| Helping people face up to a better
future Plastic surgery vanity or practicality? The ability to
change someone’s appearance is now an everyday reality. But it’s
not all about cellulite-free legs or flat stomachs and bigger breasts.
Three Irish plastic surgeons tell Cornelia Lucey how their work has helped
transform people’s lives for the better.
Ciaran Healy
Consultant Plastic Surgeon Guy’s Nuffield House Special interests:
Breast Surgery, Cosmetic Surgery, Hand and Upper Limb, Head and Neck Cancer,
Lower Limb, Medico-legal, Skin Malignancy, Vascular Abnormalities
Ciaran Healy Barely looks up from his papers as I sit down to ask my
round of questions he’s a busy man and is reluctant to look up in
case it wastes a second of his time which could be otherwise dedicated
to his patients.
Mr Healy who was state educated in Dublin aimed to excel in the medical
world from a young age.
He now devotes the majority of his time to his patients at his NHS practise.
He left Ireland for Cardiff in the 1980s because he had no choice. He
looks up and says: “In those days there were no recognised training
jobs in Ireland especially not in the South.
“It would have been impossible to have the role I have now I’m
a busy NHS consultant, I’m part of the Royal College of Surgeons
and I play a big part in training surgeons for the future.
“Because I’m in London I’ve been able to work with
almost 300 melanoma patients I can draw on a big population and build
up a lot of cases.”
And the practicalities of a rooted family a son aged 24 and a daughter
aged 21 means he is based in London.
He has created innovative waves bringing a new method of treating cancer
melanoma wounds to the surgical table. He was the first to use the chemically-developed
Integra material a treatment initially used for treating burns to reconstruct
damage areas.
The body incorporates the Integra and produces blood vessels which then
enable a successful skin graft to perfect the area.
He says: “I was attracted to plastic surgery because for me it’s
challenging and satisfying. When I was a medical student in America I
was assisting a surgeon one day and he had to stitch back on one man’s
arm after an accident — he had to ensure that the layers of tissue
were perfectly matched. It was so dramatic I wanted to do that.
“It’s not easy to make somebody look normal again if they’ve
had a huge nasal tumour. I have moderated the procedure of rhinoplasty
in ways to speed up the process and get closer to achieving aesthetic
perfection.
“In the NHS you don’t have the luxury of taking six hours
over a nose job patients need you and lots of them. In the NHS you have
to be more efficient, you might only have two hours to reconstruct a nose.”
Like most surgeons, he also does some private work.
But Mr Healy insists he puts his NHS patients first and only spends one
day a week with a range of face lifts, boob-jobs and liposuction.
And his patients are mostly those returning from cancer treatments years
on.
And like all plastic surgeons he must also deal with insecure patients
who are not in need of surgery.
He said “I get people coming to me all the time who don’t
need surgery. In fact the majority of women concerned about the appearance
don’t have a problem.”
He expresses fears about unrecognised surgeons working mercenarily disinterested
in patient care.
“Some surgeons will take on any patient and just get the job done.
But I ensure the patient needs the surgery and I spend long periods of
time with them in consultation.”
But is surgery too often becoming the solution for aging women? Mr Healy
defends the decision increasingly made by many women.
He argues: “I don’t see anything wrong with women wanting
to turn to surgery if they need it. In your 20s and 30s you may find it
impossible to believe anybody would want to.”
But a little surgery can often make a big difference, according to the
surgeon.
“A small procedure can change somebody’s life it can have
a huge psychological effect.
One lady wrote to me years after I had given her a tummy tuck. I told
her it wouldn’t change her life. But she wrote to me with a long
list about all the different ways her life had changed she had a renewed
sense of confidence.”
Even more remarkably Mr Healy says that in some cases plastic surgery
can stop suicide.
He said: “One day a patient came to me who had contemplated suicide.
Eventually she came away from that frame of mind but she said her face
still carried that sadness, and so I gave her a facelift.
“I saw her years later and she had transformed herself into the
person she wanted to be and this she felt was because of the facelift.”
Martin Kelly
Consultant Plastic Surgeon Special interests: Cosmetic Surgery, Craniofacial,
Paediatric
It’s 11.30am and already Martin Kelly has been working for four
hours and he still has eight hours of work ahead of him.
Martin Kelly whose family hail from Dublin was drawn to plastic surgery
by a fascination of reconstruction, particularly rhinoplasty which is
the construction of the nose.
He says: “There’s still so much we can learn about rhinoplasty.
It’s a field of experimentation we are constantly discovering new
techniques and methods.”
Mr Kelly evidently gains a sense of satisfaction in helping his patient
regain their confidence after horrific cancer tumours have left them disfigured
and depressed.
He said: “People walk in here with awful scars where cancerous
tumours have ravaged a part of their face they’re afraid to walk
down the street — but because of plastic surgery we can change that.
We can give people back a sense of normality that they have lost.”
Mr Kelly also works in cosmetic surgery specialising in breast augmentation
and nose jobs.
But he won’t be lured into doing what the patient wants. He is
insistent that plastic surgery maintains a sense of the real.
He tells me: “You see these pictures of women with massive and evidently
false breasts and you think what surgeon on earth did that?
“For me it is very important that plastic surgery only enhances
to the point of being natural if a woman has no breasts and as a result
has no self-confidence then a natural breast can change that.
“Cosmetic surgery can give people a new lease of life.”
But what about people who don’t really need surgery, who are drawn
to it as a solution to their insecurities?
“People tend to be quite sensible and won’t go as far as consulting
a plastic surgeon unless there is a problem. But sometimes you do get
a sad situation where somebody comes to you and there is absolutely nothing
wrong.
“It’s then when you just need to sit and talk, to explain
that there’s often another deeper problem behind their belief that
their nose is too big or their breasts are too small.”
Mr Kelly also feels compelled towards helping those for whom cosmetic
surgery can never be a reality. He helped set up charity Facing The
World so that children living in the poorest countries can have access
to the very best surgery they would normally never have the chance to
receive. But Mr Kelly insists that people realise that the intervention
of plastic surgery in helping a child who is extremely disfigured can
radically change their quality of life.
The idea for the charity arose when Mr Kelly and Norman Waterhouse the
other main founder discussed their frustration at not being able to help
children as much as they could when volunteering in under-developed countries.
Peter Butler
Consultant Plastic Surgeon, Royal Free Hospital Special interest: Cosmetic
Surgery Peter Butler is a busy man with a young family of four children
under the age of five, he is director of surgery for the Royal Free Hospital
in London, runs various research programmes and is now leading the pioneering
search for the first four full-facial transplant patients.
For him full-facial transplant surgery can offer new life to irreparably
disfigured patients.
Sitting in a café near the Royal Free Hospital in Hampstead in
North London where his team of 31 staff will perform the first 14-hour
facial transplant — Mr Butler talks about his firm belief in the
transformational powers of plastic surgery and why he got involved in
it.
He said: “I was split between arts and science when I went to college.
Plastic surgery kind of brings the two together.”
He did a mixture of training and fellowships in Dublin, London and Harvard
to become the pioneering surgeon he is today.
It was when he was moving back and forth between countries that he met
his wife Annabel Heseltine, daughter of the former Deputy Prime Minister
Michael Heseltine.
He said: “I may have gone back to Ireland but I met her. Now I have
a whole family here and I’ve set up a number of things — I’m
director of the largest plastic surgical unit in London. I could never
have done that in Ireland.”
Mr Butler made the headlines in October when he became the first surgeon
to be granted permission to carry out a full face transplant.
At the moment his focal point is raising the money he needs to perform
the fourfull facial transplants.
Face Trust was set up to do just that.
He says: “Facial transplant is still an experimental procedure
— so the NHS can’t fund it. We set up the trust to fund the
procedures which will cost around
£20-£25,000 per transplant.
“We’ve raised enough money to fund two but want to raise
money for the four transplants.”
How far is he in selecting the patients who will
undergo the first transplants?
“We are in the process of the selection schedule and it’s
proving a lengthy process. “We have developed an educational programme
for possible candidates and their families to make sure the patient understands
and this has never been done in any type of surgery before.
“If they don’t understand then they will be rejected from
the selection process.”
So how will they go about selecting an eligible patient? “Patients
seeking this process will be finished with reconstruction — they
will have gross burns, injury or infection and have undergone 50-60 reconstructive
surgery procedures they’re through with surgery.
“A full-face transplant involves only the same risks as a kidney
transplant and I suggest that a face-transplant should be the first method
of treatment.
“Take Simon Weston, patron of our charity, 30 per cent of the burns
scars he has from the Falklands War are related to the skin grafts he
has had to have for reconstruction.
“Why would you want to go through all that stuff for nothing?
That never produces a face that is normal rather a face like a patchwork
quilt.”
So how close are Britain and Ireland and the world to seeing the first
full transplant? Have the team found a ready applicant? Not yet says Butler.
He said: “We really don’t know when we can go ahead it’s
a patient-based issue, every patient is individual and they drive the
process at a different rate. We need to give the patients a chance to
adjust.
“It is going to happen but it is just a matter of when. In America they’re
already looking for a donor, which means they must have a recipient.”
So what does Mr Butler think of the ever-growing demand for cosmetic surgery
and the dangers within this expansion?
“I have the simple advice ‘Buyer Beware’.” |
