A Plastic Surgeon’s Journey at Kauvery

IT’S THE JOURNEY THAT UNFOLDS YOUR POTENTIAL… IT’S THE JOURNEY THAT ACTUALLY CREATES WHO YOU ARE…

FOREWORD BY DR. V. B. NARAYANAMURTHY

It gives me great pleasure to give this introduction to the beautiful write-up by Dr Sharat Kumar. He joined us in December 2022 and I felt it would be a good idea for him to recall and pen down his experience at Kauvery. At Kauvery Hospital, the entire spectrum of plastic surgery is undertaken. A good inter and intra-departmental collaborative work ethic is the hallmark of Kauvery Hospital in providing high-quality, patient-centric, innovative and cost-effective care. This article by a young plastic surgeon just out of training and stepping into a career in the wide and wild world in this modern era would give us a new paradigm for all of us to share. A wide variety of cases encountered and listed here have been a pleasant surprise even for us and I would like to share this on this Doctor’s Day, the first one by this budding plastic surgeon at Kauvery Hospital.

Obstetric birth palsy is best treated at birth by a plastic surgeon. The treatment involves staged evaluation and structured and planned management at various stages of growth of the baby and the child. Nerve procedures have to be done early by 6 months of age.

Tendon and bony procedures are done if this stage is missed. Note here rotation of the scapula prevents the child from the ability to eat.

Triangular tilt procedure, a bony procedure corrects this annoying disability. Winging of the scapula, a severe cosmetic problem is also corrected.

Facial palsy producing multiple deformities is also corrected by appropriate tendon transfers.

Abdominoplasty though generally, a cosmetic procedure can be a formidable challenge if associated with an incisional hernia. Generally, they present to us after having been attempted twice or sometimes 5 times. Plastic surgical principles and extensive reconstruction give a pleasant and lasting cure for these patients.

Diabetic foot, a common problem needs restoration of all the components of the foot to heal ulcers. Ulcer formation and persistence are because of bony deformities, scarring, inappropriate reconstruction leading to failure to heal and chronic ulcers. Here, bony deformity, severe scarring, and use of the plantar skin to restore a good weight-bearing sole will keep the restored sole healed.

My Life as a Plastic Surgeon So Far at Kauvery

I joined the prestigious Kauvery Hospitals as a junior consultant immediately after clearing my M.Ch Plastic & Reconstructive Surgery towards the end of 2022. I graduated from a government hospital and I was completely new to the corporate world, not knowing what to expect. To be honest I would think to myself, no way I’m going to experience the variety of cases in a private hospital like I did in the GH for the past 3 years as a PG. But guess what, I couldn’t have been more wrong. I’m currently part of an experienced plastic surgery team that includes a senior consultant (who has become my mentor and an inspiration in this short span) & two consultants (who are always patient and guiding me towards the betterment of my skill set). Looking back at these 6 months as a junior consultant plastic surgeon, I was rather astonished at, not just the number of cases we operate on, but the variety of surgeries we perform. In this brief article, I would like to list out some of the interesting cases we worked on at the Department of Plastic Surgery in the last 6 months.

Let’s go head to toe, like how we are all trained to examine a patient…

• Face:
  • Facial re-animation surgery for facial nerve palsy.
  • Fat grafting for facial symmetry in a patient with TMJ ankylosis.
  • Otoplasty for prominent ears.
  • Post acid burns bilateral ear lobe defect – ear lobe reconstruction/repair.

    

  • Facial de-bulking surgery in a patient with neurofibromatosis.

    

  • Upper lip vascular malformation correction.
• Upper Limb:
  • Triangle tilt procedure for obstetric brachial plexus injury.

    

  • Triceps to biceps tendon transfer for obstetric brachial plexus injury.
  • Dupuytren’s contracture release.

    

  • Post-traumatic revascularisation of fingertip/reconstruction of crush/de-gloving injuries of hand/upper limb.
• Trunk:
  • Abdominoplasty with umbilical hernia repair.

    

  • Gynaecomastia correction.
  • Body contouring surgery.
  • Free as well as pedicled latissimus dorsi flap for post-tumour excision defects in the breast (Fig), leg and chest wall.
  • Pectoralis major flap for post-CABG wound dehiscence with sternal osteomyelitis.

    

  • Pilonidal sinus excision with Limberg flap cover.
  • Myelomeningocele correction with rotation flap cover.
• Lower Limb:
  • Patellar tendon reconstruction with fascia lata along with gastrocnemius muscle flap for a patient with GCT excision over the proximal tibia.
  • Two-tailed tibialis posterior tendon transfer for foot drop correction.

    

  • Multiple cases of diabetic foot reconstruction and deformity correction.
  • Pacinian corpuscle neuroma excision.

These are just examples of some of the cases that I’ve been part of in this very short span as a plastic surgeon. As I quoted in the beginning of this article – “it’s the journey that actually creates who you are” and I can proudly say that I’m on the right track.

Choose a Job You Love and You Will Never Have to Work a Day in Your Life!!!