Thursday, October 01, 2009

Making people wholesome once again

Plastic surgeon Dr. R. Jayakumar of Specialists Hospital enjoys correcting babies who are born with cleft lips or those who have lost their thumbs or injured their hands. He also makes people look beautiful

Photos: Laxmi before the operation

Laxmi 12 years later

Dr. R. Jayakumar

By Shevlin Sebastian

Twelve years ago, Laxmi (name changed) was waiting at a bus stop in Kottayam. Suddenly, the thirteen-year-old decided to cross the road. As she did so, an Ambassador car hit her. As it went over her, Laxmi’s hair got caught in the central shaft underneath the car.

The entire scalp below the eyebrow was pulled off. Thankfully, passers-by stopped the car and retrieved the scalp, which was in two pieces. Laxmi was then rushed to the Specialists’ hospital at Kochi, her head bleeding, along with the scalp.

In a ten-hour operation Dr. R. Jayakumar, head of the plastic, micro-vascular and cosmetic surgery department, and his colleague, Dr. Augustine Guild, first connected the blood vessels of one part of the scalp to another. “After that, we put the scalp back and connected all the blood vessels,” says Jayakumar.

Last month Laxmi, now a young woman, went to see Jayakumar. “Her hair has grown fully back,” says the plastic surgeon. “There is a thin scar just below the eyebrows. It is not instantly noticeable. Otherwise, she is fine. When I saw her I experienced a great happiness.”

Jayakumar has done more than 2000 operations in his career. His work is divided into reconstructive and cosmetic surgery. Reconstructive surgery occurs when there are physical defects. Like, if a baby is born with a cleft lip. Or, because of an accident, the blood flow to a particular limb is blocked. Or when a thumb gets cut off in an accident.

When a thumb is lost, a toe is transferred to the hand. In the West, the big toe is used. But in Asia, where people wear slippers and sandals, the second toe is used. When you remove it, the gap between the big toe and the other toes can be closed easily. “At first glance you will not notice the missing toe,” says Jayakumar.

This is a complicated operation, which involves micro-vascular surgery and lasts eight hours. “You need a high degree of skill to do this,” he says. Jayakumar has trained in the Chang Gung Memorial hospital at Taiwan, which is regarded as one of the best plastic surgery centres in the world.

Jayakumar loves the challenge of reconstructive surgery, although it is not lucrative, as compared to cosmetic surgery. Most of the patients are poor people who have lost their thumbs or injured their hands while working in a saw-mill or a factory. Usually, they do not have insurance. The factory rarely provides financial support.

“If you want to do this type of surgery in India, you have to accept the fact that the fees will be low,” he says. “But the professional satisfaction is enormous.”

But Jayakumar also admits he enjoys doing cosmetic surgery. In cosmetic surgery, the most common operations for women in Kerala are a rhinoplasty (nose job), face rejuvenation or a.tummy tuck.

Tummy tuck occurs because when women have children, the muscles get loose and the skin stretches out. “You have to tighten the muscles, remove the excessive fat, and shape it through a combination of liposuction and abdominoplasty,” says Jayakumar.

For men, the usual operation is for enlarged breasts. They also come for rhinoplasty, liposuction and facial rejuvenation.

“As you get older, people tend to say, ‘You look tired? Are you unwell?’” says Jayakumar. “This is because you have developed bags under your eyes, there is a double chin, and the jawline has become lax. You tend to look fatigued all the time. In today’s workplace, dominated by young people, this can be a setback.”

The older procedure was to pull the skin back firmly. Now plastic surgeons tighten the muscles inside the face. “This is a much better procedure because it gives off a natural look,” he says. “That is why it is called a facial rejuvenation, rather than a face-lift.”

Incidentally, 60 per cent of Jayakumar’s clients are males. “For cosmetic surgery, Kerala is perhaps the only place in the world where the men outnumber the women,” he says. The average age for patients is between the late twenties and forties.

So, as people opt for plastic surgery in large numbers, is there a risk involved in undergoing such operations? “Things can go wrong, but it is rare,” he says. “We do a thorough check-up of the patient before surgery is done.”

In Specialists, the team of six plastic surgeons has a success rate of 98 per cent for micro-vascular surgery. “Most plastic surgeries are far safer than travelling on the streets of Kochi,” says Jayakumar.

(The New Indian Express, Kochi)


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