Meet Dr. Taylor DeBusk, Facial Plastic Surgeon

Dr. DeBusk (00:08):
So I am Dr. Taylor DeBusk and I am originally from Denton, Texas. I went to LSU for undergrad, go Tigers, stayed down there from med school and then trained all over the country up in Minnesota and California. Now I'm back in Houston, Texas. This is where my wife is from. So I didn't have much of a choice on where we were gonna end up. We have two sons. My oldest son, Liam, is almost three. My youngest son Levi, is uh, almost five months. And we are loving Houston, Texas, the heat and all. I've always wanted to be a surgeon. I, I don't know when it started, but I love working with my hands and I love helping people. But choosing to become a surgeon is much more selfish than my desire to help because I just really enjoy operating. So I've always known I wanted to be a surgeon, but that instance when I knew I wanted to go to med school, it's just always been there.

(01:09)
I mean, I played football in college and I remember my first day realizing that I was not nearly as good as the rest of the guys and I had to have a backup plan. So med school is always there and by playing football, it reaffirmed the fact that I needed to go to med school cuz I didn't have a future in football. That was for sure <laugh>. Yeah, so microvascular surgery specifically to the head and neck is we use a lot in head and neck surgery when we're rebuilding defects after cancer resections. So if you have to remove a large part of the jaw, you can take the bone and soft tissue from the lower leg along with the artery and vein or the blood vessels and then hook the blood vessels up to those in the neck. So you have vascularized tissue when you're rebuilding the jaw or large defects of the face or oral cavity.

(02:05)
There's several different routes of training to establish, um, those skill sets within ENT or head and neck surgery. People don't realize that the large portion of ENT training is, uh, head and neck cancer, both the resection or removal of the cancer as well as the reconstruction. So I spent five years in Minnesota largely just doing head and neck cancer, both cutting it out or removing it as well as reconstructing along with a lot of the facial plastic surgery, both aesthetics as well as reconstructive. I mean I've done microvascular surgery, uh, reconstructive surgery and patients as young as three years old up to, you know, 98 years old. So it's a broad spectrum cuz there's a lot of tumors in the head and neck that aren't necessarily cancer but that do need to be removed. So you do, you get a pretty good, well-rounded experience from the, uh, reconstructive standpoint.

(03:04)
So we use the microscope and we use very, very small suture smaller than that of a, the diameter of a hair to sew the arteries and the veins and the nerves together. So when we're doing or looking at somebody's face from an aesthetic or cosmetic standpoint, number one, I, I'm extremely comfortable with the anatomy of the face given my background. And number two, when you reconstruct the face you always have to take into account the cosmesis because you want to make sure that the patient looks as normal and can function in society as they did prior to removal of any sort of facial cancers or anything like that. So aesthetics has always been a part of my training and my experience. Now, when we go to purely aesthetics, again my understanding and comfort with all tissue planes of the face really gives me the advantage or that edge, my ENT or head and neck surgery background.

(04:03)
We were operating on noses from my first day in residency doing septoplasty these things on the inside of the nose. So we had a very fundamental understanding of the entire anatomy from a functional standpoint early on in training. Then in our residency, my specific residency up in Minnesota, it's a very high volume facial plastic experience. So we did a lot of functional cosmetic rhinoplasty as well as cleft lip or palate rhinoplasty. So again, that's a rhinoplasty in kids two years, one year old all the way up to patients 80 plus. So we had a very high volume experience in our residency, you know, did probably 200 rhinoplasties. So my understanding is pretty sound of the nose of the anatomy and then the ability to manipulate that anatomy to give you that aesthetic or your cosmetic goal. Now that's a whole nother level which I love and enjoy, uh, because you have to know the anatomy.

(05:05)
And then number two, you have to know how to manipulate the contour of the cartilage to give you that that desired outcome. You know, nasal bone fractures are a very common thing that we see. The beauty is, to be honest, a lot of nasal bone fractures don't need to be managed. Even if you have a pretty severe fracture, a lot of times you don't even notice the millimeter sub millimeter movement of the bone. A lot of times we intervene on it, mainly if there's a functional issue, uh, because it's hard to tell, especially with a kid hitting the nose and things like that. It's hard to get a severe fracture. Now I do have a, a pretty extensive history, uh, and experience in managing facial fractures just in general. So I've seen all kinds of nasal fractures from nasal bones looking like sawdust to kind of hairline fractures is a pretty wide array of, of management options.

(06:02)
We always kind of quote, or I quote when I talk to patients that the revision rate after a primary or initial rhinoplasty between 10 to 15%, so one and 10 people will possibly need a revision rhinoplasty. Either they don't like the cosmetic result or they can't breathe well out of the nose. Now when I look at revision rhinoplasty, the main thing that I talk about is the need for extra cartilage or grafting structure pieces to help rebuild and reshape the the nose. Cuz typically when patients have their initial rhinoplasty, a lot of the spare parts or the spare cartilage has been removed. So I talk to patients a lot about using their own rib, depending on the patient's age when their specific concerns or co-morbidities, their rib is a very nice piece of cartilage to use to rebuild the underlying structural framework of the nose as well as use it for grafting to obtain the, the specific contour that you're looking for.

(07:05)
Quite often I do a lot of functional plus cosmetic rhinoplasty. So priority wise for me, number one is always function. You have to be able to breathe out of it. A close second is form or the way the nose looks. If the nose is this beautiful little thing on your face but you can't breathe out of it, you're gonna realize that breathing is your priority. A beautiful nose isn't beautiful unless you can breathe out of it, you know, getting to know the patients, number one, it's a process with surgery and I tell all patients it's, it's a year long process. Um, getting to know you, coming up with the surgical plan, performing the surgery, and then following up through that first year. It really, you know, you're kind of there hand in hand with the, the patients and it makes the time really just speed up and fly by because again, you're setting that expectation and then you as a surgeon are really wanting to make sure that the desired outcome is achieved.

(08:06)
So you're always looking forward to seeing your patients when they come back, which is, it's a really, um, exciting and fun process. Yeah, they should expect to get to know me as a surgeon, I always introduce myself, explain my background, I talk about my wife and kids. I want them to know me as a person. Every surgical patient I give my cell phone number. Some people say that's crazy, but for me, for patients, a lot of times this is the first major surgery that they've had, especially when it's a cosmetic surgery, you know, it's a little bit more kind of on the line because it's, it is something that's not necessarily needed or required, quote unquote. Cuz again, it's, it's a 12 month process from as soon as that incision's made until you're fully healed. So a lot of times they have or things and I want to be able to, I want them to be able to get ahold of me as easy as as possible.

(09:01)
So anyways, so yeah, when I meet them the first time, I just want to get to know them. I want them to get to know me. I want to know what they understand, what they know, what their desired outcomes are. Because some people come in saying, you know, I just, I want a neck lift and I'm, I'm okay. And then you talk about, well, what their goals are. Well, they're like, well, you know, I'm not, I don't like where my gels, my cheeks, my eyes. I'm like, okay, well, you know, neck lift can help only a part of that. So I like to talk to them about the different options to achieve their desired goal. So I really make sure I understand the patient's desires or goals on that initial consultation because I don't want there to be any ambiguity between my desired outcome and theirs.

(09:45)
So I use 3D imaging software specifically for rhinoplasty because rhinoplasty, again, you know, sub millimeter changes can make all the difference or the sub millimeter desires are hard to articulate for some people. So if you can get a nice 3D image, both of us will be on the same page. Facelifts, I do have 3D imaging that I use. I sometimes it's hard to get that desired outcome on the, on the current technology, but doing a lot of tissue manipulation in clinic, in the mirror and things like that can show you really what sort of goal or what sort of outcome we can achieve. So rhinoplasty facelift are really kind of my favorite one that I like a lot and I've been doing a lot more of recently is just the deep neck lift in younger patients, thirties, early forties from where you're not removing a lot of tissue or anything, but you're just improving the contour of the neck.

(10:43)
And I'm sure you know this, I've heard this, especially within the Zoom era, everybody's looking down at their phone or on zoom and realizing, whoa, where is this double chin coming from? So you're starting to see a lot of these younger patients come in and you can do amazing things to the neck with one small incision, just removing a little bit of the deeper soft tissue and so on some things together and really improving the contour. Yeah, I mean I think the team is just as important if not more important than, than my role to be honest with you because I mean, they're the ones that are constantly in contact with the patients. They kind of set the expectation before they even meet me. And you know, I, they are the face of the practice. The team is because they, like I said, they are the ones that are really interacting with the patients, discussing the pre-op, the post-op, seeing them more often than I am.

(11:35)
And this is, you can't do it alone. And I've learned that in my first year of practice where, you know, I was doing the majority of, of everything, you know, from contacting price, quotes, everything, photos, all my own, everything. And it's overwhelming and you can't do it all yourself because you will drop the ball somewhere. And I've really learned to appreciate the team and really now understand the importance of the team because they do come first. It takes a lot for me to get flustered. I think I'm very relaxed, kind of go with the flow kind of guy. I do have high expectations from my outcomes and from my patients. But overall, uh, very relaxed, easy to get along with. Joking in the office. I think in the office is not, should not be a sterile place. I think you need to have good relationships with everybody.

(12:31)
Very collegial, uh, across the board. Cause I like to have fun. I I want to be in the office. I don't want to, I don't want people to, to want to leave, to look, you know, look at the clock and can't wait to get out. I want people to enjoy being around me and around the team. So I am also a clinical assistant professor at the University of Texas Medical Branch, teaching head and neck surgery residents and plastic surgery residents doing a lot of rhinoplasty, skin cancer, reconstruction, trying to develop more of the facial nerve as well in the microvascular department and things like that. But I do love the education. I love interacting with trainees. It's fun, it's enjoyable, can be frustrating, but that's also the fun part. Yeah, <laugh>. So debusk md.com and then soon my profile and things will also be up on Dr. Basu's website. Uh, and then I have an Instagram account and it's just Dr. Taylor Debusk.

Speaker 2 (13:34):
Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basu plastic surgery.com/podcast on Instagram. Follow Dr. Basu and the team at Basu Plastic Surgery. That's B A S U Plastic Surgery. Behind the Double Doors is a production of The Axis, t h e a x i s.io.