Correcting Pectus Chest Wall Deformities and Gender-Affirming Surgery

For facial procedures, growth is considered complete by around 15-16 years, so a 15-year-old's face is functionally comparable to an adult's for surgical purposes, with parental consent sufficient at that age. For the rest of the body, 17-18 is considered the optimum age, since patients are mature enough by then to properly weigh their own body image and understand the implications of the procedure.

Plastic surgery was originally developed for reconstruction, so any wound that hasn't healed in three weeks, whether traumatic, burn, or post-cancer resection, needs plastic surgery intervention and can be referred directly. Any congenital defect, a hand anomaly, cleft, or other soft tissue deformity, should also be sent directly. Cancerous skin lesions, where excision and reconstruction go together, are handled by plastic surgery too. And any leg oedema that doesn't resolve with elevation and conservative management is a specific trigger for lymphoedema referral. These are the practical trigger points to know.

Costs are considerably lower than in the Western world. Microvascular reconstructions range from roughly $6,000 to $9,000-10,000 depending on the number of procedures required and typically a 4-5 day hospital stay. Purely cosmetic procedures range from $2,000 to $7,000; a bundled "mommy makeover" package (breast reduction, liposuction and tummy tuck) is offered at a fixed $7,000.

Over the last two years, microsurgical success rate has been about 99%, with only two procedures not meeting expectations. For cosmetic procedures, outcomes depend heavily on patient expectations being realistic to begin with; when they are, success runs around 90-95%.

As with any surgery, there is a roughly 4-5% complication rate per case, managed through department protocols designed to minimise it. Patients prone to keloid scarring can develop keloid formation after cosmetic procedures. Patients with comorbidities like diabetes, hypertension or thyroid disease carry a higher chance of wound dehiscence, infection, haematoma or seroma formation, these are best thought of as expected side effects to plan around rather than true complications in most cases.

Yes. Chest wall compression from pectus excavatum can cause breathing difficulty during exertion; surgical correction has produced measurable improvement in lung capacity within days in cases Dr. Singh has treated.

Yes, at Dr. Singh's department both male-to-female and female-to-male gender-affirming surgeries are performed as an established part of routine practice.