December 30, 2015 117
Q: Hello Dr. Ananda, thank you very much for agreeing to talk to us. Let us start from the beginning, why did you choose to go into medical industry?
A: I come from a medical background, my father was a doctor. He was my inspiration to become a doctor. Basically I was fascinated by the way medicine could cure the pain and suffering of patients – after a doctor gave the patient medicines, it was marvellous to see how after few days or weeks they come back feeling well - this feeling of curing somebody is quite satisfying and interesting. It gives me a good feeling and positive vibe, that this profession has the ability to cure people’s illnesses and bring smile onto their faces, and that’s why I got interested in the medical field.
Q: So your career started since you were very young.
A: Yes, my father was a General Practitioner, and he owned a clinic, so I did help out in the clinic with things like registration. I took a liking for the way a patient gets cured, and you have the ability to cure people. That gives me a lot of satisfaction.
Q: What do you think is important in a doctor-patient relationship?
A: Communication is very important; I give my phone number to my patients and ask them to call me if there is anything. It has to be nothing in between and straightforward. Miscommunication can arise if message is passed via a third person and the message might not be delivered as intended. This can lead to a lot of problems.
Q: Why did you choose surgical path?
A: During my 4th or 5th year as medical student, I developed an interest for the surgical field. It was really fascinating when I walked into the operation room (OR), seeing the surgery being done. With fingers, hands, and eyes, a plastic surgeon can coordinate, repair things, remove cancer or reconstruct things. I was in general surgery for many years. When I was working as a Medical Officer, I got about 6 – 7 months plastic surgery exposure. That was when I thought plastic surgery is something very unique as it has a lot of variety, where you don’t have any boundaries on human body. We are able to “repair” any part of the body - from head to toe. For example, we are able to do hair transplant for hair loss. It is quite an interesting field because you may work on hair today, stomach or hands the next day. It is really my passion doing plastic surgery, that’s how I enjoy and appreciate doing my work.
Q: Can you share with us some cases you have worked on, that gave you satisfaction that you are in the right profession?
A: When I was a medical officer, there was a child who was born with congenital cleft lip. The consultant plastic surgeon did the surgery for the child. Seeing the faces of family members before and after the surgery, the happiness and satisfaction on their faces is priceless, something money cannot buy. I can imagine when the mother saw the child being born with deformity, it must have been devastating and depressing, after the surgery, they felt that the child is back to normal. Small episodes like these keep me motivated to carry on in this journey. We really appreciate all these little things.
Q: What is plastic surgery?
A: Plastic surgery is not all about cosmetic. Plastic surgery consists of reconstructive surgery and cosmetic surgery. Reconstructive surgery is more rewarding to surgeon, it is very broad. You may operate on deformity due to birth defect or accident or cancer.
Q: You believe that breast reconstructive surgery should be given high priority for those undergoing mastectomy, why?
A: In my ideology, I feel that every woman who had mastectomy (surgical removal of breast) should have gone through breast reconstructive surgery. It is possible for women to have both mastectomy and breast reconstructive surgeries at one go, provided it is not a late stage. I have myself seen how much of an impact this reconstructive surgery can have on a woman’s life. For a woman, the breast is a very important part of her body; it creates such a big impact on her self-esteem. And it will impact her, her family’s and her husband’s emotion as well. I had a patient who had mastectomy in year 1998, but she has been depressed ever since. Although in her fifties, she still came all the way from Cheras for surgery. After the surgery, she has been so happy and cheerful. This really shows that you can’t function if you have lost self-confidence or self-esteem. If you want something, you need to get it done, no matter what the age. Reconstructive surgery is straightforward, and it does bring about change in people’s life.
Q: You are one of the very few plastic surgeons in Malaysia to have completed a one year fellowship programme in Burns, Laser and Aesthetic Surgery; can you tell us more about it?
A: I received special training for burns when I was in Taiwan for a year. In Malaysia not many people are highly trained for major burns treatment because of infrastructure, also there is lack of teamwork. You need to work as a team to get the patient’s life back to normal. Very few centres and very few people in Malaysia were trained to handle major burn. You need a team of doctors, paramedics, nurses, psychiatrists, pathologists. And all the team members have to be focussed to get successful outcome, it is not a one-man show. If a patient is successfully discharged alive, it’s because of team effort. It is unfortunately not so easy to get that kind of a team that is in sync with each other.
Q: Are burn cases one of the toughest that you have had to handle?
A: It is very difficult to say, everything is challenging. You can have minor or major burns, you can’t say it is the most challenging task. When I am treating someone with major burns, I find myself unable to sleep for few days or weeks, because my mind will be occupied. As patient’s status can turn critical anytime, we need to act fast. You need to plan, strategize and have the mind set to organize everything for a burn case. Burn patients will normally stay in hospital for 1 – 2 months because of the complications. But seeing them going back to normal life, like children continue schooling, which is something rewarding.
Q: What has been your biggest challenge in your career so far?
A: I’m still looking for more challenges. (Laughing) Working in private practice is quite challenging because I was in government service for more than 18 years including my housemanship. I have been in private practice for only about 4 years now. The difference between private and government practice is that I had a team to work with in government practice, but in private, you have to do everything yourself from A to Z.
Q: How did you overcome it?
A: I had fear, but I guess as long as you have the passion to work for something in your life, you can do it. Believe in yourself, have self-confidence, you have the skills, knowledge and passion; stick to ethics, patients will come to you naturally.
Q: How did people perceive plastic surgery today as compared to the old days?
A: Patients are still very conservative nowadays in Malaysia. When I was in Taiwan, awareness among patients was very good. They know what can be done safely. The main problem we are facing right now in Malaysia is patients feel that plastic surgery is not safe. They have fear.
Q: What advice or message would you like to tell your patients?
A: Every surgery has risks; but it doesn’t mean that plastic surgery has higher risk compared to other surgeries. The message I would like to send to public is that, it is important to choose the right person who is qualified to perform the surgery. Nowadays people are getting more open-minded to cosmetic surgery, but at the same time, a lot people are jumping on the bandwagon, so ultimately patients can get confused who is the qualified practitioner and who is not. Some beauty salons get doctors flying in from China to do the procedures. But this is wrong. Firstly it might be done by a person who is not qualified. Secondly this procedure must be done in proper setting, i.e. hospital. Some people lost their life during the procedure; hence some patients are worried when news like this published in the media. It has created a ripple of fear to the public, but they didn’t know that it was not done correctly from the very beginning.
Q: What should a patient do before going to a plastic surgery?
A: Firstly, knowing your surgeon, knowing who is doing the surgery, all procedures should be done by qualified doctors. Don’t get mesmerized by sweet talks, do your research. Secondly, there are many ways to do a surgery, get your doctor to explain in detail for you.
Q: There is a difference between qualified and non-qualified practitioners.
A: Yes, I had a patient who came to me for liposuction at tummy tuck. She spent almost RM100,000 on slimming centres, beauty centres or salons for their therapy treatments like hot stone therapy, wrapping body. You name it, she has gone through everything. Finally, she gave up ‘shopping’. She came to see me for liposuction and was very happy with the result after the surgery.
Q: Any other similar cases you have come across?
A: Yes, there was this lady who had a scar on her lips after an accident. The tar wasn’t properly removed during her surgery. She had a lot of salon treatments trying to remove the dark spot but all ineffective. Finally she consulted me and got it removed through a minor surgery. People think that going to beauty salon can have all their problems solved, but a medical problem like this should not be treated by beauty salon. People don’t tend to realize that in Malaysia.
Q: How do people decide when should they consult a doctor, and not beauty salons?
A: We are living in an era of information; it is very easy to find everything online. If you have scar problem, you should look for plastic surgeon, not beauty salon. They should be looking at right place and right person to do it, so they can save the money. Medical conditions should be treated by licensed practitioner.
Q: At least they have to talk to a qualifying doctor, and it is not necessary that they have to opt for surgery right after consultation with the doctor.
A: Yes, get professional advice. It doesn’t make sense to get advice from people who are not qualified. They should go to the professional.
Q: What is fat transfer procedure and how does it work?
A: Fat transfer has more permanent effect as compared to silicone. Fat has stem cells, it grows with the person, but silicone has limited life span and needed to replace after few years. In fat transfer surgery, we take fat from your body and re-inject to several areas. There are a lot of techniques doing this procedure, and I use a very unique technique which is water spray gun to get maximum result. As water is very gentle, it doesn’t destroy the fat cells, it just loosens the fat cells. Hence it’s safe and effective. Patients will experience minimum bruising, down time and there is less complications in this procedure too.
Q: What treatments do you offer?
A: I offer various plastic and reconstructive surgical treatments such as liposuction, fat transfer and body contouring (abdominoplasty, arm lift, thigh lift), facial cosmetic surgery (face lift, blepharoplasty, rhinoplasty), breast augmentation and reduction etc. Patients are always welcome to discuss the treatments they want for their body. As I have mentioned, plastic surgery is always two-way communication.
To know more about Dr Ananda Dorai, kindly check here
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Qian's interest in healthcare industry came about after her father was diagnosed with bladder cancer. This experience has led her to become a strong believer in empowering individuals to take charge of their own health. View all articles by Qian.