Dr Marcus Wagstaff knows what comes to mind when people hear the term Plastic Surgeon. He’s keen to point out, however, that the job isn’t exactly how it comes across in the movies.
“The most common form of surgery I do is skin cancer surgery – cutting out the cancer and reconstructing the defect to provide the best cosmetic result,” he says.
Marcus does also provide a specialist service in breast surgery, including breast augmentations and breast reductions, and finds this area of surgery particularly rewarding because of the dramatic positive effect it can have on people’s lives.
“Women present with G cup breasts – they have 5kg on their chest pulling their head and neck down, causing a lot of back pain. The burden is relentless, there’s no escaping it, and it doesn’t get better with age.
“If you take 3kg off them and provide an aesthetically pleasing result, you’ve transformed their lives, it improves their function and confidence, they can exercise, it makes a radical difference to their wellbeing.
“I also perform all techniques in breast reconstruction, from implant insertion to transfer of tissue from the back or abdomen. When someone goes through breast cancer, either lumpectomy or mastectomy, and they decide they want a breast reconstruction… when you can rebuild their breast and help restore their confidence, that can be a great feeling.
“And I do a lot of hand surgery… plastic surgeons are trained and confident in operating around the complexity of the bones and tissues of the hand, including bone, nerve and tendon repair after injury, or for established problems such as carpal tunnel syndrome, Dupuytren’s disease or osteoarthritis.”
Marcus also see patients for body contouring who have lost a significant amount of weight after a period of obesity and have excessive skin as a result.
“Removal of excess skin and body contouring is a very fulfilling practice… it rewards patients with a positive functional and aesthetic outcome following the demanding weight loss process.”
In addition to the private patients Marcus sees at North Eastern, he’s also a consultant plastic surgeon at the Royal Adelaide Hospital, where the scope of surgeries he carries out is wide-ranging. Marcus does a lot of microvascular surgery after cancer is removed with large areas such as the jaw or tongue, which then need to be rebuilt. That involves taking tissue and blood vessels from somewhere else and re-attaching them under a microscope.
They day before this interview, Marcus completed a 12-hour jaw reconstruction surgery, in which he took bone from the patient’s leg and used it to fashion a new, living, jawbone.
These marathon surgeries can be tough, however Marcus says it helps to mentally break the operation down into stages, and allow each member of the team to take breaks.
“Preparation is also important… I go through every operation in my head the day before, and read up on anything I feel I should. Regular practice and experience have also reduced any fear factor.”
Marcus says there are tough parts to every operation, with each one presenting different challenges, and when they occur the best thing to do is slow down.
“I tell people that operating is like driving to Melbourne – you can take the freeway or the country roads, the destination is the same, however if you end up on the country roads you have to slow down and take your time.”
“There are also emotional challenges. You get to know some patients over a number of operations and you become emotionally invested in the outcome. They keep you up at night, particularly if the patient has had a tough time or a really aggressive cancer.”
Marcus recommends that all patients considering surgery should consult their GPs first. “GPs are a part of the surgical team before and after the operation. If they feel a surgical opinion is indicated, they will recommend an appropriate surgeon with the particular skills to meet the patients’ needs, and will provide vital support during the recovery process.”
Marcus warns against the temptations of plastic surgery tourism, where surgeons are sought out abroad to carry out low-cost procedures.
“Surgery is a serious endeavour. Although it may seem cheaper on paper, one cannot know the experience of the surgeon operating and once the patient flies home the surgeon has no responsibility to their continued care. I have had to treat many complications and revise many procedures badly performed abroad over the years”.
He also recommends that patients only seek surgery from fully trained and qualified surgeons, namely those that are fellows of a Royal College.
“They have had their training validated and their competence assessed over many years and continue to be governed by their own professional body.”
Marcus is the only plastic surgeon that operates at North Eastern. As a resident of the Eastern Suburbs, he was drawn to the hospital because of its strong roots in the community.
“GPs are proud of North Eastern Community Hospital. Patients are fiercely proud of it… they ask to go there… It’s part of their community and their culture.
“I operate on people that tell me they had their children at North Eastern, or their mother or father is a resident in the nursing home, and I really enjoy that. The staff are skilled and caring… it’s a hospital that deserves people who work to a very high standard.”