When thinking of a metaphor for the operating room, “kitchen” isn’t likely the first thing that comes to mind.

But surgery is often just like a recipe, according to Dr. James Lacey. “If you think of orthopedics — having your hip or knee done — literally, the surgeon will tell you, ‘This is what I do. This is what can happen.’ and 10 minutes later, the patient’s out of there, because they have a recipe,” says the Kanata, Ont.,-based plastic surgeon, 39. “In plastic surgery, there’s no recipe.”

Lacey has practised for 10 years, now operating out of Kanata Plastic & Cosmetic Surgery, where he performs a variety of procedures for injured hands and cosmetic surgeries like facelifts, breast augmentations and liposuction.

Initially intrigued by anatomy and microsurgery, Lacey segued into plastics when he was galvanized by surgery’s creative potential.

“The microsurgery, which is the small anatomy where you can attach small blood vessels, is what attracted me,” he says, “I enjoyed the finesse, artistry and creativity.”

He also enjoys the empathetic approach he says doctors in his line of work must have. Lacey’s bottom line is making sure his patients are happy, he says. “It’s not just like having your hip done where you can tell them to go to their family doctor to have the staples taken out. We are there throughout the healing phase.”

That individualized care matches the specialized process Lacey says separates plastic surgery from other kinds. “We have techniques, but the breast that walks in looks different from the next breast that walks in. It’s not like just making a knee ligament or replacing a joint.”

It’s also not the kind of thing just any physician can perform. Lacey says the horror stories are seldom coming out of offices like his. A point, he says, that is often overlooked is “it’s the general practitioners, ear, nose and throat doctors and dermatologists who are doing liposuction and breast augs who never did it in residency and they took a weekend course.”

Such educational brevity is far less than the required schooling to become a plastic surgeon in Canada. Karyn Wagner, executive director of the Canadian Society of Plastic Surgeons says, “In order to become a plastic surgeon, a physician must be certified by the Royal College of Physicians and Surgeons in plastic surgery.” Wagner says that certification can only come after doctors who have already finished medical school complete a five-year plastic surgery residency, plus written and oral exams.

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