Facial rejuvenation is a challenging area of work for a plastic surgeon but with all its complexities, I wouldn’t change it for anything.
As surgeons, while we are building our experience in surgery, we always look forward to tackling challenging cases, so that we can use those years of training to their best effect. It takes time to learn to improve your skill level in facial rejuvenation surgery, because it’s not just anatomy that’s involved, but understanding the complex range of aesthetic and psychologic issues that patients present with.
To put it another way, starting out in the surgery is about acquiring the skills and anatomic knowledge to undertake the surgery properly. But the judgement and perspective required to work with a patient in their facial rejuvenation journey takes time to acquire.
I love my work, but like any job, it does have its stresses. It can definitely be challenging, and the hours spent in surgery are often long. For me, the average facelift takes between four and five hours. It takes a sustained level of concentration to complete the procedure, so when preparing for facelift, it’s important to treat it with the respect that the operation and the patient deserves.
Two of my personal rules before surgery are that I must never be overly tired, and I must have enough time to complete the procedure without feeling stressed or rushed. I’ve learned never to have any event, commitment or meeting after work on days when I am doing facelift surgery.
Some surgeries might take a few hours to complete, but a lot of the work is not stressful in the sense that once the planning is done the rest is simply carefully undertaking the operation. An example of this is body lift surgery, where there is careful planning and the surgery is prolonged, but it is not especially demanding and does not have continual decision making. So in a typical day, it’s a little easier to do a four-hour body lift than a four-hour facelift.
With facelift surgery, the anatomy is fairly complex as I move through the different parts of the face, so high levels of concentration are necessary. There are quite a few judgements required during the surgery and the enjoyment come from the satisfaction of seeing the result take shape.
It’s important to have ideal interpersonal conditions to do the surgery, meaning a good operative surgery team who work together regularly. Knowing that these criteria have been met minimises stress for everyone. And it means the surgical team can move through the steps in the operative plan to achieve the best result. That’s what’s enjoyable for me.
What’s not so great is when I feel stressed during surgery because I find there are more complex anatomical or surgical difficulties in accomplishing the plan than I thought. Even with the most careful planning, this does occasionally happen.
One of the things that makes operating harder than usual is when there is more bleeding than I would like. Blood loss in a facelift procedure is always minimal, but occasionally, a patient bleeds a little more than usual and this slows things down. Like all plastic surgeons, I hate the sight of blood and I generally operate in a way that minimises bleeding. More importantly, excess blood can make it harder to see the anatomical structures we are working on, so the team and I take great care to keep the area as dry as possible.
The outcome for a patient who bleeds more than the average is not really affected, though it may cause more bruising. I just find that it adds to the operative time and it’s generally frustrating when it occurs.
On the whole, though, I love my work and I look forward to going to the office or into surgery every day. I relish the day-to-day challenges of surgery and I look forward to seeing the patients come back to the office after the surgery and watching their result take shape as the swelling and bruising go down.
You’ll find more detailed information on facial rejuvenation in the procedural information centre.
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