When the Doctor Uses A Hack

The procedure for removing epicanthal folds can effectively eliminate the excess skin in the inner corners of the eyes to change the shape of the eye corners and clear up wrinkles.

This minor cosmetic surgery is currently very popular, especially among middle-aged and elderly women.

Before the surgery began, Xiao Tianhua lay there while Chen Cang started drawing lines, delineating the range for the removal of the epicanthal folds on both sides.

This step was the most difficult!

After Chen Cang finished drawing, the supporting role made a dazzling entrance.

Zhang Zhixin routinely disinfected the area and laid out sterile drapes, then applied a suitable amount of 2% lidocaine to the inner canthus for local infiltration anesthesia.

Once effective, Yang Tao first addressed the right side, cutting along the designed line for an improved “Z-plasty” on the skin, separated the subcutaneous tissue, and formed a skin flap.

At this time, Qin Xiang, very cooperative and agile, used a 7-0 nylon suture to anchor the subcutaneous tissue and the inner canthal tendon, tightening and suturing it with a stitch.

Properly trimming the skin flap edges can effectively reduce skin folds, remove the excess skin, and after proper alignment, they used an 8-0 nylon thread for interrupted suturing.

It seemed simple, and Chen Cang felt he could do it after just one observation.

But in fact, it was not so simple.

Given that the facial nerve distribution is extremely complex, and that it could serve as the medical student’s bedside book (hypnotic book), one can imagine how difficult and complicated it is.

Chen Gang’s current understanding of facial nerve anatomy was limited to a very basic level.

And greater attention was required for the understanding of how the procedure for cutting the lateral canthus affected the facial nerve.

As Chen Cang watched and learned, Qin Xiang and Yang Tao explained while performing the procedure, “Little Chen, look here, the facial nerve passes stealthily from this spot, so when using the scalpel, you have to be steady. Facial plastic surgery is different from abdominal surgery; the hand must be heavy but the scalpel must be light. You’ll gradually get a feel for it!”

The surgery lasted almost an hour and a half!

It went very smoothly!

It was also very successful, the team worked together with great tacit understanding.

Chen Cang played a significant role too; apart from drawing lines, he was fully engaged with his watchful eyes during the surgery, providing an indelible supporting role.

Don’t underestimate the power of an assist!

Chen Cang had his passive skills, after all.

Just at that moment, a notification tone sounded!

[Ding! Operating room rookie passive learning skill triggered with a 1% chance, acquiring Yang Tao’s skill: incision method blepharoplasty.)

[Incision method blepharoplasty, level: advanced, special effect: rapid recovery.]

Scored a minor blepharoplasty surgery!

Satisfying!

Blepharoplasty, or double eyelid surgery, mainly involves three methods: the most commonly used is the suture method, followed by incision, and lastly the stitching method.

Of these, the stitching method is the simplest, suitable for beginners, but… the simplest things often have the most flaws and shortcomings.

The stitching method has many side effects, so it’s generally not recommended for people to try.

Because after suturing, the entire thickness of the eyelid tissue is tied off, creating an obstruction in lymphatic flow. Post-surgery, it relies on the tissue reaction to the stitching to form an oblique fibrous adhesion from the inside upper to the outside lower between the levator aponeurosis and the skin. However, the amount of fibrous tissue formed often varies.

If there’s too little, once the scar loosens, the fold may become shallower or disappear.

If there’s too much, the fold can be excessively high and difficult to reduce.

In severe cases, if the through-and-through suture is placed too high, it can limit the movement of the levator and Muller’s muscles, leading to eyelid ptosis, eye fatigue, and difficulty opening the eyes.

Therefore, the suture and incision methods are the most common surgical approaches used now.

Among them, suturing is the most commonly used method, while incision is the technique with the highest potential and the one that tests the surgeon’s skills the most.

It can be said that those who dare to perform double eyelid surgery using the incision method are either at the lowest ranks or at the level of kings!

These are two extremes!

Just after the surgery, Xiao Tianhua was sent to rest, and Chen Cang noticed that two of his tasks were still incomplete.

Could it be that he had to wait until General Manager Xiao recovered to consider it a success?

It seemed he would have to wait a while longer!

At least seven days.

But today, I got a great skill from Yang Tao, which makes the trip worthwhile.

As Chen Cang was getting ready to rest, his phone suddenly rang.

“Xiao Chen! What are you up to?”

It was Li Baoshan!

What’s the matter?

Director Li seldom calls me, could there be an emergency patient at the hospital? “Director, I’m free.”

Chen Cang hid the fact that he had gone out to learn about plastic surgery.

Li Baoshan made a sound of acknowledgement, “Come over to my place. There’s something I want to discuss with you.”

Li Baoshan’s home was in a residential area near the hospital, just a 5-minute walk to the hospital. It wasn’t cheap, but the hospital had purchased it for him.

Li Baoshan was brought to the Second Provincial Hospital as part of a talent recruitment program and was given a 100-square-meter apartment.

After knocking, Li Baoshan answered the door.

Once inside, there were a few people already sitting there, all familiar faces: An Yanjun, Chen Bingsheng, and… was that Qin Xiaoyuan? Hao Xuliang?

What big issue could this be?

Chen Cang wondered to himself but smiled and greeted everyone in order of seniority before finding a place to sit.

In this setting, it was clear that it was better to listen more and speak less.

Qin Xiaoyuan addressed Li Baoshan, “Baoshan, you tell us.”

Li Baoshan nodded and addressed everyone, “I called everyone here today because I want to discuss an important matter with you all.”

“The development of the thoracic surgery department is not working out. The hospital is considering closing it down. Of course, that’s just the intention; no specific actions have been taken yet. But… even though the thoracic surgery department isn’t large, it does have its own operating room, and the original operating room number eight is also vacant, so after discussing with Director Qin, we’re considering setting up an emergency surgery room. What do you all think?”

As soon as these words came out, everyone’s expressions suddenly became animated.

Having a separate operating room!

That would mean moving up in status!

No more need to compete with other departments for surgery time.

Typically, the surgery rooms in a hospital are an independent department, but some large departments have their own surgery rooms. For example, departments like gynecology and obstetrics, general surgery, orthopedics, and neurosurgery all schedule surgeries within their own department without needing to involve the central surgery department.

While the emergency department in the Second Provincial Hospital did conduct a fair number of surgeries, it didn’t have its own dedicated operating room. It worked with relevant departments on related diseases and used the relevant operating rooms.

To put it bluntly, it was like a son-in-law who comes to live in the wife’s parents’ house, delivering goods and also lending a hand with work.

The emergency department had become a “middleman,” preliminarily dealing with patients and identifying the cause before sending them directly to the corresponding department or… to the morgue.

That meant there could be a lack of autonomy!

However, having a separate operating room would change things entirely; it was like a serf turning into a landowner!

Of course…

There were pros as well as cons.

At the very least, all the expenses of the operating room, including rent, utilities, consumables, nurses, supplies… all costs would be on the emergency department!

You have to understand, a hospital is like a large commercial building, and the departments are like tenants inside the building—each has to pay monthly rent, utilities, and so forth.

Then, after everything is deducted, your money is deposited into the department’s account!

So, the hospital has its own marketplace, with severe polarization.

And the emergency department is a poor, struggling department that often can barely make ends meet, and if it weren’t for special funds and targeted subsidies, it might have already gone bankrupt…

Of course, the hospital wouldn’t actually let the emergency department go bankrupt.

But… not letting you go bankrupt doesn’t mean that applying for an operating room would be any easier!

ps: Waking up early to code, aren’t I good?-