Alexander Judge ’14, Ganchi Plastic Surgery

Day 1:

The first day of my Princeternship at Ganchi Plastic Surgery was spent mostly talking with patients. Many pre-op patients came in to talk to Dr. Ganchi about exactly what kind of a procedure they wanted, to discuss their options, and air out their reservations. Dr. Ganchi would explain to them the differences in possible courses of action, check their medical history, and figure out how exactly to specialize the procedure for just what they wanted. These patients were typically considering having a breast augmentation, a tummy tuck, liposuction, a face lift, or something of the sort. Dr. Ganchi would take pictures of these patients as well, primarily as a comparison for before and after pictures to show future patients. Patients also came in to consult about Botox (or the similar medication Dysport) to remove wrinkles from the face, and this could be, and was, done that day on site. All it took was a few small injections to the forehead, crow’s feet, or glabella depending on which wrinkles they wanted to target. Some of these patients had done Botox before and Dr. Ganchi knew what dose was best for them, but for new patients he needed to estimate what he thought would work best and asked the patients to monitor when exactly it started working and how long it lasted (typically between 3-4 months) so that he could fine-tune their dosage for the future. Patients also came in for post-op check-ups, as Dr. Ganchi monitored the progress of most of his patients for over a year after surgery, to advise them on activity levels, take out stitches, check on how their scars were healing properly, make sure there weren’t any complications, and take pictures to compare with the befores.

Day 2:

The second day was completely different from the first, as it was full with surgeries. The morning was spent prepping the operating room for, completing, and cleaning up after a breast augmentation. During this procedure, Dr. Ganchi would make small incisions at the base of the breast and free up space underneath the muscle to insert the implant. He would then test for what size works best by inserting an empty test implant and filling it with water, seeing which combination of sizes in each breast left the two looking most even, because of previous asymmetry.  After removing these test implants, the silicone implants of the proper size were inserted before closure. The Anesthesiologist Dr. Lee, who had sedated the patient before surgery and who was monitoring her status throughout, then woke the patient up and she was moved to the recovery room as the OR was prepped for the next patient, who was having a tummy tuck with abdominal muscle tightening, a neck lift, and Botox. She also had a small fingernail infection that she asked Dr. Ganchi to take care of while she was out. The tummy tuck was completely different from the breast augmentation, as instead of just a small incision and opening, the skin of nearly her entire abdominal area was separated from the muscle and lifted up in order for the muscle to be tightened. This required a large incision from hip to hip, and then a cut up from the middle of that first one to the belly button. After the muscle had been tightened, all the skin from the top of the belly button and below was removed and the skin from above the belly button stretched down and connected to the bottom with several layers of stitches. Finally a new hole had to be cut for the belly button, which had been separated from its surrounding skin that was removed. The neck lift involved nearly the same process as the abdominal muscle tightening, but through a very small incision below the chin. This surgery lasted approximately five hours, after which Dr. Ganchi had one last patient to see, a six year old who had a small piece of asphalt stuck beneath the skin of her knee, which he removed skillfully.

It was really fascinating to see both sides of plastic surgery, the consulting and the surgery itself, and seeing patients in all stages of the process. Dr. Ganchi has a great deal of experience and expertise in the field, and it is interesting to hear what he has to say about each of his patients and talk about old cases from when he was newer to the field.. Overall, it was an incredible experience that showed me a great deal about a field I knew little about. I learned a lot about surgery and the medical profession as a whole, and I am very thankful to have had this opportunity.