Thank you to the lovely staff of Resident Magazine for this fabulous profile of Dr. Devgan in the June 2015 issue. Read Dr. Devgan's interview, over tea at the Carlyle Hotel, below.
On being a mother and a surgeon
Anyone who knows me knows that I love being a surgeon, and I love being a mother and wife. Those are the very best things in my life, and I am grateful everyday that I don't have to choose between them.
Yesterday, I received a very touching email from a high school freshman in Texas asking me about balancing career and family. She wrote:
Dear Dr. Devgan, Hi there! I am a freshman in high school and I am extremely interested in becoming a surgeon, but I also want to be able to balance my career with a family. I read your post on kevinmd.com about being a mother and a surgeon. I was wondering if you could tell me about how you have balanced your life so well. You are one of my inspirations to prove to people that I can have my dream career and family too. Thank you so much. -K.R.
This sweet email was also very poignant to me, as it stirred up many feelings I have had during the past several decades of education, training, and practicing. I will be the first to admit that the road to a surgical career has been long, challenging, and filled with sacrifices. But that being said, I absolutely love what I do, and I wouldn't change a thing about my journey to get here.
I am thrilled that young women and girls like K.R. are growing up in an era when they don't feel like they have to choose between being a physician and being a mom. My grandmother (herself a mother of three) was a busy doctor, and so are my mother (herself a mother of four) and my older sister (also a mother of four). I am incredibly fortunate to have these strong women as role models. I know that the challenges that they faced were far greater than the ones that I faced, and I am hopeful that the next generation of female doctors (like K.R.) has an even smoother path than I have had.
If you are a young person-- male or female-- interested in a career in surgery, please know that you do not have to choose between your dream job and your ideal family structure. There are people of all descriptions and all circumstances who have done it, and you can do it too.
As I told K.R., being organized and determined are the two most important factors in getting there. Study hard, expose yourself to science and medicine, choose a supportive spouse, and rely on help from others when you have kids.
I am always happy to mentor young people interested in surgical careers, and if you would like to reach out to me directly, you may email Lara@LaraDevganMD.com.
Click to read my article on surgery and family on KevinMD.com, which is also displayed below.
Being a mother has made me a better physician
LARA DEVGAN, MD, MPH | PHYSICIAN | JANUARY 24, 2014
Once in a while someone asks me if it is hard to be a mother and a surgeon. Certainly, any surgeon-parent can appreciate that juggling a household full of schedules, classes, meals, bedtimes, and activities with a practice full of office visits, pre-operative clearances, post-operative check-ups, and surgeries has its challenges. And to be sure, before I became a mother I had no idea how this would impact my work.
What I have found, however, has been a pleasant surprise. In many ways, being a mother has made me a better physician. Perhaps it is because I am a plastic surgeon and most of my patients are women, but I have found that my ability to empathize with my patients has dramatically improved. When a woman speaks to me in confidence about how breastfeeding has destroyed her breasts, or about how her jeans still don’t fit even though she is back at her pre-pregnancy weight, I am able to nod my head with genuine understanding. When a child shows up in the ER with a broken nose or facial laceration after taking a spill at the playground, I see their big, worried eyes in a way that I never did before I became a mother myself.
Motherhood has also added a gentleness to my demeanor. My experience in academic surgery during residency training often involved quickly and sometimes harshly cutting to the chase. In private practice, I spend time seeing patients who are wrestling with breast cancer, skin cancer, debilitating injuries, and body consciousness that can sometimes be difficult to talk about out loud. I have the luxury of more time to spend with my patients, and I make sure that I spend nearly an hour with every new patient I see. Motherhood has given me a sense of patience that greatly assists in taking the time to really listen.
Finally, raising a child from the tiny stages of infancy has made me appreciate the minute delicacy of plastic surgery more than ever before. In a field where margins as small as one millimeter are visually apparent, obtaining excellent, exacting, and meticulous results is important. Perhaps it is all those hours spent gazing at a newborn that drove home the point so emphatically in my day-to-day work life.
I certainly could not be as effective a surgeon or mother without an incredible support network, a loving family, and lots of child care — and to those things, I am forever indebted. But for young women in medical school and residency wondering if they have to choose a career in surgery or a family, I hope they consider that perhaps they not only can choose both, but that there are strong arguments for doing so.
Lara Devgan is a plastic and reconstructive surgeon and can be reached on the self-titled site, Lara Devgan, MD, MPH.
Dr. Devgan named a plastic surgical consultant for GLG
We are pleased to announce that Dr. Devgan has been named a Council Member for Gerson Lehrman Group (GLG). As a recognized expert in plastic and reconstructive surgery, this role allows Dr. Devgan to act as a consultant and medical expert for a variety of industry endeavors.
Dr. Devgan's new relationship with GLG comes in addition to her ongoing consultancy work with Guidepoint Global and Medefield, two other large, global consulting firms.
GLG, Guidepoint Global, and Medefield-- each in their own ways-- strive to find answers to difficult questions by consulting authority figures with demonstrated professional expertise. As a renowned plastic and reconstructive surgeon, Dr. Devgan is pleased to contribute to research, education, and development in this way.
Read a breast augmentation review by a recent patient
I strive to perform the best breast augmentation in New York City, and I am always thrilled when a patient feels that I have achieved this personal and professional ambition. Here, a recent patient has submitted a verified review of me and her experience. No review in my practice is ever compensated, coerced, or otherwise altered. All reviews and testimonials are subject to independent review and IP address verification.
Verified review from a recent breast augmentation patient. Submitted via RealSelf.com.
Breast Reconstruction 101: A basic primer about reconstructing your breasts after cancer
Before and after autologous breast reconstruction (SGAP flaps). Image credit breastcancer.org.
This was an invited article for Healio.com, an online journal for doctors.
Breast Reconstruction 101: A basic primer about reconstructing your breasts after cancer
May 20, 2015
By Dr. Lara Devgan
Breast cancer has a prevalence of 1 in 8 American women, with its incidence ever-increasing as screening becomes more widespread. While breast cancer can be a trying and life-altering diagnosis, plastic surgical techniques for breast cancer reconstruction have improved significantly over the past several decades. Women facing mastectomy have a variety of options when it comes to breast reconstruction, and post-operative results are better than ever.
To Reconstruct or Not to Reconstruct?
Although I am a proponent of breast reconstruction as a way to rebuild a sense of normalcy after breast cancer, it is worth mentioning that breast reconstruction is not required. Some women, for a variety of reasons, opt not to proceed with breast reconstruction. As long as you are fully aware of your options (and you know that all American insurers are required to cover your plastic surgical reconstruction after cancer), opting not to reconstruct your breasts is a perfectly valid personal choice.
Immediate or Delayed?
The current standard of care is for most women to undergo immediate breast reconstruction, meaning that your breasts are recreated by a plastic surgeon at the time of your mastectomy. However, in some situations, women undergo delayed reconstruction, which can happen any time from days to years after the cancer operation. Delayed reconstruction can be an option as a result of patient choice, need for radiation or chemotherapy, need to expedite the surgical procedure, infection, comorbidity, or some combination of these reasons.
Implants or Tissue?
The major choice for a woman and her plastic surgeon to make regarding breast reconstruction is whether the breast mounds will be reconstructed with her own tissue or with breast implants. Currently, in the United States, the vast majority of breast reconstruction is performed with implant-based techniques, either in 2-stage (tissue expanders followed by implants 3 months later) or in 1-stage (implants placed at the time of mastectomy) procedures.
Both techniques have their roles, and neither one is superior to the other in all cases.
Implant-Based Breast Reconstruction
The benefits of breast implants include an easier, shorter operation, more predictable post-operative results in many patients, the lack of a second surgical donor site, and minimization of scarring. Most women, and interestingly, most female plastic surgeons prefer implant-based techniques. Implants can be especially helpful in very thin or athletic women, who have little extra body fat and desire a quick return to normal life after surgery. In addition, many women like the "augmented" look that can come with breast implants.
Breast implants can be problematic in women who require radiation therapy, women who smoke, and women who have a higher risk of infection (such as those with diabetes). In addition, breast implants carry with them higher risk of infection in all patients, as well as risks related to implant rupture, implant failure, and capsular contracture. Breast implants are not considered lifetime devices, so women who get implant-based breast reconstruction will likely need additional surgeries at later times. Moreover, many plastic surgeons feel that implants used in breast reconstruction look better initially than they do after several years.
Autologous Tissue Breast Reconstruction
Tissue-based reconstruction uses extra skin and fat on a woman's body to rebuild the breast. The most common donor site for autologous tissue reconstruction is the abdomen. Other donor sites, such as the inner thigh, buttocks, and outer thigh have also been described. The technique used for constructing a breast in this way is referred to as either a free or pedicled flap.
The major benefit of autologous tissue reconstruction is that it recreates a breast that mimics the normal human breast in tissue type and tissue feel. This means that it can look and feel quite natural, and that it ages with a woman and changes with her as her weight changes. Autologous tissue reconstruction is also regarded as the safer technique in many women who have radiation damage to their tissue or who will require radiation after surgery. Because there are no foreign bodies placed, risks of infection are lower overall.
The disadvantages of this technique include a long, technically complex operation, a protracted recovery, a second surgical site, additional scarring, and potential need for revision operations to sculpt the breast mounds.
Nipple Reconstruction
Three to six months after the breast mounds are reconstructed (either with implants or tissue), many women will be ready to progress to nipple reconstruction. As nipple sparing mastectomy becomes more common, this technique may become less popular overall and may play a role more prominently in those who have sub-areolar disease.
Nipple reconstruction is a short outpatient procedure wherein local tissues on top of the breast are rearranged as a flap in a configuration that gives the breast a nipple-like cylindrical projection. This procedure is generally tolerated well and can be performed under local anesthesia only in selected patients.
Areolar Tattooing
At least three months after nipple reconstruction, the areolae can be tattooed to mimic the pigmentation and three-dimensionality of an anatomic nipple-areolar-complex. Techniques in medical tattooing have evolved significantly, and very impressive results are achievable in skilled hands. For women who prefer to avoid tattoos, a full-thickness skin graft harvested from the groin is an alternative method to achieve areolar pigmentation.
Overall Care
In order to achieve the best possible aesthetic appearance after breast cancer surgery, it is essential for your plastic surgeon to perform a thorough pre-operative evaluation; consult with your breast surgeon, oncologist, and radiation oncologist; have a discussion with you about your preferences and desires; help you weigh the risks and benefits of the various types of breast reconstruction; and answer your questions about recovery and long-term care.
While breast reconstruction can be a long journey, many women feel that rebuilding their breasts after mastectomy has elements of both physical and psychological healing. Indeed, many of my patients have told me that undergoing breast reconstruction is what ultimately allowed them to put their cancer diagnoses behind them and move forward with their lives.
For questions about this article, I can be reached via www.LaraDevganMD.com.
Click here to read Dr. Devgan's full article on Healio.com.
