While working as a young resident in plastic surgery, I received a piece of advice from a man who was and remains one of the most renowned plastic surgeons in the world, Dr. Thomas Biggs. Dr. Biggs achieved prominence as a member of the team that developed the first silicone breast implant, and he went on to serve in leadership roles that included president of both the International Society of Aesthetic Plastic Surgery and the Texas Society of Plastic Surgeons.
Dr. Patronella with Dr. Thomas Biggs, who was a member of the team that developed the first silicone breast implant, at the Houston Society of Plastic Surgeons’ meeting in December 2012.
I was surprised when this legendary plastic surgeon shared with my fellow residents and me, “I’ve never done a perfect operation.”
Dr. Biggs’ comment revealed a great depth of wisdom and understanding of his skills and abilities but also the limitations of his humanity. The message he was attempting to transmit to us was that a plastic surgeon must implement a certain level of prudence and the judgment necessary to achieve the desired results without taking potentially damaging risks in an effort to make the results a little better.
I think about his advice every time I perform a procedure, asking myself, “Is this the best I can do? Is there something I can do to make it better, or is there something I’m going to do that could make it worse?” If you don’t go through these questions every time, you might miss that balance. As a surgeon, I can always do more, but I must determine the limitations.
While we aspire to be perfect in the work we do as plastic surgeons, perfection is an elusive goal. You have to be humble in your understanding of how much you realistically can do to transform, improve, and/or adjust a person’s appearance.
Both the surgeon and the patient must have realistic expectations. It’s better at the time of the consultation to set that expectation by communicating, “This is what I can do and what I can’t do” instead of promising something that you can’t accomplish or that will compromise the patient’s safety.
Dr. Biggs’ candid advice inreased my respect for the man, and as the years have passed, even more so for the valuable role they have played in shaping my philosophy and guiding my work as a plastic surgeon.