For many doctors and their patients, plastic surgery is about so much more than appearance. The real effects of plastic surgery and cosmetic treatments are seen every day on RealSelf, where thousands of patients share their personal stories of procedures that renew confidence, rebuild physical ability, and affirm identity. For our Beyond Beauty campaign, our community of patients and doctors shows how beauty is just the starting point for so much more.
Plastic surgery—whether cosmetic or reconstructive—has the power to be a life-changing experience, not just for a patient and their loved ones but often for the surgeon who performs the procedure as well. Doctors know how vulnerable undergoing this process is, and the responsibility they have in shaping or restoring someone’s physical identity is not one they take lightly. Over the course of their careers, they build relationships with thousands of patients who come to them with uniquely personal cosmetic desires or medical needs—and some stories stay with them long after the patient has healed. We asked six plastic surgeons to share the most meaningful surgery they have performed.
Dr. Lara Devgan, board-certified plastic and reconstructive surgeon in New York City, RealSelf chief medical editor
“One of my most meaningful cases was during my first year of clinical practice. A patient [came] in with massive facial fractures after [having been] assaulted in a bar. He was a young, handsome, professional guy, and all of a sudden he found himself completely out of sorts. The entire floor of his orbit had been broken into many tiny little pieces, his cheekbone, nasal bones—basically, his entire facial architecture had been crushed. His face was totally dysmorphic and distorted, and his vision was potentially being compromised. It was one of my first major cases by myself, and I basically rebuilt the entire structure of his face with tiny little plates and screws. It was almost like putting a puzzle back together.
The thing that is so fulfilling about constructive surgery, particularly of the face, is that it’s so much about somebody’s facial identity. And facial identity is arguably more important than facial attractiveness, because it’s what gives you the feeling of being yourself. Putting each little piece of bone back together, at times, almost felt like repairing a broken eggshell. It’s a situation where every little millimeter matters. I remember that he was about my age. He was a young guy, and I was a young surgeon. He said, ‘Thank you’ in the most heartfelt way, and I really felt that because we were in many ways peers and he was really counting on me to help him through it. It was one of those very formative moments for me as a surgeon. I think that there’s a huge element of self-sacrifice in the mindset of people who become surgeons because you really have to put someone else’s well-being above your own. Your entire life gets put on the back burner so that you can be there to help somebody else. It was a great personal learning experience for me to be the person to carry him through that moment.”
Dr. Jason Roostaeian, board-certified plastic surgeon in Los Angeles
“There was one meaningful case that I went on The Doctors to talk about. The patient was an avid bike rider who got hit by a drunk driver and became stuck under the car, where half of his face got burned off by the heat of the muffler. It was pretty horrific, and a unique case in the sense that the injury itself was very unusual. I reconstructed [his face] using his thigh tissue. Of course, thigh tissue doesn’t look like anything like a face, but we had to do this first for damage control. Once the bone is exposed to air, it’s at risk for infection—and it was also right by his brain. It was definitely life-threatening at that point. So you want to get it all covered with healthy, vascularized tissue, which essentially means tissue with blood flow, since that’s how we heal and treat infections. That was step one. Getting it to look really good was the second step and also the really gratifying part because [I got] to give him back his sense of identity.
What I love most about plastic surgery is that it encompasses both the reconstructive and problem-solving aspect. First the damage control, then the artistic side of getting what is initially a thigh on your face to actually look like a face. Years later, I was at my buddy’s birthday party at a winery in Solvang, [California,] and I happened to run into the patient and his wife there and we took a picture together. It was such a memorable story—and then the chances of running into them later made it stand out as one of my favorites.”
Dr. Lesley A. Rabach, board-certified facial plastic surgeon in New York City
“I can think of so many patients who are contenders, but one does stand out. She was a wonderful woman in her 60s who had, to use her own words, ‘neglected’ herself in support of her husband and her three successful sons. Basically, she had done zero self-care since she got married in her 20s. Her eyelids and lower eyelid bulge looked a bit sad, and there was almost no jawline visible because the jowls and skin had completely taken over. Naturally, she was terrified of surgery. We discussed upper and lower blepharoplasty and a deep plane face-/neck lift. She opted for the eyelid procedure as a ‘test,’ to see if she could handle it. The procedure was done in my office, with a small amount of a Valium-type medication and local anesthetic. In less than two hours, her beautiful blue eyes were back! She was shocked about how great she felt and walked across the street with her doting husband—he had stayed in the waiting room the entire time—and they ate lunch at Claudette!
After she had her sea legs, she was ready for the face-/neck lift. Though it was performed in an accredited operating room with sedation, she was very surprised how good she felt even by the evening. The following morning, when I saw her in the office to remove her dressing, she became tearful with happiness because she literally hadn’t seen her jawline in almost 35 years.”
Dr. Brian J. Reagan, board-certified plastic surgeon in La Jolla, California
“The most meaningful surgery I did was on a young man in his early 20s from Armenia who was a soldier in the Armenian civil war. He was walking next to a tank that got hit with artillery and exploded, and the explosion removed his nose. The doctors in Armenia did just a rudimentary procedure, where they were just trying to deal with [his injuries]—so they attached skin from his forearm to his nose to sort of close the wounds. Everything that entails what plastic surgery is, was involved in this case—the way we plan surgery, the things we do to try to maximize success, the way that it was a focus on structure, function, aesthetics. When you talk about reconstruction of the nose, you have to provide three things—a lining, structure and support, and a covering. So I was able to use his tissue that was left from the previous surgery and use it to create this lining. I then harvested [bone from] his rib and created the structure, the support, like a house. And then I used tissue from his forehead to cover his nose.
This gentleman was able to go on to live a life, get a job, and get married. So we took a person who was essentially captive [in] his own house because of the way he looked, and he was able to become a productive, happy individual. One of the things that made this rewarding was, it was for a charity that I was involved with called Fresh Start Surgical Gifts. This was all about people coming together to change people’s lives. Not a single surgeon was paid a dime. and it was just a wonderful experience.”
Dr. Manish H. Shah, board-certified plastic surgeon in Denver
“When I first started practicing as a plastic surgeon, I was chief of plastic surgery at the local academic level 1 trauma center. A woman had been mountain biking with her teenage son when she [was in] a horrific high-speed crash. Her son was knowledgeable enough to know to protect her airway until EMS arrived. I can’t imagine how scary the experience was for him. Once he protected her, he had to leave her to find someone further down the trail [who] had a working cell phone, to call rescuers. The kid was my hero! She was stabilized at the local hospital and then airlifted to my trauma service. She had massive facial injuries, and I spent the better part of the next three years slowly putting her back together as she underwent therapy for her traumatic brain injury. Her son was fascinated with what I did for her—and the experience actually inspired him to go into the medical field as he got older. All that I learned in the earlier years of my practice, I rely on every day in my facial cosmetic surgery practice.”
Dr. Charles Galanis, board-certified plastic surgeon in Beverly Hills, California
“It can easily come across as cliché, but it is never easy for a surgeon to pick their most ‘meaningful’ surgery, as doing so suggests one is less meaningful than another. All surgeries carry such significance for each patient and, by extension, me personally. I can recall a recent story a patient shared with me that stuck out. She was a mother of one who [had been] widowed the year prior to her consultation. Her abdomen had never recovered its pre-pregnancy shape despite her best efforts with diet and exercise, and over time it had had an increasingly negative impact on her quality of life. With tears in her eyes, she told me how she finally needed to do this for herself. Her surgery went off perfectly, and we were both thrilled with her result. What really stuck out to me was what happened at her three-month post-op visit. She stood up near the end of our appointment and told me there was something I needed to know. With tears in her eyes, she told me she woke up that morning in her bed and it was the first time since she lost her husband that she felt she was ready to wake up next to someone. I was floored. I am, of course, aware that surgery can impact a patient’s life in dramatic ways. But to see this real-life example play out in such a powerful and meaningful way—with implications for the rest of this lovely woman’s life—really gave me pause. I felt such a swell of joy for her and gratitude that I had the honor of a front-row seat to this transformation. If this wasn’t a meaningful experience, I don’t know what is.”
