Dr. Morse, you are a highly regarded plastic and reconstructive surgeon. How did you choose the specialized areas of medicine you’ve been practicing for the past 15 years?
Reconstructive surgery and particularly hand and upper extremity surgery require an exceptional knowledge of anatomy and physiology, as well as meticulous attention to detail. I wanted to understand the intricacies of anatomy and physiology in order to attain excellent and optimal surgical results with even the most complicated cases. Advances in medicine that allowed highly trained surgeons to reattach digits and limbs and to perform organ transplants with unprecedented success particularly fascinated me. These procedures are life changing and, in some cases, life saving. To perform them well requires an in-depth knowledge of not only plastic and reconstructive surgical techniques, but also the principles of general surgery, orthopedic surgery, pediatric surgery, and neurosurgery. I wanted to be involved in this type of complex medical practice, and knew it would suit me well.
When you think back upon your training, what made the biggest impression on you? Who inspired you?
I was inspired to build a career in Medicine by my family pediatrician, and to specialize in Surgery by the late Dr. David Sabiston, Dr. Howard Filston, and Dr. Arthur Ross, III, at the Duke University School of Medicine, by the late Dr. M. Judah Folkman and by Dr. Joseph P. Vacanti at the Harvard Children’s Hospital. These individuals taught me the importance of constant questioning and the quest for better answers, and their dedication to patients gave me an understanding of what’s required to provide an impeccable standard of care that is required to achieve optimal results. I was also inspired to build a specialty in Plastic and Reconstructive Surgery by Dr. David Billmire at the University of Cincinnati and my subspecialty career in Hand and Upper Extremity Surgery, by Drs. James H. Herndon and Dean Sotereanos at the University of Pittsburgh’s Department of Orthopedic Surgery.
Describe the geographic region in which you practice, the types of patients who seek your care, and your office setting.
My practice is located in suburban northern Virginia, in close proximity to the major metropolitan area of Washington, D.C., which encompasses a population of approximately 5 million people. Our patients come from all educational and socioeconomic levels and are multicultural, multinational in origin. I treat patients of all ages, from newborn to centenarian. The variety of my practice accommodates the treatment of those seeking general plastic and reconstructive surgery, hand and upper extremity, and cosmetic surgery of the head and neck. We have several exam rooms specifically designed for our hand surgery, reconstructive surgery, and cosmetic patients; and, an in-office procedure and operating room for minor surgeries. Patients appreciate the fact that the office is small and quiet.
Please describe the types of surgical procedures you perform in your practice.
For general plastic and reconstructive surgery, skin and soft tissue tumors, burn and other head and neck, torso, and extremity trauma, and wound care;
For hand and upper extremity surgery, carpal tunnel surgery and other peripheral nerve issues, Dupuytren’s contracture, trigger digits, congenital birth defects, and traumatic injuries involving wrist and hand fracture, nerve, tendon, ligament, joint, and nerve repair including revascularization and replantation;
For cosmetic surgery, facial and neck rejuvenation including skin care, acne, rosacea, Botox®, Latisse®, fillers and fat injections, cheek and chin implants, peels and microdermabrasion, laser treatment, and brow lifts, facelifts, eyelid lifts, neck lifts, rhinoplasty (nose reshaping), and brachioplasty (arm lifts), and
For children, acne, otoplasty (protruding and other congenital ear deformities), rhinoplasty, hemangiomas (red spots), hairy nevi (brown spots), and Gynecomastia (enlarged breasts in teenage boys).
What types of non-surgical treatments/procedures are offered by your practice?
The non-surgical treatments most requested by patients are skin care, Botox®, Latisse®, fillers, and laser treatments. And, unlike most plastic surgery practices, I personally perform all of these procedures myself. I want to make sure my patients receive the best possible care. Though fillers and laser treatments are defined as non-surgical, the outcomes are highly dependent upon the expertise of the practitioner. It’s a choice we made and our patients appreciate it.
Dr. Morse, how do you define physical beauty and what is your philosophy of patient care?
Our philosophy and practice mission is to provide the highest quality non-surgical and surgical plastic and reconstructive health care to children and adults in a professional and pleasant environment. My definition of physical beauty is unimportant; it is the patient’s perceptions of themselves and their goals and expectations that matter. In terms of cosmetic surgery, a natural result is a subtle result. It’s better to do too little than too much.
Is there an optimal age for seeking a plastic/cosmetic surgery procedure? How old is too old?
Essentially, there isn’t a defined optimal age, nor is there an age that makes a person too old for plastic surgery. The patient’s underlying physical state and associated social (e.g., tobacco use) and medical (e.g., diabetes) history are more important. There is a definite increase in the number of older individuals requesting head and neck procedures, in part because the population in general is healthier at later stages of life than they used to be.
The average age of patients requesting facial rejuvenation - where a facelift is recommended, for instance - is between 40 and 60. However, the younger the appropriate patient undergoes the appropriate procedure, the longer the effect will last. Likewise, for those seeking a body procedure, age isn’t the primary issue; what’s important is that the most appropriate procedure is selected for the individual patient, taking age into consideration. There are different procedures appropriate for different age groups.
Can you postpone major surgery (such as a facelift) by having non-surgical procedures when you’re younger?
In the short term, and for the younger patient in her or his teens to early thirties, yes, But it’s important to understand that it is not always an either/or situation and that, in general, non-surgical treatments are an adjunct to surgery, not an alternative.
Which non-surgical procedures yield the most impact/positive results?
Skin care (using pharmaceutical-grade products) chemical peels, Botox®, Latisse®, Microdermabrasion, Fillers, and Laser treatments.
What should a consultation patient expect when coming to your office for the first time?
First of all, that I will be doing the consultation personally. During that time, I want to understand how my patient defines herself (or himself.) This includes how they see themselves, what concerns they have about their appearance, and what their goals are in that regard. I listen carefully to my patient, in order to ascertain both what’s desired and whether their goals are realistic. It is imperative that my patients have specific goals and reasonable expectations; and in enumerating these, to make sure they are emotionally stable and physically healthy. I want each patient to undergo the proposed treatments safely and comfortably.
My goals are to develop an appropriate treatment plan and to make sure each patient’s concerns and questions are addressed. Patients are understandably interested in potential complications from anesthesia and they want to know when they can return to work and/or to their regular activities. I always discuss these issues during the consultation, and my patients are relieved to learn that anesthesia is safe! A good deal of thought goes into a good treatment plan, and I consider all possible options before devising a plan that I feel is best.
Excellent surgical skills are important, and paying attention to details at all times – no short cuts – enables me to achieve optimal results for my patient. But I also want them to learn about the healing process, and about the importance of following all recommendations for post-surgical self-care. They will have a speedier recovery with a better outcome if they lead a healthier life, eating and exercising and taking good care of themselves – not only after surgery, but throughout their lives, as well.
What’s your view regarding surgeons from a wide range of specialties performing cosmetic surgery? Are their risks for patients who don’t select a Board Certified Plastic Surgeon?
I believe there should be “truth in advertising,” i.e., if an individual feels comfortable and is trained to do a procedure or if trained, a surgery, he or she should be able to do so. However, there should be better policing of an individual’s credentials and how that person is able to advertise his qualifications to the public. For example, it is okay for an ENT or an oral surgeon to do a facelift because he or she is trained (and may have more experience) than a Board Certified plastic surgeon, but they should be required to advertise that they are Board Certified in otolaryngology (ENT) or oral surgery – not in plastic surgery – because they are trained in their specialties and are, in fact, not Board Certified as plastic surgeons. Similarly, although a dermatologist can do body liposuction, they should not be allowed to have an advertisement claiming to be a “Board Certified Plastic Surgeon” and doing body liposuction when in fact they should have to say they are “Board Certified in Dermatology.”
Thank you, Dr. Morse.