motivation for plastic surgery, it is almost impossible to persevere through
the years of hard work.
Lastly, connection is an element that must survive throughout your career. The network
of people that are willing to help and guide you. The easiest way to guarantee the connections is
to give first and expect nothing, rather receive help as gifts rather than payments. The most
intelligent decision he made was to work with people from other fields, as one person can never
manage every aspect of medicine. He formed a team from his days in medical school and they
have a trust that defies any greed for money or fame.
Asking him why he chose plastic surgery, he provided a simple but genuine answer. It is
the only profession out of medicine where patients come happy and leave happier. Cosmetic
surgery, although an aesthetic luxury, provides immediate results and gratification. It is an
enhancement that will undeniably change your life and adjust your self esteem tremendously. I
noted that society often look down on the profession since it is superficial and only skin deep. Dr.
Sun merely chuckled and reminded me of society’s conflicting views. He proved to me that
society puts appearance in every aspect, whether for a job, for a mate, or just a friend. Society,
unfortunately, judges a book by its cover. It is not immoral or cruel; it is merely because physical
appearances are all we have when we approach something unfamiliar and new. However, first
impressions often become lasting impressions. (Sun)
It seems tough. All of it, the ridicule, the coursework, the exams- is it all worth it? He
quickly answered that medicine can become spiteful if there is no passion. You cannot merely
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love the career, you have to be passionate about plastic surgery. It is undeniable that along the
road to become a successful surgeon, you will face dips and conflicts but it is the passion that
will bring you back up, it is the other people who believe in you and it is you who believe in you.
Then Dr. Sun brought my attention to the finance. His eyes gleamed as he guessed what I was
thinking, how are the profits. He said simply “if you’re in it for the money, find another job”.
The years of work, the years of labor and tears, the money to start the business and keep the
practice operation will never be returned by the profit. He informed me that the amount of
dedication any surgeon put in their education and practice is more than enough to operate a
successful entrepreneurship. A typical week surprisingly involves more consultation and post
operative procedures rather than the actual operation. Usually, two or three days in surgery the
rest of the week is meetings. Plastic surgery is both mental and physical. The mental perspective
deals with judgment and decisions, while the physical aspect is the actual execution. It’s a onetwo step: diagnose then treat, diagnose then treat. The surgeon reroutes me back to where he
mentioned that passion will be the only way in and the only way to stay in this career. Money is
a plus, but the satisfaction of the patients is what keeps him coming to work everyday.
Finally he challenges me to answer his question: Name two characteristics to be a
successful person, not a surgeon, not a student, but a person. I was stumped but he wrote it on
my notepad. Character. Skill.
Character, he claims, cannot be taught but it can be learned. Character is learned
throughout life, the mistakes of betrayals or the successes of kindness all build character. To be a
successful surgeon he says, you have to be a successful person. Without character, your patients
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will not trust you and therefore will not respect you. Skill. It can be taught but it is difficult,
competence and perseverance always require practice and patience. Character and Skill. Without
each other, success cannot be achieved. He gave me a quick scenario. Two doctors. One has
great skill but he may cheat you out of your money, but the other genuinely helps people and is
always honest, yet he lacks in physical skill. Who do you go for the surgery? The answer? You
go to the doctor you can trust and ask how the surgery is performed, then demand the exact
procedures from the surgeon with the skill. To be a successful surgeon, you have to be honest
with a passion for aesthetics, yet at the same time have the time and patience to hone skill and
knowledge.