Stanley Yuan ’14, Ganchi Plastic Surgery

January 30, 2012

Today, I shadowed Dr. Parham Ganchi ’87 at his clinic in Wayne, NJ. I was welcomed in by a member of his staff, who then gave me a tour of the clinic. It was an impressive display, from all of Dr. Ganchi’s diplomas to the spacious patient examination rooms to the private surgical operating room. Soon after, Dr. Ganchi himself arrived and we prepared for the long day that was to come. His schedule was packed, with patients coming in 15 minute intervals. There were a variety of procedures that patients were considering having, from cosmetic surgery to botox to laser/wrinkle hair removals. We also met with patients who were about to have their surgery, what he called a “pre-op”, to make sure that they were certain that they wanted to have the procedure. During the mini-breaks between patients, we talked about surgery and medicine in general, Princeton life, and our hobbies and lives outside of academics. Dr. Ganchi not only enlightened me in the realm of medicine but also on many topics that I wasn’t as well versed in, such as nutrition and the psychology of economics.

During the consultations, I really saw how engaging and compassionate Dr. Ganchi was as a doctor, making sure that all of his patients were fully informed on all the procedures and that they were comfortable in this environment. Many of the patients that were following up with him after their procedures were all extremely satisfied with their surgeries, which serves to demonstrate the great skill and dedication Dr. Ganchi brings to his field of medicine. It was really inspiring to see it all firsthand, and he will be the perfect role model for me to look up to as I pursue my own path towards medicine.

January 31, 2012

Stanley and Dr.Ganchi

Today was surgery day! I arrived bright and early to prep for surgery, getting scrubbed in and being informed on OR shadowing etiquette. I also met the anesthesiologist, Dr. Lee.
Both of the major surgeries done today were breast augmentation procedures, one with silicone implants and the other saline. He demonstrated the different techniques that went in with different implants, and showed his versatility and experience while performing surgeries on these patients. Throughout the surgery, Dr. Ganchi explained every step of the procedure and was very informative. Something that struck me was that he always had the patient’s best interest in mind. During the surgery, he was telling me that he had made a small incision under the breast of the patient, as opposed to a longer one, to prevent a larger scar from appearing. Even though that would make the surgery more complicated for him, he was more than willing to give the extra effort to make his patients satisfied with his work.

After the surgeries, I witnessed an earlobe repair surgery. The meticulousness and detail of his work showed through this procedure, as he slowly weaved back and forth with his stitches through the parts of the ear. I was surprised at how little time it took yet how natural the ear looked after the surgery, a testament to his skill and prowess.

I had come into this Princeternship on the fence about medicine and came out more positive than ever that medicine is the right track for me. I cannot thank Dr. Ganchi enough for all of the great wisdom and firsthand experience that I was able to obtain during these two days. I now have a great mentor and role model to follow and hopefully I will be able to open my own medical clinic some day. This Princeternship program was an amazing experience; the shadowing was more in depth than anything I had ever done and scrubbing into surgery for the first time was breathtaking. Everybody was really inviting and compassionate and really made me feel at home at the clinic. I would recommend this program to anybody that is unsure about medicine, because this will definitely help you make up your mind!

Tracie Kong ’14, Ganchi Plastic Surgery

The surgery scheduled for today was a facial rejuvenation. As opposed to Day 1, in which I learned about the physician-patient aspect of plastic surgery, today I observed the mechanics of a plastic surgery itself. I learned about the job of the surgeon’s assistant and of the anesthesiologist, Dr. Lee. Of course, I had to stand a foot back from the patient and be sure not to touch any of the sterile equipment. Nevertheless, I was able to get a clear view of what Dr. Ganchi was doing throughout by standing at strategic locations. Watching the surgery was quite an eye-opening experience. The skin was lifted, and the organic mass beneath it revealed. This, I must say, was the highlight of the day and a most memorable sight – the grotesque blood vessels, connective tissue, and lipocytes lying a mere skin layer below the facial façade that defines us. On one hand, the itinerary for the procedure seems logical and straightforward: open, fix, close. On the other hand, plastic surgery of the face requires such extreme dexterity of the hands, patience of the mind, and keenness of the eye. We are so sensitive to asymmetry between the right and left sides of the face that operations to reshape the face seem to me an extremely daunting task. The body was made to recover, said Dr. Ganchi. It seemed amazing to me, a testament to our miraculous biology, that we can heal after being cut open and sewn closed like so.
 
Coming to Dr. Ganchi’s office was an invaluable experience – Day 1 of seeing patients and Day 2 of observing surgery complement nicely to show different aspects of plastic surgery in a private practice setting. I learned much about the psychology, philosophy, obstacles and ethics of plastic surgery. I came in with the idea that patients, empowered by their plastic surgeons, have an “artistic license” to nip and tuck however they want. But I learned that there are fixed procedures, defined ways to make the human physique more aesthetically pleasing. A responsible surgeon, an experienced surgeon, will guide a patient to achieving a natural beauty, rather than follow his or her every desire.

Dr. Ganchi and Tracie

 
These two days were not only a great learning experience, but also very enjoyable. Every patient had a different story, so every minute brought something new; this reaffirmed my motivation in choosing medicine. Dr. Ganchi is not only a skilled surgeon, but also an exemplar of how a doctor should interact with patients, and a great mentor to talk to. He and his staff were very nice to accommodate a college student and very receptive to answer all my questions. Thank you to the office and to Career Services for making this possible! I enthusiastically recommend this Princeternship to those with an interest in cosmetic plastic surgery.

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.

Priscella Chan ’14, Ganchi Plastic Surgery

Monday, 1/23/2012

As I entered the office on my first day at Ganchi Plastic Surgery,I was immediately greeted by Karen, who is in charge of financial negotiations.  She took me on a tour of the office, showing me the patient rooms, waiting rooms, operating rooms, and introducing me to medical assistants Carly and Michelle.  I also met Leyla, who works with Karen handling the financial side of the business.  Soon afterwards I met Dr. Ganchi ’87, who then proceeded to tell me about the day.  Today was “Patient Day,” which meant I would be sitting in on all his meetings and consultations with patients.  I saw a variety of clients: some came back for check-ups after face lifts, while others were interested in breast augmentation, breast lift, rhinoplasty, liposuction, and labiaplasty.  One of the things I was most curious about in the field of plastic surgery was how plastic surgeons are able to please their client but also do what’s best for them. Today, Dr. Ganchi taught me that he only conducted operations that would allow the patient to see at least an 80% benefit.  This way he helped the client appreciate his/her natural beauty, even though that meant he would not operate on the patient.  One of the most important things I realized from my experience today is that great doctors have to both be able to help the patient and also effectively communicate with them as well.  I noticed especially that Dr. Ganchi spent a lot of time with the patients thoroughly explaining procedures and answering questions, which are activities that other doctors might delegate to nurses. I believe his clients appreciate the time he takes speaking to them, which is one of the reasons they trust Dr. Ganchi to make them look the best they can.  Everyone in the office was friendly and welcoming, and I really enjoyed my experience today.  I not only learned a lot about plastic surgery, but also the business side to medicine. I am extremely excited about “Surgery Day” tomorrow!

Tuesday, 1/24/2012

When I entered the office today, Dr. Ganchi had not arrived yet.  I was extremely eager for today because it was “Surgery Day,” which meant I got to watch Dr. Ganchi operate on his patients.  Karen and Michelle gave me scrubs, a hairnet, and a mask to prepare me for the operating room.  Today, I saw two brothers who had gynecomastia to have their mammary glands removed.  I met Dr. Lee, the anesthesiologist, who showed me what medications he was using to put the patients under.  Dr. Ganchi explained each step of the procedure – first, he wiped the body with betadine to sterilize the body.  Next, he made a small incision, and then proceeded to conduct liposuction to remove the fat around the mammary gland.  Then, with great dexterity, he removed the mammary gland using small tools.  Afterwards, he removed the remaining fat.  Finally he put in dissolvable stitches in the areola so the scar would heal smoothly.  This procedure was fascinating. I asked Dr. Ganchi if this was similar to breast reduction surgeries, and he taught me that they were not exactly similar since breast surgeries were usually accompanied by an additional breast lift procedure.  Dr. Lee also showed me that it was important to not only be able to work with the machines monitoring the patients’ breathing and heart rate, but to also look at the patient and be able to predict and respond to the changes before the machines reported it.  Another surgery I was able to observe today was an ear tuck procedure.  Dr. Ganchi made a small incision and put in small stitches in order to tighten up the skin below the ear, giving the client a more youthful appearance.  After the surgeries, Dr. Ganchi showed me pictures of past surgeries he performed. Like the procedures he had done earlier, he explained how he helped the patient.  Through his explanations, I gained a sense of what it’s like for a plastic surgeon to work with surgeons of other specialties and the importance of collaboration.

Priscella and Dr. Ganchi

Overall, I really enjoyed my experience at Ganchi Plastic Surgery.  I would highly recommend this program- the days were well-organized and informative, and Dr. Ganchi and his staff were extremely willing to answer all my questions and show me around the office.  I most appreciated the interactive aspect of this Princeternship: I learned a lot about plastic surgery and operations simply by observing them and asking questions.  I would like to thank the Princeternship program and Dr. Ganchi for giving me this wonderful opportunity!