Every specialty has features which make it unique versus the others. For Plastic Surgery, it’s not the anatomic area; we go everywhere. It’s not necessarily the procedures; other specialties like to adopt both cosmetic and reconstructive surgeries originally pioneered by Plastic Surgeons. These observations have lead some to conjecture that Plastic Surgery is a doomed specialty. I hope not, because what really distinguishes Plastic Surgery is its thought process. I sometimes explain it to patients with an an analogy (no, it’s not cupcakes and frosting): procedures are like golf clubs in your bag that you can use to solve whatever problem the course (or body) presents. There are a lot of ways to get the ball into the hole.
Much of medicine is figuring out the diagnosis (which can be very difficult). Treatment is then often directed by an algorithmic decision tree. So, there are lots of diagnoses, but relatively fewer treatments for each one. In Plastic Surgery, the diagnosis is often times as clear as the nose on your face (maybe it has a hump that you don’t like). Then, there can be ten different ways to treat the same problem. Some may be better approaches than others, but there often is not one “right” way. As I’ve said, if you ask 10 different Plastic Surgeons a question, you’ll get 11 different answers. While it may be nice not to have to remember over one hundred algorithms like I did for my General Surgery Board Exams, there is something comforting about knowing that most of the time, there is a consensus right answer out there. Taking the more obvious diagnosis and arriving at the optimal solution as an individual surgeon is the thought process that I believe distinguishes Plastic Surgery as a specialty. I feel fortunate to occupy this unique corner of medicine and hope it will live on in an uncertain future.
