Week 3 Jess Orton

I started this week by shadowing Dr. Spector during his clinical rounds on Tuesday. We again saw a variety of patients and cases. On Wednesday I attended Dr. Spector's OR where I saw a fat graft, a breast reduction and a nose reconstruction. The rest of the week I spent in and around the lab, where I was able to observe some breast tissue digestion from the breast reduction surgery I had observed in the OR. The fat graft surgery was for a patient that I had seen previously with Dr. Spector in the clinic. Fat from the patients abdomen and thighs was removed and then injected into the patients face as treatment for her scleroderma. Scleroderma is a rare autoimmune disease that involves an overproduction of collagen which leads to tightening of the connective tissue. The severity of the disease varies from patient to patient and can present in multiple different locations throughout the body. Little is known about the cause of scleroderma, however some treatments exist to alleviate certain symptoms. This patient's scleroderma presented most severely in her face, causing tightening of the skin, and leaving her unable to close her mouth at rest. She was undergoing her second fat graft, the first Dr. Spector had done a few weeks prior. When we initially saw her in the clinic, Dr. Spector was evaluating the results of her first fat transplant. He explained to us that even in the best case scenario, about half of the fat that is transferred will be lost, therefore multiple grafts will need to be performed over time to achieve the best results. I think the most interesting thing about this week has been seeing the journey from the clinical setting to the operating room and then to the lab.