What is it really like being a plastic surgeon?
When we wanted to interview a plastic surgeon for this career special, we headed straight for the best. Dr Martin Huang, is an accredited plastic surgeon with more than twenty five years of experience, practicing out of his clinic in Paragon. He is not just known for his work in aesthetic surgery, but is a specialist in the fields of cleft lip and palate surgery, craniomaxillofacial surgery and endoscopic plastic surgery.
Speaking to Dr Huang, we got a sense of the amount of intensive training and practice it takes to be a good plastic surgeon, the ethical issues involved in dealing with patients, and why the Singapore plastic surgery scene is sometimes perceived as not being as advanced as Korea. Find out what it takes to make a career in this highly competitive, but ultimately, rewarding field.
AUDIO EXCLUSIVE: Listen to our full conversation with Dr Martin Huang, of MH Plastic Surgery.
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What are the qualifications you need to be a plastic surgeon here?
Martin Huang (MH): First, you need to go through medical school and become a registered doctor. Then after doing a one year internship, you will then become a medical officer or resident. And during that time, you will need to apply for and secure a training position in plastic surgery — and that can take anywhere between one to three or four years. Once you get into a training programme, it's four years of training before you become a qualified plastic surgeon. For myself it was about 10 years.
For most of us, after we qualify as a plastic surgeon and complete our training in Singapore, we will go further (usually abroad) for one to two years, to gain more experience in our chosen sub-specialty. That means that in the whole field of plastic surgery, we will chose one particular area to specialise in, and go deep into that area.
What is you area of specialty?
MH: My area of specialisation is birth defects of the head and face, and surgery of the facial bones. That is known as craniomaxillofacial surgery and cleft lip and palate surgery. I spent two years in the US focusing on those areas. As you can tell from that description, this is all reconstructive work — it's not cosmetic surgery — and that really is the foundation for cosmetic and aesthetic surgery.
When you learn a lot about reconstructive surgery, you have to know the anatomy of those structures very well and you have to learn how to correct abnormalities in order to restore normality. And then the step beyond that is then working on the normal to make it more beautiful. That is the ideal way to step up to aesthetic surgery. In a way you could say that aesthetic surgery is an advanced stage of plastic surgery which you sort of graduate into after you have developed a strong foundation in reconstructive surgery.
What are the main differences between reconstructive and aesthetic surgery?
MH: When we do reconstructive surgery and we are correcting an abnormality, the margin for error is quite big. If someone has a severely deformed face, to try and bring them close to normal, you're usually starting from quite a bad position. You have a lot of margin for error — if you they are at 20 percent and you bring them to 80 percent... you've done a good job, and the patient will be very grateful and the magnitude of change will be very discernible. But when we do aesthetic surgery, it changes completely into a game of fine to no margins — in the sense that now we are dealing with people who are essentially normal and who are very particular about the way they look. And so the margin for error is a lot less.
And the patient is a lot more demanding and expectations are higher. In that sense we have to really step up the game. Every little detail counts and we have to become extremely meticulous and perfectionistic if we want to be the best.
What do you think of the plastic surgery scene in Singapore?
MH: This is a question that arises quite often. The plastic surgery scene in Singapore is quite advanced and quite vibrant. And like any other developed country in the world, the top percentage of plastic surgeons are very good, and then we have the average, and the not so good — this is true of any profession in any country.
Let's talk about Korea — the ten per cent of top plastic surgeons in Korea are probably very good, and then you have a big segment of average surgeons and then you have the not so good ones as well. One big difference between Korea and Singapore is just size and numbers. We have 60 to 70 plastic surgeons here and they have 2500 — it's partly a numbers game.
Another reason that Korean plastic surgery is so high-profile is because of the culture, mindset and support that the Korean plastic surgeons receive from their government. There is a very unified, government-supported drive to promote plastic and cosmetic surgery in Korea to the rest of the world. This does not exist in Singapore.
Furthermore, we have exceedingly strict regulations imposed by our health authorities in terms of how aggressively we can market ourselves, so we have to stay within these regulations. And this is why it is relatively low-key here — it's because of the framework of our society. It's not a big priority for our government. Whereas in Korea it is a big priority. For whatever reason, our health authorities and government don't feel that medical tourism is important, so we don't actually get that support, and you won't see much of us in the media.
Are there any clients that you have to say no to? Do you draw the line at any procedures?
MH: Absolutely — if occasions arise where the patient wants something that is unattainable or unacheivable, or the risk of trying to achieve it is too high. Or if we honestly feel that it will not enhance them, then it is our responsibility to tell them... and I do. And we will say no.
How about patients with body dysmorphia or psychological issues... what is your responsibility as a medical prefessional?
MH: When we think that we are dealing with such a patient, we have to be a lot more careful and sensitive. They need a lot of support and guidance as they may be going in the wrong direction in terms of what they want to change about themselves. We definitely need to manage them with sensitivity and we have to think a lot more for them. Quite often they have unrealistic expectations or they are overly obsessed with certain aspects which are not as important as they think. There is a fair bit of counselling involved that we sometimes have to do in order to manage these patients the right way.
Does a plastic surgeon's duty go beyond having merely an aesthetic sense and technical skills?
MH: Absolutely. The basis of going for aesthetic surgery is psychological. The reason for changing the way you look to enhance your appearance, or to reverse the affects of ageing, is to make yourself feel better.
Our work is all about making patients feel better about themselves. It is important to appeciate that in the way we manage our patients. You always have to approach it from that perspective. Plastic surgery is psychology with a knife.
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