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Plastic surgery’s pivotal role on a healthcare team

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When someone discovers a new mole or a lump, they are often unsure about what to do next. Should they call their primary care provider? Do they make an appointment with a dermatologist? Or should they go straight to an oncologist?

Healthcare providers can be specialists or generalists. Who should a patient turn to in their time of need? The answer is that it often takes a team of medical professionals with diverse specialties and skills.

Primary health care providers are the best place to go for non-emergency needs. But that mole might need a dermatologist’s trained eye, and that lump might need to be biopsied by a surgeon. Mount Nittany Health’s team members can help patients navigate their way from diagnosis to treatment and recovery.

Most teams are not surprising; for patients diagnosed with breast cancer, an oncologist and a radiologist work with a breast surgeon. However, an often-misunderstood specialty is plastic surgery. Often seen as an elective choice for procedures like tummy tucks and facelifts – reconstructive plastic surgery is critical to a patient’s health and well-being.

“The role of the plastic surgeon is considerable,” said Matthew Davidson, DO, General Surgery, Mount Nittany Health. “People who have lost a lot of weight might need a tummy tuck, or for breast issues, we might have to remove the entire breast or just part of it, and they need to know their reconstructive options.”

The American Society of Plastic Surgeons estimates that less than 20 percent of mastectomy patients had a reconstructive surgery plan at their mastectomy.

Patients have different bodies and expectations regarding mastectomy and reconstructive surgery. Knowing a patient’s goals while the tissue remains intact can inform the breast surgeon.

“Whether it’s a total removal or a lumpectomy, I can find out what a patient wants to achieve post-surgery and work toward that goal,” said Emily Peterson, MD, Plastic and Reconstructive Surgeon, Mount Nittany Health. “For some, it’s body contour. Breast reconstruction makes their clothes fit better since some patients might not want to fuss with a prosthesis in their bathing suits. Everyone is different.”

Health insurance is legally required to cover reconstruction costs after breast cancer. At Mount Nittany Health, Davidson and Peterson collaborate before and after breast surgery to ensure the best patient outcome possible.

“I tell my colleagues not to hesitate to ask if they think they have a patient who is a good candidate for reconstructive surgery,” said Davidson. “Dr. Peterson and I are always happy to offer a consult and let them know.

Similarly, Matthew Hazey, MD, Dermatology, collaborates with Peterson to perform specific surgical procedures requiring the care of a plastic surgeon.

“If I need to excise a small cyst or a lesion that’s simple to stitch up in the office, I do that,” said Hazey. “There are a number of procedures that require a plastic surgeon’s techniques depending on their location and size. I don’t do a lot of surgeries on cosmetically sensitive areas like a patient’s face. I will ask Dr. Peterson, who is very helpful in removing things like lesions on someone’s face, to ensure that its removal minimizes scarring.”

The dermatologist’s office and the plastic surgeon’s suite overlap considerably. Many dermatologists offer cosmetic procedures like those done by Mount Nittany Health’s Reconstructive and Cosmetic Surgery practice. However, the two practices at Mount Nittany Health are separate, collaborative, and more beneficial to the patient.

“I specialize in the medical dermatology side of things,” said Hazey, who also trained in cosmetic procedures like chemical peels. “Dr. Peterson and the aestheticians in the cosmetic surgery group specialize in those cosmetic procedures that improve a patient’s appearance and self-esteem.”

As a board-certified plastic surgeon with twenty years of experience, Peterson and the Reconstructive and Cosmetic Surgery practice at Mount Nittany Health can treat a range of patient needs. From breast reconstruction to CoolSculpting®, the plastic surgery team cares for patients’ bodies, faces, and skin for aesthetic and medical conditions. However, Peterson’s medical work is not simply referrals from dermatology and breast surgery. Sometimes it’s a two-way street.

“It’s not uncommon to find an abdominal hernia in a patient receiving a tummy tuck,” said Peterson. “These are some of the things we find that need to be referred to the general surgeons.”

“We are often in the operating room (OR) at the same time,” said Davidson. “Dr. Peterson will remove the skin before I fix the hernia, and then I will let her finish her work.”

Not every patient is a candidate for plastic surgery, either. Patients who smoke, have high blood pressure, or diabetes might be unable to undergo some procedures.

“Before referring a patient with pre-existing conditions like diabetes, care providers should check with our office first to see if the condition precludes them from being treated,” said Dr. Peterson. “Sometimes patients come to us after long recoveries expecting a reconstructive treatment, only to find out that we can’t help them because they have certain medical conditions.”

Mount Nittany Health’s Reconstructive and Cosmetic Surgery practice is at 100 Radnor Road in State College. In addition to Peterson, Eileen Maney, PA-C, and Mallory Miller, PA-C, provide comprehensive reconstructive and cosmetic healthcare. Lashelle Kuhlman, a licensed aesthetician, provides aesthetic treatments in the office, like chemical peels, microneedling, microdermabrasion, waxing, makeup artistry, and other services.