Profile of Dr. Orna Fisher, for Las Vegas Woman Fall 2012 issue

CHANGING THE FACE OF PLASTIC SURGERY By Lisa Ferguson Dr. Orna Fisher discovered her life’s calling in the midst of an untraditional tattooing session. As a medical student fulfilling a plastic surgery rotation at the University of Southern California, she was given the task with guiding an ink-filled tattoo needle over the reconstructed breast of a cancer patient to create a new, aesthetically pleasing nipple for the woman. “It was amazing to me. Just finishing that phase (of reconstruction) made the biggest difference (to the patient, who was) amazed as well,” Fisher recalled. “A lot of times it’s just finishing that last phase that makes somebody realize the (cancer) process is over. She was very emotional seeing that.” Fisher was so moved that she changed her specialty from ear, nose and throat (ENT or otolaryngology) to plastic surgery. After undergoing years of state-of-the art training, last year she opened The Fisher Center for Aesthetic & Reconstructive Surgery, located at 5380 S. Rainbow Blvd., Suite 210, Las Vegas. According to the Nevada State Board of Medical Examiners, Fisher is one of only six female plastic surgeons in Southern Nevada (this includes 2 women currently in residency). A board-certified general surgeon, she finished her residency at the University of Nevada School of Medicine before completing a plastic surgery fellowship at Oregon Health & Science University. “I really diversified my education by doing every phase of it at a different institution. I thought it was really important to see what other places were doing,” she said. Fisher’s love of medicine began during childhood. “My mom was a scientist and I was always with her in the lab, and I got a lot of exposure to the sciences.” She became particularly interested in biology and anatomy. “When I was little, doctors used to make house calls, so I thought that was really cool.” In her early days as a medical student, Fisher began “scrubbing in” on cases alongside a physician/mentor who was an ear, nose and throat specialist. Fisher was so confident that ENT would become her specialty that she had already conducted medical research and presented information at a national industry meeting. Then came that fateful plastic surgery rotation at USC. “There was definitely some overlap between plastic surgery and ENT in terms of the anatomy. So when I got that rotation it was perfect, I thought.” “Actually, what ended up happening was within three weeks I completely changed my mind (about the direction of her career path),” she explained. “I equate it to falling in love versus falling out of love. You can’t control it—it’s just something that happens.” Fisher went on to complete plastic surgery rotations at several medical institutions, including Children’s Hospital of Los Angeles where she said she learned about “the diversity of people you can affect as a plastic surgeon.” “You can affect kids from the time they’re babies, all the way to elderly people,” she said. “You can work on any body part, and you can just do aesthetic things where you’re improving somebody’s appearance. Or, you can completely reconstruct something to take abnormal and try to restore it to normal.” Plastic surgery, she contends, “is a continuum. You have things that are, purely reconstructive surgery, for example where somebody is (involved) in a trauma, or somebody has a birth defect. And then you have the super-ultra cosmetic, where you’re taking really attractive people who are absolutely within the range of normal and they just want to be super-normal.” While Fisher does service reconstructive surgery patients at her practice, most of her business consists of aesthetic cases. The “mommy makeover” procedure she offers has proven popular with women whose child bearing days are behind them. “I always say you’re never too old for a mommy makeover,” quips Fisher, herself the mother of a young child. The doctor says the procedure is among her favorite to perform. The makeover usually entails a combination of surgeries to the breasts (possibly in the form of a lift, augmentation or reduction) and abdomen, including what’s commonly called a tummy tuck. Also, quite a bit of liposuction may be involved in the process. Mommy makeover patients—and their reasons for requesting the procedure—run the gamut, Fisher explained. “Sometimes it’s the day they know they’re done having kids,” she says. “If they’re older, in their 40s or 50s, sometimes they will say, ‘OK, I have basically financed my last kid and I’m ready to do something for me now.’” While “Mommy Makeover” results are often favorable, Fisher counsels patients to set realistic expectation levels for their body’s appearance after the surgery. “There’s a saying that you have to rob Peter to pay Paul because you can’t get something for nothing.” With cosmetic surgery procedures, she says, “You’re trading in sagging skin and a poor shape for scars. “For most people the tradeoff is well worth it because they hate their shape, the amount of sagging skin they have, the extra fat in certain places that they can’t get rid of their stretch marks. I have to try to shape the tissues and try to give them the best scar that I possibly can.” She works similarly with women who seek breast augmentations. In Las Vegas, Fisher says, the size of breast implants requested by many patients is typically larger than in other parts of the country. Despite the fact that breast augmentation surgery has become commonplace, “You really have to educate (patients) about the risks involved,” she explained. “It is a real surgery with a real surgeon performing the operation. There is a risk in everything—bleeding, scarring, and potential emergencies. It’s a big deal.” The same goes for patients who consult with Fisher after losing a large amount of weight (either through diet and exercise or via bariatric surgery) in hopes of removing the resulting excess skin. “For people who’ve lost a hundred or more pounds … that skin takes a major hit and it stretches beyond repair. It has, a lot of times, no capacity to come back at all,” she says. “Even in the best of hands, getting the contour that you would for somebody to be on the cover of a magazine or in a beauty pageant is not going to happen. It is going to improve, and sometimes it improves dramatically, but just managing those expectations and making sure that you’re on the same page as the person coming in to see you (as a patient), sometimes it’s really hard.” While it is “impossible to achieve somebody’s ideal image of perfection,” she said, “if their expectations are realistic to where they understand it’s about reaching a certain goal for them within their own body and their own skin and under their own circumstances, those people can have dramatic results.” Meanwhile, Fisher also keeps abreast of the latest advances in “non-invasive, non-surgical modalities of facial rejuvenation,” such as Botox for wrinkles, soft tissue fillers and special skincare options. “People are demanding more of that,” she said. “They don’t want as much down time from work or from taking care of their families” as is typically required to recover from traditional surgical procedures. Interestingly enough, some patients have pointed to Fisher’s own full lips as the type of plump pout they wish to possess. “It’s amazing to me because when I was growing up, (plump) lips were not in,” she said. “I got made fun of for these lips, and now I have people asking me, ‘Have you done this to your lips? I want yours.’” No matter what type of procedure she performs, “My ultimate goal is to help (patients) make their own personal goal happen,” Fisher said. “When somebody tells you that they’ve waited 20 years to be able to save up for enough money to have this surgery, that they’ve never done a single thing for themselves and you’ve helped make their dream come true, that is amazing.”