Ken Stewart

Name : Ken Stewart
Employer : NHS Royal Hospital for Sick Children, Edinburgh
University : University of Aberdeen
Subject : MBChB (with intercalated BMed)
Graduated : 1990

Before going to medical school I attended a lecture given by a plastic surgeon from Glasgow. He showed all this amazing surgery that, through correction of deformity, transformed the lives of children. It stuck in my mind and influenced my medical studies. After house jobs in Aberdeen and Glasgow, and further training in Newcastle, I moved to Edinburgh to do my basic surgical training (BST). During this time I worked as an SHO in the plastic surgery department where I am now a consultant – photos of my earlier house officer years in Edinburgh frequently return to haunt me! 

The toughest part of my training was in the early years before the regulations on junior doctors’ hours were put in place. However, the camaraderie in those days was fantastic: there were always mess parties, nights out, gossip and then back to hard work the next morning. I went into plastic surgery full time after BST and completing the FRCS. My further training also included fellowships in Sydney and Toronto and I became a consultant in 2002.

Working life

I work a 60-hour week: 44 hours in the NHS and the rest in my private practice. My NHS time is split between working in the children’s and the adult hospitals: 60 per cent operating, 30 per cent clinic work and 10 per cent administration.

The realities of plastic and reconstructive surgery

A common misconception is that plastic surgeons spend their whole time doing cosmetic surgery. Many do supplement their income in the aesthetic market, but the real passion is to restore form and function through the reconstruction of body parts. We regularly team up with surgeons from other specialties such as ENT, maxillofacial and orthopaedics to name a few. The combination of skills and strategies offers patients a far better outcome. Making a new ear for a child is rewarding, but to work with an otologist to restore the child’s hearing as well as their appearance is even better.

Key skills

The key skill for any surgeon is operating. My main interest is reconstruction of the external ear. It’s a much underrated organ: it has no function but people without one are very self conscious. The other main skill is managing a patient’s psychology. You have to carefully assess patients to understand their motivations for surgery and to get to know something of their life. It can be a huge disappointment to the patient and the surgeon when their expectations are not met. Plastic surgeons can reconstruct body parts, but if what the patient actually wanted was to reconcile their failing marriage, then surgery is of little value.

The highs and lows

The highlight of my career has undoubtedly been the opportunity for foreign travel. In addition to my training fellowships in Sydney and Toronto, over the last two years I have made educational, professional visits to San Francisco, Paris, Malmo and Tokyo. Each trip was made to visit one of the world’s experts in ear reconstruction, which is now my one of my main interests. Visiting other surgeons around the world is a fantastic privilege – you learn so much about the intricacies of surgery but also about their culture and their lives. Sadly the episodes that are most deeply ingrained in my mind are some of the tragedies related to children. It is truly heartbreaking to see a child die, particularly in my line of work when they may be healthy one day, suffer a tragic accident, and die from severe burns the next. However, from seeming tragedies also come stories of children who overcome the difficulties and do amazingly well.