From M.D. NEWS SPECIAL MEDICAL EDITION:

Transblepharoplasty Endoscopic Subperiosteal Midface Lift

From cosmetic face lifts in Metropolitan Kansas City to severe cleft lips and palates in Latin America - Tom Geraghty, M.D., spend his professional life at drastically different ends of the medical spectrum.

During most of the year, Dr. Geraghty has a busy plastic surgery practice with offices in North Kansas City and on the Plaza. He specializes in elective aesthetic and reconstructive surgery and served as the president of the Plastic Surgery Society in Kansas City in 1991 - 1993.

However, for three weeks every year, he leads a team of 60 physicians and nurses who travel to the Dominican Republic with Medical Aid for Children of Latin America (MACLA).

The medical team works non-stop to repair cleft lips and apaltes, burn scar contractures and correct other reconstuctive deformities. These patients have little access to modern health care and are the poorest of that country.

"One of the joys of going to the third world is that it is pure medicine. We work from morning until night doing 250 surgeries in three weeks. The people say thank you and perhaps pay you with a chicken or some eggs and they get well," Dr. Geraghty said.

"I have a very enjoyable practice here in Kansas City with happy, satisfied patients, but when you go to Latin America there's no managed care - no paper work, no interferences. I find great satisfaction in that typeof experience."

A Changed Practice

Dr. Geraghty began his private practice in 1978 after graduating from K.U. Medical School and completing residencies in general surgery at St. Luke's and in plastic surgery at Children's Mercy Hospital and Truman Medical Center. In the past 20 years, he's seen his practice chagne dramatically.

When he began practice, a large percentage of his work was reconstructive plastic surgery: reduction mammoplasty, skin caner removal, nasal reconstruction, vascular skin lesions and post-cancer breast reconstruction.

While thes procedures still constitute a small percent of his practice, aesthetic surgery is his primary specialty. This includes breast augmentations and lifts, endoscopic forehead lifts facelifts, laser surgery and skin resurfacing and liposuction, abdominoplasty and blepharoplasty.

"Over the years, I have changed my practice - primary due to deplorable managed care. I now do 80 percent cosmetic, aesthetic surgery," he said.

"I still do some reconstructive work such as breast reductions. My patients have often lived with back, shoulder and breast pain for years so thi