AMA Plastic Surgery Resident

Getting into Med School is Hard? Not with BeMo.
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fancymylotus said:
I should make a "ask fancy anything" thread and steal your thunder.
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i'd be first to ask ya, do you fancy me? hahahahah.
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caffeinemia said:
I agree with you on a basic level. I definitely lucked out. That said, I don't want medical students to think that going to a well-known school will automatically get you a spot. At the end of the day, the Match (and life) have an element of gamesmanship. If pick up on the clues quick enough, you can definitely work some connections and advantages to compensate for shortcomings. In my case, I knew the right people to cover for my poor gamesmanship on the clinical rotations. It's like those infomercials: "results may vary."



Agree with the last sentiment.



I sympathize with those who do not necessarily have the means to simply pay more for a stronger name. However, I want to erase the common misconception that good schools don't offer good money. In my case, the school I chose was ridiculously expensive but also gave me some good grant money as well.
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True. I don't think having a great medical school reputation/prestige means you can start getting straight "Passes" in third year, and then be handed a Plastics spot. But luckily its still within reach. Which is why I tell people now to just cough up the money, and go to the most prestigious med school u can get.

Gamesmanship is key from third year on. Glad you didn't play and still won.

All the ones I met on the trail who were from top schools seemed rich (like really rich). I didn't think top schools gave much non-loan aid overall because of demand.
 
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When trying to match into the more competitive specialties, how important do you think it is to have research in the field that you're trying to match into? Do you think that someone who had very extensive research in, say, healthcare policy would be at a disadvantage?

Was your research in plastics? Surgery? Neither?
 
Omppu27 said:
When trying to match into the more competitive specialties, how important do you think it is to have research in the field that you're trying to match into? Do you think that someone who had very extensive research in, say, healthcare policy would be at a disadvantage?

Was your research in plastics? Surgery? Neither?
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I think that research of any sort helps.

Healthcare policy is totally cool and doctors care about it too. However, it's important to remember that it is a touchy subject because it governs the way doctors work and it governs their bottom line. It all depends on how you present it/spin it. For example, if you go into the interviews stumping for Obamacare because of your research findings, it's definitely gonna raise some red flags.

I would say, it really helps to demonstrate at least a small effort into research in the field you want to enter, especially if it is something very competitive. Even 1 or 2 clinical papers or presentations in plastics (which take at most an few months) might be the difference.

I had research predominantly in clinical and basic science PRS stuff.
 
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How accurate was Nip/Tuck now that you're actually a plastic surgeon?
 
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I'm not DermViser. I can guarantee you that. I may still piss you off though. Just for fun. I remember who he is.
 
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famoussquamous said:
How accurate was Nip/Tuck now that you're actually a plastic surgeon?
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I'm a plastic surgery resident and I definitely have seen nip/tuck. It's nothing like real PRS, except that there are indeed some crazy patients and that some procedures can be done in the office.
 
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how were you able to determine you had the dexterity/ motor skills to execute surgery?

i like the idea of surgery, but, TBH, i have no idea if i have those skills.

would you say surgery is somewhat of a calling to those with said skills, or is it something that can be learnt. my inclination is the latter.
 
caffeinemia said:
I'm a plastic surgery resident and I definitely have seen nip/tuck. It's nothing like real PRS, except that there are indeed some crazy patients and that some procedures can be done in the office.
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Ok, I'll make my questions a bit more nuanced....

How often did you hear/witness the attendings or residents cheating on their S/O?
How often did patients come in and offer sexual favors of any kind/flirt?
How often did you secretly feel a pang of despair whenever a female asked for a breast reduction?
Do you look down on patients that come in to have elective cosmetic procedures done as being weak and having low self-esteem, or did you witness it doing the patients a great deal of good in their personal life?
If you saw that things like breast implants or face lifts did wonders for people's social lives, did you lose a bit of respect for humanity when you realized how shallow people truly are, or did you already know/not care?
Would you recommend other people try to go into plastics? If you had to pick something else besides plastics, what would you have picked and why?


Finally to end on a lighter note, what's the first super car you'll buy with attending money?
 
famoussquamous said:
Ok, I'll make my questions a bit more nuanced....

How often did you hear/witness the attendings or residents cheating on their S/O?
How often did patients come in and offer sexual favors of any kind/flirt?
How often did you secretly feel a pang of despair whenever a female asked for a breast reduction?
Do you look down on patients that come in to have elective cosmetic procedures done as being weak and having low self-esteem, or did you witness it doing the patients a great deal of good in their personal life?
If you saw that things like breast implants or face lifts did wonders for people's social lives, did you lose a bit of respect for humanity when you realized how shallow people truly are, or did you already know/not care?
Would you recommend other people try to go into plastics? If you had to pick something else besides plastics, what would you have picked and why?


Finally to end on a lighter note, what's the first super car you'll buy with attending money?
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Ark??
 
fancymylotus said:
A poster who loved to spout TRP stuff any chance he got
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Wait, so you're telling me people actually CHOOSE to stay in the matrix?

red-pill.png


I thought most people would choose the red pill in that situation. It's better to face a painful truth than to live a comfortable lie.
 
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How often did you hear/witness the attendings or residents cheating on their S/O?
This is a personal character issue and not really a specialty-related issue. If you attribute infidelity to the stresses of the surgical lifestyle, I would say general surgery, ENT, Ortho should have similar issues and it may be best to take a wider survey. As far as my attendings go, they seem to be in happy home lives. Many of my co-residents are in happy marriages or long term relationships. Myself and some other people are happy being single or casually dating at this moment.​

How often did patients come in and offer sexual favors of any kind/flirt?
I have not heard of any offers for any sexual favors for any medical personnel at my institution. Anesthetized patients and post-op pain patients typically are not interested in flirting either. A general rule is to never poop where you eat. You'll get gastroenteritis and sued/pushed out of your chairmanship/lose your solid reputation. I refer you to the illustrious former chair of the UT Southwestern program.
​
How often did you secretly feel a pang of despair whenever a female asked for a breast reduction?
Never. I enjoy the cases. The outcomes are often great for the patient on both a cosmetic as well as symptomatic level. Yes -- in case you didn't know -- reductions do have a medical indication and are covered by health insurance.
​
Do you look down on patients that come in to have elective cosmetic procedures done as being weak and having low self-esteem, or did you witness it doing the patients a great deal of good in their personal life?
We try to avoid operating on patients who do not have the right motivations for cosmetic surgery. Improving the appearance of your body is not necessarily something bad or shameful or indicative of poor self-perception. Sometimes, perception of a less than appealing trait is very accurate. However, undergoing a procedure with the expectation of some improvement in external circumstances, such as job prospects or romantic relationships, is frowned upon.
​
If you saw that things like breast implants or face lifts did wonders for people's social lives, did you lose a bit of respect for humanity when you realized how shallow people truly are, or did you already know/not care?
I don't care at all. We are all concerned about our own mortality and as a byproduct, some of us are more finely attuned to the effects of aging. To that end, a face lift, can give some people much improved quality of life. I don't think that cosmetic procedures should ever be done to derive external benefits, but if it makes a patient feel younger and enjoy life more, then I respect their decision.​

Would you recommend other people try to go into plastics?
Sure. It's a great field with a diverse range of surgeries. The outcomes can be very satisfying. The patients are typically not as sick as in some other fields of surgery (ahem ... CT, vascular, colorectal). The practice options are much more flexible than some other fields.
​
If you had to pick something else besides plastics, what would you have picked and why?
Another person asked essentially the same thing, emergency medicine or consulting.​

Finally to end on a lighter note, what's the first super car you'll buy with attending money?
I have always loved the Audi R8. But I've many more loans to pay and many other goals to achieve before I drive the R8.​
 
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caffeinemia said:
Also, what is this TRP I keep hearing about?
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A quick google search comes back with the fact that it's essentially what women are actually attracted to and not the lies they tell you when growing up. For example, most people will tell you as a man that having a fantastic personality, having confidence, and being a great person are what you need to succeed in the dating world, but truth is that simply being good looking, popular, and coming from a well-to-do family will guarantee you more "dates" and fun with the opposite sex. You should have the other stuff ideally, but it's not nearly as important as the other stuff, especially before women are looking for a husband. Basically it's common sense.
 
famoussquamous said:
A quick google search comes back with the fact that it's essentially what women are actually attracted to and not the lies they tell you when growing up. For example, most people will tell you as a man that having a fantastic personality, having confidence, and being a great person are what you need to succeed in the dating world, but truth is that simply being good looking, popular, and coming from a well-to-do family will guarantee you more "dates" and fun with the opposite sex. You should have the other stuff ideally, but it's not nearly as important as the other stuff, especially before women are looking for a husband. Basically it's common sense.
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Hmm.. this sounds like PUA BS.
 
caffeinemia said:
Hmm.. this sounds like PUA BS.
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I thought TRP was BS, but most TRP people actually say that PUA itself is BS in that you can't "game" a woman that wasn't interested in you before to be interested. From the websites I looked at when I googled "the red pill", the basic premise was to tell people to not believe the lies about relationship dynamics they learned from tv and adults around them.
 
famoussquamous said:
I thought TRP was BS, but most TRP people actually say that PUA itself is BS in that you can't "game" a woman that wasn't interested in you before to be interested. From the websites I looked at when I googled "the red pill", the basic premise was to tell people to not believe the lies about relationship dynamics they learned from tv and adults around them.
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Cool. Guess we got sidetracked. I'll offer everyone botox to be my friend, someday.
 
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When did you do most of your research during med school? Did you take any gap years? How many hours per week did your research commitments take? Was most of it during your first year summer or did you have time to do research while taking classes? Thanks.
 
technician said:
When did you do most of your research during med school? Did you take any gap years? How many hours per week did your research commitments take? Was most of it during your first year summer or did you have time to do research while taking classes? Thanks.
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I actually did research in another field during my M1 summer. I started clinical plastics research during M2 fall. Research group meetings took place once a week at 5 or 6 am. We spent about 1-2 hours talking about our projects and where to go with it. Beyond that, time spent on projects was about 5-10 hours per week, depending on how many I was juggling. I remember I had to construct a database from OR records for about 300 patients on my first project. The attending wanted it done ASAP (just to test us I think). So my buddy and I sat in the office over a weekend and finished that monster. It took about 13 hours each day, but we got some huge cred after that. For basic science, I took one year off. I continued all my research on through the clinical years. That's probably why I didn't do so hot on them, but I was also a jerkface. So eh. At the end of the day, most of presentations and conference circuit running was during the year off. Most of writing and publishing occurred during my third year.
 
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Do you think you make enough $ (or would make enough when you're no longer a resident)?

I'm really interested in the attention to detail work of plastic surgeries, specifically microsurgery plastic procedures. But I would also like to feel that the work I am doing is for more than just the paycheck and an external fix. Do you really have to love the fundamental principles of plastic surgery to choose plastics over something like neurosurgery? What attracts me into plastics is the salary, very fine detail procedures, and being able to connect tissues but... is that worth it over dedicating a life to plastics over something like neuro?
-terribly phrased question but.. I swear there is a question in there somewhere-

What are the #'s of doctors who have done ENT then facial, GS then plastics, and plastics integrated? Is there a difference at all when you've already spent 8years working in plastics(rhinoplasty for ENT)?
 
caffeinemia said:
Sometimes you must entertain the masses. I didn't think those questions were particularly insightful, but hopefully the answers were sufficiently mature.
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Well EXCUSE me. I just wanted to be entertaining is all.

On a serious note I do appreciate you playing along and actually answering all of them.
 
medicalmnt said:
Do you think you make enough $ (or would make enough when you're no longer a resident)?

I'm really interested in the attention to detail work of plastic surgeries, specifically microsurgery plastic procedures. But I would also like to feel that the work I am doing is for more than just the paycheck and an external fix. Do you really have to love the fundamental principles of plastic surgery to choose plastics over something like neurosurgery? What attracts me into plastics is the salary, very fine detail procedures, and being able to connect tissues but... is that worth it over dedicating a life to plastics over something like neuro?
-terribly phrased question but.. I swear there is a question in there somewhere-

What are the #'s of doctors who have done ENT then facial, GS then plastics, and plastics integrated? Is there a difference at all when you've already spent 8years working in plastics(rhinoplasty for ENT)?
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An attending once asked me, "what's the value of your thumb?"

I said, "It's worth everything to me -- I can't operate without it."

Then he said, "well if it's chopped off, how much would you pay to have it reattached and functional again?"

I said, "everything." So is the 2 or 3 grand that medicare pays for a micro procedure really enough? I doubt it. But I also think all doctors are not paid enough. I am biased.

Am I going into plastics for the money? Absolutely not. Neuro, cardiac, spine and joints likely make more money anyway. And my friend who started a business at the age of 22 just sold it for 7.8million dollars, so I think she's better than all us. What I like about plastics is three-fold:

1) The case diversity is enormous, I can never learn enough anatomy because we are constantly roaming the soft tissues of the body.
2) I like being my own boss and working on my own schedule (yes, I often chafe under the yoke of residency hours). Plastics offers a lot of flexibility in terms of molding your own practice. Many of our surgeries can be done on at an ambulatory surgical center setting on an elective basis, so we completely beholden to hospitals, OR staffs (ugh), and call schedules.
3) In general and particularly in micro, we do pay attention to detailed anatomy. It's a very visual/spatially oriented field. If you enjoy that, like I do, then it's a perfect field for you. There is almost ZERO endoscopy. I HATE endoscopy.

As far as dedicating your life to plastics... I don't mind at all, but not necessarily for the reasons you have stated. I chose plastics because I don't think it will get boring any time soon. 60 years ago, Joseph Murray, a plastic surgeon, was changing the world with the first ever kidney allotransplantation. In the last 10 years, we've started transplanting composite face allografts. And just this week, there were reports of the first ever successful penile transplant. Many of the senior surgeons I've met are constantly re-inventing the way they do things. Plastics is a field of terrific innovation and we do try to embrace that spirit. I love that. Few people have ever told me, "hey, you can't do that." All I've ever heard is, "how would solve this obstacle?"

As far as the routes to PRS.

ENT --> Facial plastics is completely acceptable. However, they are usually limited to the face and neck.
PRS integrated and GS --> Plastics "fellowship" produce essentially equivalent plastic surgeons, though some would argue the merits of one other the other. That's an entirely separate discussion. At the end of the day, the skills you acquire are only partially related to your training. There is some component of personal motivation to be excellent.
 
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In a earlier post you mentioned that there are much more things you can do after getting your MD rather than practicing medicine. You also said you considered consulting. What would a job like that actually entail? What are some other popular options for someone with a MD who decided not to complete their residency (research aside)?

Also, are you in the regret phase again after st patties day?
 
Omppu27 said:
In a earlier post you mentioned that there are much more things you can do after getting your MD rather than practicing medicine. You also said you considered consulting. What would a job like that actually entail? What are some other popular options for someone with a MD who decided not to complete their residency (research aside)?

Also, are you in the regret phase again after st patties day?
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Some popular options I can think of include:

- Reviewing claims/preauths for insurance companies
- Working in science and medical publishing
- Working in financial services with specialization in biotech and medical industries
- Working for pharmaceutical companies
- Working in consulting

Consultants essentially advise organizations on how solve a strategic problem. Say a hospital system wants to enter a new geographic market -- like Manhattan. A consultant would advise them about the competition, the actual demand, the strategy they should use to gain a foothold -- build a new hospital? make a bid for an existing hospital? buy out local physician practices, etc. Obviously the questions may vary, but the consultant usually uses a logical, well planned, data/research driven method to provide additional insight. As you can see, a person familiar with hospitals and medicine might be better suited for the job than someone who hasn't stepped inside of one ever.

And sadly, I was am not in the regret phase, because I was in the hospital all night. I did get texted pictures of my beloved Chicago river getting dyed green though. That only served to temporarily soothe the pang for Guinness.

[Edited some crazy grammar mistakes.]
 
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how were you able to determine you had the dexterity/ motor skills to execute surgery?
i like the idea of surgery, but, TBH, i have no idea if i have those skills.

would you say surgery is somewhat of a calling to those with said skills, or is it something that can be learnt?
 
caffeinemia said:
Some popular options I can think of include:

- Reviewing claims/preauths for insurance companies
- Working in science and medical publishing
- Working in financial services with specialization in biotech and medical industries
- Working for pharmaceutical companies
- Working in consulting

Consultants essentially advise organizations on how solve a strategic problem. Say a hospital system wants to enter a new geographic market -- like Manhattan. A consultant would advise them about the competition, the actual demand, the strategy they should use to gain a foothold -- build a new hospital? make a bid for an existing hospital? buy out local physician practices, etc. Obviously the questions may vary, but the consultant usually uses a logical, well planned, data/research driven method to provide additional insight. As you can see, a person familiar with hospitals and medicine might be better suited for the job than someone who isn't stepped for inside of one ever.

And sadly, I was am not in the regret phase, because I was in the hospital all night. I did get texted pictures of my beloved Chicago river getting dyed green though. That only served to temporarily soothe the pang for Guinness.
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Wow thanks for the thorough answer! Consulting actually sounds really cool. Perhaps something you could do on the side?
 
Vaseline said:
how were you able to determine you had the dexterity/ motor skills to execute surgery?
i like the idea of surgery, but, TBH, i have no idea if i have those skills.

would you say surgery is somewhat of a calling to those with said skills, or is it something that can be learnt?
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There is a joke in surgery that "you could train a monkey to operate." The true challenges of surgery and plastic surgery in particular are to know when to operate, what operation to do, and how to do it. The actual act of doing it just takes time and patience.

When I got to the operating room as a third year student, I watched people do things and volunteered to do anything and everything that was offered. Whether it was retracting pannus, putting on leg compression devices, or sticking in a foley, I was ready and fearless. I tried to do as much on my own as possible (and as safe as possibly) and when I couldn't get it right, I asked for help. No one can fault you for learning by doing earnestly and diligently and then seeking guidance. That enthusiasm gets you in the door to bigger, scarier stuff and then you repeat it a million times until you get the muscle memory to do it right.

With the exception of microsurgery, there's little in plastics that can't be done by the average hand, given that hand has been taught for 6 years and has learned good principles and patience.

Omppu27 said:
Wow thanks for the thorough answer! Consulting actually sounds really cool. Perhaps something you could do on the side?
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Consulting for big firms like McKinsey and Bain is absolutely amazing. Many of my undergraduate classmates really enjoyed the intellectual rigor of it. However, I would say that it's very much a full time job that often requires being onsite with clients. From my limited personal experience in small business, I know MDs with a little bit of business sense can find a lot of fun supplemental income.
 
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caffeinemia said:
ENT --> Facial plastics is completely acceptable. However, they are usually limited to the face and neck.
PRS integrated and GS --> Plastics "fellowship" produce essentially equivalent plastic surgeons, though some would argue the merits of one other the other. That's an entirely separate discussion. At the end of the day, the skills you acquire are only partially related to your training. There is some component of personal motivation to be excellent.
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I thought any surgical sub specialty, except ophthalmology, could do plastics.

I could have sworn I saw an ortho guy who did a plastics fellowship.
 
SouthParkStudio said:
I thought any surgical sub specialty, except ophthalmology, could do plastics.

I could have sworn I saw an ortho guy who did a plastics fellowship.
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Sure. There are fellowship programs that will accept graduates of various surgical residencies. However, general surgery and ENT are some of the most common fields that have graduates going into plastics fellowship. It's just not really economically wise to do coming from some specialties though.
 
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caffeinemia said:
Sure. There are fellowship programs that will accept graduates of various surgical residencies. However, general surgery and ENT are some of the most common fields that have graduates going into plastics fellowship. It's just not really economically wise to do coming from some specialties though.
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If I am thinking about hand surgery, do gen surg residency put me in equal footing as a plastics resident?

Also, what sub specialties is is not financially a good idea to go into plastics?

Thanks for doing this!
 
SouthParkStudio said:
If I am thinking about hand surgery, do gen surg residency put me in equal footing as a plastics resident?

Also, what sub specialties is is not financially a good idea to go into plastics?

Thanks for doing this!
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If you are considering hand surgery, you generally have three options. The majority of hand programs take plastics or ortho graduates. A number take general surgery grads as well. A recent thread in the general surgery residency forums discussed this point. The issue is that plastics residents and ortho residents get exposure to hand surgery as a mandated part of their training. Therefore they come into the fellowship with a baseline of knowledge and experience. Contrast this with the fact that few if no general surgery programs offer hand surgery as part of their formal curriculum. Therefore, you are at a disadvantage on that level. Additionally, a number of hand fellowships are combined with microsurgical training (which falls almost exclusively under the purview of plastic surgery) or upper extremity trauma (which almost exclusively falls under the purview of orthopedic surgery), therefore a general surgeon would be further disadvantaged on the basis of their lack of exposure. That said, GS to hand surgery is not an impossibility.

Regarding your second question, I don't think it is financially sound for an ortho grad to go back and do plastics fellowship. That is essentially 3 years of lost ortho salary, which is sizable. Additionally, consider the fact that ortho and plastics do not often have great overlap (yes there is some, but not a lot). That means that an orthopedic+plastic surgeon would have the opportunity cost of not doing ortho for every moment spent doing plastics. Why did he waste 5 years learning ortho then?

Additionally, there is a more complex topic to consider. A dually trained surgeon might be expected to do combined procedures. Given the way that Medicare + insurance companies have structured procedural reimbursements, combined procedures by the same surgeon under any single anesthesia provide diminishing returns. For example, if I did a spinal fusion (ortho) and then did the spinal accessory muscle flap closure (plastics). I would get full reimbursement for the first procedure (CPT), but only half for the second procedure (CPT). Why would I want to dedicate greater time to diminishing return? Instead, I'll consult my buddy to come do the flap closure, where he'll get the full reimbursement, and like me. I'll also save that time to go do other cases that will also get reimbursed at 100% as well. So that's the economics of keeping to one specialty.
 
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I think you might've touched on the type of hours you work, but what about your attendings? Is it a 7ish-6ish kinda deal? What's their call like if they have residents to do a lot of the work? And more specifically, how often do they actually have to come into the hospital when on call? How does the schedule of an PS attending compare to other surgical specialties?
 
Omppu27 said:
I think you might've touched on the type of hours you work, but what about your attendings? Is it a 7ish-6ish kinda deal? What's their call like if they have residents to do a lot of the work? And more specifically, how often do they actually have to come into the hospital when on call? How does the schedule of an PS attending compare to other surgical specialties?
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Attending hours are highly dependent on their practice arrangements.

I've known attendings who run a research lab and a full time clinical practice at a large academic center. These individuals devote time before and after their clinical hours to manage their labs. They love it, but it certainly makes their days very long. One young attending generally works 5AM to approximately 7 or 8PM every day of the week, except the weekend.

I've also known attendings who are in private practice. They spend maybe 1-3 days in an inpatient OR or outpatient surgical center. First start is around 7 or 730. They might arrive around 630 or 700 to fill out paperwork before their case. They then finish whatever they've booked and go home. Depending on the cases and the operative setting (ambulatory surgicenter vs hospital OR), they might be done by 5pm or midnight. It's hugely variable. They may spend a couple days a week in clinic. That's might be a 7 or 8 or 9AM start, but it goes until as late as the last patient. I've seen clinic days run as late as 9 or 10pm, depending on volume and the attending's efficiency. Some doctors and some patients are chatty. Some patients think chatting with their doctor is good patient care! (Good patient care is good business).

Some private group practices may have a PA who covers the floors after hours or may alternate attendings. Our attendings typically rely on residents to do the majority of care at our hospitals.

The residents do everything on the floor and in the ED, unless there is a potential operative emergency. In those cases, the attendings are present pretty darn quickly.

Essentially that is:
Expanding hematoma or worsening infection requiring operative exploration and evacuation.
Free flap congestion or ischemia requiring take back to OR for exploration and revision of anastomosis.
Trauma to replantable parts (typically fingers, hands, arms, legs, penises, noses, ears).

If you are a trauma center and tertiary center like our hospitals, it will happen with some frequency. However, we also have a lot of attendings who rotate calls, so it gets dispersed pretty evenly.
 
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Do you have any idea what you would like the scope of your practice to be in the future (hospital, pp, cosmetics, reconstructive)?
 
It differs pretty widely on a regional basis. I am too early into residency to start seriously considering it. My program has a pretty good amount of exposure to private and faculty docs, so I am just taking the time to see what practice situations I like and how easy it is to get into those types of positions. I've been making an effort to really ask my attendings about the political/business sides of building and running their practices.

After residency and fellowship, the real world hits you in the face and you have to start fending for yourself. Business does not just magically happen, and you will have to work for it. In many situations, it means getting set up with a group, either private or hospital based, and really working up the ranks (more calls, lower-end consults/referrals/cases). It might also mean moving to somewhere with higher demand and opening up shop and working from the ground up to make friends with referring physicians and the local patient population. Either way, everything has trade offs and I have yet to make a decision.

All I know is that I will be wearing a bowtie or skinny ties, tailored charcoal, light grey, or navy suits, spring-colored pastel shirts, and wingtips or loafers. And my secretary/office assistant will not have obvious PRS, cuz I just don't find that tasteful or appealing. And if I ever make it big, my girlfriend/wife/mistress will always be 20 and a model.... KIDDING. 21, so we can pop bubbly at the 1OAK.
 
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