Plastics

This person is required to cover all University Plastics Clinics.

The current approximate schedule is:
Monday: AM Chong / PM Domeshek (1st Monday of the Month)
Tuesday: AM French / PM Gordon (1st & 3rd Tuesday of the Month), PM Cohen (2nd & 4th Tuesday of the Month)
Wednesday: AM Iorio / PM Kaoutzanis (All but 1st Wednesday of the Month)
Thursday: None. Thank god.
Friday: AM Mathes, AM Kaoutzanis / PM none

All attendings prefer you wear a white coat

Chong - Okay for scrubs
Cohen - Okay for scrubs
Domeshek - Okay for scrubs
French - Prefers clinic clothes, Clinic clothes required for cosmetic clinic with white coat
Gordon - Better to wear dress clothes. He will wear scrubs if coming from a case.
Iorio - Scrubs
Kaoutzanis - Scrubs
Mathes - Clinic clothes with white coat.

Chong - Has Morgan (PA) with him for Monday clinic so workload is not so bad. Mostly breast reconstruction patients. Know the basewidth. Likes to ask “How do I do this operation?” and “Why do I do it this way?”, so it is a good idea to look over some of those operative reports. Sometimes gets lymphedema patients. He likes them to be optimized and to have undergone physical therapy first. Get mid-humeral and wrist circumferences to compare. Remember about infections. His first go to surgery is lymphovenous bypass. Keloids are also referred. He likes to excise and then do 4-6 weeks of 5FU. He will first need to do a test does in the office. He takes all the keloid excisions to the operating room. (Of note, for the ear keloids he will do 5FU and forgo the pressure earing. He says you can't do both). The 5FU injection is very painful. (But so is the steroid injection.) Doesn't do lidocaine because that is just an extra injection.

Cohen - Lots of breast recon. Has template notes for postop and TE postop/fill that are nice to use. Will quiz you about billing. Remember the global period is 91 days including the day before surgery.

Domeshek - Some very interesting facial paralysis cases come into her clinic. Bell's palsy and strokes. A good facial nerve exam is very important. She tends to send all the patients for evaluation with Syd Martin who is the Facial Paralysis Occupational Therapist in town. This needs to be done before she will give the patient botox or consider surgery. Remember about synkinesis and symptoms like gustatory sweating. These patients also tend to get EMG/NCS and the basics she will ask you about.

French - the PRS clinic will be transgender patients for facial feminization and top surgery. Also the normal breast reduction and panniculectomy. The cosmo clinic will have rhinos, mommy makeovers and sometimes non-invasive procedures

Gordon - Breast reductions and panniculectomy. Does inferior pedicle. (Although he has done SM in the past and will tell you why he doesn't like it)

Iorio - Flaps and a very busy clinic. Okay for short and sweet notes. Has Amanda in clinic with him on Wednesday mornings and then for his wound clinic on Wednesday afternoon, she is there as well.

Kaoutzanis - Breast reconstruction and transgender surgery. Has note templates for EVERYTHING. Use his note templates. He likes his notes perfect. Put the subjective in the subjective and the assessment in the assessment. No PA currently with him during his clinic but he is looking for one full time. His transgender bottom surgery clinic is once a month. He basically uses his template on his phalloplasty and vaginoplasty notes. Questions include the therapist and horomone provider notes. Social support and sexual preferences. As well as a list of requirements to submit to insurance before surgery. I basically just followed him around and was his scribe for this day.

Mathes - Breast recon similar to Dr. Chong. Make sure you ask all the breast questions. What cup size are your breasts now? What is your ideal size? What don't you like about your breasts? What size implants do you have? Do you have the implant cards? Are they pre-pectoral or sub-pectoral? What previous surgery? ie. cancer recon, augmentation, aug-pexy, mastopexy, etc… Make sure you do the measurements. Sternal notch to nipple. Nipple to IMF. Etc. Remember if >38 cm SN-N you have to consider free nipple grafting for breast reduction.