Capturing Plastic Surgery on Film—Making Reconstruction Visible

Summary:

The Swiss Plastic Surgery Association (https://plasticsurgery.ch/en/) decided to produce a corporate video to illustrate the concept of "plastic surgery of confidence" to the public. We show the diversity of specializations and the vast range of tasks that surgeons passionately handle day in and day out. We wanted to convey 2 main messages: first, that plastic surgery is more than just cosmetic surgery, and second, that plastic surgery in Switzerland is synonymous with quality and confidence. We selected 17 topics that we felt had good filmic potential and would best explain to the public what plastic surgery is about. This included the selection of appropriate patients, experts, and locations from all over the country. We thought it crucial to show the initial preoperative situation, as only in this case would the achievement of reconstruction be evident and comprehensive to the layman audience. The actual production was filmed in 5 different locations and took 5 days of shooting. We recorded 17 surgeons, 9 patients, and about 30 voluntary background actors. From 23 hours of footage, we created a 7 minute, 22 second corporate video, recorded in 3 of the Swiss national languages. The video was presented to the public online in June 2016, on the same day as the National Open Day of Plastic Surgery in Switzerland. The video is available online. We evaluated the impact of the video using a questionnaire for lay people and observed that it could substantially improve the perception of our specialty, especially regarding the reconstructive aspect. We feel that a freely available corporate video is a very useful means to promote plastic surgery and help patients better understand what it is all about.

In Switzerland, an increasing segment of patients considers having aesthetic plastic surgery abroad. The main attraction for doing so is the cost differential. After returning to Switzerland, health insurance will cover treatment costs in case of complications, which damages the health care system, ultimately leading to increased health care costs.

To mitigate this problem, the Swiss Plastic Surgery Association (SGPRAC) decided to run a campaign with 2 major goals. The first was to emphasize the quality of service offered in Switzerland and the advantages of undergoing surgery in a place where you know and trust your surgeon. The second goal was to correct the general misconception that plastic surgery mostly consists of aesthetics. We wanted to depict more realistically what plastic surgeons do day to day.

For these purposes, the SGPRAC decided to complement its Web site with a corporate video. In the video, we wanted to illustrate what we define as “plastic surgery of confidence”: the diversity of specializations and the vast range of tasks that plastic surgeons manage.

We decided that the corporate video should convey 2 main messages:

1. Plastic surgery is more than just cosmetic surgery.

2. Plastic surgery in Switzerland is synonymous with quality and confidence.

In February 2016, the project was approved by the committee members of the SGPRAC and entrusted to the NOW Communications Agency (Basel, Switzerland) for film and motion design.

We selected 17 topics we felt had good filmic potential and would best explain to the public what plastic surgery is about. We planned to present each specific topic with a short statement given by an expert, followed by a corresponding illustrating scene that would explain the concepts. To create an image of confidence and maximum credibility, real patients and their surgeons were involved in the film.

The topics we chose were history of plastic surgery, education and training, research, quality control, dermatosurgery, rhinoplasty, lower extremity reconstruction, breast reconstruction, midface reconstruction, hand surgery and microsurgery, lymphedema surgery, burns, head and neck, body contouring, aesthetics, facial palsy, and humanitarian missions.

The invited experts prepared statements that would best explain the assigned topic to a layperson in his or her mother tongue. The length of statements was limited to 15 seconds of speech to stay within a 10-minute video duration as well as to force the experts to explain the concepts as succinctly as possible (Fig. 1).

Fig. 1.

Prof. Brigitte Pittet-Cuénod (head of department of Plastic Surgery at Geneva University Hospital) during the video shooting for Swiss Plastic Surgery.

The experts were asked to invite suitable patients to take part in the project. We felt it was very important to work with real patients and show their authentic stories. For the final cast, 9 patients were recruited. All the patients gave their informed consent to participate in the video project according to the Declaration of Helsinki.

The following cases were included: an amputated hand, an open lower extremity fracture, a 90% body surface burn, a total mastectomy, a large skin defect of the nose, a rhinoplasty, an open maxillary fracture, a body contouring, and 3 noma cases. We found it crucial to show the initial preoperative situation, as this would make the achievement of reconstruction evident and comprehensive to the lay audience. The very explicit preoperative images contrasted with the standard glossy imagery of plastic—especially aesthetic—corporate video productions. To avoid scaring the audience while still illustrating the efficacy of the operation, we decided to show the preoperative situation not as full screen but rather as picture-in-picture during physician-patient interactions (Fig. 2).

Fig. 2.

Showing the preoperative image of an amputated hand as picture-in-picture to make the achievement of reconstruction visible

We shot the film scenes in a variety of venues: the operating theater (Fig. 3), the laboratory, an interdisciplinary board meeting, a seminar on cadaver dissection, at the microscope, and at a meeting of surgeons. For patient safety and privacy reasons, it was not possible to shoot patient scenes in a real-life context, so we reenacted them with the help of some 30 voluntary background actors.

Fig. 3.

The film crew shooting illustrating scenes in the operating theatre for the Swiss Plastic Surgery corporate video.

To put the whole story in a historical context, we decided to create an animated introduction to the main video using historical artifacts. We wanted to show the evolution of plastic surgery and that current treatment options of plastic surgery were not available even 50 years ago. To make the historical introduction, images from stock photo agencies were purchased and animated in a dynamic, paper-theater-like style. We decided to illustrate a time span from Greek antiquity to the beginning of the microsurgery era in the late 20th century.

In the video, we wanted to reflect the unique cultural situation in Switzerland, with its 4 national languages and distinct cultures living in the same country. The actual production was filmed by the flum e-projects (Switzerland, Basel) crew in 5 different locations, spanning the country (Zurich, Geneva, Lausanne, Basel, and Rheinfelden). It took 5 days of shooting within a month.

Of the 23 hours of footage, we created a corporate video of 7 minutes 22 seconds. The experts’ statements had to be translated and dubbed so that we could provide the video in 3 national languages. Apart from the main video, we produced a trailer for the interested visitor on the SGPRAC Web site (https://plasticsurgery.ch/) and Facebook profile. The final videos were installed on the Swiss Plastic Surgery Facebook site and YouTube channel to facilitate the expert–patient interaction. Final costs were 49,500 Swiss Francs (49,978 U.S. Dollars). The video was presented to the public on June 4th 2016, when the National Open Day of Plastic Surgery took place.

We evaluated the reception of the video by the public with a questionnaire (Fig. 4) given to lay audience. Surprisingly, only 45.24% had personal experience with plastic surgery before. Eighty percent of the audience stated that they learned something new about plastic surgery. We also observed a substantial impact on the reconstructive image of our specialty, compared with the aesthetic field, which initially represented the most strongly associated topic.

Fig. 4.

Statistical analysis of the reception (questionnaire, response rate: 127/500) of the video regarding its impact on personal attitude toward plastic surgery (question: What is your attitude toward plastic surgery?; A), main tasks of plastic surgery (question: What do you most associate with plastic surgery?; B), preferred information source of lay people regarding plastic surgery (question: Which information source would you prefer, to learn more about plastic surgery?; C).

We are convinced that a corporate video is a very useful means to promote plastic surgery and helps patients better understand what it is about.

ACKNOWLEDGMENTS

The authors thank Denys Montandon, Daniel Kalbermatten, Jan G. Poëll, Claudia Meuli-Simmen, Martin Haug, Elmar Fritsche, Jian Farhadi, Abdul R. Jandali, Jörg Grünert, Yves Harder, Wassim Raffoul, Rene D. Largo, Mihai A. Constantinescu, Pierre Quinodoz, Jonathan Leckenby, and Brigitte Pittet-Cuénod.