The other side of plastic surgery

Mention the words plastic surgery and everyone immediatly thinks of the cosmetic side of things – the boob jobs, tummy tucks, liposuction, facelift, botox, whatever. The other side is of course the reconstructive side of things. Because Chris works for the state he gets to do a lot of reconstructive work and it is the part of his job which he finds more interesting and challenging I think and one of the main reasons that he chooses to work in the state system. If one is missing a bit of skin, muscle, bone or any combination of those bits, anywhere on your body, then it is a plastic surgeon’s job to reconstruct that defect by getting skin, muscle, bone, etc. from another part of you and making you look just like you did before or as close as one can. Sometimes it means just rearranging bits, so they’d take a piece of muscle, leaving the skin and blood vessels (artery and vein/s) still attached and swing it around to another position (often done during breast reconstruction following a mastectomy). If that is not possible then they must detach the muscle or piece of muscle making sure they take the few millimetre thick artery and veins with and then re-attach it at another place on the body. They often have to take a piece of bone along.For example, if you had a tumour that’s eaten through your mouth, jaw,etc, then they take a piece of bone from your leg (with muscle and vessels) and cover the hole that is left once the tumour is removed. These kind of ops take many,many hours as one has to do microscopic surgery to reattach the minute vessels. Arteries are actually more resilient than veins, so often the “flap” (as it’s called) will have blood flowing into it but the veins aren’t working so well yet and it gets engorged. Then one sometimes has to use leeches, yes leeches, to get rid of some of the blood while the veins recover. It’s all pretty fascinating stuff but time-consuming, stressful and requires amazing skill. They need to work out which particular muscle in the body would work best at closing the particular defect and so one must know one’s anatomy very well as you need to know where the blood vessels are and the size of all the various muscles. I would be absolutely useless, I have useless spatial awareness. I can’t even judge which size of container I need to put a particular amount of leftovers into.

Other times they need to make new ears or noses or other bits and pieces if the person is born without or the bit is bitten off, burnt, ripped off, whatever. I won’t go into all that. Why am I talking about flaps? Well, Chris has some registrars working under him. They are training to become plastic surgeons and as part of their training they must publish articles in medical journals. The study that they’ve chosen to do is about a calf muscle flap. They measured 300 peoples’ calves (black, white and Indian men and women) and I think it’s just Black men and women (might be Indian as well but I can’t remember) that have statistically shorter calf muscles. This would mean that if they need to use your calf muscle as a flap to cover a hole left by a tumour or if you’ve badly injured your leg in an accident or whatever, if you are black, then the amount of muscle available to use, is less than if you are white or Indian. Nothing really ground-breaking but as part of the study they must dissect the calf muscle from cadavers (dead bodies) and because the registrars have no experience in doing this flap, Chris must fly with them to Cape Town to go and dissect cadavers’ calf muscles at Tygerberg. Rather him than me. I did Anatomy in my 2nd year and hated it. Our cadaver was this ancient old lady who obviously thought she was being a real hero by donating her body to science. She was so skinny that we couldn’t really see where the muscles started and the tendons ended. We spent most of our time looking at the cadaver of the group next to us, who had one of a young, muscular man. The cadavers are either donated or they use unclaimed bodies I think. The smell was the worst, one just couldn’t get rid of that Formaldehyde smell and then you had to wrap it all up afterwards with wet cloths soaked in Formaldehyde. Our practical exams also gave me the creeps. You’d have all these stations in a room and when a buzzer sounded one moved to the next station. At each station one was confronted with some bit of anatomy ( a real bit, not a picture or a model), with a little flag pointing/stuck somewhere and you’d have to say what it was. I wasn’t very good, sometimes I didn’t even know what bit of the body it was, let alone what the darn flag was pointing at. So, imagine flying down to Cape Town to go and cut up bodies for the day. Not quite the stuff you thought Plastic Surgeons did I bet.

In kiddie news. Ava is actually better, YAY!!!! We suspect that she actually got another cold immediatly after the original one. Well, that’s what we hope and pray as Zoe is now pretty ill (with Ava’s cold). If that’s not the case and it’s actually her with the new cold that Ava is still going to catch in 3 days time then I think I’ll just run away and come back when summer is here. Once again thank goodness for grandparents. Chris and I went out last night and left my parents with Zoe with a fever and a terrible cough. I really wouldn’t have felt happy about leaving her with anyone else. By the time we got home at about 23h45 (again, thank goodness for grandparents that do it all with a smile) she was sleeping peacefully and both girls only woke well after 7am, what little superstars. Zoe was quite a bit better today thank goodness, so maybe the end is in sight (till the next wave I presume).


5 Responses to “The other side of plastic surgery”

  1. Irene Says:

    Wow a very interesting post indeed ….. I’d probably run away screaming were that my profession (then again it wouldn’t have matured into a profession if this were the case).

    So glad to hear Ava is better now – and you’re right, as much as I complained of the heat in summer I really want this cold winter gone now.


  2. bratty37 Says:

    I have had plastic surgery twice in my life….first at age 3.5…a dog bit my nose off… and secondly, to have a birthmark removed from my face (possibiliy of being cancerous, hence removal)…so I have the deepest respect for plastic surgeons.

    Glad your LO is much better…

    • zamom Says:

      It’s amazing how artistic they have to be in order to re-create noses, ears,etc. Seeing your photos I would never have noticed so glad they did a good job – noses are apparently extremely difficult to “build”.

  3. Sharon Says:

    Oh my heavens, you are so right when you say rather him than you/me. I would have made a terrible Dr, I’m so squeamish that the thought of cutting anything, whether it were living or dead, human flesh makes me want to pass out!

    Glad to hear Ava is doing better!

    • zamom Says:

      Apparently one does get used to all the blood and stuff but the smells would just kill me – when they burn the flesh to stop bleeding – I’d pass out straight away every time – I know because I once watched a hip replacement and only lasted about 5 minutes before waking up staring into some kind nurse’s face!!!

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