Along the way, during the 23 years of my professional practice as a plastic surgeon I discovered that, because I am a woman, I can easily empathize with my female patients, since we bring together similar thoughts, emotions and a language that uniquely binds our common feminine experience.

Women have their personalities influenced by diverse factors which range from the genetic hormonal, to those created by culture. In the Western societies where we belong, it is common practice to attribute to women the characteristics associated with determination, delicacy and perfection; which is what drives us towards not giving up on our ideals. In this sense, I can say that within my personal life and professional career, I have embodied those qualities, leading me to greatly value the feelings and desires of my female patients. In other words: I love being a woman.

To me, Plastic Surgery unites knowledge, engineering and art, with dedication, sensitivity and passion, for the objective of obtaining a natural result which is in harmony with the patient's own biotype.

When striving for harmony, it is important to closely understand what the patient is expecting from a surgery, and then one should care enough to strive to achieve the closest results as those expressed by the patient, while remaining safely within established technical parameters.

Knowing personally of the type of frustrations that we women suffer from unexpected results, I take care not to sell illusions to any of my patients. I take the time to clearly underscore the technical limitations of Plastic Surgery, since it is neither magical nor a means of creating miracles.

The conversations/consultations that occur with my patients happen within an environment of transparency, since normally we both meet at the same frequency. The examination occurs serenely since I understand and respect that I am being shown what may be a privately held aesthetic defect; something that is possibly embarrassing and often not shared even with a spouse or a close friend. As I make an examination we discuss the options available to make corrections.

If a defect bothers a patient it is not hard for me to imagine how it would be if I had the same defect on my body. Since I know that the defect would surely bother me too, I look for the best solution to alleviate her problem. As I attend the patient I am able to capture what she is expecting as the surgical result, after-all, were it the case, I too would strive to achieve the same results for myself.

I understand perfectly how much a patient may desire to liberate herself from an aesthetic defect that she may have on her body, so that she can then feel pleased when looking in the mirror. It is good to like what one sees in the mirror and then to face the challenges of family and professional life with greater security

I listen and give value to the individual questions posed by each patient, considering their concern as being of major importance since this is an expression of something that is bothering the person. All details are discussed. The surgical plan is outlined on the basis of my conversations with the patient, and is supported by an environment of transparency and mutual agreement. Nothing is imposed on the patient. We establish a surgical strategy, which is only modified in the rare case of a risk to the patient's life or when an unexpected anatomical alteration forces me a change of technique.

A clear example of when my 'feminine vision' or feminine understanding comes into play is when planning a breast reduction. With this procedure I always take the utmost care to use techniques that preserve the erogenous sensibility of the breast and nipple. Many men don't have an clear understanding of the importance our sensibility in this area. From many conversations with women patients, and from personal experience, I know how important this erogenous zone is to a woman. To me it is of little value for a woman to have beautifully shaped and attractive breasts, but not be able to sexually enjoy this important region.

Another example is taking the time to correctly position a scar so that it can be hidden when wearing an evening dress, or a bikini. Prior to surgery, when marking the surgical areas, I always ask my patients to bring along their bikini or whatever 'revealing' clothes they may be apt to wearing, so that I can better estimate the position of scars. How many men have walked the beach in a bikini or worn a strapless dress? I have. And I know how important it is for a woman to feel secure in each of these instances. These are but only two examples, and other details exist that are associated with each surgery that involves the female patient. Within the section on describing the surgical procedures (unfortunately for the moment only in Portuguese) a reader may find other references regarding my Feminine Vision of Plastic Surgery.

The W.H.O. (World Health Organization) defines 'health' as physical and psychological wellbeing. Aesthetic deformities of our physical body can provoke mental traumas (how many of us have looked in the mirror and have been stressed by our reflection? That's mental trauma manifested.) but in the majority of times these physical deformities can be corrected through a plastic surgery procedure that has been well planned and executed. Liberating one self of a psychological trauma contributes tremendously towards the recuperation of a person's self esteem.

The comments that I place here are a small snapshot of my professional day-to-day living experience gained during my 23 years as a plastic surgeon and the attention to the specific questions brought to me by women. Never-the-less, I have to point out my respect for my surgeon colleagues who have demonstrated seriousness and competence in their approach to plastic surgery for women.

Dra. Mariângela Santiago