Minimizing Plastic Surgical Complications By a Team Approach
When patients are looking for a surgeon, they consider a lot of things: before-and-after photos on the doctor's website, online patient ratings, word-of-mouth, and board-certification. What is rarely considered is operative time. Why does that matter? It is true that a quick surgeon can save time by doing less than discussed or promised. Or by plowing through delicate anatomic structures like a bull in a china shop. But those techniques generally lead to bad results that should be evident in the before-and-after photos, either through bad results or the need to rely on make-up and photo tricks to hide the true results. But given that the surgeon is conscientious, operative time can have an impact on complications. This month's Aesthetic Surgery Journal published a study that looked at different plastic surgical procedures (both aesthetic and reconstructive), their operative times, and the associated complications. Not surprisingly, after three hours, the longer the procedures lasted, the greater the number of complications reported. So, assuming the surgeon is careful and detail-oriented, when can be done to minimize surgical time? First, although it's tempting, it's important not to have too many procedures done at once. Often there is a financial incentive to combine a lot of procedures, but if the complication rate is significantly higher, it may not be worth it. Another factor that we take advantage of in our own practice is to have two plastic surgeons working at once. For example, by working together, we are able to do a combined breast augmentation and a tummy tuck in two to three hours. In the past we used to do our procedures separately, since we have two operating rooms in our facility, but we decided to work together for several reasons. First, we enjoy working together. Second, we ask each other's advice and opinion during our cases, and that makes us better surgeons. And third, we knew that be working together, we shortened our surgical times and lowered the complication rate for the patient. Never before had operative time and complications been quantified so well until this month's article. Of course, there are other factors that impact complication rates, and we take each one seriously. We want our patients to know we have their backs. After all, we hate complications as much as our patients!