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MUSC facial plastic surgery restoring patients' confidence by Heather Woolwine Public Relations Adam Ross, M.D., doesn’t spend his days working on just anything deserving a little nip or tuck.   Indeed, Ross is a member of the Otolaryngology and Head and Neck Surgery department at MUSC and the director of Facial Plastic and Reconstructive Surgery, meaning that the surgery he performs is confined to the head and neck.   That’s another thing—instead of seeing reconstructive plastic surgery and cosmetic surgery as two distinct types, Ross dubs it all cosmetic surgery.   A patient's ear after a basal cell carcinoma removal. Right photo: The same ear after surgery.  “Don’t misunderstand me, there are some very different reasons associated with various procedures and how patients come to needing those procedures,” he said. “But the ultimate goal is one and the same and that is to alter or restore someone’s appearance so that he or she feels more confident. Both kinds of patients are worried about the way they look and how that makes them feel is part of who they are.”   By becoming skilled in what is traditionally called cosmetic surgery and reconstructive surgery, Ross believes he is a better facial plastic surgeon. “Traditional cosmetic surgery like facelifts or cheek implants are very straight forward and easy to perform and applying those skills with the creativity needed for reconstructive surgeries makes a surgeon a good plastic surgeon,” he said. “I believe you must practice both to become excellent.”   Through his position in the otolaryngology department, Ross collaborates often with specialists from many areas, including experts in his own department, dermatologists, pediatricians, and various cancer-related sub-specialists.   “One of the reasons that I came to MUSC in the first place was it was apparent how well members of my department worked together and how the department collaborates with other entities. It’s unusual to find an institution where the departments are not competitive with one another,” Ross said. “It just proves that everyone is here to provide the best services for our patients.”   A love of medicine runs in Ross’ family and he “tried to pursue other avenues first, but I always knew that I would end up in the field,” he joked.   A graduate of Johns Hopkins University School of Medicine, Ross carefully chose his residency and fellowship to reflect his desire to work in an academic medical institution and not only learn, but learn to teach others as well. “Most plastic surgeons will learn to operate on the entire body and not dedicate any more time on one particular area versus another,” he said. “I was fascinated with the face/head/neck region because of its complexity and the number of structures confined to one area of the body. I liked the thought of having a real influence on a patient’s quality of life because I worked where all the senses are affected.”   At left Dr. Ross' patient prior to cleft palate reconstructive surgery. At right after her procedure.  Ross began in general otolaryngology but a fellowship with two renowned facial plastic surgeons slightly changed his course. Wanting to build a practice on reconstructive and traditional cosmetic surgery, Ross found himself at MUSC where there has been some difficulty in acquiring and retaining a successful facial plastic surgery practice. What separates Ross from the rest of the pack is his commitment to remain balanced within his new practice in Mount Pleasant concerning the demands of reconstructive and cosmetic surgery.   Self-described as meticulous to a fault and very detail-oriented, Ross’ reconstructive work involves cancer-related issues, congenital defects, facial trauma, nasal/orbital/mandible fractures, and cleft palates on patients ranging in age from a few months to senior status. His cosmetic work includes his forte’, rhinoplasties, and brow lifts, blepho-plasties, facelifts, cheek implants, neck lifts, chin augmentation, dermabrasions, chemical peels, injectible fillers, Botox, and other aging process repairs.    “I use traditional techniques that are long lasting and safe for patients,” he said. “I use meticulous dissection to avoid bleeding and bruising so that my patients can be back within the public eye in a couple of weeks. Spending extra time during the procedure saves days of recovery time for patients.”   Ross also has research interests involving tissue engineering, more specifically engineering tissue that looks and feels normal, as often times reconstructing tissue is a trade-off because looking normal may not mean feeling normal and vice versa.  “I’m interested in growing cells to replace tissue or bone that must be removed and other novel ways at improving reconstructive and cosmetic surgery.”   Ross’ Mount Pleasant practice will open in August and he and his staff celebrated with an open house for MUSC faculty and staff July 14 to thank them for their support. A patient appreciation event will be on Aug. 18. Monthly seminars beginning in September will explain and discuss pertinent topics related to facial plastic surgery.   Left: A patient of Dr. Ross' preoperation. Right: The patient after a rhinoplasty procedure.  Dedicated to patient safety, Ross is happy that he is able to practice in two hospital settings, one downtown at MUSC and the other at East Cooper Hospital. “Working in a hospital setting means that if a complication occurs, the staff needed to handle it is available immediately,” he said. “I like to see all of my new patients at the new office in Mount Pleasant and am excited about this new area because it’s designed for privacy, convenience, and comfort.”   Ross encourages his patients to seek second opinions and is passionate about making sure that he and his patients see the same view when it comes to expectations.   “I want my patients to make educated decisions and then to be satisfied with what decision they’ve made,” Ross said. “If a patient is comfortable with the path that they’re taking, comfortable with me, and has realistic expectations about what surgery will do for them, then you can’t ask much more than that. The whole process is as much art as it is science because you have to take an individual’s needs and desires and match it with surgical capabilities to positively affect a person’s life. I have a responsibility to deliver a realistic assessment of what I can help them with and the best way to do that is to listen to what they want. How can you understand a person’s motivations and expectations by only spending 15 minutes with them? Plastic surgery is much more affordable now so I don’t feel like I need to sell the surgery to those who come to see me. Instead, I feel like it has to be a mutual decision between myself and the patient that surgery would be the best way to proceed. The challenge will always be finding the option that best fits each patient, because it’s not a minor decision, whether it’s cosmetic or reconstructive.”   For more information about Ross’ practice, call 792-6900.     Friday, July 22, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.