Dr Kuldeep Singh: The best cosmetic treatments are subtle

Dr Kuldeep Singh is a distinguished plastic surgeon and senior consultant at Indraprastha Apollo Hospital in New Delhi, specializing in aesthetic plastic and reconstructive surgery. With over 25 years of experience, Dr Singh has developed exceptional skills and expertise in the field, establishing a reputation for excellence and professionalism in cosmetic and aesthetic surgical procedures throughout his nearly three-decade-long career.

Can you tell us about your journey into the field of plastic and reconstructive surgery?

I embarked on my medical career after earning my MBBS in 1982, followed by a master’s degree in surgery in 1986. I completed my plastic surgery training at PGI Chandigarh in December 1989. In January 1990, I began working as an Assistant Professor in Plastic Surgery at KMC Manipal, a position I held until November 1995. Subsequently, I relocated to Delhi and joined Apollo Hospital as a resident consultant. I have since been a full-time consultant at Apollo Hospital, where I continue to practice today.

What inspired you to specialize in this area of medicine?

After completing my master’s in surgery, I hadn't initially considered a career in plastic surgery until my move to Delhi. Upon arriving in Delhi, I secured a position as a registrar at Saptajain Hospital, specifically in the plastic surgery department. The department was exceptionally well-run and efficient, which piqued my interest in the field of plastic surgery. Although I joined as a resident, I soon realized that many people there were preparing for entrance exams for the super specialty course in plastic surgery. Motivated by this environment, I decided to apply for the course as well. This decision led to my admission to PGI Chandigarh, where I completed my advanced training in plastic surgery. Following my time at PGI, I landed my first professional role in Manipal, which marked the beginning of my dedicated career in plastic surgery.

What are some of the latest trends and advancements in cosmetic surgery that you find particularly interesting?

Plastic surgery encompasses two main branches: reconstructive and cosmetic surgery. Reconstructive surgery corrects defects, deformities, and injuries to restore normal function and appearance, while cosmetic surgery focuses on enhancing the features of those who are already normal. In our practice, 30 to 40 percent involves cosmetic procedures, with the rest being reconstructive. Cosmetic surgery primarily deals with rejuvenation or restoration, addressing age-related changes such as skin pigmentation, texture, and sagging. Previously, surgical options were mainly available for those over 50, but now non-surgical methods like Botox, fillers, and lasers are accessible for younger patients, helping to minimize aging changes early on. By intervening early, we can prevent more severe issues later in life. The best cosmetic treatments are subtle, aiming to make you look like a healthier, fresher version of yourself without obvious signs of intervention, maintaining a natural and unique appearance.

How do cultural perceptions and societal attitudes toward cosmetic surgery differ between countries, such as India and Nepal ?

Traditionally, in India and Nepal, people lived in joint families and typically began earning in their late twenties or early thirties, often continuing to reside in the family home. Cosmetic surgery was generally frowned upon, seen as vain, and reserved for life-saving situations. This perspective is now evolving as young people gain professional and financial independence earlier, choosing to live separately and make personal decisions, including opting for cosmetic procedures without seeking family permission. Increased purchasing power and cultural shifts towards personal autonomy have led to more young people spending on travel, health, exercise, and cosmetic procedures. This trend mirrors practices in the West, where children often leave home at 16, becoming financially independent and personally funding their education and surgeries. Consequently, cosmetic procedures became more common there sooner. Over the past five to ten years, similar trends have emerged in India and Nepal, with more young people embracing independence, reflecting a broader cultural shift towards self-sufficiency and personal well-being.

How do technological innovations such as 3D printing and robotics play a role in modern plastic and reconstructive surgery?

Technological advancements have significantly impacted both cosmetic and reconstructive surgery. In cosmetic work, three primary types of energy, including radio frequency, are now delivered through advanced systems that enable precise and safe treatments for skin tightening, fat reduction, and texture improvement. These systems have evolved to offer highly selective treatment options, with modern machines incorporating sophisticated software that includes preset settings tailored to specific skin types and issues, making non-surgical procedures more effective and safer. In reconstructive surgery, significant progress includes the development of microsurgery, which allows surgeons to join arteries and veins less than one millimeter in size under a microscope, restoring blood flow to amputated limbs and tissues used in cancer reconstruction. Additionally, super microsurgery has emerged as a groundbreaking technique for repairing lymphatic vessels, which are less than 0.5 millimeters in diameter. This is particularly beneficial for conditions like post-breast cancer treatment, where tissue removal can cause swelling due to blocked lymphatic channels. By repairing these channels, the fluid flow is restored, preventing limb swelling. While robotics has not yet significantly influenced plastic surgery, 3D printing is proving to be highly beneficial, allowing for the creation of customized bone and dental implants, especially useful after injuries or cancer surgeries. These advancements collectively enhance the precision, safety, and outcomes of both cosmetic and reconstructive procedures.

What advice would you give to young medical professionals who are considering a career in plastic surgery?

For young medical professionals contemplating a career in plastic surgery, my advice would be to embrace the captivating nature of our specialty. Unlike other fields, plastic surgery knows no geographical bounds, encompassing the entire human body. It offers a constant source of stimulation and creativity, demanding innovative thinking and adaptability on a daily basis. Those with an artistic inclination will find plastic surgery particularly rewarding. Before each procedure, envisioning the desired outcome and working towards it requires a blend of surgical skill and creative vision. If you’re drawn to the artistic side of medicine, plastic surgery is a field worth exploring and committing to.