Innovation forms the backbone of our specialty—Rohrich et al. [1]
Ideas→ Insight→ Ingenuity→ Improvisation→ Invention→ Innovation. Perhaps the preceding
is not in the correct order nor one leads to the other, but surely we cannot argue
that without innovation there will be no future for the specialty of plastic and reconstructive
surgery [1]. We own no anatomical territory [2], but we are the “problem solvers” for all other surgical specialties [3]. From the Oxford English Dictionary, innovation may be defined as the “alteration
of what is established by the introduction of new elements or forms [4]
[5].” A too often rigid adherence to what is established, that is, omnipresent dogma,
restrictive rules, and deafening protocols, will only stifle creativity [6]. An unsolvable problem or for that matter one that is just routine, may have an
unforeseen better solution—that an innovation that must be original, quite relevant,
pragmatic, and preferably simple in application [3]
[4]. Necessity may be the mother of invention, but innovation is its identical twin.
The typical innovator has a unique personality. Diverse traits may encompass common
sense, a flair for creativity, flexibility, logical intuition, pragmatism, independent
source of motivation, a spirit of enthusiasm, obsession for perfectionism, and undaunted
perseverance [6]—already characteristics of most plastic surgeons!
Remember though that Edison stressed that the genius of innovation was “1% inspiration
and 99% perspiration [7].” Thanks to technological advances in communication, today innovation has become
a global capability [8]. No longer is there a hindrance for the solitary individual in a community hospital
or remote geographical location. After all, did not long ago Buncke develop microsurgery
in his garage [9], and it is said that Robert Acland in the beginning was a “one man band [10],” although the two often exchanged ideas and perhaps innovations using correspondence
today we call snail mail!
But innovation will be valueless unless there is dissemination in some form, usually
via presentations or currently more often in our literature [11]. Rohrich et al. [1] have emphasized that innovations must be backed by high-level proof of efficacy
to overcome the appropriate skepticism and conservative behavior of most physicians.
Buncke’s guiding philosophy was that “ideas are cheap, results are priceless [12],” and that “we learn by failures [10],” often our own. Thus, it is logical that most major plastic surgery journals today
seek “results;” and have a preference for publishing large clinical trials, meta-analysis,
and outcome studies. Submissions for “ideas and innovations” are typically restricted
to a minimum number of words, figures, and supporting references—barely enough to
scribble down the details. Yet without innovation, whether appropriate or not often
to be first found in the daring and novelty of case reports (e.g., Taylor and Daniel’s
first composite tissue free flap [13]) or small patient series, the fear without them should be that there will be no
future new outcomes to study. This should not be forgotten by this new editorial board
of the Archives of Plastic Surgery. Their goal should not be just to be the premier
Asian plastic surgery journal. This journal should stand out as the “Journal of Plastic
Surgery Innovations.”
The goal would then easily be changed, to be the premier global plastic surgery journal!
