Behind the facade

Any surgeon can repair a broken rib, but not every surgeon can take that same rib and build you an ear.

In today’s Hollywood-obsessed culture, it’s easy to forget the world of plastic surgery reaches far beyond nose jobs and facelifts. Reconstructive plastic surgery can put a woman back into a bikini after a battle with breast cancer or give a child with a cleft lip the ability to smile.

Of the 12.1 million plastic surgery procedures performed in 2008, 4.9 million were reconstructive surgeries, according to the American Society of Plastic Surgeons. Reconstructive surgery is performed to improve or correct abnormalities caused by trauma, injury, infection, tumors or disease. This can include everything from creating skin grafts for burn victims to removing cancerous tumors and reconstructing the area with flaps of tissue and blood vessels taken from other parts of the patient’s body.

“The biggest thrust of what we’re involved in is restoring form and function and trying to take that to the highest level possible,” said Matthew Steele, M.D., an assistant professor of plastic and reconstructive surgery in the UF College of Medicine.

He said one of the reasons he was attracted to plastic surgery was the chance to be innovative and find new solutions to medical problems.

“It’s not the same cookbook kind of surgeries,” he said. “There’s not necessarily a right answer all the time.”

One of his cleft palate patients, a young girl, couldn’t smile because of her condition. Whenever she laughed or felt happy she couldn’t show that emotion on her face, Steele said. Her doctors weren’t able to use the nerves they normally would for a similar procedure, so they found a way to use the nerves associated with chewing instead.

The recovery was gradual, but she eventually learned to use her chewing muscles to smile and show emotion. Steele said the first time she passed a mirror in a store and realized she was smiling she ran around laughing and yelling to her mother.

“They came back and told everyone the story,” he said. “They were really happy.”

Dr. Brent Seagle (center), chief of plastic and reconstructive surgery, operates with fellow Dr. Mark Clayman (left) as student Lee Ferguson watches.

Dr. Brent Seagle (center), chief of plastic and reconstructive surgery, operates with fellow Dr. Mark Clayman (left) as student Lee Ferguson watches.

M. Brent Seagle, M.D., chief of plastic and reconstructive surgery at UF, said helping children like this and helping people get their lives back, in a sense, are the most rewarding aspects of reconstructive surgery.

“It’s really rewarding when you get someone back to a place of normal function … when you get someone close to who they were before cancer or an accident,” he said.

Seagle said the public still harbors some misconceptions about plastic surgeons and what they do.

“There’s a good bit of misunderstanding,” Seagle said. “The cosmetic side is sensationalized on TV, in newspapers, all over the place.”

He says another large part of the misunderstanding is that people assume cosmetic surgery is always performed by plastic surgeons, and when they hear about botched surgeries, they don’t realize it wasn’t necessarily a plastic surgeon who performed the failed procedure.

To achieve board certification, plastic surgeons are required to attend a U.S. accredited medical school and are subjected to a rigorous examination process that assesses everything from their surgical skills to their ethics and advertising practices, according to the American Board of Plastic Surgery.

“Real plastic surgeons aren’t like ‘Dr. 90210,’” Steele said in reference to the popular reality show following an eccentric cosmetic surgeon in Beverly Hills.

The field is constantly changing and innovating to find new solutions and develop less-invasive procedures with shorter recovery times.

In the future, Steele hopes to see more developments in stem cell research and genetic tissue engineering so plastic surgeons can use genetically engineered body parts rather than taking flaps from other parts of the body or using donor transplants, which the body can reject.

“When you get more experience you’re constantly making changes, and your work improves,” he said.