In the summer of 1986, (when We are the World was the top song, Out of Africa was the top movie, and a gallon of gas cost $.89) having just finished my residency in plastic surgery at the University of Pennsylvania in Plastic Surgery, I moved to Knoxville, Tennessee to start my practice.
You could say that this was my first job. I was not entirely sure what to expect, or how I would like Knoxville, but 30 years later I find myself loving my work, loving Knoxville, and – truth be told— loving my life! During these 3 decades, much has changed and much has remained the same. It was as true then as it is now that practicing the art and science of medicine and surgery is a wonderful occupation and a wonderful privilege.
I began my practice at the University of Tennessee Medical Center and spent the first 15 years there. My practice was about 80% reconstructive work, and about 20% cosmetic. There was a lot of night and weekend work in those days! I remember one Thursday night, having just finished rebuilding a chest wall in a shotgun blast victim at around midnight, getting a call from the ER of another hospital about a patient with a facial laceration (which turned out to be a facial fracture) that had to go to the operating room for repair. No sleep that night!
The high volume of trauma made me immediately busy and kept me so. In addition to trauma work, I also did a lot of cleft lip and palate work, as well as breast reconstruction. This was, really, an excellent way to start my practice.
Fast forward to 2001
In 2001 (when the song of the year was Beautiful Day, Gladiator was the best movie, and a gallon of gas cost $1.42), I moved my practice to my current location in Bearden. With this move came an increased emphasis on cosmetic surgery, which now comprises the entirety of my practice. My practice has truly grown and flourished here. My staff has doubled, we have enlarged our space, and we have been able to add many great non-surgical services.
After being in one place for a long time, you begin to appreciate the continuum of your practice life. Indeed, there have been some very rewarding experiences. I have repaired a cleft lip on the child of a mother’s whose cleft lip I had repaired. I have done a facelift on someone whose facial lacerations I repaired 23 years earlier. People I have worked with at the hospital in the past are now my patients. I have worked with mothers and daughters (the mothers always make the daughters go first), husbands and wives (the wives always make the husbands go first), siblings, twins — you name it!
30 years later
So, in 2016 (top song might be “Can’t Stop the Feeling,” current top grossing movie is Finding Dory, and the average cost for gas is $2.21 a gallon), 30 years into my practice, I thought it would be interesting to look back. When I began, as noted above, most of my work was reconstructive, and now it is cosmetic. 30 years ago, most of my operations were done in a hospital operating room and the patients were in-patients in the hospital. Now, the vast majority of my work is done in an outpatient surgery center (the Physicians Surgery Center of Knoxville) and the patients all go home to recover.
What else? Let me fill in the blanks.
- The best thing about cosmetic surgery is…what we do and how we do it is entirely up to me and my patient. No third parties allowed!
- The best thing I’ve been given is…a hug and a sincere thank you from a happy patient.
- The strangest request I’ve received is…a patient who wanted me to remove her belly button so that she could look like a clone on the show Kyle XY.
- My favorite operation is…for a long time I have always said a tummy tuck, and that is still probably true.
- The biggest thing missing from cosmetic surgery is…non-surgical skin tightening.
- The worst decision the FDA made is…placing a moratorium on silicone breast implants in 1992.
- The operation I have done more than any other is…breast augmentation, nothing else comes close!
- What keeps me up at night is…a patient who is having a problem. Always has, always will.
- Some of the happiest patients are…those who have had a breast reduction.
- The operation I no longer do that I miss the most is…cleft lip repair.
Although the particulars of what I am doing have changed through the years, many important aspects of plastic surgery have not. It was and remains a very innovative field, which requires a lifelong practice of learning. While we rarely save lives in plastic surgery, we are improving the quality of life for patients on a daily basis, and the profession remains an extremely rewarding one.
It is certain that I will not practice for another 30 years! But at this point, I am enjoying my work, my health is good, and there really doesn’t seem to be a reason to be doing anything else.
All the best,
David B. Reath, MD