Smile for a While

written by Dr Kim K. Tan on 20 June 2012


Smile for a While
It’s easy to forget just how fragile we all are. We are easily damaged.  Not so terribly long ago when a part of the body was badly injured it would need to be amputated. It’s a clear sign of how far we have come, and in a relatively short time, that doctors can now repair and reconstruct some quite appalling disfigurements, injuries, burns etc.  Dr Kim K Tan specialises in Plastic, Reconstructive & Aesthetic/Cosmetic Surgery and Hand & Microsurgery at Pantai Hospital. He is in the business of revolutionising lives. Dr Tan was schooled and trained in the UK initially specialising in orthopaedics. It was in this field and back in his native Malaysia where he developed his passion for reconstructive work. It’s worth noting that orthopaedics was moved substantially forward by Russian surgeon Gavril Abramovich Ilizarov in the 1950s. He was working on injured soldiers in Siberia with very little equipment. Ingeniously he employed local bicycle shop tools and devised ring external “fixators” which are tightened in the same way as spokes of a bicycle wheel. The technique proved highly effective in curing misaligned fractures and the “Ilizarov apparatus” is still used today. Such is Medicine.
“I realised that it was actually possible to restore and repair damaged bits of the body that might otherwise be thrown away,” Dr Tan explains. “In this area the emphasis is on the tissue around the wound and understanding the applications of plastics. I had found my calling, as it were, and I pursued it.” He returned to London to train as a cosmetic surgeon. “It was back to stage one,” he laughs. 
Cosmetic surgery as a discipline dates back to the Great War when a whole new range of facial injuries were prevalent as a result of the trench warfare. Kiwi Sir Harold Gillies is widely credited as the father of plastic surgery.
“The thing that really switched me onto this area was seeing what could be done for children with facial deformities and the profound difference this could make to their lives,” says the doctor scrolling through scores of files of pictures of the cases he has worked on. In 2003 he went on a holiday to Sarawak visiting the Mulu caves. While there he came across a 20-year-old man with a cleft lip. It dawned on Dr Tan just how difficult it was for many people to have such a condition treated. “In these rural areas it’s not easy for people to get access to medical care, transportation is tricky and poverty is the norm. Parents of children with simple deformities like a cleft lip and palate simply cannot get the treatment that their child requires and that is a real tragedy.”
Around the world one child in every 600 is born with a cleft lip. The untreated child in these rural situations is stigmatized and they cannot talk so usually drop out of school thereby closing off their one door out of poverty. “It’s so important that we treat children before they get beyond the five-six-seven-years of age so that they can get a proper schooling and have half a chance,” says Dr Tan. He has been regularly visiting Sarawak for the past five years and has conducted over 200 operations over that period. He works with a team at Columbia Asia Medical Centre in Miri who identify the cases and who organise transport and accommodation for the patients. They broadcast across local radio stations announcing that these treatments are taking place to reach the remote communities. Dr Tan has treated a wide variety of patients from young toddlers to his oldest a 63-year-old Penan headman. Funding for this comes from companies like McDonalds, Shell and ING through their CSR projects, the local Irish Society and Alice Smith School have both contributed substantially.  Of the operation involved Dr Tan is modest: “It’s a 45 minute operation and it’s basically cut and sew. You just need to be able to cut and sew properly.”
Dr Tan sternly defends his cosmetic surgery craft: “It’s not about vanity, it’s not about all that Pamela Anderson nonsense.” Non-existent breasts, breast that are unfeasibly large, ravages of child birth and protruding noses, Dr Tan fixes them all. “A person’s self-image and their confidence are closely linked. If you take a woman in her mid-twenties whose breasts have just never grown this is something that seriously impacts on how she sees herself. A simple operation and this can be resolved.” He lambasts the outbreak of so many so called cosmetic clinics that he says: “Are trivialising a serious craft selling cosmetic treatments as if it were a haircut, it’s legitimised quackery.”