With over 5,000 cosmetic surgical procedures under his belt, meet Dr. Malcolm Paul, the plastic surgeon of plastic surgeons.
Early Days And Today
My undergraduate degree was a Bachelor of Science in Psychology. The importance of body image, self-esteem, and their influence on success is a natural marriage with the practice of cosmetic surgery, which consequently has major influence on body image. The most satisfying part of my job is seeing the sense of inward tranquillity and outward confidence that is the result of cosmetic surgery of the face, breast and body contouring. I never regretted my decision to become a plastic surgeon. Every patient has a different anatomy and surgical needs and every day is different and challenging.
Secondary or revisionary surgery is very demanding. It is important to understand what correction is desired by the patient and what can be expected as a result of secondary surgery. An important, in-depth review of the patient’s history and a thorough physical examination limited to the areas of concern allows me to develop a treatment plan that is realistically designed to provide a pleasing result with an infrequent need for further revisions. However, some patients require more than one revisionary procedure to obtain a pleasing result and they have to be informed of this during the first consultation.
Plastic Surgery Innovations
Procedures performed 40 years ago were based on concepts that have changed and, therefore, the procedures have been changed to provide a harmonious rejuvenation. Techniques in cosmetic surgery have markedly improved nowadays. Less invasive procedures with more predictable results have evolved. Being able to safely perform procedures under local anaesthesia with oral sedation provides a safe alternative to general anaesthesia, which many patients want to avoid. We are paying attention to the factors that contribute to ageing of the face including the loss of facial fat and sagging of tissues. Therefore, correction of the ageing face and neck includes adding volume where needed as well as repositioning sagging tissues. We also are now aware of the ageing changes in the face and neck skin, which has provided many options for improvement including lasers, chemical peels and injectables.
All About Procedures
I find that surgical procedures on the face and neck are the most difficult to perform, particularly recreating a youthful profile by addressing all of the elements of the ageing face and neck. The difficulty relates to the complex anatomy of the face and neck and the architectural and geometric configurations that demand an in-depth knowledge to be able to deliver natural results. I find the central part of the face, the lower lid/cheek junction, and the neck to be the most interesting areas to work on because every patient has a different complex anatomy and, therefore, they have different requirements to achieve a harmonious result.
I am most proud of the years that I spent learning, teaching and publishing, as well as being involved at the leadership level in my local, state and national plastic surgery societies. Giving back to my profession and developing state of the art procedures has been most rewarding.
The most satisfying part of my job is seeing the sense of inward tranquillity and outward confidence that is the result of cosmetic surgery of the face, breast and body contouring.
– Dr. Malcolm Paul
The Patient’s Surgeon
I feel very strongly that our best work should go unnoticed. I always tell my patients, if you have to change your hairstyle to cover up the incisions, the incisions were not placed artistically. So, care must be taken when deciding where to place the incisions. In addition, the direction of rotation of the skin of the neck and of the face has to be planned to avoid a stretched or pulled look.
In older patients who have many skin wrinkles on their cheeks, the direction of pull is even more important to avoid producing traction lines that are objected to by the patient as well as their family and their friends. I frequently see patients that have had too many procedures performed and they get to the point where reversing the post-surgical unnatural appearance is difficult and often impossible.
Many people are choosing to have facial plastic surgery to look younger and more attractive and nowadays brow and fat pad repositioning, removing redundant eyelid skin, lifting the jawline and correcting a sagging neck are very popular procedures. However, many patients want less invasive procedures like laser resurfacing, injecting facial fillers, Botox, and chemical peels. These procedures are very popular because they allow for a more rapid recovery with faster return to work and social obligations.
Self-esteem is often improved with cosmetic surgical procedures, but it is not a cure for personality disorders, chronic depression, and an abnormal/excessive focus on minimal anatomical variations. To the extent that psychological problems can be directly related to face, breast, and/or body contour deformities. Psychological improvement can be usually obtained with successfully performed cosmetic surgical procedures. Patients are most happy when they look in the mirror and see a younger, natural appearing version of themselves. They do not want to look different. Rather, they want to look refreshed and vibrant.
I am known as an educator to other plastic surgeons and the advice I give my students so that they can become outstanding surgeons is to learn the anatomy, listen to what the patient wants, perform a careful physical examination, do not operate on everyone that you see, promise less and deliver more, contribute to the literature, do not take on difficult cases nor perform complex procedures when you are starting your practice, and give back to society because if you give more than you get, you will get more than you give.
Secondary or revisionary surgery is very demanding. It is important to understand what correction is desired by the patient and what can be expected as a result of secondary surgery.
– Dr. Malcolm Paul
Plastic Surgery As A Vocation
One must have an interest in body image, be willing to blend art as well as science, be interested in anatomy and restoring anatomy to a normal state, be willing to dedicate your life to learning, and be willing to change what you do and how you do it when the literature supports a different approach than that which you were taught in residency training at medical school.
Cosmetic surgeons come from many different backgrounds. My belief is that the best cosmetic surgeons have been trained in plastic surgery or in facial plastic surgery. Many surgeons who are Board Certified in plastic surgery or in otolaryngology/head and neck surgery have obtained additional fellowship training in cosmetic surgery of the face and neck. Many surgeons have also obtained fellowship training in cosmetic surgery of the breast, as well as the procedure of body contouring.
I find that surgical procedures on the face and neck are the most difficult to perform, particularly recreating a youthful profile by addressing all of the elements of the ageing face and neck.
– Dr. Malcolm Paul
Dr. Malcolm Paul will be seeing patients at La Vie Clinic in Dubai from January 12-19, 2018.