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The Profile – Marc Pacifico: Plastic surgeon

So Tunbridge Wells 2010

People make a town and in tunbridge wells there are plenty of men and womenwho reflect the nature and culture of the place. We set out to meet a cross-section of them and this month venture into the medical world.

The first thing we clear up is his background. Marc Pacifco is not Italian. Two centuries ago his family had Italian links but Marc himself (“it’s not Mark”) was born and bred in London. “My problem is everyone expects me to speak Italian, especially in restaurants,” he tells me. “I can speak a bit but not a lot.”

Marc and his German born wife Sandra (“she works for a gap year company and likes to be called Sandy”) moved to Tunbridge Wells three years ago. The pair had visited the town a couple of times “and both of us knew this is where we wanted to live.”

The location also fts in with his work as a Consultant Plastic and Reconstructive Surgeon with impressive credentials, BSc(Hons) MB BS MRCS MD FRCS(Plast). He practices at  Spire Tunbridge Wells Hospital, Queen Victoria (East Grinstead), Kent and Canterbury (Canterbury) and  William Harvey (Ashford).

Do you like being referred to as a ‘plastic’ surgeon?
“I’d rather be called a plastic surgeon than a cosmetic surgeon. That in fact is the correct term although people think it’s about putting plastic into people. It’s not, it’s derived from the Greek word ‘plastos’ meaning to form or to mould a shape. It’s nothing to do with plastic materials, that’s an image celebrities have given it. I don’t like the term cosmetic surgeon, it sounds a bit short lived, transient and superfcial.”

How did you end up in the job?
“I’d always wanted to be a doctor and for me that meant  being a surgeon, although it doesn’t run in my family. While I was at school I had some great opportunities to do relevant work experience.

“Like what?”
Shadowing surgeons at a London hospital which was fantastic, I was 16. It was a brilliant opportunity and  confrmed for me what I wanted to do.

“Most people might have been too queasy?”
I did feel a bit wobbly for a while in the frst operation I saw but that was it. I was fne after that and eventually went on to St Bartholomew’s Hospital Medical College making sure I had plenty of exposure to plastic surgery. It takes several years after qualifying as a doctor to become a surgeon and  a further six years to qualify as a plastic surgeon.

“What appeals about plastic surgery in particular?”
I think the satisfaction you can get. It’s very rewarding the way that patients themselves can actually see what you’ve done. If someone has to have their gall bladder taken out it

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And your biggest ever buzz?
“Probably a cancer patient in her early 30’s who had obviously been through an ordeal and having had both breasts removed. I reconstructed both of them during an eight hour operation and not only did she write me a ‘thank you’ letter, her four children did as well. They were aged between 9 and 13 and told me how much their mother’s life had changed because of the operation. That will stay with me forever.”

Do you only do private work?
“Not at all. Up to four and a half days of my week is spent working for the NHS. Private work is done in the evenings and sometimes at weekends. The majority of work for surgeons is NHS work.”

Would you give up the NHS?
“No!”

Why not?
“Many reasons. The NHS side is again, incredibly rewarding with patients from every walk of life and this country is unique in that it’s not a financially based healthcare system. People can have surgery with the decision based on what’s best for them, not what they can afford. That’s not always the same in other countries where the level of surgeon you get can often depend on the level of insurance you pay.”

How important is it to have a good rapport with your patient?
“It’s most important because it’s a two-way thing. The patient has got to have confidence and trust in me as a surgeon and I’ve got to feel I’m on the same wave-length as them and that what I’m offering can meet their expectations. If I have to, I’ll spend several consultations making sure we see eye-to-eye.”

Is there a difference between NHS and Private patients?
“No I treat them exactly the same, I go through exactly the same consultation for both sides. There’s no difference.”

How does breast reconstruction work?
“In layman’s terms, you take skin and fat with blood vessels from the stomach, as you might with a tummy tuck, put it on the chest and bring it back to life. Typically it can take about seven hours for one side.”

How do you keep focused for seven hours?
“You can’t, so we take a lunch break of about 20 minutes although not all at the same time. There’s always a team in the theatre. We don’t just walk out and leave the patient. Even so, three or four hours at a time is long enough. You can’t do them day-in-day-out. I average about two every three weeks.”

What makes a good plastic surgeon?
“Having the technical ability is implicit. You also have to have a degree of artistic ability because you’re changing from one form to another so you have to have some three dimensional awareness, probably similar to an architect or graphic designer. Someone who can see what something could look like if you make certain changes to it. You’ve also got to be able to improvise and you have to have good decision making abilities, choosing the right type of operation for the right patient is crucial.”

What’s on the horizon?
“The current hot topic in breast surgery is body fat transfer; if someone has big thighs and small breasts, you’ll take fat from the thighs and put it on the chest instead of using silicone implants. If you can show that it doesn’t cause or stimulate breast cancer through transferring something with very strong stem cells, it will transform how we do a lot of things in the next few years. My concern is there’s not been enough research yet and I’m very wary. I would not use it at the moment.”

If you’d like to ask Marc Pacifico your own questions about cosmetic surgery then you can meet him face to face when he holds an informal presentation at the Hotel du Vin In Tunbridge Wells at 7.30pm on May 5. For full details call Sharon Lacey: 01892 616103.