Plastic surgery residents nearing the completion of their training or even newly minted plastic surgeons in today’s world seem to be more focused on positioning themselves in social media on the internet rather than using their immense skills and making a difference. Things like public relations and SEO positioning appear to be much more important to them rather than focusing on how to give back to society with the enormous skills they have acquired.

As one looks through the Internet it appears as though every young surgeon, regardless of how long they have been in practice, is world-famous in some cosmetic procedure, whether it be in breast augmentation, liposuction or facelift surgery.

BUYER BEWARE–very few young surgeons have been trained in and skilled in cosmetic surgery since most training programs do not focus on this aspect of our specialty. In reality it requires years of training after residency in order to develop the technical skills and judgment for a surgeon to be able to distinguish his or herself in cosmetic surgery.

Without question the best cosmetic surgeon is the one who does reconstructive surgery throughout their professional career. This was true when I trained 30 years ago and is ever truer today where resident experience is much abbreviated. As I look back on those people who I consider the greatest of the 20th Century, ALL continued to challenge themselves with reconstructive surgery. Whether it be the great Mexican surgeon, Fernando Ortiz-Monasterio, who took care of children with facial deformity, to my mentor Daniel Marchac, arguably the greatest plastic surgeon in France of the 20th Century, all were great surgeons who continued to challenge themselves dealing with the poor and underserved.

Even Ralph Millard, the master surgeon who practiced in Miami and left a lasting impression in cosmetic surgery, continued up until the end to deal with children with clefts and building noses when they had been traumatically lost.

I would like to see young plastic surgeons give back to the community in which they practice, not just take away from it. Rather than going on one trip so they can appear compassionate on their “holy” website and never do it again, I would like to see them start something that they can sustain over their professional career. The surgeon who continues to stimulate himself technically is the one who continues to push the limits in their surgical career allowing the integration of many of the reconstructive talents acquired into their cosmetic surgery. It avoids the burnout one frequently sees in the cosmetic surgeon.

I have been fortunate that during my surgical training at Harvard and the Massachusetts General Hospital I was surrounded by outstanding attending surgeons who taught us that medicine meant more than doing a technically perfect operation. They instilled in us a sense that we had to be of service to our community whether that be local, nationally or internationally. This has stayed with me throughout my career.

I have continued this commitment by doing craniofacial surgery two days per week at the UCSF Benioff Children’s Hospital in Oakland. I am the Co-Director of the Craniofacial Department that I started over 30 years ago. My commitment to these children with facial deformities has not wavered.

In my first years in practice, I, along with one of my mentors, Dr. John Constable from Massachusetts General Hospital and a close friend, plastic surgeon, Dr. Michael Moses in New Orleans, started the Indochina Surgical Educational Exchange (ISEE). This enabled us to travel to Vietnam and Cambodia, the poorest two countries in the world at that time, to operate on facial clefts and correct some of the casualties left from the Vietnam War.

This was during a time when there was no support from the US government. We knew that to be effective we needed to have the surgeons come here to the U.S. to stay for six months to a year to train with us and they could then go back to their respective countries and train their colleagues. ISEE has always believed, “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.” Our organization has sponsored physicians from all over Southeast Asia that have ultimately resulted in the training of hundreds of surgeons. This continues today.

I have never considered giving up my reconstructive work to focus entirely on aesthetic surgery. My training in reconstructive surgery has made me a better cosmetic surgeon. I continue in the footprints of the great plastic surgeons that I admired and mentored me.

“If I have seen further than others, it is by standing upon the

shoulders of giants.”

—- Isaac Newton 1676

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