Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Surgical Eductaion


Today is Match Day – Maybe the Most Important Day in the Life of a Doctor

March 17th, 2018 — 8:40am

Seattle Plastic Surgeon goes back, way back to Match Day 1983.

I remember the excitement of MATCH DAY like it was yesterday.

Every March, fourth year medical students across the United States convene to receive and open a small white envelope that has a huge influence on their future.  The information contained in this white envelope is where they “matched” for post-graduate training.

The Match System works like this:  As a fourth year student, you apply to a dozen or so residency programs and if asked, go for an interviews at these programs.  Then you rank the programs in decending order of fabulous to surely miserable and everything in between.  And the residency directors rank all of the applicants in decending order of incredible to surely a disaster.  An all knowing computer takes these rankings and matches the applicants with the programs.  Supposedly, the applicants’ wish list has more weight than the residency programs’  but I bet that students are still advised NOT to list any program that makes them want to chew glass instead of go there.

This is a momentous day.  This Match determines where you will live and train for anywhere from 3 – 8 years, who will become your BFFs, often whom you will marry, where you will eventually live and how you will practice your specialty.  Every fourth year medical student wants a great residency experience both academically and socially.

Okay, enough about that and more about me.  I matched at my 2nd of 10 choices, the University of Utah and, as a skiier and a woman, was thrilled.  Of course Utah has the BEST SNOW ON EARTH and the University of Utah had a lot of women in their general surgery program, even back then.

I ended up spending 6 years in Salt Lake City, 5 years as a general surgery resident and 1 year working in the Intermountain Burn Unit.  My years there made a man out of me (even though I’m a girl).  I came away from Utah feeling I could handle just about anything that walked in through the emergency room door.  I also came away from Utah in fantastic physical condition (the altitude makes for a strong cardio-pulmonay system), with many, many lifelong friends and a deep love and appreciation for deep, dry powder snow and Mormons (really).

And then there was Match Day for plastic surgery.  Again I snagged my 2nd choice, the University of Cincinnati.  I loved the program and training but it was a bit of culture and climate shock for me.  I even took up golfing which was about the only outdoor activity available.  I learned to love fireflies, the Ohio River, badass thunderstorms, cicadas and the way the humidity turned my naturally wavy hair into a Brillo Pad.  I never learned to love Skyline Chile which involves spaghetti noodles and cinnamon.

And now I am living in my home state, Washington in my dream city, Seattle.  But I so cherish those years away.  They expanded my world view while giving me great surgical training and some interesting ex-boyfriends.

So I hope every fourth year student matches at one of their top ranked programs and  some 35 years hence, looks back on their residency program with as much fondness as I do.

Thanks for reading.  I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity.    Dr. Lisa Lynn Sowder

Surgical Eductaion

The surgeon as teacher.

February 25th, 2018 — 12:21pm

This weekend I had the opportunity to participate in a suture lab at Whitman College, a small liberal arts school in Walla Walla, Washington.  This lab is designed for Whitman students who are interested in medical careers. The lab consisted of about 30 students and 7 doctors.  The participating docs included one general surgeon, one plastic surgeon (moi), two OB-Gyns, two ER docs and one family practice doc.  

Now you may be asking what the big deal is in tying a knot and that is a great question.  Proper knots are important in surgery because an improper knot can come untied and the thing the suture was holding together will fall apart.  Not good.  Other activities that require proper knots that come to mind are rock climbing and boating.  Knots need to hold. Also in surgery, it’s important to tie a knot that holds with the least amount of suture material.  Excess suture material can be irritating to living tissue and can also harbor bacteria so you always want to use the knot that is just enough to do the job.

The first part of the lab involved showing the students how to tie two-handed knots and one-handed knots with a length of nylon cord.  I immediately discovered how hard it was to teach a skill that I do without even thinking about  it!  I don’t need my brain because knot tying for me is now in my “muscle memory”, not in my head. It’s the same for many physical skills that involve repetition such as dancing, sports or playing a musical instrument.  And I found that the more I tried to explain it, the harder it was to do.  Fortunately I finally discovered I just needed to shut up and show the students how to do it and they were able to copy my movements.

The next part of the lab was showing the students how to suture.  For this we had a nice supply of pig’s feet.  Pig skin is similar to human skin although thicker and tougher.  Suture needles are different than a seamstress needle in that they are curved and require a instrument called a needle driver.   The force required is very different than a simple push.  It’s more of a stoke with a turn of the wrist.  Again, I found explaining it very difficult because it all comes so automatically to me after all of these years.  I was very impressed with the enthusiasm of the students and I think a number of them may very well make fine surgeons.

Another part of this visit included dining with the students in an informal lunch and dinner and answering their many, many questions about being a doctor.  I found it bittersweet to compare my current position with theirs.  I am nearing the end of my surgical career (I’m planning on 5 more years) and they are just at the beginning.  They have so much uncertainty and so many challenges ahead.  Most of that is now in my rear view mirror.  I tried to give them some honest answers and not sugar coat the difficult pathway to becoming a doctor and in particular a surgeon.  I really had a chance to reflect on all of those tough years of medical school and residency and the ongoing challenges of being in practice. I am envious of their youth but honestly would not want to trade places with any of them!

A real bonus for me was the information my 17 year-old daughter, who came with me,  received from these bright college students.  She is at the beginning of her college search and she got some great advice about choosing a college.  And she got a nice tour of Whitman.

I am hoping I get invited back again to teach another batch pre-med students a few tricks of the trade. And who knows, one of those students may be my daughter!

Thanks for reading.  Dr. Lisa Lynn Sowder

I would be honored if you followed my on Instagram @sowdermd and @breastimplantsanity.

 

Surgical Eductaion

Being a woman and a surgeon isn’t always easy but it sure beats the alternatives: Being a woman and not being a surgeon or being a surgeon and not being a woman.

January 16th, 2018 — 2:36pm

I participate in a few doctor only on line message boards and forums.  A topic that has been front and center the past few months has been the #METOO movement and some of the challenges women in medicine face.  I’d like to share a few of my own stories.  Fortunately none of them include Harvey Weinstein.

I finished medical school in 1983.  1/3 of my graduating class were women.  These days women comprise more than 50% of most medical school classes.  I did my general surgery residence at the University of Utah, not exactly a bastion of progressive ideas.  Surprisingly about 20% of the surgery residents were women.  I felt very little discrimination but maybe I was just to busy and exhausted to notice?  I did get a couple of evaluations that I thought were just hilarious and still do. They were both from the Latter Day Saints (Mormon) Hospital.  One described me as “defensive, argumentative and with a chip on my shoulder”.  The other described me as “a sharp little gal”.  My boyfriend at the time just about split a gut laughing when he saw these. He was also a general surgery resident and never got such amusing reviews.

I had a few interesting experiences with male patients.  When I was doing an Intensive Care Unit rotation as a wet behind the ears intern at the University Hospital, I helped with a middle aged Mormon Elder who was crashing badly from acute pancreatitis.  (If you have never heard of this disease, count yourself lucky).  I was cleaning his penis in preparation to place a catheter so we could monitor his urinary output.  This man was very ill and a little delirious.  He looked at me and said “Doc, I’ll give you 10 minutes to stop that”.  It never crossed my mind to take offense at this.  It added a bit of levity (ha, ha) to a very serious situation.  I got to know this gentleman quite well during his ICU stay and he was a totally stand up guy.  On the gastroenterology rotation during my third year, I was doing a colonoscopy on an elderly man and he twisted his torso and neck to look me right in the eye and asked “What is a pretty little thing like you doing here?”  At the time, I thought that was actually a very good question!  This fellow grew up in a time where women rarely worked outside the home and certainly did not become surgeons.  Again, since I was the one with the scope, I felt no animosity towards him.

Dr. Henry Neal in 1990 with his girl residents, me, Sue Wermerling and Kimberley Goh. Can you tell that he secretly loves us?

My first year of my plastic surgery residency (after 6 years of general surgery) three of the four residents were women.  This was a fluke of the computer based residency matching system.  The chairman of plastic surgery, Dr. Henry Neale was a good old boy from the south.  He kept a bull whip in his desk drawer.  Really.  He was a great surgeon and ran a powerful department.  We operated our brains out and he had our back every day.  Dr. Neale was very, very politically incorrect.  He pondered if Sue, Kim and I would start cycling together and once stated he should put a Kotex machine in the resident’s office.  Well, the three of us just dished it right back at him and we did end up cycling together.

There was one occasion where I really felt harassed.  I was a 4th year general surgery resident on call at a private hospital in Ogden, Utah.  Late one night there was knock on my call room door.  I opened it to find an elderly staff surgeon with alcohol on his breath with a fifth of Southern Comfort (yuck!) in his hand.  He wanted to know if I wanted to party.  This scene was so ludicrous that I laugh out loud just thinking about it.  Most residents given the choice of sleep vs. party would pick sleep no matter whom was holding the bottle.  This man’s son was a medical student who had rotated on my service a few months previously.  I told the party hound horn dog that he had three seconds to leave or I would tell his son.  I think he was gone before I hit “two”.  I never assisted him on a case again which was no loss on my part because he was a lousy surgeon.  No, I did not file a complaint or make a fuss of this.  Again, he grew up in a different time.

I’ve had a few really weird patient encounters in private practice related to my gender.  Years ago when I was pregnant with my twin sons and could barely fit through a door, I had a mentally unstable older man with a skin cancer on his scalp the size of a poker chip.  This, gentle readers, is what we surgeons call a GREAT CASE.  The mentally unstable older man was quite the cad with many comments about my huge belly and the certain studhood of my husband.  He also had many bizarre ideas about selenium deficinecy and sexual function.  I was not sad to send him on his way once he had healed.  A few years later I had an elderly woman come in with another neglected and ginormous skin cancer who shrieked when she saw me and declared that “women are stupid and I won’t have one for my doctor”.  Oh well, that great case went to my partner who has a Y chromosome.  She was nasty to him too.

As I write this blog, I can’t really think of any weird encounters in recent years.  I think in the 26(!) years since I started practice that being a woman surgeon or woman astronaut or woman programmer or even race car driver has become sort of a no big deal which suits me just fine.  Recently my 17 year-old daughter took a field trip with her computer science class to the Microsoft campus just outside of Seattle.  She attends an all girl high school and they were given a tour by an all female coding team.  The advice given to these bright young students by these bright young and not-so-young techies was to work hard, advocate for yourself and don’t take things too personally.  I think that is good advice regardless of your gender or your workplace.

Thanks for reading and follow me on Instagram @sowdermd and @breastimplantsanity.  Dr. Lisa Lynn Sowder, girl surgeon.  And there will be an upcoming blog about delayed childbearing which is something I don’t recommend but sure worked for me.

General Health, Government and Politics, It's All About Me., Plastic Surgery, Surgical Eductaion

Plastic Surgery FAQ: I’m a total wreck. Where should I start?

June 14th, 2017 — 4:16pm

Seattle Plastic Surgeon answers Plastic Surgery FAQ:  I’m a total wreck.  Where should I start?

faq total wreckI often see patients who are interested in several different procedures.  They have a laundry list of things they would like to change.  A recent example was a middle aged lady who wanted hip liposuction, a face lift, a tummy tuck, a breast lift and an otoplasty to pin back her protruding ears.  Geeze, it would be unsafe and impractical to do all of those procedures in one mega 12 hour case.  It would be unsafe because that is a long, long time to be under anesthesia, multiple areas of the body would need to be exposed and that increases the risk of hypothermia, although any one operation has very little blood loss, all those procedures combined could significantly lower her blood count, and she would be sore from head to toe making her post operative recovery miserable.  It would be impractical because I really can’t stay at my best in the OR for 12 straight hours.  I just can’t.  And my nurses and techs and anesthesiologists don’t want to work a 12 hour case and we would finish the case well after dinner time.

My advice to this patient is to start with the area that bothers her the most.  In her case, it was her abdomen.  So we made the decision to do her hip liposuction and her breast lift at the same time as her abdomen.  By grouping these procedures, she saves some money and it saves her a lot of recovery time.   And – this is really important- I won’t be fatigued when I am putting in those last few stitches and the anesthesiologist will still be awake!

So if you are contemplating several procedures, try to decide which procedure you want the very most.  We can usually group procedures and still keep it safe and practical.

Oh, one more thing.  Sometimes the place to start is not the operating room.  It may be smoking cessation, getting into better shape or even a serious medical skin care program.  Sometimes surgery is the last stop on the line to improving appearance.

Thanks for reading! Dr. Lisa Lynn Sowder

If you think you are a total wreck and don’t know where to start, give my office a call to schedule a consultation, (206) 467-1101.

I would be honored if you followed me on Instagram @sowdermd and @breastimplantsantity. See you there!

Mommy Makeover, Patient Safety, Plastic Surgery, Surgical Eductaion

Saying goodbye to a plastic surgery giant, Dr. Mark Gorney

November 25th, 2014 — 2:45pm
blog mark gorney

Dr. Mark Gorney, 1924 – 2014

Plastic Surgery loses one of its giants.

From Plastic Surgery News

Mark Gorney, MD, Napa, Calif., who led ASPS as its president in 1983 and served as a founding member and first medical director of The Doctors Company (TDC), passed away Monday, Nov. 17, at age 89.

Dr. Gorney led the Society during a period of relative calm in the early 1980s. The stability of his term of office stood in contrast to his other roles with the Society and the specialty, in particular his work with risk prevention.

Dr. Gorney used his extensive knowledge of the specialty and the nuances of matters of risk and insurance coverage to become a valuable resource for both plastic surgeons and insurers. In 2005, he stepped down from his TDC position and assumed Life Member status in ASPS.  

See Napa Valley Registrar Obituary

From Lisa Lynn Sowder, M.D.
I first met Dr. Mark Gorney when he was at the top of his game.  He was winding down his successful clinical practice and winding up his work as the one of the founders of  The Doctors Company, my medical malpractice insurer. This was a man who really had it all, who had seen it all, and who had done it all.

He gave a talk at the Senior Residents’ Conference in 1991 on risk management.  His idea of risk management is do good work, don’t operate on mentally unstable people, and above all,  be kind.  He introduced us to the Gorneyogram which I think about every time I consider a patient for surgery.   The Gorneyogram compares the patients concern about a problem with the magnitude of the problem and the difficulty of the surgery needed to treat the problem.     Here are two examples:  A patient with an almost microscopic mole on her face who says it is ruining her life may go off the rails when she sees that removal of the microscopic mole leaves a microscopic scar.  Now that scar will be the thing ruining her life and guess who is responsible for that scar?   This  patient has an unfavorable Gorneyogram rating.  Contrast that patient with a mother of 4 whose breasts are so gigantic that she has trouble chopping wood for her  wood burning stove.  She’s going to be thrilled with a breast reduction even if it doesn’t give her the chest of a Victoria’s Secret model.  And guess who she is going to send chocolates to every Christmas?   This patient has a favorable Gorneyogram rating.  I was so taken with his honesty and his directness and his wisdom but it was what happened next that really touched me.

After Dr. Gorney’s excellent talk, one of the residents raised his hand and asked this question:  “Dr. Gorney, we who are sitting here are just about to finish our training and enter practice.  What is it like to be you, someone who has accomplished so much and who has contributed so much to plastic surgery?”  I will never forget Dr. Goney’s answer.  His voice cracked, almost imperceptibly when he said:  “All I’ve done and all I’ve got plus a buck gets me on the bus.”  This was a man of great modesty who did not let his accomplishments go to his head.

The last time I had the privilege of seeing Dr. Gorney was in November of 2008.  I attended the annual meeting of the American Society of Plastic Surgeons and attended one of his talks about the psychology of the plastic surgery patient.  He shared the podium with Dr. David Sarwer, a professor of psychology.   They gave a terrific presentation using many examples of unhappy patients who had sued their surgeons.  Dr. Gorney examined each case with his usual candor and humanity.  I could tell that he was slowing down and knew that his teaching days were likely coming to a close.   Even though I will never again be able to hear his wise words in person, those words are with me every day.

R.I.P Dr. Gorney

 

 

Patient Safety, Plastic Surgery, Surgical Eductaion

A brow lift provides an anatomy lesson in the operating room.

May 22nd, 2014 — 9:13pm

Seattle Plastic Surgeon gives a little anatomy lesson during a brow lift. 

blog anatomy

Leonardo DaVinci loved anatomy as much as surgeons do.

I did an open brow lift yesterday on a lady who had just excellent anatomy.

An open brow lift is done with an incision that is made ear to ear across the scalp about and inch in back of the hair line.  The forehead is then separated from the frontal bone of the skull down to the top of the eye sockets.  (It’s not nearly as gruesome as it sounds.)  There are several important structures in harm’s way so great care must be taken with the dissection.  The rule of surgery is identify it before you cut it (or in this case, don’t cut it) which I think is pretty good advice for everyday living, don’t you?

This lady’s anatomy was right out of a text book.  Her supraorbital nerves that give sensation to the forehead and anterior scalp exited two little holes through the frontal bone  just about the rim of her eye socket.  And the little muscles that allow us to scowl (the corregators) were exactly where they should have been.  I made sure that everyone in the operating room got a good look at this anatomy not just because I find it fascinating no matter how many times I see it, but because it is clinically important.

For example, the entire forehead can be anesthetized with local anesthetic injections into the supraorbital nerves.  This is commonly done for excision of skin cancers on the forehead.  And another example is the corregator muscles.  These are the muscles that are injected with Botox to relax the area and eliminate the scowl.  They are very deep which is why the Botox injection in this area needs to go almost to the frontal bone.

Anyway, it’s a great day in the operating room when the anatomy is so clear.   And, yes, I am easily amused but believe me, the ability to be easily amused is a gift.

Thanks for reading!  Dr. Lisa Lynn Sowder

Now That's Cool, Plastic Surgery, Surgical Eductaion, Uncategorized

The Northwest Society of Plastic Surgeons – their annual meeting starts this Saturday.

February 14th, 2014 — 9:02pm

Seattle Plastic Surgeon is heading north to British Columbia for the annual meeting of the Northwest Society of Plastic Surgeons (NWSPS).  I’ll return to Seattle a little bit smarter.

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One of my proudest accomplishments.

I look forward to this particular medical meeting every year.  I have been a member of NWSPS for over twenty years and have to say that this group of plastic surgeons is just bursting with smart, innovative, and generous surgeons.  Members include full professors and department heads at major universities, solo docs practicing in the middle of Alaska and everything in between.   Some of us do a wide variety of plastic surgery and some of us are highly specialized.  Some of us have nurtured gourmet practices and some remain in the trenches of the inner city teaching hospitals.  Once thing we all have in common is that we share a deep appreciation for this organization and the annual meeting where we all come together to share our successes, foibles, ideas and experience.  I learn more from eating breakfast with these colleagues than I could learn in a whole year’s worth of medical journals.

This year I am moderating a panel of highly accomplished surgeons who will discuss topics as varied as rhinoplasty, laser technology and surgical education.   And I have been chosen to be one of the judges for “The Dom”, which is the name of highly coveted award for the best presentation by a member.  The name comes from the prize which is a nice chilled bottle of Dom Perignon.  I won this award in 2005 for a presentation I gave on “Revisional Surgery of the Augmented Breast.”  I presented my experience with difficult breast implant problems and many of the lessons I had learned in treating these patients over the years.  Many of my lessons were learned the hard way and I think my honest presentation of some of my most difficult and challenging cases were appreciated by this audience.

Anyway,  as of Saturday evening, I will be basking in the companionship and collegiality of some of the greatest surgeons on the planet.  I’ll let you know who wins “The Dom” this year.  From the looks of the program, it’s going to be a tough call.

Thanks for reading!  Dr. Lisa Lynn Sowder

 

Surgical Eductaion

The difference between a complication and a trade off.

October 29th, 2013 — 2:41pm

Seattle Plastic Surgeon clears up some confusion about postoperative “issues.”

imagesCAOSLYZTI recently did a pre-operative visit on a lady who will be having a face lift next month.  We have patients read an extensive informed consent document and discuss any issues that arise from that document.  She was most concerned about nerve damage that may leave her face “paralyzed and numb.”  This got me thinking about surgical complications and trade offs.

Facial paralysis after a face lift is an exceedingly rare (as in it has never occurred in any of my face lift patients) but possible complication of face lift surgery.  That is in contrast to facial numbness after a face lift which is not a complication at all.  It is a trade off meaning that it happens because of what the surgeon must do to accomplish the face lift.  In raising or peeling up the skin on the face, many teeny, tiny sensory nerves are cut and this leaves the face numb until those teeny, tiny sensory nerves grow back and the sensation returns (this usually takes about a year).

Here is another example:   A trade off for a tummy tuck is the hip to hip scar.  An incision must be made to remove the excess skin and all incisions heal with a scar so a normal scar is not a complication.  It is a predicatble and expected trade off.   Now if the skin on either side of the incision becomes infected or falls apart  and the scar ends up being really wide or indented, that is considered a complication.  It was not expected.

Complications are not expected but can happen and patients need to be aware of their risks.  Trade offs are expected and will happen and patients need to be accepting of them.

Wow, it was good to get that cleared up, at least for me it was.  Thanks for reading!  Dr. Lisa Lynn Sowder

Postoperative Care, Scar, Surgical Eductaion

The Learning Curve

October 9th, 2013 — 2:24pm

Seattle Plastic Surgeon discusses the challenge of introducing new procedures to her practice.

The learning curve can be challenging for surgeon and patient.

The learning curve can be challenging for the surgeon and the patient.

This coming weekend thousands of Plastic Surgeons and their staff will decend on San Diego for the Annual Meeting of the American Society of Plastic Surgeons.  These meetings provide an opportunity to share ideas, techniques, new procedures, and new equipment and instruments.

Plastic surgeons tend to be very innovative and open to new ideas and it’s not unusual to come away from one of these meetings all fired up to try the latest and greatest.

Enter the learning curve:   With every new procedure or variation on a well established procedure, by definition someone has to be the first patient and that first patient may not get as good a result as the 10th or 100th or 1000th patient.  Or maybe the surgeon, after a handful of cases, decides that this latest and greatest is not really an improvement and he/she abandons it altogether.

Sometimes the learning curve is very favorable and sometimes it is so harsh that I am not willing to even give it a try.  An example of a favorable learning curve is transblepharoplasty browlift with Endotine fixation devices.  The anatomy was familiar.  The new instrumentation was eary to learn how to use.  Risk to the patient was low.  If it didn’t work, a conventional coronal brow lift could be done.  After about half a dozen cases, I got very good at selecting patients with favorable anatomy for this procedure and now do this procedure frequently.  Last year, after many, many patients, I had a failure of the fixation device on one side and had to redo that side.  That single device failure has not dampened my enthusiasm.

A procedure that I just can’t bring my self to try is a deep plane a.k.a. subperiosteal face lift.  This procedure was the latest rage 15 or 20 years ago.  It was supposed to give the most natural looking and longest lasting facelift results.  The downside is that the operative area is very close to where the facial nerves live.  These are the nerves that control facial movement.  A permanent injury to one of these nerves can be devestating.  Also, postoperative swelling can take up to a year to resolve.  There was a bit of a machismo aura attached to this procedure and maybe I just didn’t have large enough cajones to jump on this particular bandwagon.  The benefit of this operation, IMO, did not justify the risk to the patient.  And, these days, almost nobody talks about this procedure.  The buzz just isn’t there.

When I embark on a new procedure, I am very honest with my patients about my expereince or lack thereof.  I explain that it is a lot like cooking.  If a cook has good basic skills,  knowledge, and experience, making a new dish is not reinventing cooking, but rather applying those skills, knowlege and experience in a new way.

Thanks for reading!  Dr. Lisa Lynn Sowder

 

New Technology, Surgical Eductaion

The IKEA Effect

February 7th, 2013 — 10:59am

Seattle Plastic Surgeon discusses the IKEA Effect.

blog Ikea effect

It may be crooked but I love it because I built it.

The IKEA effect refers to the phenomenon of how we are apt to like or even love something that required a lot of work on our part even if that something is flawed.

Take this crooked chair.  You would never buy this at a store but if you bought it at IKEA and did a lousy job of assembling it, you may very well be satisfied with it or even in love with it because it was the fruit of your labor.

So what does this have to do with plastic surgery?  Quite a bit actually.  It is very common for plastic surgeons to cling to a technique, procedure or device that they themselves developed even if something better comes along.     Also, it can be difficult to accept that a patient is unhappy with a result that the surgeon really sweated over.  We can sometimes deny that the result could have been better because we had to work so hard to get the result we did.

I recently saw a patient who had  minor asymmetry after breast surgery and I really thought she should be thrilled with her result but she was not.  I finally “gave in” and did a revision and now she is beyond thrilled and I am thrilled that she is thrilled.  Looking back  I see now that I had fallen victim to the IKEA Effect.

Thanks for reading and keep and open mind!  Dr. Lisa Lynn Sowder

My Plastic Surgery Philosophy, Now That's a Little Weird, Surgical Eductaion, Uncategorized

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