Plastic surgeon finds new niche as MMA fight doctor

Plastic surgeon finds new niche as MMA fight doctor
by jim leonardo
I
t stands to reason that people who get
punched in the face for a living would
have a plastic surgeon on speed-dial,
but it was a hand injury (presumably from
his patient punching someone else in the
face) that led ASPS member Gregory Albert,
MD, Delray Beach, Fla., into the corner of
professional Mixed Martial Arts (MMA)
light-heavyweight champion Tyrone “King
of the Ring” Spong. Dr. Albert, who has
served as team plastic surgeon for the
NHL’s Florida Panthers since 2002, as well
as for other MMA combatants over the
years, was consulted by Spong.
The fighter had sustained a cut to his
hand during practice five weeks prior to a
scheduled MMA championship bout in
March 2013 with Remy Bonjasky during
“Glory World Series Five” in London, and
the wound was becoming infected in proximity to hardware that fixated bone from an
earlier break.
“By this time, I’d developed a reputation
from treating other fighters,” Dr. Albert says.
“Tyrone called me right after the infection
had become apparent, and as I examined
him I became concerned that the hardware
might have to be removed due to the severity
of the infection. So I saw him frequently,
cleaned the area surgically, made sure it
healed and advised him on the subsequent
intensity of his training. And then he went to
London and won.”
Pressure to perform
Spong was typical of many athletes in his
constant need for treatment and reassurance, Dr. Albert says. “I told him early-on
that I had a lot of experience with professional athletes, and that he could probably
return to training in time to be ready for the
fight,” he says. “After examining the hand I
informed Tyrone that he could probably
get back to training in two weeks, and could
be at the top of his game in four weeks.
A couple of days later, he got back to me:
‘Doc, I’m on board.’
“That’s when I really began to feel the
pressure – he was the main event on the
London ticket,” Dr. Albert admits. “Two bad
things could’ve happened: A week before the
fight he might have said, ‘Doc, I can’t do it,’
or he could’ve gone to London and lost –
and I’d be blaming myself.”
Fortunately, Spong landed a one-punch,
second-round knockout – with Dr. Albert
literally in his corner, standing beside the
trainer and the corner man, “getting ready to
do anything that I needed to,” he says.
“It was really fun to be part of the team,”
he adds, “being in the corner and being
‘hands-on,’ while the trainer barked at
Spong inside the ring and the crowd roared.
It was all kind of cinematic in that regard.
After the fight, we all climbed into the ring
for photos.
“But beyond the experience of the fight
itself, it was very gratifying to have accurately
treated his injury quickly,” Dr. Albert says.
“Spong said he trusted me, and that if I
told him he could fight that he would – he
said we were working together. I literally
told him ‘the show must go on!’ He was
gracious enough to follow my direction
regarding when to train (or not train), and
how far to go. So being on the team and
experiencing all that I did in London – even
being in his entourage that walked from the
back, under the spotlight, all the way to
the ring with the crowd just roaring – that
was an amazing experience.”
8 March 2014 Plastic Surgery News
Gregory Albert, MD (left), in the corner of mixed martial arts fighter Tyrone Spong during “Glory
World Series Five” in London
Unique patient population
Like all plastic surgeons, Dr. Albert’s chief
concerns center on the health and safety of
his patients, as well as the appearance and
functionality of their surgical outcomes.
However, he says that treating professional
athletes can be quite different in many
respects than caring for the average patient
population.
“An injury to one of my athletes that’s
severe enough to require surgery requires a
quite different approach than that in treating
a ‘typical patient.’ Without a doubt, there’s a
much more intense style of communication,
as well as the consideration of politics
between the three or four levels of individuals who have a tremendous interest in the
athlete’s treatment plan.”
This often requires providing an unending stream of reassurance and building a
unanimous sense of outcomes satisfaction
with the athlete as well as his or her coaches,
trainers, general managers and agents.
“Pro athletes are very, very sensitive as to
who treats them; although they’re confident
individuals, they need a lot of reassurance
from their doctors,” Dr. Albert says. “They
hang onto everything we say, and that often
necessitates a precise prediction of the athlete’s full recovery. And particularly with an
in-season injury, all the ‘invested’ individuals
need reassurance regarding the procedure
I’ll perform, what I expect the outcome to
be, time frames involved in healing and postop rehab, when physical contact can and
can’t be involved, and the date at which they
can return to competition.
“If they return too soon, they risk reinjury,” he explains. “If they wait too long,
such variables as the team’s win-loss record
or even the player’s contract can be in jeop-
ardy. It really amounts to a balancing act on
my part: It’s a mix of the procedure, information and the clearance to play.
“It’s a difficult niche to belong to,”
acknowledges Dr. Albert. “It can be quite
stressful when everyone is counting on you
to get them back as soon as possible, as the
outcome and the timing are important to
everyone.”
Ice time
The treatment of hockey players has been
just as exciting as the fight game, Dr. Albert
says. “Working with a team of other wellrespected physicians, we repair the players
so they can get back into play. The usual
game requires suturing player’s faces and
having them return to the ice within a
matter of minutes.
“Making decisions on how to treat the
players involves many working parts,” he
says. “The general manager and coach need
to know when the player will be back; the
player wants to protect his health, and possibly his career; and agents occasionally get
involved in the decision-making process.
“It involves making significant decisions
on when to do surgery, whether it be during
season, or if it can wait until the off season.
While treating players, there is quite a bit of
politics involved. The ultimate question
comes down to being able to deliver a
healthy player in a given amount of time.
“There’s a difference between a player
needing surgery in the immediate future, and
getting him through the season,” he says. “If
he’s taken a puck to the nose or orbit and
needs to be benched until he gets it fixed, I’ll
do those right away. But a lesser injury,
though it may be somewhat severe, doesn’t
necessarily need to be fixed in the middle
of the season – they’d be out too long.
Therefore, those injuries I temporize to get
them to the offseason and then do the procedure. But only if that’s medically warranted.”
Dr. Albert says he performs the significant surgeries approximately four times per
off-season, with the less-serious injuries –
those treated locally and shored-up through
bandages and face shields – twice as
frequently during the hockey season.
“For those, I can usually get good fixation
that’s stable,” he says. “Then they put their
helmet and facemask on and they get back.
They’re not bearing weight on the face, so
they can go back sooner than most orthopedic surgeries.
“A couple of seasons ago, Panthers
defenseman Bryan McCabe took a puck to
the face, causing an orbital fracture and a
severely comminuted and displaced nasal
fracture. He had fixation with hardware
throughout his orbit and nose. One of the
great things about plastic surgery of the
bones of the face, he was back playing in
about two weeks,” Dr. Albert says. “He was
not only very motivated and tough, but that
area of the body doesn’t get the stress or wear
that a fixation of the bone in the leg or arm
would have. Once it’s fixated, he’s not moving his face; it’s good to go. When he went
back, he just wore the standard face shield.”
Dr. Albert says he has developed a healthy
respect for the resiliency of hockey players
during his tenure with the team.
“Hockey players are the toughest athletes,
by far,” he says. “Football’s brutal, but they
only play once a week and, relatively, have
much more time to recuperate,” he says.
“Hockey players sometimes play back-toback games, which leaves no time for recuperation. They skate, they get hit by pucks
and sticks, and they’re run into the boards –
then they do it again 20 hours later. They
regularly play in a lot of pain.”
An upside of being the Panthers’ team
physician has been the constant stream of
compliments of his nasal reconstruction
skills issued by the wives and girlfriends of
hockey players. “I’ve had several tell me that
the guys have never looked better – and
some of the players themselves have said
that,” he says. “Many of them had old
injuries that hadn’t been fixed. That’s been
very rewarding to hear. And some of family
members have become patients, as well.”
No sweat
Not all of Dr. Albert’s interventions with athletes involve the treatment of injury, however, as he’s been asked to perform such noninvasive procedures as the injection of
Botox® to treat excessive sweating.
“This treatment allows athletes to go
about their activities without having wet
underarms,” Dr. Albert says. “They tell me
it’s annoying to put on a dress shirt and suit
for an interview and then have visible sweat
in the armpits.”
Being a “hockey doc” can also prove challenging for the medical professional, as Dr.
Albert is required to attend each Panthers
home game, and attend to the visiting team as
well. Still, he is enjoying his ice time – and the
interesting side path it has opened for him.
“At times, I’ve found myself treating
athletes with the orthopedic surgeon,
dentist, medical doctor and chiropractor,
thinking: ‘Wow, this is pretty neat.’ I didn’t
think I would be in contact with professional athletes unless I was an orthopedic
surgeon or sports medicine doctor,”
Dr. Albert says. “All in all, I’ve carved out
a really neat niche.” PSN