David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

Mystery: New Grisham Book’s Plastic Surgery Facts

Last month, Lisa and I had a road trip to Charleston. As we often do, we listened to a the racketeer coverrecorded book. The selection for this trip was John Grisham’s latest, The Racketeer. This book has been well-reviewed and seemed like a good one to pass time on the road, as it was. Spoiler Alert: However, one of the plot details has to do with the main character going into the witness protection program and, as a part of this, have plastic surgery to alter his face and thus change his identity. Hmm…

Where Grisham Missed It
In the author’s note at the conclusion of the book, Grisham states that “accuracy was not deemed crucial” and that research “was rarely called upon” in the preparation of the manuscript. When it comes to writing about plastic surgery this really shows!

Here are some examples: first, the main character consults with a team of people at a hospital to discuss how to change his appearance like what his nose would look like, whether he should have fuller cheekbones, what type of glasses to wear, and if he should shave his head. Then, voila, he was a new person. Unfortunately, the details of how this is done and the recovery are so fanciful that they make a mockery of the writing of this gifted writer.

The book also suggests that after doing some work on the nose and cheeks, bandages are applied and left in place for days on the protagonist’s face. He is advised that he must be very careful with his movements for many weeks so as not to pull out his stitches. I don’t think so.

Another clichéd piece of misinformation, and perhaps my favorite, was that he had to stay in bed for many days after the surgery with no moving. Wrong, very wrong.

The Truth
To set the record straight, patients are encouraged to get up and move around early after surgery, as in within the first hour of two. This helps prevent blood clots from developing in the veins of the leg and is beneficial for breathing, especially after a general anesthetic. Most of us who actually do plastic surgery on the face use minimal bandages after the first day or two. And, if moving around is going to rip out all the sutures, one wonders who put these sutures in and if they were using wet toilet paper for suture material.

What Grisham Got Right
The broader question of what makes someone look like himself is always a concern. Do we really make someone unrecognizable by changing a few facial features? However, Grisham was headed a bit more in the right direction when he had the character change is cadence and pattern of speech, and change his movement patterns. These are just as important as facial appearance when it comes to recognition, and perhaps more so when seen at a distance (a point I made when I blogged about Johnny Depp in The Tourist).

So, note to authors and screenwriters writing about plastic surgery: call me. I am always happy to give you some pointers on how we really do what we do. Even if you are doing minimal research, little details like these will give you a stronger text.

All the best,
David B.

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