“I have Harry Potter’s wand and grandma’s quilt that save lives,” says Dr. Prabha S.Yadav and keeps you wondering about her point of reference.
“People come to me with terrifying diagnosis and severe deformities and I help them to go back to their jobs and give them their lives back,” she says.
As the chief of the plastic and reconstructive surgery and head of the department of surgical oncology at the Tata Memorial Hospital in Mumbai, there is no greater joy than this for Dr.Prabha.
As the country’s first woman reconstructive surgeon, she understands it is not easy for any patient to walk into a plastic surgeon's office for reconstruction after breast cancer. Or for that matter for people with oral cancers, jaw, cheek, tongue and wind pipe tumours, who are both functionally and aesthetically affected. They are left with hole in the jaw and may need to rebuild the bones of tissues of the mouth.
“Most people have doubt whether they will be able to talk, eat, swallow or smile like before. Many back off for the fear of a second surgery,” she says.
But it is a fact that reconstructive procedures have gained major ground in the last two decades. It is done in a host of surgeries from head to toe that are restorative in nature and often reduce pain and return the patient to almost normal. These include breast reduction and reconstruction, tumor removal, cleft lip and palate repair, burn care, hand and limb surgery.
Despite beneficial and multiple applications of reconstructive surgery, cosmetic surgery is in more demand. Cosmetic surgery is always done by choice because the patient is already convinced about enhancing results before going under the scalpel and knife, explains Dr.Prabha, who was in Madurai to address the golden jubilee celebrations of the Department of Plastic and Reconstructive Surgery at Government Rajaji Hospital.
In reconstructive surgery, she points out, the doctor has to convince the patient that whatever is being done is good for you. Working at TMH, which is synonymous with cancer, it is very gratifying for the doctor to see patients walk out happy. “If you can make a person smile again by plugging the hole in the jaw or help a person walk by saving him or her from traumatic amputation, it is like giving them a second life,” she adds.
In case of breast cancer patients, smiles Dr.Prabha, I call it ‘buy one get one free’. The tissue is taken from the lower abdomen to replace the diseased breast and the patient gets a trimmed tummy free. Likewise, she calls the leg bone ‘the Harry Potter wand’ because for the reconstruction of any bony or composite defect, it is the flap of choice.
“I tell my patients you have two bones in the leg, one is for you to walk and one is for me to work on,” she says in lighter vein. The fibular graft is shaped and joined with the recipient vessels. It is very handy in oral cancers and even paediatric oral reconstruction surgery. Similarly the skin from the radial forearm, that she calls a grandma’s quilt for its stretch, is used for the tongue. For many surgeries, skin is also taken from the forehead or chest.
It is for the assurance of reconstructive surgeons to oncology surgeons that ‘what can be excised can be reconstructed’ that the discipline has seen a surge in cases over the years. Dr.Prabha, who also heads the Plastic Surgeons Association of India as its president, does minimum of four major surgeries a day, which includes one jaw tumor surgery practically every day. “The volume of surgery is very high at TMH and I recognise this as an opportunity and feel blessed to have got it,” she says.
It is her patience that counts each day even though the success rate is as high as 96 to 98 per cent. “Microvascular surgery has changed the scope of our surgeries,” she says. Still, there are times when in two out of 100 cases, she is unable to salvage the flap or an anastomotic problem arises due to blood clotting while re-establishing the blood supply between the thin skin and a chunk of tissues.
I feel depressed because for the patient everything goes topsy turvy and also means extra spending, she notes.
Dr.Prabha credits the team work between departments that saves the patient from the trauma of two separate surgeries. While the oncology surgeon removes the cancer growth, we simultaneously take the tissue or bone from another part and then seal the gap from where the tumor is removed, she explains.
After nearly three decades of teaching and practising, Dr.Prabha with all her humility states, ‘what we do, any surgeon can do’. According to her, all you need are a magnifying loop and a good camera. It is with this very down-to-earth approach that Dr.Prabha uses her skills as a stimulus for positive life growth and navigates a difficult road to wellness. She believes that the transition from sickness to wellness is a journey. “Each patient that I treat,” she says, “has his or her own hero’s journey.”
