The Art of Reconstruction for Plastic Surgeons

Lead Research Organisation: University of Lincoln
Department Name: Lincoln School of Art & Design


Rationale: Since Aristotle and Hippocrates in ancient Greece through Claudius Galen in the middle ages and Leonardo de Vinci in the renaissance art has been inextricably entwined with medicine. Although more often viewed in the context of illustrations, such as from Max Brodel in the early 20th century, today's advances in modern plastic surgery now call for a far more dynamic involvement directly supporting the proficiency, and thereby outcomes, of the surgeons technical skill. 21st Century plastic surgery is as much concerned with improving the perceived quality of life as it is, over and above, essential reconstruction. This requires an aesthetic sensitivity and understanding of art and form that is not part of a surgeon's normal training.

Objective: Building from the success and feedback of an initial provisional workshop for surgeons in November 2009 this project is structured as a pilot study to develop a new research network that will extend the application of the visual arts in medicine enabling the development and treatise of the intersection of art and science in respect of the new practice based ideas and concepts currently formulating in plastic surgery.

Research considerations: In integrating the visual and representational skills of art to the reconstructive technical skills of a plastic surgeon there are a number of key issue to address.
- Is there an added value applying 'art based' skills to the understanding and implementation of aesthetic considerations within the operating theatre?
- Can we examine the intention of the value of 'art based' skills to the understanding of aesthetic considerations within the operating theatre?
- Can we improve on NHS pre and post operative patient and surgeons perceptions of 'success'?
- Can we discuss and assist in cultivating an ability to identify facial and body characteristics differing from the norm?

Applications and Beneficiaries:
- Primary and initial beneficiaries will be participating NHS surgeons who acquire new skills enabling a more informed and confident aesthetic decision-making process; investigating formal and practical aesthetic principles to integrate into their medical practice. Surgeons who participate will also pass on the benefits to NHS colleagues.
- This project will test and develop strategies that explore the relationship between differing spheres of activity through a process of reciprocal interactions reinforcing the intimately connected worlds of art and science. The benefit follow up and qualitative analysis is thus central in order to validate the approaches used and identify routes to further progress and uptake.
- Ultimately, the major benefit is to the patient through improved outcomes and perceived quality of life.

Additional Impact: The University has a planned conference on 'Drawing' in 2010 for artists, plastic surgeons and conservation/heritage science professionals and the conference and Network Project will interrelate directly with this.

Additional Background: In addition a limited skills based workshop has been run in New Zealand and Australia for surgeons but there has been no follow-up academic research, debate and dissemination. 'The Art of Reconstruction' pilot project will address this and formulate development and application roadmaps relevant to the NHS medical specialist in the UK. Thus contributing to both the disciplines of medicine and the visual arts in the UK.

Outputs: Workshops and seminars will develop and validate the central tenets. Academic analysis of the projects findings and best practice guidelines will be will be through peer reviewed journals as well as other Journal articles, website, film recordings, case study material, teaching material and establishment of a new and important international network for Art, Architecture, Design at University of Lincoln. This initial Network will maintain contact and extend on a sustainable basis through subsequent projects and implimentation.

Planned Impact

Network Benefits: The research project underscores the significant nexus between art and science professions in such a way that both academic collaborative practices are considerably expanded and enriched. It is appreciated that this collaboration represents an acknowledgement of shared respect for our practices, research and the associated expertise within these disciplines. Art and Design HE Education in the UK is acknowledged to be world class. Drawing functions across various disciplines and this research project establishes the basis for further research into the benefits and implications of 'visual art studies' for other professions. This goes beyond the direct value it offers the aesthetic medical specialist, and provides avenues to explore into how other areas can complement their professional activities with the assistance of training in visual communication and creative problem solving. For example, the development of drawing for conservation/heritage science will be piloted at Lincoln University, in the School of Natural and Applied Sciences.

Impact on surgeons and patients in the UK: The benefits accrued through this project will have a direct impact on the field of reconstructive and aesthetic surgery. It is through their training that surgeons approach their activity from a formal surgical methodology but usually evaluate the results from an aesthetic point of view. This dichotomy can present difficulties in both the expectations of surgeon and patient. Through the research project surgeons will acquire new skills enabling a more informed and confident aesthetic decision-making process for public medical practice. It is also anticipated that surgeons will continue to seek to upgrade and develop these skills (as they have done in Australia). The University will look into this provision as part the workshop outcomes. The Interactive website and future associated events will facilitate continued dialogue and communication with key players. Similarly the engagement of art and the use of life study classes within the undergraduate medical curriculum is being tentatively developed by several prestigious Medical Schools, such as the University of Nottingham. This project will further develop the rationale for such approaches.

Impact on visual arts in the UK with relevant experience and track record: The drawing research group at University of Lincoln, embedded within Art, Design and Architecture, fosters drawing as a process of reciprocal interactions reinforcing the intimately connected worlds of art and science. Drawing functions across various disciplines, not only within the visual arts, but in other areas, particularly those dependent on visual communication and understanding. Similar projects for reconstructive, cosmetic and maxillofacial surgeons have been held in Australia and New Zealand. The classes originated from drawing classes run at The Royal College of Surgeons, Edinburgh in 1993/94 when Esson was an Artist in Residence and Healey was the Head of the Design School at Glasgow School of Art. Subsequently, in Australia, the project was extended with the most prominent surgeons in the field enrolled.

They expounded the value of the project experience to their colleagues. Since 2000 approximately 70 of Australia and New Zealand's most senior surgeons have completed the evolving project. Due to the success of the course it was introduced in Melbourne in 2008 to 80 registrars with the possibility of it being adopted as a regular component.

Economic Impact: The introduction and development of this project into the UK will impact on the potential for enhancement of UK medical economic competitiveness by delivering better results for patients who are undergoing pre and post operative plastic surgery. The enhancement and development of the field of NHS cosmetic and maxillofacial surgeons would be a power


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