Published: February 1, 2022

Never-ending Puzzle of the Perfect Surgery

The “time off” forced upon us during the initial phase of the pandemic provided an important pause in our lives permitting some self-reflection.


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How does a practice evolve over time and through self-reflection?

The “time off” forced upon us during the initial phase of the pandemic provided an important pause in our lives permitting some self-reflection. As surgeons we continually strive to be the best for each surgery. Best outcomes are particularly imperative for a cash-based practice. Once completing a surgical case, we would like to think we have made all the right decisions. After all, we complete each case with the very best of our abilities. Having a couple of years under my belt, I realize that my skills continue to improve. As a facial plastic surgeon, the skills I employed for an aesthetic rhinoplasty several years ago are different than my current skills. Our photographs are our memories of the “what if” or “if I had” done a given surgery differently. The photographs are not just actual memories but factual representation of our work. Each case is different, and we take a different element away.

 

Why does our work always feel unfinished?

 As an academician, my hands have had to learn to operate secondhand. Technology has made it much easier to teach difficult maneuvers and techniques, such as with endoscopic septoplasty. I can tell if a resident is forceful by their hand movements as well if we are operating without an endoscope. In the area of endoscopic surgery, even a before and after picture of an endoscopic septoplasty yields much attention. Furthermore, with each case I take an experiential “piece” home with me each day, hoping that it will help me eventually solve a much grander puzzle.

There is always a missing piece since there is so much left to learn. I’m always chasing a “better self/role model” since the puzzle never seems to be complete. Maybe in five years I’ll ask myself the same thing. Am I the best I am? Yes, just for that moment, since the puzzle pieces keep adding. Then in 10 years I’ll ask myself the same thing—am I the best?— well yes, just for that moment. Each day we earn a new piece for the never-ending puzzle called operative perfection. In a cash-paying practice this is inherently important because the expectation of perfection is there, but perfection is a moment in time. The perception of beautiful work in the present may be “okay” for our futures selves due to changing practices, beliefs, and improvement.


More from February 2022 – Vol. 41, No. 1