Plastic Surgeons Share the First Surgery They Ever Performed

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“It was summer 2006 and I just started my solo private practice. I got a consultation from one of the local cardiothoracic surgeons to see his patient, an 80-year-old-man, one year after he had an open-heart procedure (it involved a sternotomy—a vertical division of the sternum with a power saw to access the heart). He developed a chronic infection of the sternum (infection of the bone known as osteomyelitis). So, the patient is an elderly, sick man, requiring supplemental oxygen around-the-clock, and he can barely walk with a serious chronic infection involving his entire sternum.

My procedure, which I performed solo, was a total sternectomy and removal of all adjacent costal cartilage—bilateral pectoralis major muscle flaps and wound closure. The patient returned to the ICU, did well, and was discharged from the hospital in good condition within a short period of time.

When I completed the procedure and was still in the operating room writing notes, I received a call from a friend and colleague of mine—a plastic surgeon in my community, whom I trained under, who is six years my senior—asking me what I was up to. I excitedly explained that I had just completed my first private-practice surgical case and told him what it was. To say he was surprised is an understatement. He could not believe that I took on such a complex procedure, especially with no help. He asked, ‘Why didn’t you call me for help?!’ And I simply stated that I didn’t need it and there was no way I was calling for back up on my first case!” —Miami plastic surgeon Sean Simon, MD

“My first surgery as a facial plastic surgeon was memorable for sure! It was on the Friday after Thanksgiving, and I performed a complex reconstructive rhinoplasty with rib cartilage grafting. The patient was a kind, older man who had suffered from a nasal abscess/infection that was missed by doctors. Unfortunately, it resulted in him losing all of the support in his nose, so that it saddled and collapsed. I rebuilt his nose with rib cartilage and helped him not only look better, but also breathe through his nose again.” —Boston facial plastic surgeon Jaimie DeRosa, MD

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“I remember the first time I had the privilege of operating on a patient. I was in medical school on a plastic surgery rotation and we were getting ready to remove a nevus sebaceous from the scalp of a teenager. The attending surgeon quizzed me on the lesions history, pathophysiology, treatment, and outcomes and I guess I answered OK because—much to my surprise—he handed me the scalpel! The procedure was a relatively simple one compared to the surgeries that I routinely do now, but I remember being very focused and stressed because I wanted to do it perfectly and every sensation was new. The procedure went well and I was fortunate to spend more time in the operating room on that rotation, which solidified my interest in becoming a plastic surgeon.” —Orange County, CA plastic surgeon Andrew Smith, MD

“I have two early surgical patients who are memorable: One of my first surgical patients was a man with HIV who had lost more than 100 pounds. He was consulting for a circumferential tummy tuck. He had seen many plastic surgeons who came up with every excuse not to operate on him. A key element of being a great plastic surgeon is improving the quality of life and level of happiness of one’s patients. I gladly operated on him and he still sends me a thank you note on a yearly basis for changing his life. 

Another was a young woman who did not feel confident about her nasal appearance. She underwent a rhinoplasty and within weeks seemed to develop a newfound confidence. I had not seen her in years and she recently returned to the office to schedule her mommy makeover after having three children. She thanked me again for treating her and credited her academic success and social ease to her new and improved appearance.” —New York plastic surgeon Elie Levine, MD

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