"How is the examination?"
"The skin quality on the right thigh is better than expected. Although the scars are prominent and widespread, the deeper tissues are healthy with rich blood supply. I designed a three-surgery plan, and she agreed. She even raised a technical question about the incision direction, regarding how to better follow the tension direction of Langer’s lines."
"Thank you!"
"You’re welco! I should be thanking you for giving this opportunity. But I must ask you a question, why aren’t you doing this surgery yourself? As far as I know, your level in plastic surgery must be on par with mine."
Yang Ping answered honestly, "Because I am not good enough, in functional reconstruction, I definitely surpass you. But in aesthetic judgnt, I lack talent and sufficient training. This is also one of the reasons why I am not interested in plastic surgery. I enjoy doing surgery, but plastic surgery is the exception."
The phone was silent for a long ti. Then Ivan said, "You know, Professor, this is the first ti I’ve heard you say these things. In my mind, you are always perfect, always right, always able to accomplish everything. Now, you are willing to acknowledge limitations, willing to demonstrate these limitations for the sake of a student. This makes you more like a ntor, rather than a dical machine. I will take good care of her, even though it’s just a scar surgery, I will give it my all."
The surgery was scheduled for Monday morning at seven.
Sisi lay on the operating table, her right thigh exposed under the shadowless lamp. Under the intense light, those scars appeared even more obvious, like a rough map marking multiple surgeries from years ago. By the ti she counted to twenty-three, the anesthesia began to take effect. Her last consciousness was Ivan’s voice, humming a song in a language she couldn’t understand.
Yang Ping stood beside, dressed in surgical gown, with an agreent with Ivan — today he would not intervene, just be an observer.
Ivan’s movents had a unique rhythm, unlike Yang Ping’s precise restraint, but instead, a fluidity, almost akin to a dance. He first injected a diluted epinephrine saline around the scars, reducing bleeding while separating the subcutaneous tissue. Then, he began designing the incision, not a simple resection, but a series of complex geotric modifications, interweaving Z and W shapes, like so ancient woven pattern.
"The key to Z-plasty," Ivan once said to Director Lan of the Plastic Surgery Departnt, "is not the geotric angle calculation, but understanding the language of skin tension. Every scar is speaking, telling you the pressure it bears, telling you the direction it wishes to release. What you need to do is to listen, then reorganize these tensions, harmonize them in. The highest realm of judgnt in plastic surgery is not calculations, but feeling with heart, like a musician."
"Pay attention to the tension direction here," Ivan said, gently lifting a skin flap with his fingers, "If I suture according to this angle, shear force will be generated when moving post-surgery. But if I adjust five degrees, of course, approximately five degrees, in line with the direction of muscle contraction..."
"Following chanical vectors in three-dinsional space, just like cells conforming to morphogen gradients during embryonic developnt. Macro surgery and micro chanisms adhere to the sa geotric principles."
"The suturing is fluid and precise."
Director Lan temporarily couldn’t understand this analogy. But now, watching Ivan’s operation, he began to comprehend what it ant.
Sisi’s main incision scars on the right thigh were cleverly decomposed, skin flaps flipped, interlocked, and then sutured. The originally straight, contracted scars beca new lines conforming to skin texture and natural tension lines. When Ivan completed the final suture and gently articulated Sisi’s knee joint, Yang Ping saw the skin movent beca natural, no longer having that tight, confronting sensation.
The first surgery involved embedding a skin expander, and now Director Lan knew the level of a world-class plastic surgery master, even the placent of several skin expanders could be considered perfect. The expanded skin not only fit just right, neither too much nor too little, but most importantly, those interwoven skin textures surprisingly could beco continuous, natural under recombination, without any sense of disorder.
This is truly a beauty of enjoynt, requiring extrely high aesthetic intuition.
The surgery lasted four hours. Yang Ping stood in the operating room for four hours.
Ivan removed his surgical gown.
"The surgery is complete, once the swelling subsides, you will see the effect. But the real magic will manifest in a month."
"Thank you," Yang Ping said.
"You’re welco. But I must tell you one thing..." Ivan leaned against the wall, rubbing his neck, "I’ve been thinking about your theory, three-dinsional orientation, cellular positional sense. Do you know what the biggest problem with scar tissue is? It’s not the excessive collagen deposition, it’s the chaotic arrangent. Normal skin, collagen fibers are orderly, like woven fabric; the collagen of scar tissue is chaotic, like a ss."
"If," Yang Ping finished for him, "if we can re-establish that ’positional sense’ in the early stage of wound healing, guiding fibroblasts to grow according to the normal spatial pattern?"
"That would be preventing scars, not treating scars," Ivan said, "My theory of scar preventive treatnt is based on your theory. You will gradually see the power of this technology, dare I say, your theory helped overco scars, overco my past self."
Sisi’s recovery was smoother than expected, also because of her own involvent.
Two weeks post-surgery, she returned to the hospital for stitch removal. Yang Ping accompanied her, watching Ivan carefully remove the dressings. The swelling had subsided more than half, and the new incision lines were still quite noticeable, but the shapes already showed Ivan’s ticulous design. They followed the direction of the muscle gaps on the outer thigh, rging naturally into the skin texture like rivers flowing into the sea.
Sisi was not rely passively accepting the examination. She asked Ivan every technical detail: why choose this angle, how to calculate the length of the skin flap, how to anticipate post-surgery tension changes, the design of the skin texture junctions, making the recombined skin textures appear natural and harmonious. Ivan answered each one, sotis illustrating, sotis asking Yang Ping to supplent theoretical background. This three-party dialogue turned into a unique educational scene, Ivan teaching techniques, Yang Ping teaching principles, and Sisi learning.
"You will continue to change," Ivan said, "The color will fade in three months, and stabilize after a year. All this is within my considerations, and I will ensure that the final color matches the surrounding normal color." He asked Sisi to flex, extend her knee joint, "The skin moves along, without a sensation of being pulled. This is the redistribution of tension."
"I want to docunt this process," Sisi said, "as my first case study. Not as a patient, but as a learner. I want to track my recovery, take photos, asure, record subjective feelings. This could beco a complete educational case, about functional and aesthetic reconstruction in plastic surgery."
Yang Ping and Ivan exchanged a look.
"You can do it," Yang Ping said, "but it requires ethical review, protecting privacy, obtaining consent from all involved parties. dical records are not just data, they are human stories. If you want to use this story, you must first respect it."
"I understand," Sisi said, "I will formally submit an application. Also, I want to invite you and Professor Ivan as co-ntors. This is a surgery you both completed together, you should both guide my research."
Ivan laughed, a hearty laugh like a seabird, "She has already learned, how to make requests, how to establish cooperation, how to transform personal experience into public resources. Your student is very smart, my goodness, she is still just a high school student yet to enter college. I truly envy you, having such a good student and being able to intervene in her education from now on. I dare not imagine, what kind of doctor she will beco in the future."
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