As a renowned plastic surgeon and respected member of the medical community, please share with our readers what motivated you to become a physician and go to medical school. What event in your career or training drove your decision to choose a career in plastic surgery?
As a child, I never dreamed about becoming a physician. Without any family members or close relatives in the medical field, I had very little attachment or exposure to this career path. When I was in high school, I was just an ordinary student who studied hard but had a hard time deciding which career path was right for me. At the time I applied for college, going to medical school was a popular educational pathway for many students. Thus, as I outlined my career and future, I talked to my family members, who suggested that I become a physician. These conversations instilled in me values that continue to inspire and encourage me to pursue this profession.
After entering medical school, I joined a volunteer group called Korea Medical Student Association (KMSC), a joint club founded in 1957 that connects all medical schools in Seoul. Through this organization, participants engage in various volunteer opportunities during weekends and summer holidays. Such fulfilling experiences enabled me to think about my professional identity. More specifically, working with KMSC, I learned about the important expectations and responsibilities of a doctor.
During my studies, Professor Se-min Baek’s lecture on reconstructive surgery pushed an ordinary medical student like myself to dream of becoming a plastic surgeon. Dr. Baek graduated from medical school in Korea and furthered his studies in the United States to become a board-certified surgeon in both general surgery and plastic surgery. By his mid-30s, Dr. Baek was the Chief of Plastic Surgery at Mount Sinai hospital in New York. To this day, he is a legendary plastic surgeon who developed cutting-edge concepts in microsurgery and craniomaxillofacial surgery.
I remember being dumbfounded when I first learned about microsurgery reconstruction and maxillofacial surgery from Professor Baek. My stubborn preconceptions about plastic surgery were completely broken as I learned that plastic surgery can not only enhance one’s appearance but also restore function. Upon this realization, I set my heart on becoming a plastic surgeon who helps patients restore and improve their quality
of life through reconstructive surgery.
As the first surgeon in Korea to introduce scarless breast reconstructive surgery using robot-assisted technology in 2012, please explain to us why robotic surgery is an exciting field category in the field of healthcare and medical technology. Can you share with our readers about specific robot-assisted technology and what drew you to this work? What is the biggest challenge you have faced as an early adopter of this technology?
Robotic surgery, a surgical innovation that is far more advanced than conventional endoscopic surgery, allows surgeons to perform a variety of procedures using a mechanical hand attached to a robot. This hand mirrors that of the physician, eliminating any adverse effects caused by the surgeon’s hand tremor. At only 5 to 8 millimeters thick, it can easily navigate narrow cavities and perform delicate tasks. The robot can also provide surgeons with high-resolution, enlarged images, offering a crucial tool and advantage during a procedure.
In the past, surgical robots with multiple arms had to create multiple incisions during a surgery. However, recent advances in robotic surgery have given full range of motion to the robotic arm, allowing three instruments to be maneuvered simultaneously through a single port. These advances in robotic surgery have introduced more precision and safety to operations.
I started performing robotic surgery in 2012. In those days, there were only a few plastic surgeons who were able to perform robotic surgery. As a result, there was very little precedent for me to follow. Thus, I had to learn everything from scratch and on my own. I observed robotic surgeries performed in other fields such as general surgery and urology to learn how to operate surgical robots. By compiling and synthesizing this research and experience, I eventually pioneered a new surgical method.
From the perspective of a plastic surgeon, the most desirable way to perform reproductive breast surgery is to produce optimal results with minimal incisions. Conventional methods cannot avoid complications, leaving a large scar ranging from as little as 10cm to as long as 30cm, along with seroma at the surgical site. However, with robotic surgery, surgeons can perform sophisticated resections that drastically reduce the scar length to around 5cm, minimizing damage to nerves and muscles and decreasing the recovery period. According to a statistical analysis conducted at our hospital, Korea University Anam Hospital, postoperative complications of robotic surgery were significantly minimal compared to those of conventional surgery. Thus, robotic surgery is the latest technology that can minimize pain and risk while offering optimal results when treating a patient.
Robotic surgery is a technology that also fulfills the needs of surgeons who have to perform delicate and complex procedures in the field of digital healthcare and telemedicine. In 2001, Dr. Michel Gagner of the Mount Sinai Medical Center in New York successfully performed robotic cholecystectomy on a 68-year-old woman living in Strasbourg, France, located more than 3,700 miles (6,000 km) away from him.This telesurgery took the same amount of time as the traditional gallbladder operation which lasts 54 minutes. Since then, laparoscopic surgery, as well as ablative procedures for the treatment of cardiac arrhythmia, has been successfully performed in the United States and Italy due to these newfound capabilities. Today, the technology continues to advance, with development in areas such as surgical assistance, transportation of medical supplies, and imaging analysis.
Telemedicine has become an especially salient topic of discussion worldwide due to the COVID-19 pandemic. Although regulatory issues and social consensus prevent the widespread implementation of the system, robotic surgery is expected to play an important role in providing better treatment for patients in remote areas such as military units, prisons, and hazardous areas.
In your role as the chairman of the Korean Society of Plastic and Reconstructive surgeons, can you share with us some background about the organization and its mission and goals? What are your responsibilities, principles, and challenges as you are leading the professional body for board-certified plastic surgeons in Korea?
The Korean Society of Plastic and Reconstructive Surgeons (KSPRS) is an academic organization that represents 2,600 plastic surgeons in the Republic of Korea and is celebrating its 56th anniversary this year. The capabilities of reconstructive surgery have allowed our group to both save lives and dramatically alter the course of patient’s life. Through the capabilities of reconstructive surgery, our group has not only strived to save patients but also try to alter the course of patient’s life.
When I first became the Chairman of KSPRS, I initiated a project, named “The Future Dream Project,” with the aim of creating a globally recognized society that its members can be proud of. Nearly halfway into my term, the project is on track to achieve its objectives. Despite the difficulties of the ongoing COVID-19 crisis, the dedication and commitment of our members have made it possible for the project to stay the course.
My first goal was to lay the foundation for our organization and instill dignity in our members. As the new Chair of KSPRS, I established four strategies to achieve the mission and vision of our society. Specifically, I believe our society’s mission to improve the health of humankind through the development of plastic and reconstructive surgery shows our willingness to become a leading academic society not only in Korea but also around the world. We undertake such a daunting task by remembering and taking pride in our history, captured by the “History Wall” on the back wall of our office. Moreover, we are taking measures to utilize online portals and social network platforms such as Instagram and Facebook to encourage global connection and communication amongst our members.
"Robotic surgery is expected to play an important role in providing better treatment for patients in remote areas"
The next important agenda as the Chairman was to push our official journal “Archives of Plastic Surgery (APS)” to meet the international standards. Since KSPRS is fundamentally an academic organization, the quality of academic journals is directly tied to the dignity of the society. APS is published as an international journal six times a year, but it has not yet been indexed in Science Citation Index (SCI). To improve the quality of journals, we assigned a new global publishing company and appointed world-class scholars to produce and edit our work. In addition, our journal has been upgraded to an official journal in five Asian countries, including Indonesia and Hong Kong, maximizing journal exposure on social media and liaising with other academic societies overseas. We expect to be indexed within the next two years.
Third, we worked to improve the quality of residency training by reorganizing the educational experience for students. For example, we have implemented an international online platform to improve the current online educational portals. All qualifying examinations are now taken as computer-based test (CBT). In addition, the existing educational content has been modified to better reflect clinical situations that are applicable to real-life settings.
Finally, we are trying to protect the rights and interests of our patients and members by further improving the medical environment. We are currently working on establishing a diagnosis and operation coding system for plastic surgery. We also have a task force to develop new medical technologies. Of course, our organization has also continued to focus on combatting the shortcomings of the current National Health Insurance system in Korea.
Through these endeavors, I hope to make KSPRS the best academic society that ultimately earns the trust of the public through communication and collaboration.
As the president of Korea University Anam Hospital, do you serve patients who travel to Korea from other parts of the world? How do they learn about your specialized services? What are some benefits that international patients can receive by getting medical services in Korea?
Foreign patients can receive the same treatment as domestic patients. Korea University Medical Center (KUMC) opened an International Health Care Center(IHCC) in 2009. This center provides high-quality medical services to foreign patients in a comfortable atmosphere with physicians, nurses, and administrative coordinators that are fluent in various foreign languages. In fact, KUMC has obtained the fifth certification from the Joint Commission International (JCI) and has been recognized for establishing the world’s best system in patient safety and quality of medical services.
For the convenience of our foreign patients, we have made our website available in four languages. On this platform, patients can conveniently make their appointments online. On your first visit, a primary physician dedicated to foreign patients will assess your needs, and, when necessary, make referrals to a specific department. The IHCC coordinator will take care of all the necessary processes for treatment, from the moment you arrive in Korea to the time you receive treatment, including preparing documents for expected medical expenses and visa issuance.
As an eminent opinion leader in plastic surgery, what are some major changes or new trends in plastic surgery? Also, how do you forecast the field of plastic surgery will change in the next five years?
The field of plastic and reconstructive surgery has always introduced new technologies and led changes. The COVID-19 crisis is demanding more adaptation and transformation in the field, particularly following the recent shift to a digital environment. PRS KOREA 2021, an international academic congress that I hosted last month as a chairman of the board, also tried to suggest a new direction in our field under the theme of “The Next Normal, A New Journey”.
To adapt to rapidly changing demands, our department has recently focused on introducing cutting-edge technologies and exploring medical frontiers. Robotic surgery is a good example of this developed technology, and now, more and more hospitals continue to adopt it. In addition, navigation surgery, which combines the latest cycling probe technology and real-time imaging, is rapidly gaining popularity.
The surgical treatment of lymphedema is a new field of reconstructive surgery that is also gaining attention. With the remarkable development of microsurgical techniques, various physiological surgical methods are being introduced. An example of these methods is lymphovenous anastomosis (LVA), which connects 0.3mm diameter (which is thinner than hair) lymphatics to small veins to create detours. Another example is vascularized lymph node transfer (VLNT), which transplants healthy lymphatic tissue. Moreover, prophylactic lymphovenous anastomosis, which is only performed in some countries such as the United States and Italy, is also gaining traction.
Transgender medicine and surgery also continues to progress in Korea in tandem with the LGBTQIA+ rights movement that has been growing in the country. To raise public awareness about the lack of Gender Affirming Clinics in Korea, KUMC took a step to launch the very first Gender Clinic in South Korea. We also aim to establish a research institute that will support and develop related fields. As a Physician and Chairman of the KUMC, we will always stand in the forefront to protect the rights of all patients needing treatment regardless of their gender, race, religion, and/or disability.
Vascularized composite allotransplantation (VCA) is an emerging field in transplant medicine, in which our fellow plastic surgeons and I are working continuously. In Korea, there were two cases of hand transplantation, and all of them have shown good results. There are still regulatory issues, but some hospitals are already preparing to undergo a facial transplantation.
3D printing, artificial intelligence (AI), and regenerative medical technology are expected to be the next new trend in plastic surgery. I think medical treatment that relies heavily on the physician alone is nearly over. From now on, it is a matter of how fast new technologies are introduced and how it will be implemented in the field of medicine. Many 3D printing and regenerative treatment techniques are already being adopted in the clinical setting, and AI is also expected to appear within two to three years.
Can you share your final remarks with our readers from around the world? Also, do you have any advice for physicians and healthcare professionals who wish to take part in the medical field and innovation?
"Your constant self-reflection and creativity will be a driving force behind your future success"
Medicine is changing rapidly with recent advances in technology and research. Treatment protocols are updated continuously and pose a challenge for textbook publishers who must keep up with all the new treatment modalities and techniques that are being introduced. What I want to emphasize to our readers, especially those in the healthcare professionals, is: In line with these changes, don’t stick only to the existing techniques; always be innovative with goodwill. Your constant self-reflection and creativity will be a driving force behind your future success.
Eul-Sik Yoon, M.D., Ph.D.
Chairman and Board of Directors, Korean Society of Plastic and Reconstructive Surgeons
President, Korea University Anam Hospital
Eul-Sik Yoon, M.D., Ph.D., is a distinguished Plastic and Reconstructive Surgeon with over 35 years of experience. Dr. Yoon is Chairman of the Korean Society of Plastic and Reconstructive Surgeons. He also serves as the President of Korea University Anam Hospital. As an influential and active figure in his field, Dr. Yoon is a widely celebrated member of the Korean Medical Association, Korean Society of Association of Microsurgery,
Korean Society of Aesthetic Plastic Surgery, Plastic Surgery Research Council, International Plastic Reconstructive Surgery, and American Society of Plastic Surgery. Dr. Yoon has served as a prominent leader and innovator in his field. He has published various scientific papers and reviews. Dr. Yoon’s commitment to progress and research in cosmetic surgery earned him the 2016 Best Academic Award at the 74th Congress of Korean Society of Plastic and Reconstructive Surgeons. He completed his medical education, receiving his M.D. degree at the Korea University College of Medicine. He also served as a Visiting Associate Professor and Researcher in the University of California, Irvine. Today, Dr. Yoon Eul-Sik continues to be a leader in South Korean and international cosmetic surgery.