A Plastic Surgeon Who Lifts Spirits, Not Faces – The New York Times

By GABRIELLE GLASER

Mention plastic surgery in New York, and the mind automatically travels to the indulgences of
the rich and famous: tummy tucks for celebrity mothers, brow lifts for television anchors, face
lifts for Upper East Side doyennes. But far from the hushed décor of Park Avenue waiting rooms,
there is a grittier edge to plastic surgery in this city, where doctors struggle to repair the ravages
of urban life.

”Everyone thinks about those women who get their faces done over and over, or people who are
trying to change, to get away from something,” said Dr. Richard Garvey, a plastic and
reconstructive surgeon who works in the Burn Unit and Trauma Center at Jacobi Medical Center in
the Bronx. ”Of course they exist, but there’s a whole other side. A lot of people don’t have it so
easy.”

At Jacobi, Dr. Garvey helps victims of gang warfare and subway accidents as well as people born
with physical deformities.

”These kids come in here, all messed up, they’re on drugs or in gangs or both,” he said. ”They get
their faces cut up, their noses chopped, they think it’s an honor. They don’t realize it’s going to
stigmatize them later. You should see their parents. ‘Can you help my son? He’ll never get a job!
No one will hire some gang member!’ ”

In a typical week, Dr. Garvey reattaches severed limbs and uses microsurgery to repair damaged
flesh on the leg or arm by transferring healthy muscles from the back or belly. Under a
microscope, with a needle finer than a strand of hair, he stitches blood vessels from the new
tissue to the old. Often, they are as small as one millimeter in diameter. Speed is essential. The
limb will die if fresh blood is not supplied within hours.

”Once you’ve done these complicated procedures, you get a lot of confidence for comparatively
small challenges,” Dr. Garvey said. On a recent day, he was positively relaxed as he prepared to
reconstruct the nose of a 17-year-old Bronx boy who had lost a half-inch chunk of tissue to a
switchblade. The boy’s cheeks bore slashing scars, which had been repaired in earlier surgeries.

”You doing O.K., man?” Dr. Garvey asked. ”My man, you with me here? We’re going to fix your
nose, pal. You’ll breathe better, and you won’t be upset when you look in the mirror, O.K.? You
got to promise me to just stay out of trouble.”

The boy looked dazed. ”I’ll try, Doc,” he said.

The surgery required Dr. Garvey to graft a piece of cartilage from the base of the boy’s nasal cartilage into the hollow.

”Look, there was a lot of other stuff going on in my neighborhood growing up, too,” said Dr.
Garvey, 39, who is the youngest of six and grew up in the Pelham Parkway section of the Bronx. ”I
respect these kids. I know where they come from. It’s hard work to be different, believe me.”

Dr. Garvey’s work is inspired in many ways by his sister Valerie, who had spina bifida, lung and
heart defects, and severe facial deformities, and died at 13. At an early age, he saw how the world
reacted to her. As the closest in age, he became her surrogate care giver, measuring her medicine,
checking her blood sugar, and helping his mother take her to doctors.
”Kids at school would make fun of her because she was in a wheelchair, and I would just get
furious,” he said. ”She’d smile, and her gums would show. They’d laugh, because she looked
different. People called her terrible things. I would storm out of the house and want to beat up
any kid who made fun of her. There was even a time when I almost hit someone in church, I was
so mad. Even there, kids would laugh at her when she’d sing or even talk out loud. Her voice was
different.”

As a child, he often thought about the doctors at Jacobi, which was across the street from his
grandmother’s house. ”I’d wonder what it was like to be able to really help people,” he said. ”With
Valerie, we felt so

Dr. Garvey is not the only doctor in the city who is aware of the emotional dimension of plastic
surgery. ”People come in with injuries and deformities that are very distressing to them,” said Dr.
Ferdinand Ofodile, who was born in Nigeria and does reconstructive procedures at Harlem
Hospital Center. Dr. Ofodile concentrates on treating black patients with burns, whose skin may
present special challenges. ”They cause big social problems.”

When Dr. Garvey was 14, he saw a PBS documentary about plastic surgeons. He watched, riveted,
as doctors did extensive reconstructive surgery on patients with congenital deformities, burns and
injured limbs. ”I just knew that’s what I’d do,” he said.

His own path was not easy. Dr. Garvey’s father died when he was 2, and his stepfather, who
adopted him, supported the family on a bus driver’s salary. At 15, Dr. Garvey started work at
Frankie and Johnny’s Pine Tavern on Bronxdale Avenue. He was a busboy, a waiter and finally a
bartender, saving money throughout his four years at Columbia University to pay for for medical
school at Georgetown University.

He is on the staff at Jacobi, where he works up to three days a week. He also has a private
practice, which he splits between an office on Fifth Avenue and one in Westchester.
Training for plastic surgery is long, beginning with four years of medical school and a residency of
seven years. Then, there is at least a 14-month wait for board certification, which Dr. Garvey is in
the process of obtaining.

Dr. Garvey, who prefers black turtlenecks to starched shirts, puts patients at ease with his
informality.

”You get people coming in, embarrassed, ashamed,” he said. ”I try to help people relax. I say:
‘Look at my nose! It’s no symmetrical masterpiece!’ It’s all crooked. I got into fights. I try to
remember the anxiety you feel when you’re on the other side.”

”I always knew I was going to be a doctor,” Richard Garvey said. ”There was a lot of other stuff going on in my neighborhood, believe me, but I always knew I was going to be a doctor.”

”Sometimes patients want things that are unreasonable. You’ll get a person on their 12th
procedure, with implants everywhere.” ”What gets to me most is seeing people suffer, whether it’s
from an accident or just that they’re feeling trapped inside their bodies.” ”As a plastic surgeon
you work on the surface. You fix scars or cut away the bumps or time, is all. It’s like changing
drapes that don’t work with the rest of the room. Of course, I wish that the outer layer wasn’t so
important. But look at the Romans. The Greeks. The Egyptians. Nefertiti. Beauty’s been around a
long, long time.”

Copyright 2010
The New York Times Company