Procedure Changed a Plastic and Reconstructive Surgeon's Life

When Jeffrey Hartog, MD, completed his early training in dentistry in Johannesburg, South Africa, where he grew up, there was no long-range plan to parlay those skills into a career as a leading plastic surgeon. Circumstances, and a personality trait that Hartog classifies as being a glutton for punishment and training, brought about the career progression.

“My formal maxillofacial training in Miami was very aggressive in the sense that we were thrown into the thick of things with a lot of big surgeries that you don’t normally associate with dentists and oral surgeons,” Hartog explains. “Stuff that in many other places would be done by other medical surgical specialties. So it was just this thing to continue more training.”

And to this day, the training continues.

Career learner

The training and education Hartog has received clearly sets him apart from other doctors and plastic surgeons. In addition to having dual board certifications in plastic surgery and in oral and maxillofacial surgery, Hartog has completed residencies in four different specialties: plastic and reconstructive surgery at the University of Utah; general surgery at the Baylor University Medical Center; oral and maxillofacial surgery at the University of Miami; and anesthesiology at the University of Miami.

“I just think pretty much all of my life I’ve marched to the beat of a different drummer,” Hartog says. “When I get something in my mind that this is what I want to do, the worst thing someone can tell me is that I can’t do it, or it’s not smart, or that I should take the easy way out. It’s a personality trait with me, I guess. Sometimes I think it would have been a lot easier to take some of the easy ways out. I could probably be retired on the Florida Keys by now.”

But that probably would not have lasted long for a man who admits to being “easily bored” — a trait he believes may be one of his weaknesses, but is also a strength.

“More than anything else, it’s the interesting things that keep you going,” he adds. “I always need to be doing something new, or that’s cutting edge.”

Perfecting a technique

Since Hartog opened The Bougainvillea Clinique in Winter Park, Fla., he has become a visionary in the field of plastic and reconstructive surgery. His visionary approach, and belief that there is more to surgery than just surgery, led him to attend a conference four years ago that focused on fat grafting, or breast reconstruction with fat.

Hartog explains that fat grafting is not new; it had been done in plastic surgery for more than 100 years with various ups and downs in popularity, “mostly related to the fact that we couldn’t get it to work consistently.” But over the last decade, thanks in part to the efforts of several pioneers, including Gino Rigotti, MD, from Italy, fat grafting works in a much more consistent fashion. Hartog says that attending the conference changed his life.

“My take coming out of this conference was, well, ‘why would you even do anything else?’” he asks, rhetorically. “Why would we even think about implants and flaps that seem sophisticated on the surface but they have a much higher complication rate? Whereas fat grafting was always sort of at the bottom of the list of reconstruction options, I came out thinking it should be at the top of the list, because I think it’s inherently superior.”

Hartog says that fat grafting is “true regenerative medicine surgery” because it enables a patient’s body to use its own tissues.

“Short of growing a breast in the lab, fat grafting is about as close as we can get to sort of re-growing a breast,” he explains. “So in a sense we’re really re-growing a breast without the breast tissue, which, from a cancer perspective, is desirable.”

As fate would have it, four months later Hartog’s wife was diagnosed with breast cancer that, eventually, would necessitate a double mastectomy. Following discussions with his wife, fat grafting, as an option, became a no-brainer. Hartog immediately sought out “the masters” — those plastic and reconstructive surgeons skilled in fat grafting. However, due to scheduling conflicts, Hartog ended up performing the procedure himself.

He admits to having been a little nervous, but adds that “the beauty of fat grafting is, my comfort level in terms of not having major complications is much higher, in the sense that at any one point or stage in the procedure, I can feel comfortable that the complication level is so low compared to other procedures out there, I’m not going to hurt the patient. So that also made it easier.”

Other passions

Away from his practice, Hartog is also an avid photographer and scuba diver. His interest in photography began in elementary school, and at times he used his skill to acquire part-time jobs to supplement his income while in school. He was also a photo journalist while in the military in South Africa.

He began scuba diving when he arrived in the United States in his 20s, and almost immediately the two passions grew together. It started with underwater photography of wildlife, and evolved into doing photography in a pool with models — some of whom are his patients with their newly reconstructed breasts. His work has won awards.

“I don’t play golf, so it’s a good distraction,” Hartog says. “I’ve also been a little fortunate in how things have come full circle, in the sense that some of the studio work I do provides a little bit of an artistic outlet for me.”

Fortunate guy

Hartog says he is “lucky” to have found fat grafting — a regenerative concept of plastic surgery that he finds very rewarding, and is excited about its future.

“It goes beyond vanity,” Hartog explains. “We make people feel better about themselves by putting in breast implants, but at the same time we know there are issues and complications related to these. So it’s rewarding to know that I’m not just helping people, but also helping them with something that seems to make so much more sense than anything I’ve ever done before.”