One fine fall morning last year my wife turned to me and said: “I want a tummy tuck. There are no rules against you doing that for me are there?”

We had talked about tummy tuck surgery for her several times over the years. She had had a gastric bypass a decade before we had met and was a pretty good candidate. No cigarettes. Well she did have a few surgical scars. Her gastric bypass was via the older “open” approach. It pre-dated the emergence of laparoscopic surgery by about five years.

I had some dim remembrance as a medical student of being told that surgeons did not operate upon their wives. But I also knew that my program director in plastic surgery had done his wife’s facelift. I also recalled asking him when I found out why he had done this…in a very non confrontational way of course.

He said spryly: “She deserved the best.” OK. I do a pretty good tummy tuck. If wifey wanted a nose job, I would have declined. I don’t do noses really.

So in investigating the big picture on the topic I started as I do for everything else: a Google search. This led me to the AMA web site and:

Interestingly, the American Medical Association in its initial, 1847, “Code of Medical Ethics” addressed treatment of physicians’ families when it said of the physician, “the natural anxiety and solicitude which he experiences at the sickness of a wife, a child, or anyone who by the ties of consanguinity is rendered peculiarly dear to him, tend to obscure his judgment and produce timidity and irresolution in his practice.”

So the AMA warned that my objectivity might be compromised. The more I thought about it I wanted to do it. Despite the fact that it might make me sound arrogant, I wouldn’t want anyone else doing it. Then again if I did it and there was a problem, might it mar an otherwise good marriage? If someone else did her surgery and there was a problem, would I feel guilty for not having done it myself? This was a catch 22 for sure.

The day of surgery was weird. The anesthesia and the skin incision were especially surreal. Operating upon loved ones feels different. Fortunately once the operation got going I snapped out of it and got into the flow of things. Pain was not a problem either. Thank God for the pain pump. Those things work well.

So at the end of the experience, while I better understand the issues about which the AMA warns, I was satisfied that I had done the right thing. Kim did well with surgery and has a nice result. I would be dishonest not to admit that it was a bit more “wear and tear” on me than the average case. Keeping the family surgery to a minimum is my recommendation for those who may follow.

I wrote this one for Kevinmd.com. It will appear at this link once posted.

Best Regards,

John Di Saia MD