otohns.net Conference Coverage COSM 2000

otohns.net Conference Coverage
COSM 2000 - Orlando, FL - May 2000

"Facial Plastic and Reconstructive Surgery"
Barbara Nesbitt, Executive Editor MediSpecialty.com, speaks with Dr. Eugene Alford Director of the Texas Center for Facial Plastic and Reconstructive Surgery
Audio/Video Link
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Barbara Nesbitt: "Hi, I'm Barbara Nesbitt and we are in Orlando, Florida at COSM 2000. I have the privilege of being here with Dr. Eugene Alford who is a fellow Texan from Houston, and he's the Director of the Texas Center for Facial Plastic and Reconstructive Surgery and a friend of Dr. Ron Kuppersmith."

Dr. Eugene Alford: "I've known Ron for years."

Barbara Nesbitt: "We're going to do a series; in the next month or so we'll visit you at your office in Houston, doctor, and have you take us through the steps of what a patient can expect and also what a physician should look for. I'll play the role of patient, and you're going to educate other physicians as to how they should answer questions and we'll also educate the women in what they should be asking."

Dr. Eugene Alford: "Sure, with facial plastic and reconstructive surgery, the cosmetic market has expanded well beyond what anyone would consider the traditional bounds of cosmetic surgery. What we'd like to do is to go through a consultation process with you, let you see what it's like to be that patient, see what the consultations are like, maybe advise you as to how to choose a physician, and maybe advise physicians on what they would look for in someone to whom they might refer their patients for facial plastic and reconstructive surgery. Certainly, you know if you as a referring physician refer or send a patient to someone who the patient has a bad experience with, it's a negative against the physician who referred them so we're going to kind of go through some of that as well."

Barbara Nesbitt: "That's very good because maybe somebody does noses very well and in another area they would say - I think you should go another direction."

Dr. Eugene Alford: "Exactly, everyone has their area of expertise. We as facial plastic surgeons like to consider the whole face our expertise but you need to kind of learn how to interview that physician and find out what they really do well, what they like to do well, and we all choose to do what we do best. So how do you find out what that physician does well - there's lots of techniques and things available, which you can really find out. Just to start off, don't forget that cosmetic surgery is still surgery and the definition of a minor surgery is surgery on somebody else, if it's on you - it's major. So you really want to focus on how to choose that physician, are they a real physician, are they really more interested in your skin care, or are they going to ask you questions that you expect that physician to ask - history of past medical problems, previous surgery, current medications, allergies, do a good physical examination, and then proceed to talk about cosmetic sorts of concerns because it's a responsibility. You're still taking care of that whole patient, we're not just going to bob the nose or take care of a wrinkle in the chin."

Barbara Nesbitt: "There's a lot of talk about board certification, and obviously physicians know what it means but I think patients should know what board certification means especially in plastic surgery or any of the specialties. So I think that's a good area to explain when we do that walk through your office for patients."

Dr. Eugene Alford: "Absolutely, there are lots of boards out there. There are really only two boards in plastic surgery, which have been recognized as having identifiable and substantial training in areas of plastic and reconstructive surgery. One of which is the ADMS Board in Plastic Surgery and the other is the American Board of Facial Plastic and Reconstructive Surgery, which limits its area of certification to facial plastic and reconstructive surgery. There's also the American Board of Otolaryngology - Head and Neck Surgery, which trains people in plastic and reconstructive surgery of the face, head, and neck. So just to begin that conversation, that's where you start with those three boards."

Barbara Nesbitt: "There is computer imaging where somebody can go to your office or to anyone's office but I would want you to explain to us later why it's important. I think we like to think of computers as just being sometimes a play toy, and this is an important thing for a patient to be able to look and say with this or this, this is how I will probably look."

Dr. Eugene Alford: "Actually, it's a tool like anything else. It is a very important communication tool in that I don't have to interpret your words and see what they mean in my mind. I interpret your words, I transfer them to a computer photograph, and I'll say - by what you're saying, this is what I think you want your face to look like and you can say yes, no, a little more here or there, so there's enhanced communication. Now it does not imply that's what your result is going to be because we can't control wound healing but I can very clearly tell you whether or not I feel I'm capable of achieving that result."

Barbara Nesbitt: "Before we end this today at the show, and I know you have to get back to Houston, could you just explain facial reconstruction could be after a major auto accident or a burn patient or something which is entirely different than what maybe I started out talking about like lifting my neck and looking younger or whatever. Tell me a little bit about that because that's really serious surgery."

Dr. Eugene Alford: "My initial background was in reconstructive surgery of the head and neck and that was making a new jaw bone out of a leg or creating a new tongue from tissue from the arm. So that is function, form, and appearance and it's those skills that need to interact with cosmetic surgery. Cosmetic surgery is elective; you choose to do that on your time schedule. The victims and survivors of trauma, burns, or cancer surgery - it's not just elective it's something they don't have a choice to do or not. So to say what is more important than the other depends upon which chair you're sitting in."

Barbara Nesbitt: "That's right."

Dr. Eugene Alford: "If you're the cosmetic surgery patient who's having that procedure, it's no more important than it is to the person who's having her jaw reconstructed, but to the rest of the world it is much more important, I think."

Barbara Nesbitt: "If I was to have facial plastic surgery to look younger, perhaps not many people would notice. But for a person who has been disfigured by illness or injury, you're really giving them a life again, don't you think?"

Dr. Eugene Alford: "Part of my motivation for doing this was I initially did head and neck surgical oncology - head neck cancer fellowship - and I thought we did a great job of curing head and neck cancer but those people would never leave their homes. They would never get out in public because they were so disfigured they could never hide their face. By learning to do free tissue transfer and advanced methods of reconstruction, we released those patients from the prison of their home and their self-induced prison so that they would go back out. There's a patient of mine who is a partner in a large accounting firm nationwide and three quarters of his tongue was removed for cancer, and this is a man who's job depended on his ability to talk on the telephone. By these methods of reconstructive surgery, he not only talks on the telephone, but he can eat, drink, and he can articulate very clearly and so we were able to keep his livelihood. He has a four-year-old son that he has to care for with his wife so that's very important but those are the things we can do for those types of patients."

Barbara Nesbitt: "So when we come to Houston and we go through your clinic and we talk with some of your patients, we'll go through all these different areas, right?"

Dr. Eugene Alford: "Sure, we'll see cosmetic surgery patients, and we'll see patients that have undergone state of the art functional reconstruction after cancer. We'll just talk with those patients and find out about their experiences and what is was like for them."

Barbara Nesbitt: "You're going to be on the Board, and I'm very happy to have you."

Dr. Eugene Alford: "Thanks."

Barbara Nesbitt: "I'm thrilled to death that I met you here today, doctor."

Dr. Eugene Alford: "Thanks, Barbara, I appreciate it very much."

Barbara Nesbitt: "Thank you."

Visit the website of Eugene Alford, MD