Sally Lee/Dr. Thomas J.Fahey - Week 5

Week 5 

Name: Sally Lee

Clinician mentor: Dr. Thomas J. Fahey


    This week, I had the opportunity to observe a fascinating plastic surgery procedure known as facial fat grafting. The patient sought treatment for drooping on the right side of their face. An incision through the skin of the face was made and sutures were used to lift and tighten the underlying facial tissues. It was incredible to witness how these carefully placed and pulled stitches could restore symmetry of the patient’s face and see how liposuction and fat grafting works. 

    The surgeon inserted a large liposuction cannula through the belly button and moved it around the abdomen. The cannula was connected to a syringe via a long tubing, and the negative pressure was generated by pulling the syringe plunger out. However, I noticed that this method alone was insufficient to collect all the fat in the tubing, and the surgeon had to manually hold the tube, ensuring that the fat remained in place while the syringe was pushed in again in order to re-generate the negative pressure. Although effective, I wondered whether a canister under constant negative pressure could potentially enhance the overall efficiency of the liposuction process. After the fat was harvested, it was placed onto a thin layer of absorbent sheet and proceeded to move it in various directions. This motion allowed the excess fluid or water to be absorbed by the sheet. However, I could not help but wonder why alternative techniques like centrifugation or filtration using a membrane were not utilized. I believe these methods could be not only efficient but also ensure better purity or quality. 

    I also had a chance to shadow Annabel, an NP in the endocrine surgery department. One of the consultations was with a patient who presented symptoms of regurgitation and persistent sore throat. This patient had previously undergone various tests, including ENT evaluations, Bravo pH monitoring, and endoscopy, at a different hospital. However, the collected data proved inconclusive, leaving Annabel unable to determine the appropriate surgical intervention. This situation re-emphasized the significance of evidence-based science and medicine in guiding patient care. 

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