So You Want to Be an Innovator?

Abstract

We have all heard the expression “You can never be too thin, too wealthy, or have too many friends.” We would like to add that “You can never have too much innovation.” Considering our roots that lie in transplantation and general surgery, and considering that unlike other specialties, plastic surgery does not “own” a single organ in the body, plastic surgeons have relied on their ability to innovate to create a distinct and valued identity among physicians and surgical specialists. Innovation has not only formed our specialty, it remains one of our core capabilities that enables us to remain in the forefront of new technology in medicine. Furthermore, innovation will be a primary component of our future success. Plastic surgery does indeed own innovation as its “organ.” WHAT IS INNOVATION? What is “innovation” as opposed to “invention”? Innovation is a new way of doing something or “new stuff that is made useful.”1 It may refer to incremental and emergent or radical and revolutionary changes in thinking, products, processes, or organizations. The goal of innovation is positive change, to make someone or something better.2 Furthermore, innovation occurs when someone uses an invention or an idea to change how the world works, how people organize themselves, or how they conduct their lives. In this view, innovation occurs whether or not the act of innovating succeeds in generating value for its champions. Innovation is distinct from improvement in that it permeates society and can cause reorganization.2 Innovation is the introduction of new ideas, new processes, or new protocols that change the way we think, work, and live. What makes an innovation “good” or worthwhile? A number of criteria can be assigned to this task, but four key elements are the following3: Innovations save lives, extend average life-span, or materially improve the quality of life (e.g., anesthetics, surgery, vaccines, antibiotics, and genetic screening). Innovations lead directly and indirectly to downstream derivative innovations that fundamentally alter how we live and what we are able to do as a species (e.g., mathematics, money, property ownership, containerized shipping, and the Internet). Innovations help to increase the amplifier effect of modern economies—increasing the standard of living for the population as a whole (e.g., printing, free markets, capital markets, and limited liability). Innovations free up people's time to do something besides just scramble endlessly for the food and shelter and clothing they need to survive. Not surprisingly, different groups assign a wide variety of innovations to the “top 10 innovations of all time” list. For example, Business Week (Table 1) and the Foreign Policy Research Institute (Table 2) have ranked the top 10 innovations of all time quite differently.3,4 For plastic surgery, see our own suggested top 10 innovations as a specialty (Table 3), and the top 10 recent innovations in plastic surgery according to the definitions above (Table 4).Table 1: Top Innovations of All Time According to Business WeekTable 2: Top Innovations of All Time According to the Foreign Policy Research InstituteTable 3: Top Plastic Surgery Innovations—HistoricalTable 4: Recent Top 10 Innovations in Plastic SurgeryGiven these broad definitions and examples, where does the specialty of plastic surgery need innovation? Reviewing our present state and prognosticating our future, what are the foreseeable areas of plastic surgery that need innovation? We think the following areas need further innovation for plastic surgery to continue to thrive well into the future: resident education and ongoing education, tissue engineering, transplantation, telemedicine, regeneration, robotics, and vastly improved translational medicine. One of our primary missions is the training of our residents and fellows. We take the greatest pride in how well we have done to prepare our students for their future careers. Whether in private practice or in academic