Hello, everybody. I'm Stefania De Fazio. I'm a board certified plastic surgeon, and I am the chair of the International Women Plastic Surgeon Forum. I'm very proud today to open the first webinar of the IWPS, and I'm really excited and I'm really honored to have one of the pillars of the plastic surgery in United States, and a very good friend of mine, Dr. Andrea Pusic. I'd love to introduce her to the audience. She is the Joseph Murray Professor of Surgery at Harvard University, and Chief of the Division of Plastic and Reconstructive Surgery at the Brennan Women's Hospital in Boston. Originally from Canada, she completed a plastic surgery training at McGill University and microsurgery fellowship at Memorial Sloan Kettering Cancer Center. Dr. Pusic has established herself as a leading expert in surgical outcomes and quality of life assessment with over 500 publications and 20 millions in research funding. One of our contribution is the Breast-Q, a widely recognized patient-reported outcomes measures that has been used in over 75 countries globally, helping surgeons appreciate how women perceive the results of their breast surgery. As Director of the Patient-Reported Outcomes Value and Experience Center, she pioneers research that put the patient perspective at the forefront of surgical care. Dr. Pusic is a past president of the Plastic Surgery Foundation. She is a current trustee of the American Association of Plastic Surgeons and co-director of the PSF SHARE program, Surgeons in Humanitarian Alliance for Reconstructive Research and Education. The objective of SHARE program is to increase plastic surgery capacity and research in the sub-Saharan Africa through education and mentorship. Since 2019, this program has supported the training of over 100 junior plastic surgeons. Now, typically, two-thirds of graduated SHARE fellows are now active faculty in the program. She is really amazing and wonderful. Please, Andrea, the microphone is yours. Thank you, Stefania. I'll share my slides. Thank you for that really lovely introduction. It is so fun to be here. I'm particularly delighted about what we're talking about today, but I'm also just to be here with some good friends. I would say the panelists that we have for this session, particularly, I think we have an amazing group of panelists. I'll speak for a portion of the time, but what I'm really most looking forward to also is our discussion to follow and to share our various experiences and shared wisdom about what it's like to be. All of the women on this panel are leaders in plastic surgery and have so much to share. I think what's really exciting is to be able to share our global perspectives. Congratulations to the organizers for setting up this opportunity for us to have this conversation. I'll just jump right in. My disclosure is that, as Stefania said, I'm a developer of the BreastQ and other QPROMs, that we do charge companies for their use, but there is no charge for the use of these measures in non-for-profit research studies or any clinical care that you might be interested in doing. I'll try to keep my comments a bit short because, again, I would love to engage in a discussion with these panelists a little bit about myself and my background, and then my reflections on my own journey in national and international plastic surgery, and what I've perhaps found most rewarding and some of the challenges. Then I'd like to spend the last time just really thinking about where we are at in terms of female leadership in plastic surgery, and what we bring to our specialty in that regard, and what the future might look like. A little bit about me just to start off with. I'm Canadian, and so this picture was taken in about 1992. It was me in my first job as a primary care doctor, a family physician in a place called Churchill, Manitoba, which is known as the polar bear capital of Canada. Just to orient you here, this is a map of Canada. As I've said previously, this is Canada, not for sale, not 51st state. This is where Churchill, Manitoba is. And then from there, after working in Churchill for a year or so, I moved up even further north to a place called Iqaluit. And this was, again, this was me probably 1993, 1994. And this was my patient population at that time. This was also this is the first hospital that I worked at. This seemed like a big hospital at the time. And and I will say also, just in terms of, again, is getting to know me. This was my my marvelous husband now of over 30 years. I've lost track. And we met in this hospital resuscitating a child together, actually. And and then and we had our own. And this was the beginning of our family. I share this in part to help you get to know me, but also to help you understand that at that time in my life, a leadership role in plastic surgery, an academic career, were frankly the last thing that was just not on my mind. That was I was I saw myself as someone who was going to be in a more rural setting and and raise my kids. And and all of that would have been great, too. I will say, though, that I was there was a moment in my life where I had the very good fortune to be to meet these three marvelous women at different times. But early on, early on in my training, that really influenced my path and I think in a very positive way. And so this is one of my reflection is to find great mentors that that that you can relate to as a as a as a woman, because sometimes a man in that role doesn't resonate to the same extent. And so these were women who I could relate to and inspired me. Dr. Carolyn Kerrigan, also a past president of Plastic Surgery Foundation. Carolyn was really the pioneer in patient for outcome measurement. And in our specialty, she was the one who said to me, maybe you should study what women think of the results of breast surgery, which at the time seemed like kind of a crazy idea, but isn't anymore. Dr. Sherry Slasek from Baltimore. Dr. Slasek was as a past chair of the American Board of Plastic Surgery and was a consummate educator and but also a mom. Carolyn had five kids. Sherry had a number of children as well. And and I got to know both of them in that way in terms of both the professional and their personal lives. And Susan McKinnon, who was just a giant in our field in nerve surgery, was also the the first was a president of the American Association of Plastic Surgeons and and and just a marvelous mentor and also a mom with a surgeon husband. But these women really inspired me. And what I saw in there in getting to know them is that in addition to looking at providing great patient care, they were also doing things beyond that to innovate and contribute. That was really what I what I watched them do nationally and in their research. So when I first when I took my first real job as a plastic surgeon, this was the University of British Columbia. This is snow on the mountains, which is actually unusual in Vancouver. But it was this is a recent photo. But my reflection, having been influenced by by these three mentors, was that I saw them being internally motivated to innovate and contribute. And that really informed my future career as well. So I still, to this day, really love looking after patients. I also really love small towns in northern Canada. But I but I've also been this has been sort of the other key theme in my in my my life and my career. And so with that, that's really how that was how the rescue came about is was out of sort of wanting to be able to innovate and to contribute in a bigger way. A little bit about the rescue of we published it in 2009. It has been used in so many different studies, which is great to see. But particularly in the context of this, this group is that it's been used all around the world. And that's been so nice to see how research being performed in all these different settings is how we can now understand each other. And I can read a study that that Nicola Dean is putting in in Australia or that Claudia is writing in Chile. And and we can all learn from each other and learn from our patients perspective. So that's been that's been probably that's been a real joy is to see all the different studies that have come out of using the rescue. It's also really got me thinking about how we interact globally. And I think that's something that's special about being on this panel today. I still that's still a key piece of the work that I do. And this actually just very recently, this is a 2009 was the rescue. But 2025 was the is the gender cue, which we've just published on. And this was we had almost 50 countries helping in this this effort. So surgeon scientists and clinicians in close to 50 countries and close to fifty five hundred patients. So a real global effort to be able to channel patient voice. And Nicola Dean was very much involved with that. So thank you, Nicola. The International Service, I say, global has always been something that I've been really delighted to have been part of and from for a long time. And through the ASPS and Plastic Surgery Foundation, I had the good fortune that at one of the annual meetings was to meet two women who had just founded a new organization and that was reconstructing women international. And the mission of the goal of reconstructing women international is to to advocate and to provide care to women and girls globally in need of reconstructive surgical care. And that was a really a lot of this work was has been was in India and Bangladesh and very meaningful for me personally over the years. But it also I think my reflections from this was also the joy of working with other women in this in this work together. So RWI, the Reconstructing Women International, it's all female surgical teams. So our patients are all women and girls and the surgical teams are all women. And so female also the surgeons, anesthesiologists, the team. And and it's just a joy to work together. So I have some marvelous male colleagues. But one week a year, I just I work with my girlfriends and we have we have fun. And it's it is a different it is a different experience. And it's just it's it's really it's the anti burnout drug. It's to just go in and work hard and enjoy providing great care to patients. The thing that I also learned, so although we're a female team in terms of providing care and teaching and training, we were training the whole we're teaching and training the whole community, male men and women. And so this is my other over the years. My reflection with RWI has been that, well, it's been very rewarding to do to operate and take care of patients. What really has really moves the needle in terms of patient outcomes is teaching and training in local communities, empowering local communities and engaging with them to help them be able to provide high quality care in their own to to patients in their own country and their communities. And so that's really been that's over this number of years now that Reconstructing Women Internationals really pivoted towards being a force of education and teaching and training, which is also you can see here's Kavitha Ranganathan, one of my faculty and two Swiss surgeons with one of the this is in Dar es Salaam, Tanzania. So that experience, just in terms of my journey, also this idea of teaching and training and leveraging that really led directly to the development of the SHARE program. And I'll just take a few moments to tell you about that. So the SHARE program is is a program that I co-founded with Dr. Amanda Gosman when I was president of the Plastic Surgery Foundation. And Amanda was head of the Volunteers in Plastic Surgery Committee. And really, the the mission of SHARE is to help increase access to high quality plastic surgery care in low and middle income countries to improve lives globally. And with a focus to date, our focus has been in sub-Saharan Africa, which is a region in the world that has some of the highest incidence of conditions requiring plastic and reconstructive surgical care and some and the least number of plastic surgeons. How are we doing that? It's really about education. It's teaching and training and mentorship and relationship building with local with local surgical residents and junior surgeons. And really the leveraging the phenomenal resources of the American Society of Plastic Surgeons and and our MOU partners globally to help really help teach and treat and help these young surgeons that are at the beginning of their their career arc to become to be and become the very best plastic surgeons that they can possibly be to then provide the very best care to patients in their local communities. The the SHARE program works on a fellowship model. So it's geared for either chief senior residents or early career surgeons. In our first it's a two year program, both for its virtual and in person. In our first cohort, we had about 17. We had 17 fellows. These are some of these are the group I was looking at them as I was putting these slides together. And they've all become really good friends now because these were these were the group. And most of them now are actually faculty in the program, which is another key piece of it is fellows to faculty. So we went from 17. And then the next two years, we had 31. And then it's just just this January. We've had 55 fellows in ours to starting the two year program, which has been great to see the growth of the program. And I'm so grateful for the Plastic Surgery Foundation and our whole global network of MOU partners and educators. So the SHARE program has a lot of different things that it offers to to our fellows. But I think the most important piece of that, I would say, is the relationship building and the mentorship and sometimes just the camaraderie and the the sense of sort of, yes, let's let's let's worry about this together, which I think women do very well. So I just this is an example. So in the first cohort, this was Irene was my mentee. So each of the fellows has a mentorship group. And so she was my mentee. Now, Irene is faculty in the program, and she and I are mentoring other other fellows together. But Irene and I would spend every other Saturday or once a month and then with text messages in between on WhatsApp. And she would share some of the challenges, the clinical challenges that she was facing, working in a hospital often where she had to drive five hours north and only had a medical student to help her. So here's someone who's been dragged behind a vehicle. Very challenging. Here's a woman presenting with a slow growing mass and very limited imaging. At that time, there was a lot of there was violence in Kampala. And this was a bomb that went off in the market. And this poor woman was affected. And here's a 13 year old that had a slow growing, very painful sarcoma that required resection and reconstruction. And if that wasn't enough, this is here's Irene showing me like when one Saturday I thought this is what pops up and she's got to drive to this outside center and help with this situation, which I'm like, I'm like, I'm going to call a friend for us because I don't know what we should do either. But then what was so rewarding and really just goes to the heart of why we just love our specialty is just then she would we would talk about ideas and some of the students would pull papers. And so we came up with this idea that was an extended superclavicular flap. And Irene, God bless her, did it and did that. And and she got this this woman's face closed. And she she she assisted the neurosurgeons to get this tumor off. And she did a beautiful scalp rotation flap, the skin graft in the donor site. And and this little girl had finally stopped crying because this is that's what Irene's message is. She finally stopped crying and smiled in this photo because the tumor was gone and the pain had stopped. And if that was she did this, too. So it just also just makes you feel really good about plastic surgery. And so it was also just good to sort of like just be cheering Irene on and providing whatever support I could. Just very rewarding because we started share around the time of the pandemic. Actually, we learned a lot about what we could do virtually. And so we actually had a very robust virtual simulation program such as the share microsurgery program. And but I must say, like, so you would have thought, like, so we have this is we can we can work virtually on chicken thighs using iPhones and other approaches. You might think that this is, well, that how can you how much can you do? Actually, virtually. But I just share one fun example. This was Pedro was one of the fellows in the program in that first group. And he sent this message one day on our WhatsApp line says, hi, everyone. Emergency case today made me jump from the chicken model to a person. Brachial artery transected an altercation. And and the limb was compromised. And then the next scene was the next screen was repaired. The artery with the vein graft, if it were not for a few micro sessions, I probably wouldn't have been able to do this case. And it speaks so much about Pedro and him being able to innovate and and and and and really put himself out there for this for this patient. You can see he's pointing to the pulse oximeter that's on the patient's affected limb. But probably what was also so great was that the whole share community was just cheering for him, that everybody was just like, go, Pedro. So even, you know, and we would have been there for him also if he tried and had failed. So it was just I think that it also speaks to how how incredibly valuable and meaningful our global community is and our and our and our and all our great colleagues. And we can share each other on share has also become as we've moved. We still do a lot virtually. We also do more and more in person. This is this is a days of MoMA. You can see here with Sampore and Christine Rody, all leaders in the SPS. And this is an in-person microsurgery program that we've been doing in Rwanda and Kigali. Those red orbs that you see are 3D printed practice microscopes that Sam and his team developed, so like some also just great innovation in education. And she has also been it's been just in the interest of time. I won't get into this too much, but it's been amazing how productive our fellows have been in terms of research projects and through a great relationship with PRS Global Open. In this short period of time, we've had about 20 publications, which is really amazing. So I'm going to wrap up talking just about female leadership in plastic surgery and what we get a sense a little bit what my experience has been. But also, I think about what I think more about all of us. So how are we doing in terms of leadership? We have about 13 percent of of our plastic surgery program directors. Our training programs are women. 50 percent of our chiefs and chairs are women. Of 135 presidents of our National Society, seven have been female. I'm one of them. There have been three women presidents of the association, but Susan McKinnon being one of them and three women have been chairs and Sherry Slizak being one of them. But when you think then about, though, that maybe 80, 85 percent of our patients are women, and about 50% of our medical students coming through are women. I think we still have quite a ways to go. And we have a lot of challenges that we face. I don't need to go into the details of all of these because I think they all, you know what I'm talking about in terms of these different challenges. I hope as a panel, we can talk about this a little bit. I wanted to share these two slides, these 12 things, because they just resonated with me. And I won't, I'm not gonna go through all of them in a lot of detail, but I think if you're reading these comments, ask yourself what resonates with you. What do you do? What do I, I know what I do that actually, that holds me back a bit. And it can be things like the lexins to claim your achievements, expecting others to just spontaneously notice what you, what, you know, the great value of what you've done and building rather than building and leveraging relationships. This is the second six. These actually resonate even more for me. The perfection trap, like if it's not perfect, and I can't put it out there, the disease to please, taking on too much and just maybe ruminating on something that didn't go as well as you wanted it to go or letting you, because we have, because women I think often have such emotional intelligence and we're aware of everything that's going on, that that radar can actually be distracting because you could be almost too aware of what people might be thinking and that makes you stop in your tracks. So how can we help each other? Well, I think it's all about relationships and it's about conversations like this. When I first started as division chief at Brigham and Women's Hospital, I have to admit, I think I was a little, I mean, lost might be too strong a word, but there was a lot of challenges to start off with. And so when my good friend, Christine Rohde became chief at Columbia, I said, we need to, you need more mentorship than just me on this one. So we put together a group of women chiefs and chairs in plastic surgery. And I pulled up the screenshot because I'll point out here, here's Carolyn Kerrigan, my original mentor, Sherry Slazak and Susan McKinnon, still there, still there for us and mentoring this next generation of women leaders. And this group, actually, this was an early screenshot. It's a much bigger group now, even just in these last few years, which is also just really fantastic to see. But it's these other women stepping up to sort of also help women that are coming, that are new into leadership roles, which I think has been really fantastic and a big part of our success. I think when you stand back from it, we might, there's all those 12 reasons that hold us back. But when you think about it, women are natural leaders. Think about your households, think about your offices. Like we get stuff done. We know we have to prioritize. We don't have the luxury of not. When people talk about multitasking, maybe it's not a good thing, but it's what we do. We are creative. We understand the value of teams and we have discipline. And we just, like our mothers and our grandmothers, we have time management skills. And we know how to balance our priorities. I just, I'm getting to the end here, but I just think about sort of a why lead? Because that's just like, that was me up North when I was in Northern Canada going, well, why would I lead? I'm perfectly happy here. I can lead, I can lead around my house, but that's as far as that. But it's finding the why, I think. And that would be an important, the idea that in terms of leadership, I think women are more motivated by what they're going to be able to contribute and find the why and the motivation for it. So for me, it's never been about leadership for the purpose of power or prestige. It's always about what's the positive effect? What's the change that I can make happen? And that was modeled for me by my three mentors. I just put this slide in because I also just want to differentiate a little bit about leaders versus managers. And it's just because it can be a trap that women can fall into too, is like, oh, I'll take care of making sure that the call schedule is sorted out, or I'll take care of doing all the resident evaluations. When leadership is, yes, that all has to get done, but we also need to have our, we need to be at the table also as leaders, setting vision, setting strategy, empowering and setting the tone. I think I won't read through all of these again in the interest of time, but I think if you look through these different attributes, I know you all do these things. Many of them come very intuitively to us, which again speaks to why women are natural leaders in so many different circumstances. But sometimes we just also, we need the why and we need to believe in ourselves. There's lots of opportunities to lead, whether you're in private practice or academic practice. And I think, again, when you find the why and how you want, what's the positive impact that you could have, which I think is needed now, perhaps more than any time in the history of our specialty, then I think the, so then I think that's where the magic happens. And I would encourage you to think locally about what are your opportunities to lead. So my, so parting thoughts, I think it's strive for your own, my own journey in leadership, it was trying to find my own version of what success would look like, not somebody else's, not about the power or prestige of the title. I would try to be your authentic self, not the vision of a leader that someone else might, that you might have seen in others or find a vision of it that you can relate to that seems more like you. So I'm always my most successful when I'm actually trying to be me as opposed to what I think, I think somebody else might be expecting. But it's a journey. And along the way, I've had to learn a lot and change in different ways. And I think that if the goal is to make things better, to have a positive impact, then I think then we can find, then you find the motivation to do all these things. And I'll end with this, that I also would say though, that a key reflection on this journey is to prioritize friends and family. These are those two little boys that you saw at the beginning. And we actually had not gone back up to Northern Canada from the time that we left. So we just took them, the boys, as my husband and I, we took them back up to Iqaluit this last summer. So it was fun to go back and scramble over the rocks together as a family, but now with young adults. My last little plug is that if you have any interest in global work, please think about joining the SHARE program. We would so love to have more international educators and global faculty. And you can do so much of it virtually if that fits better for you. You can also be involved in more of our in-person work, but check out the site and consider registering as a global educator. We would really love to have you involved. So I will stop there. Thank you. Thank you. Thank you so much, Andrea. Thank you for being so inspiring to all of us and to all of the participants. I'm very lucky because tonight for me, because I'm actually in Rome and it are nine o'clock PM, but we are lucky to have a representative from all over the world tonight for me. And I would love to introduce Nicola Dean. They are all representative for the International Women Plastic Surgeon about their countries. And so I would love to introduce my good friend, Nicola Dean. She comes from Australia. She is a board certified plastic surgeons and her current workplace is the Flinders Medical Center. Nicola, what do you think about to ask something or compare something of your life and your experience with Andrea? Thank you so much, Stefania. And thank you for a wonderful presentation, Andrea. I think to me, the things that I'm thinking about is that key idea of empowering others, whether it's your patients through the patient reported outcome measures, or whether it's your junior doctors and all your international colleagues that you've come across. And I think one of the things that I think has helped me in my career is I had a year out doing some epidemiology in public health. And I think that one of the things that I say to up and coming people is, maybe it's important to get all the points in the plastic surgery kind of career ladder, but don't miss out on opportunities to be involved in other interesting areas of medicine or perhaps outside of medicine, because that can really inform your thinking and allow you to have novel ideas. And when I saw the pictures of you in Canada, I was thinking maybe that's something that's informed you in a similar way. Yeah, thanks. I would actually, it's interesting you'd say that because I did a two year master's in epidemiology biostats and my master's thesis advisor on my last day when I was finishing, he said, read widely in areas outside of your discipline because that's where you will find new ideas that you will bring back to our specialty. And that's exactly how the patient report outcome work came about because I looked more widely about how do we measure patient board outcomes and other people had already been doing it. We just didn't know that. In Canada, we call that being at the flow edge where the water and the ice, and that's where all the animals and all the life happens. Thanks. Thank you. Thank you very much. And thank you, Nicola. And now it's the turn to introduce you, Claudia. Claudia Alvarez. She is the representative for Chile. Her specialty goes around breast reconstruction and breast cosmetic surgery. And her current workplace is the Universidad de Chile assistant professor. She is an assistant professor. Claudia, please compare your experience or ask something to our five star tonight, Andrea. Thank you so much, Estefania, for the nice presentation. And thank you, Andrea, for this wonderful talk. I had the fortune to know Andrea for a long time right now. She actually was my professor when I was doing my fellowship. And she was actually a great example to follow and a great mentor. I was pregnant during my fellowship. I had two young kids as well. So it was kind of a difficult time. And she always was there and had a nice way to support us, male or women, whoever. So I think, of course, your story is very inspiring. And I think a lot of us feel like you were at the beginning, like in the middle of the mountains and snow and things like that. But somehow it works out that we have some leadership positions. So I wanted to ask you, what do you think is the most or what are the most important advices that you would give to young plastic surgeons that are just starting their career? And they can see that this sometimes and in different countries can be challenging for women. Yeah, it is lovely to see how well you've done, Claudia. And I remember you were in the fellowship time, but you were so brave and doing it all in New York City with the kids and such. And so it has been such a pleasure to know you all these years. I mean, I think, so some of it when you're in the thick of it is to give yourself some grace. Is to be, sometimes we can be too hard on ourselves, I think. And then if you're as female plastic surgeons, we set a very high bar, we have all our lives. So I think to some, it's also just to give yourself, be a little kind to yourself in that regard. But at the same time, recognize that you do have something very special and important to offer. And so as you're in leadership roles where you're maybe, you're not the person that they're necessarily picking for the role. And yet, you know on your heart that there's something that you have that you could bring. Then also believe in yourself. Like that's that sort of like, be both gentle with yourself, but also listen and go, I have something, I think. And I think sometimes we hesitate to bring that forward if we think it's because it's for us. But don't think of it, but think of it more like it's for our society. It's for our patients, it's for our community. And then I find, I think that is more motivating and also ultimately more successful. As Nicholas said, that you taking a leadership role may result in the empowerment of others and that voices that would otherwise not be heard will be heard. Thank you. Thank you. Thank you, Andrea. And thank you, Claudia. Laila, are you there? Laila Mostri, she comes from Argentina. She's the representatives for the International Women's Plastic Surgeon for the country of Argentina. And her specialty is plastic surgery and the current workplace. She's on private practice. Yes. Hello. Thank you. How are you everyone? Very good. Well, I want to say. Two things that Dr. Pusik said. The conclusion, first of all, that after all his life, at the conclusion, she said the family is very important in this way of plastic surgeon. And the other thing, very important, she said is that she was inspired by the mentors that she mentioned three mentors. And so I think this is the way how to be a leadership in plastic surgeon. But my question for you, Dr. Pusik, is you didn't see that you need to make more than the men to became a leader. So to be a leader, you need to demonstrate that you are a good plastic surgeon, that you know a lot about, you study a lot, you make a lot, and you need to demonstrate a lot to became a leadership. Didn't you know that, you see like it's the same? You mean in terms of, is it hard? Like the fact that it can be harder and even at the same level? I think, yes, I think you're right. I think that sometimes we have to sort of for the same level of accomplishment, we still have to do even that little bit extra. I think for me, probably the way I approach leadership was not so much that I was trying to become this role specifically or like this title, but it was advancing an idea or whether it was patient-reported outcomes or whether it was international work. And that, so I was leading sort of from my core and that somehow made me more successful, I think. I think, but you're absolutely right. I think we also have to be proactive in terms of if there's a table of sitting around and who's gonna pick who the next leader is, as a woman, you may not, we're often not the person that people identify as being the leader unless you're sort of uber successful, which I don't think in that way, I don't think I stood out in that way. I think so. I think that's where also as other women, we can help each other. I think that's where when that, what I would encourage to those that are listening to this, is that we also just need to show up and be there and be part of leadership discussions and insert ourselves into it. Even if you don't think you're like that person yet, but we need to be there and then people will get more used to seeing us there and then also see the value of a female perspective. Diversity in every group has been shown to make more successful outcomes. And so I think our different perspectives, the difference where we see things is good for every organization, for every venture, for everything that we aspire towards. So I think it's also about, even if you think that I may not get that role, but then if you don't, you've still made it that the woman behind you is more likely to get that role. And that's what I saw in my mentors as well. Yes. And I think that now this kind of things are changing because some years ago to introduce ourselves to this world of plastic, of surgery, the woman that can arrive didn't let us to be with them. I don't know if you agree about that. And now I think that we are more friends of other women and invite them to be like part of us and access to be a leadership without the problems of feel us like she's going to be in our place. I don't know if I can explain it. Yeah. No, you've explained it well. I think, yeah, I think that the thing that has been most meaningful for me in my career, most important in my career has been other women helping me and every step of the way. And perhaps going back, previously that wasn't always the case. It was always, it was my case. But I think that now as a generation moving forward that we need to be women who help other women. Yes. But in South America, I don't know if Dr. Claudia agree with me. I think the distance to be a leadership is you noted more than United States. It's possible. For example, in our society, in Argentinian plastic surgery society, in the history of Argentinian society, there was no woman plastic surgeon president. You have- Yeah, well, in Latin America, we have kind of the same issues, but what we've learned here in TLS is that when you are together, you are stronger. So basically when some of us start to have leadership position that empowers the other ones, like the younger ones, and you make life easier for everyone at the end. Yes. And I would like to remind you that this is one of the most important mission of this organization, the International Women Plastic Surgeon, because together we are stronger. And we would love to share with you our experience, yes, but give strength to the women who are facing some weakness in other countries. I have the example of the president, female president of Spain. She wanted to organize some women group in our society and the peers, their peers, male peers, they were opposed to this idea. She couldn't carry it out that. I believe that if we can give ideas and support to our colleagues of other countries that are facing this kind of situation, we can improve, definitely, and together be stronger. And this is one of the most important mission of the International Women Plastic Surgeon Forum. Very good. So, are you okay? And Laila, it's okay with you? Yes, I would invite the audience to, don't be shy, submit questions to Andrea. You have the opportunity to ask a question and compare with that. We have at the moment one question from the audience for you, Andrea. The question is from Iber Igbo. She said, I appreciate the organizer of this webinar. What a great way to celebrate Women History Month. Thank you, Iber. And thank you, Andrea. I have had to use the breast cube for study and was excited to learn that you developed it. My question is, how can one detect early that one is taking on too much? Yeah, I think so. It's very easy for us to take on, I think, too much when you add in sort of, whether it's our work and all our professional life, but then also our families and whether it's looking after older parents or younger children and all those things, it can be a lot. I think when you're not enjoying, one sign, I think, is when you're not enjoying things. I can tell for myself, I generally just love being in clinic and looking after patients, but I can tell that if I'm not enjoying that, it's a sign that there's too much going on for me. I think that the other thing is to take a hard look at all the different things you do and, where possible, look to see is this something that's really, I enjoy doing it or it's really important in terms of the things that I'm trying to advance and not try to do everything. That's a difficult decision to make and I'm not good at it either, but my indicator for myself is when I'm finding it clinically, like if I'm either operating or I'm seeing patients and I'm a little not, I'm not actually just happy there, that's my sign that I'm a little bit off. I've got too much other things in my head. I'm basically like, I'm trying to get off to do another call or do something else, but I think it's just important to try and look at least maybe once a year or something, take a look at all the projects you're doing and going on. Do I really want to continue doing that? Because you often end up, you keep, something gets added, but nothing else gets taken off the list. Thank you. Thank you, Andrea. Now it's time to involve the representative of our, she wrote me the pronunciation and I hope not to be wrong with that. Bo-mi Sa and she is, yes, the representative of the International Women Plastic Surgeon from South Korea. She's a very good friend of us. Her specialty, breast and hand reconstruction. Her current workplace is the Yi Yang Boo St. Mary Hospital, the Catholic University of Korea. So Bo-mi, it's your turn. Andrea is there for you. Thank you, Stefania. It's quite early in the morning here. I don't think a lot of our Korean participants will be able to join live, but it was wonderful hearing you talk again, Andrea. I just wanted to say that hearing you talk about the whole process of getting to where you are right now is, just hearing that is very, very important as young and upcoming female surgeons who are trying to begin their way. It's just hearing, because it always looks like you've been born where you're at and hearing the process, having the knowledge that you have been through struggles as well is in itself very important and influential for younger surgeons to hear. Thank you for sharing that. I wanted to ask you, I know you always mention the three mentors that have influenced you very much. How in detail did they help support you when you were with them? I did want to comment, that was the first thing. The other thing I wanted to comment on is that I know that we all have struggles in our domestic national societies. Laila, you were speaking about difficulties in various aspects and having this international symposium, I think, will help expand the horizon for each national society. It'll be, I think, easier to have a collective WPS in each society when there's knowledge of a background international society and it'll just help us move forward in that way. Yes, back to you, Andrea. Yeah, thank you. I appreciate the observation because you're right. I know my story and then you all know your stories, but we don't all know each other's stories. Then we just look at someone and go like, oh, look at that mustard. That's very different than what my story has been like because I've had all these setbacks. I think I would encourage all of us to share some of the setbacks. Just as an example, when I was up north and I was interested in plastic surgery, I applied to one plastic surgery program in the time when you sent a letter and you mailed it down. I never heard back. I assumed at that moment that they might have even laughed at it. I remember thinking that, oh, they probably just threw that in the garbage immediately because they would never have thought that that could have someone who was at that time in a callow, it could ever be a plastic surgeon. It probably never even reached them at the residency program that I was looking at. I took that as like, so I went into general surgery and did other things. Even when I moved to New York and I applied to Sloan Kettering for a clinical fellowship, but they didn't really know me at that time. They offered me a research year and then I worked my way up from there, but it didn't all come that way either. I think it's good for all of us to share these stories so that we don't look like we just suddenly arrived like this, which none of us did. We all know how hard it's been. There's no woman who has come through plastic surgery training, surgical training that hasn't struggled and had setbacks. I think there's that. I think in terms of your question about mentors and mentorship, it's interesting now that I reflect back on it. The number of times I actually interacted and had conversations with those three women was actually quite limited, honestly, because they were busy. They had busy families and a lot of it was watching and just watching how they did things. It was observing. They knew it wasn't that they were ignoring me. I say it in part because even a little bit of mentorship and a little bit of role modeling can be much more powerful. I say that to all of you. You know this as well already. We don't always have the bandwidth to be perfect mentors to everybody. I can't keep up. But at the same time, just know that people are watching you. They're watching to see how you interact with others. Sometimes even just those little interactions are more meaningful than you might even know. It's like kids. They're watching you all the time and learning from what they're seeing. The interactions were obviously some key conversations, but otherwise, it was also just sort of watching them a little bit from afar, but knowing that they were always kind of there for me if I needed to reach out. To this day, they are. Did I miss part of the question? No, that was so important to hear, moving forward. Thank you. Excellent. Thank you. We have another comment from the audience. We have Betty Toshida from Mexico. She says, I agree with Laila. Latin American countries are quite behind in female leadership. I think we need to talk more about intersectionality and to stay together because a woman in the leadership does not guarantee female empowerment. That's why this reinforced my dream of creating the International Women Plastic Surgeon. We need to get together. Any more comments or questions or hypotheses? I would love to say to the audience that International Women Plastic Surgeon is open to the female trainees, so you can ask Romina to be involved in the forum. Don't forget to click the webpage of the American Society of Plastic Surgeons, the page dedicated to the International Women Plastic Surgeon Forum. Many, many news and many things. Stay tuned because we are preparing and carrying out new things and new involvements. I would like to express my gratitude to Romina Valadares. I just mentioned that she is the ISPS International Relations Manager for exceptional support and dedication to make this project come to reality. She is really the beating heart of the ISPS International. All the international members know Romina very well. Nicole, do you have another question? No, it was really just a reflection on Betty's comment. I think the issue of intersectionality is really important. For me, I'm starting to see more surgical trainees and see those in different places. I'm really conscious that for us in Australia, we have Indigenous people that can contribute a huge amount of cultural knowledge. Trying to encourage Indigenous medical students and doctors, that they too can become plastic surgeons, I think is really important. Also, we get people who are refugees and who then somehow manage to get through medical school. I think having a really broad spectrum of women with different cultural backgrounds can contribute a huge amount to our patients and to our colleagues group. Usually, it results in fantastic food at parties as well. You get such a broad mix of wonderful things. I just wanted to talk to that point of intersectionality. Thank you, Nicole. Yes, it's very important to involve the minority. We have from the audience colleagues that are expressing happiness for this organisation. Thank you so much for so amazing motivation and insight. This experience is exceptional. Amazing. That's Nicole. Amazing and inspiring discussion, Dr. Puzik and everyone. Thank you for sharing and bringing us all together. This is very nice coming from the audience. Andrea, I would like to let you the last minute to tell us to enjoy the opportunity to have you here. Tell us something more, please. I would just want to say thank you to all of you. I really was looking forward to this opportunity to just be all of us together to women and having this conversation and talking about the things that in a safe space that we could say and think about together. I really just appreciate all the comments that have been made about empowering others, about how we are better together. I appreciate it as Claudia said. Nicola, in terms of the diversity, this is about we recognise having been at times minoritised in terms of what we brought to the table has not always been recognised. We can be the force that also pulls others into this conversation. We know based on what we bring, but what others would bring too. I think it is also a time, as Leila has said, when old ways of doing things can change. As women, we can help each other. That's what this is all about. I appreciate the comment from Bomi. We've all had challenges. I think we need to be a bit gentle with ourselves in terms of saying, yes, these are hard things we do. They are hard, but we do amazing things. How fantastic it is, the specialty of plastic surgery. To this day, I really love looking after our patients and I love our specialty. Part of it has been because it is also interacting with people like yourselves and organise plastic surgery and doing things in the collective as well. It is just a great celebration. I feel blessed to be part of this conversation and our specialty. I am grateful to the ASPSPSF and Romi for organising and Stefania for being such an amazing moderator and role model yourself. I love your passion and energy and everything you do globally as well. I think this is going to be a great feeling about the future of our specialty. It is a very female feature as well. Thank you, Andrea. It has been a great honour to have you here joining the first webinar of the International Women Plastic Surgeon Forum. I would like to highlight that the International Women Plastic Surgeon Forum is dedicated to the strategic organisation of women leaders within the fields of plastic surgery to create and maintain an environment that recognises, cultivates and utilises the talent of its community. The aim is to facilitate networking. Tonight, this morning and so on, all over the world, we did it with this webinar. Communication between women plastic surgeons throughout the year and develop programmes and opportunities targeted to women that develop leadership competencies. In Italy, the situation is that 69% of women are employed in the healthcare, but only 21% is at the leadership. So a long way is to be done here in Italy too, but we all together have strength. It comes from staying together and to fight together. And this is the first step of the International Women Plastic Surgeon Forum. Many things are coming. Stay tuned and please contact Romina to enjoy and to join this community, this new international community. I look forward to seeing you on site and physically in New Orleans at the Plastic Surgery Meeting, but we had some news before, some surprise before with the forum. I would like to thank you again, Andrea, because you were lovely and thank you again. I would like to thank you, all the participants, because I look at the participants and we have had many international women and friends participating. Don't be shy, next time you have to ask more. And I would like to thank the presenters and Nicola Dean and Lalla Mousri and Bombi Florence and Claudia Albornoz for joining us. I would like to thank you, the technician behind the scenes, who allowed us to have this webinar. And I would like to thank the American Society of Plastic Surgeons. And what else? I look forward to seeing you and participate and contribute to the empowerment of women all over the world and to make this forum grow day by day. Okay, thank you, Andrea. And all of you have a good night and bye-bye. Thank you very much. Bye-bye. Bye for now. Thank you, bye. Bye-bye. Bye. Goodbye.

IWPS Forum

webinar

Dr. Andrea Pusic

Breast-Q

PSF SHARE

mentorship

gender disparity

global collaboration

women in plastic surgery