fbpx Specialist Q&A: What Can a Plastic Surgeon Do for You?
Gloved hands draw lines and incision points on an invisible body against a blue background.
Gloved hands draw lines and incision points on an invisible body against a blue background.

Specialist Q&A: What Can a Plastic Surgeon Do for You?

Anna Pavlov, M.D., explains what it means to repair, reconstruct and replace physical tissue.
David Hopper
Written by

David Hopper

Anna Pavlov, M.D., is a plastic surgeon affiliated with Memorial Health System in Gulfport, Mississippi, and has been in independent practice for over a year. She attended the University of Mississippi School of Medicine before completing six years of plastic surgery training at the University of North Carolina at Chapel Hill.

Pavlov was recently named the top plastic surgeon on the Mississippi Gulf Coast by Gulf Coast Woman magazine.

"Dr. Pavlov is an excellent surgeon," a review in the article reads. "She cares for her patients and performs surgeries that give women [and men] the self-confidence everyone should feel. She's supportive and knowledgeable and honest with her professional opinions regarding body contouring changes requested by her patients."

Pavlov spoke to Giddy as part of a series on medical specialists.

Editor's note: This interview has been edited for length and clarity.

How do you become a plastic surgeon? What education and training is required?

Pavlov: There are two pathways to becoming a plastic surgeon. Both pathways require an undergraduate degree with certain prerequisites in science followed by four years of medical school. After medical school, you can match directly into a plastic surgery program, which is what I did. These programs are six years long.

You could match into another surgical field, such as general surgery or ear, nose and throat (ENT). Following a residency in general surgery, ENT, etcetera, you could then do a three-year plastic surgery fellowship. After completing training, you must pass both a written and an oral exam to become board certified. The oral exam takes place at least one year after completion of training where the surgeon is tested on their own cases as well as a variety of unknown cases in order to test their knowledge and ethics.

You can rest assured that a board-certified plastic surgeon has completed medical school, surgery training and at least three years of plastic surgery-specific training, plus rigorous examination following training. I would recommend anyone who is seeking cosmetic or reconstructive surgery only see a board-certified plastic surgeon.

There are many other doctors out there with cosmetic surgery fellowships, but this is a one-year fellowship that is not nearly at the same level as traditional plastics training. In fact, I know an oral surgeon who did a one-year fellowship in cosmetic surgery, and now this person,who primarily trained in surgery of the mouth, is now performing cosmetic face and body surgery. Training matters!

What do you do as a plastic surgeon?

I offer a variety of cosmetic and reconstructive surgeries, including but not limited to:

Wound and burn care

  • Acute burns
  • Dog bites
  • Hypertrophic scar revision
  • Scar contracture release
  • Skin grafting
  • Wound debridement

Cosmetic surgery

  • Breast augmentation
  • Breast reduction
  • Brow lift
  • Chin augmentation
  • Labiaplasty
  • Laser treatment of the face and body
  • Liposuction
  • Mastopexy (breast lift)
  • Rhinoplasty
  • Rhytidectomy (face- and neck lift)
  • Upper and lower blepharoplasty (eyelid surgery)

Reconstruction

  • Closure of wounds with infected or exposed hardware
  • Fat grafting to face, breasts and body
  • Gender affirmation (top surgery only)
  • Implant-based and autologous breast reconstruction
  • Reconstruction of traumatic defects
  • Scalp defects

Head and neck

  • Jaw fracture and other maxillofacial fractures (orbit; ZMC, or zygomaticomaxillary complex; frontal)

Hand

  • Carpal tunnel syndrome
  • Dupuytren's contracture
  • Fingertip injuries
  • Fractures of the hand
  • Hand wounds and burns
  • Simple polydactyly and syndactyly (congenital malformations of fingers or toes)
  • Tendon injuries
  • Trigger finger release
What attracted you to plastic surgery?

There are a lot of reasons why I love plastic surgery. I like being able to operate anywhere from head to toe. Each surgery I do is customized to each patient. Plastic surgery is a field where you learn the principles of surgery and then have to apply those principles to each patient's specific problem. In that way, every surgery we do is unique and different from the last.

I love the instant gratification of surgery. For example, a few weeks ago, I did a breast reduction where I removed 14 pounds of breast tissue in four hours. What a difference that makes, both in the patient's quality of life and how it looks. I love being able to improve a patient's quality of life, whether it's their self-esteem, their ability to wear clothes that fit properly and the ability to exercise without pain, such as from large breasts. Plastic surgery is known as a field where we "restore what nature has taken away," and for me, as well as for the patients, this is a really gratifying thing.

What are some common reasons that someone would see a plastic surgeon?

The most common patients in my practice are breast and body patients. Breast reduction, augmentation, revision [and] reconstruction. I see many breast cancer patients who need reconstruction.

I also see certain hand complaints commonly. It's a little-known fact that plastic surgeons train in surgery of the hand. I treat carpal tunnel, trigger finger and Dupuytren's contracture. I see a lot of massive weight-loss patients who need body contouring, such as tummy tuck, breast lift or arm lift.

I also see a lot of mommy makeover consultations, which typically consist of a tummy tuck, breast lift and breast augmentation. I also see a lot of patients from other surgeons who need plastic surgery assistance with getting wounds to heal.

How should people prepare for their first appointment?

I would encourage every patient to research the surgery they are interested in discussing. If you think you might like to have a tummy tuck, I recommend looking it up online, watching YouTube videos and reading patient testimonials. That way, you will know ahead of time what to expect and can come prepared with questions for your surgeon.

It is important to know that most plastic surgeons do not offer cosmetic or elective surgery to patients who are active smokers, patients whose BMI [body mass index] is more than 35 to 40 or patients who have uncontrolled diabetes. These conditions increase the risk of complications following surgery, so it is important to quit smoking, lose weight and get diabetes under control before considering cosmetic or elective surgery.

What can a patient expect from their first visit? And how many visits can they expect before/after surgery?

This is quite variable. If we use breast reduction as an example, I usually see patients for an initial visit where we discuss the surgery and how it applies to their bodies. We take photos of the breasts. We then submit the case to insurance for approval. After approval, we can schedule surgery. Following surgery, I see patients one day after surgery, one week after surgery, one month after surgery, three months after surgery, six months after surgery, one year after surgery and every one to two years after, as needed.

In general, how do you make a diagnosis?

This is generally done by taking an extensive history of the patient's condition and performing a thorough physical exam, plus or minus any imaging modalities or lab work that might be necessary.

What kind of presurgery tests do you commonly do or order to be done?

Mammogram for patients over the age of 40 before any breast surgery. A CT [scan] of the abdomen for patients undergoing tummy tuck who might have a hernia. Ultrasound or MRI of breast implants for implant problems. Blood counts and chemistry for patients with medical comorbidities or who are over the age of 40. X-rays for hand conditions. Electrodiagnostics for carpal tunnel syndrome.

What is one medical breakthrough that would really make a difference in the field?

A reliable coupling device for arterial anastomosis for microsurgical reconstruction would be an amazing breakthrough. Right now, these anastomoses are done by hand suturing the anastomosis. There are great venous couplers, just not for arteries. Face transplantation and hand/arm transplantation are burgeoning fields in plastic surgery. These procedures are only done in select specialty centers but are becoming more common. Transgender surgery [gender confirmation surgery] is becoming more and more common. I, myself, have been doing top surgery in Mississippi. I don't believe anyone else offers this in my area.