Name: 所以，你想成為一名整形外科醫生[Ep. 4]。 (So You Want to Be a PLASTIC SURGEON [Ep. 4])
Uploaded: 2021-01-14T11:03:54.000Z
Duration: 12 min 15 s
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You like the idea of making millions, working with celebrities, doing boob jobs and facelifts. Not so fast.

We're going to debunk the public perception myths of what it means to be a plastic surgeon, and give it to you straight.

This is the reality of plastic surgery, and we'll help you decide if it's a good field for you.

Welcome to our next installment in the So You Want To Be series.

In this series, we highlight a specific specialty within medicine,

such as plastic surgery, and help you decide if it's a good fit for you.

You can find the entire list on our So You Want To Be playlist.

A lot of you have asked for plastic surgery in the last video,

If you want to see what being a plastic surgeon actually looks like,

check out my second channel Kevin Jubbal, M.D., where I do a second series in parallel titled a Day in the Life.

We'll be doing a day in the life of a plastic surgeon soon,

so make sure you're subscribed so that you don't miss it.

Plastic surgery is all about using plastic to make people look pretty, right?

The word plastic comes from the Greek word “plastikos“, meaning “to mold”,

a reference to how plastic surgery is involved in the reshaping and manipulation of tissues.

Generally speaking, plastic surgeons focus on soft tissue such as skin, muscle, and fat,

rather than bones, which are in the territory of orthopedic surgeons.

Plastic surgery is far more diverse than what you probably expect.

The public is most familiar with aesthetic, or cosmetic plastic surgery that has been popularized by celebrities and showbiz,

but the overwhelming majority of actual surgical procedures in plastic surgery are reconstructive in nature.

In 2018, there were 5.8 million reconstructive surgical procedures in the U.S.,

compared to only 1.8 million cosmetic surgical procedures.

That being said, non-surgical minimally invasive cosmetic procedures, like botox or fillers, are extremely popular.

In 2018 alone, there were 15.9 million non-surgical cosmetic procedures.

So what's the difference between cosmetic and reconstructive plastic surgery?

Cosmetic plastic surgery includes procedures involved with enhancing one's appearance.

The most popular cosmetic surgical procedures include breast augmentation or "boob job", liposuction,

The most popular cosmetic non-surgical procedures include botox injections, soft tissue fillers,

chemical peels, laser hair removal, and microdermabrasion.

Reconstructive plastic surgery is highly diverse, and in my personal opinion, far more fascinating.

Recon includes surgical procedures to correct facial and body abnormalities

that can be caused by birth defects, like cleft lip, or cleft palate,

injury, like soft tissue reconstruction for severe traumatic injuries,

disease, like breast reconstruction after mastectomy for breast cancer, or aging.

Plastic surgery is on the cutting edge of innovation in medicine, with radical procedures like face and hand transplants,

or even gender reassignment surgeries that are so convincing you wouldn't believe it.

The first surgical case I saw was an animated latissimus dorsi transfer where we created a makeshift bicep,

or rather elbow flexor, out of a patient's lat muscle in their back.

With the beauty of neuroplasticity in the brain, the patient was able to train themselves to bend the elbow

by focusing on activating their latissimus dorsi muscle.

I talked more about this first case and how I fell in love with plastic surgery in a previous video.

Another one of my favorites was doing a nerve graft to treat Bell's palsy hemifacial paralysis.

In short, one side of the patient's face was paralyzed,

so we harvested the sural nerve from their leg and using microsurgical techniques,

grafted it to their face to reanimate to the paralyzed side.

Between cosmetic and reconstructive practices,

one isn't necessarily better than the other, but there are pros and cons which we'll get to shortly.

I was obviously enamored by the complex recon,

and would sometimes tease my cosmetic-focused colleague

that I'm at least helping the world and not just trying to make a quick buck.

"I'm also making the world a better place, one pair of breasts at a time."

In the hospital, we call plastic surgeons the "surgeon's surgeon",

as they are the most relied upon by other surgical specialists.

Anytime a neurosurgeon, urologist, general surgeon, orthopedic surgeon, otolaryngologist,

or any other surgeon needs help with complex coverage in reconstruction,

they call in the plastic surgeons. Unlike any other surgical specialty, plastic surgery is unrestricted by body part.

They work on any part of the body, from head to toe, hands to feet, eyelids to genitalia.

To become a plastic surgeon, there are two paths of training after completing medical school.

whereby you complete 6 years of plastic surgery residency, and this is the path that I took.

This is consistently the number one or number two most competitive specialty to match into.

To give you a sense of just how competitive this is,

one of my colleagues went into neurosurgery, another very competitive field because he said plastics was too competitive.

If the integrated path is out of reach, all hope is not lost.

whereby you first complete 5 years of general surgery residency and then apply for an additional 3 years of independent plastic surgery residency,

This route is best suited for those who either did not know they wanted to go into plastic surgery when they were applying to residency,

or those who were unable to match into the Integrated Path.

After completing residency, you can practice as a plastic surgeon, or choose to sub-specialize further with 1 to 2 years of fellowship.

These are the main pockets of self specialization you can choose from:

Plastic surgeon specializing in breast obviously can do breast augmentation,

but also a major part of their practice includes breast cancer reconstruction.

After the general surgeon removes the tumor,

the plastic surgeon comes in with a variety of techniques and procedures to restore a woman's anatomy.

Breast surgeons also do breast reductions and lifts, among other procedures.

Craniofacial trained plastic surgeons specialize in soft tissue reconstruction of the head and face.

Their bread and butter includes pathologies like cleft lip and cleft palate, or craniosynostosis,

whereby sutures in the skull fuse prematurely resulting in abnormal head shapes and babies,

Microsurgery is the most innovative and sci-fi sub-specialization within plastic surgery.

The "micro" in microsurgery refers to the microscopes used when connecting blood vessels or nerves together.

This allows for moving tissues around the body, like the nerve graft for facial reanimation in Bell's palsy.

Microsurgical cases are some of the longest, with some lasting over 24 hours, and it also comes with a challenging call schedule.

For that reason, we say microsurgery is a young man's sport.

It's probably not the ideal lifestyle when you're 50 years old with a family and kids.

Hand was what I fell in love with and was planning on specializing in.

The hand has some of the most complex, intricate and beautiful anatomy in the entire human body.

Hand surgery includes pathologies, like carpal tunnel, fractures, contractures, and resections and reconstruction.

Burn is the black sheep of the family and is not nearly as precise, meticulous, or fun as the rest of plastic surgery.

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所以，你想成為一名整形外科醫生[Ep. 4]。 (So You Want to Be a PLASTIC SURGEON [Ep. 4])

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