Plastic Surgery: so much more than a boob job!

I just finished 2 weeks on the plastic surgery service, and wow, plastic surgeons can do pretty cool work. Now I know you are thinking plastic surgery is all about boob jobs and botox, but at an academic medical center it is all reconstructive surgery. All of our patients were burn patients, cancer patients, or trauma patients. It was so fascinating! During my two weeks I operated on every part of the body, from head to toe. Here is a sample:

- sewed the scalp back together in a trauma patient that had completely separated from the skull
- repaired a frontal sinus fracture (another trauma patient)
- reconstructed an ear after the surgical oncology team took a 3 cm excision for a melanoma
- cleft lip & palate repair
- skin graft over the stump of a traumatically amputated arm (chicken factory accident)
- breast reconstruction using the transverse rectus abdominus muscle (the "6-pack" muscle and the belly fat is kept attached to it's blood vessels and moved to the breast)
- breast reconstruction using fat and skin from the butt (superior gluteal artery perforators free flap - basically you use the skin and underlying fat and the arteries/veins that supply it and sew the artery and vein into arteries and veins into the chest and construct a new breast)

- hand surgery

- Z-plasty for burn contractures (a way to lengthen scars)
- skin grafting for a man with Fournier's gangrene
- a fibula free flap for oral cancer (using the skin, fat, and muscle along with the fibula to reconstruct the floor of the mouth and mandible)
- excision of a arterio-venous malformation on the big toe with a skin graft to cover the defect (the big whole left behind)

They were a great team to work with - all of the residents and attendings were happy, nice, helpful, and supportive. I was sad today when I realized it was my last day!

If I actually have any reader's left, I will post more about surgery in general soon! Now, I need to study and sleep so I can pass the national shelf exam...