From Rhinoplasty to Reconstruction: The Art & Science of Facial Plastic Surgery

Podcast Transcript

Paul Bryson: Welcome to Head and Neck Innovations, a Cleveland Clinic podcast for medical professionals exploring the latest innovations, discoveries, and surgical advances in otolaryngology - head and neck surgery.

Thanks for joining us for another episode of Head and Neck Innovations. I'm your host, Paul Bryson, Director of the Cleveland Clinic Voice Center. You can follow me on X, formerly Twitter, @PaulCBryson, and you can get the latest updates from Cleveland Clinic Otolaryngology-Head and Neck Surgery by following @CleClinicHNI on X. That's @CleClinicHNI. You can also find us on LinkedIn at Cleveland Clinic Otolaryngology - Head and Neck Surgery, and Instagram at Cleveland Clinic Otolaryngology.

Today I am excited to be joined by Dr. Sara Liu, who recently joined our facial plastic and reconstructive surgery team at Cleveland Clinic. Dr. Liu, welcome to Head and Neck Innovations.

Sara Liu: Thank you for having me.

Paul Bryson: Well, let's start by having you share some background on yourself, where you're from, where you trained, and how you came back to Cleveland Clinic. So take it away. Tell us a little bit more about you.

Sara Liu: Yeah, of course. So I grew up in Toronto, Canada and went to college at McGill in Montreal, and then I went to Boston University for medical school. And from there I came to Cleveland and I did my head and neck surgery residency here. Loved it so much, obviously. And then I left for a year. I went to the University of Minnesota to do my facial plastics fellowship, and then was lucky enough to be able to come back and join Cleveland Clinic, and super happy that I did. Been back for about eight months now, and yeah, it's been really great.

Paul Bryson: Well, I mean, from remembering you during your residency time and now to have you back, I mean very well-rounded, exceptionally trained, you could have many clinical interests, but I wanted to ask you, what are some of the things that you're particularly interested in your plastics and reconstructive practice as you have started your practice here?

Sara Liu: Yeah. Well, part of the reason why I went into this subspecialty is I really just love the whole breadth of it. And right now I'm still early in my career, and so I very much want to still do everything. And so I do, I would say my practice consists of a lot of reconstructive and functional surgeries, but also some cosmetic and aesthetic surgery as well. So big head and neck cancer reconstructions trauma, skin cancer reconstruction, functional nasal airway surgery, but then also cosmetic rhinoplasty, facelifts, aging face eyelid surgery, and something that I'm really excited to bring back to the head and neck, which is something that we haven't really offered, a service line we haven't really offered patients, is facial feminization surgery for gender affirmation surgery for our transgender patients. So yeah, that's kind of the spectrum of my practice right now.

Paul Bryson: So I understand you're getting busy accepting new patients and kind of growing things in all areas.

Sara Liu: Yeah.

Paul Bryson: Well, share with us a little bit, if you would, what's your approach to patient assessment and consultation? What can the patient expect as you kind of develop a treatment plan?

Sara Liu: Yeah, I think I usually often will start off by asking the patients what their goals and priorities are, what they're really trying to get out of it. I think especially with aesthetic surgery, a lot of that is managing patient expectations, trying to make sure we're on the same page about what they're looking for, what they're looking to achieve, and hopefully coming to a realistic goal that we can both decide to meet. And then I think with any kind of surgery, obviously sometimes things can take multiple stages, have revisions be pretty involved, especially with complicated nuanced reconstructive things. And so I always try to reassure patients that I'm here with them every step of the way. I'm not done with it until they feel like they're happy with it. But that, again, managing expectations I think is a really big part of it, that they know that sometimes these are long processes to get them to the final stage that they want to be at.

Paul Bryson: Yeah, it's really important. As you said, you take care of a lot of complex problems and sometimes the solutions are multiple steps and stages, and that's great. I wanted to ask you also part of taking care of patients with complex needs, you're naturally very collaborative. Can you talk about how you collaborate with some of our multidisciplinary teams? I mean, the reconstructive and just other aspects of your plastics and reconstructive practice.

Sara Liu: Yeah. I actually, I think that's one of my favorite parts of this position that I have is that I get to collaborate with so many different people across different subspecialties and also across just different specialties. And so within our own head and neck, my work with the sinus surgeons, we do combo cases where I'm doing functional nasal rhinoplasties and they are doing sinus surgery on the same patient at the same time. I work obviously with the head and neck team a lot doing reconstruction for head and neck ablation. And then outside of our head neck surgery realm, I'm collaborating with the neurosurgeons doing cranioplasty, with the dermatologists doing skin cancer reconstruction.

And then with the gender affirmation surgeries, I am working with the gender affirmation surgery team here. And so that includes members of the plastic surgery department and OB-GYN and urology. And I think that being able to have that multidisciplinary collaboration and approach to patient care is one of the big reasons I came back here. I think at the Cleveland Clinic, everyone just has this really, really great collaborative nature and spirit, and you don't always find that everywhere.

Paul Bryson: Yeah, no, it is, I think one of the special sauce things about the Cleveland Clinic, and it is really nice for patients. We try to really put things together for people.

Sara Liu: Yeah, it's nice.

Paul Bryson: Well, I also wanted to highlight, I understand that coming up in August, there's going to be a new medical education program that you're leading titled Advances in Nasal Reconstruction. Can you give our listeners a little preview of the meeting and what's going to be covered?

Sara Liu: Yeah, we're super excited about this. It's a really unique course. First of its kind, a course solely focused on nasal reconstruction. And I think nasal reconstruction is an aspect of facial plastic surgery that I think a lot of us are very passionate about. It can be very challenging. The defects are all different, challenging to be able to restore form and function for a patient, and ultimately very rewarding.

And so the course is going to be taking place in August. August 23^rd-24^th here in Cleveland. And we are super fortunate that we are going to be joined by several visiting guest lecturers from across the country. And we have people joining us from Hopkins and UCSF and Harvard and Jefferson and Minnesota, and there's more that I'm probably forgetting, but so they'll all be kind of participating on panels and giving talks. And then we have two featured guest speakers who are kind of world renowned leading experts in nasal reconstruction.

So Dr. Fred Menick basically wrote the book on nasal reconstruction. He's coming to give our keynote speech. And then Dr. Robert Walton, based out of Chicago, he's also coming and giving us some talks. And so I think it's just going to be this really great meeting of the minds. And as an early career person, I'm super excited to be part of this and contributing to it. And obviously all of our talented, my partners here that also are going to be part of the course as well. And so Dr. Byrne, Dr. Fritz, Dr. Ciolek, and Dr. Genther and myself are all going to be giving talks.

Paul Bryson: Yeah, it sounds like it's going to be great.

Sara Liu: Yeah, it's going to be awesome

Paul Bryson: Awesome. So if you're interested in learning more or registering, visit ccfcme.org/nasalrecon2024. That's ccfcme.org/nasalrecon2024.

Well, as we wrap up the podcast today, can you share any final take home messages for our listeners?

Sara Liu: I love my job so much, and I love getting to help people the way that I do. And I think that for every patient that I meet and every problem that I get to help take care of, I think that remains true, is I want to know what the patients, what's important to them and what they want out of the experience, and really try to tailor each surgical plan or treatment plan to each person's individual needs and what they're looking for. I think every person is very different. Every problem, every reconstructive or aesthetic problem is very different. And really trying to find the balance between the reconstructive and the aesthetic side I think is super important.

Paul Bryson: Well, for more information on facial plastic and reconstructive surgery at Cleveland Clinic, visit clevelandclinic.org/facialreconstruction. That's clevelandclinic.org/facialreconstruction. And to speak with one of our facial plastic and reconstructive surgeons or submit a referral, please call 216.444.8500, that's 216.444.8500.

And one final reminder, if you're interested in learning more or registering for our Advances in Nasal Reconstruction course, visit ccfcme.org/nasalrecon2024. That's ccfcme.org/nasalrecon2024.

Dr. Liu, thanks for joining Head and Neck Innovations.

Sara Liu: Thanks for having me.

Paul Bryson: Thanks for listening to Head and Neck Innovations. You can find additional podcast episodes on our website clevelandclinic.org/podcasts. Or you can subscribe to the podcast on iTunes, Google Play, Spotify, BuzzSprout, or wherever you listen to podcasts. Don't forget, you can access realtime updates from Cleveland Clinic experts in otolaryngology – head and neck surgery on our Consult QD website at consultqd.clevelandclinic.org/headandneck. Thank you for listening and join us again next time.