Michael Fattal, MD, an otolaryngologist who is fellowship-trained in facial plastic and reconstructive surgery, says that Mass. Eye and Ear, Concord, his practice at 54 Baker Avenue Extension, offers him the best of both worlds: an academic affiliation while providing the full range of ear, nose and throat (ENT) services to the community. His patients include challenging cases that combine the two sides of the specialty — functional ENT care and facial plastic surgery.
What led you to such a highly specialized field?
Even before medical school, I knew I wanted to practice surgery. My family is science-oriented and like working with their hands to fix things. The physical demands and dexterity required in this field appeals to me. During anatomy class, I really enjoyed the head and neck anatomy section. It’s a complex anatomy to figure out because of the 3D orientation and how close structures are to one another. When a friend suggested I try ENT, I did three weeks and I loved it, I think because of the variety. The ear is completely different from the sinuses, which is completely different from the head and neck.
Was there a patient from your training years who stands out?
During my ENT rotations in medical school, I remember being called to the ER to see a man who had been run over by a riding mower. The blade had struck his scalp and face, causing significant injury. We repaired his wounds, and the patient did very well. It’s a challenge to repair facial injuries as there is a very small margin of error, both functionally and aesthetically. That experience confirmed my interest in ENT and facial plastic surgery. It’s an ideal combination of addressing disease and injury and then reconstruction to provide both good functional and aesthetic outcomes.
Is that what differentiates you from a plastic surgeon?
I would say so. ENT surgeons who perform facial plastic surgery concentrate on functional procedures, such as functional rhinoplasty. You can make a nose look good, but can it breathe? Those cases can be really challenging. People are often surprised to learn that ENT surgeons practice plastic surgery, but facial plastics is part of the specialty; we have fellowship training and board certification for that, too. We’re very sub-specialized, because we receive no training in body plastics and can offer suggestions and services to patients who have medical and functional problems. It’s plastics incorporated into a medical practice.
Describe the types of patients you see in your practice.
My practice is 80-90 percent adult patients; my colleague, Dr. Jennifer Setlur, primarily treats pediatric patients. I see many general ENT cases — straightforward issues such as tonsils and sinusitis — as well as thyroid and neck masses and salivary gland tumors, which are bigger cases. The cancer center sends lots of head and neck cancer cases to me. There are sensitive structures there. For example, with parotid cancer, we need to be careful of the facial nerve; we have to remove the cancer but not paralyze the face. In addition to the patients referred from Emerson’s primary care and pediatric practices, we also receive patients from area schools who have injured their noses in a fight or during a basketball game. They come directly from the school infirmary.
Do some patients need to have their surgery at Mass. Eye and Ear?
Yes. We have Mass. Eye and Ear as a secondary source for complex cases that may require a bit more expertise. I might require help surgically, as well as someone to keep an eye on the patient, sometimes all day. But I can get the entire workup done here at Emerson — PET scan, MRI, biopsy, pathology — so that the patient doesn’t need to go into Boston for that. Also, I can ensure the surgery is scheduled quickly, and that the care is seamless among our office, the cancer center and Boston specialists. I can serve as an intermediary with the primary care physician. It’s nice to be able to provide this to the Emerson Hospital community — to have the presence of Mass. Eye and Ear, which has the number one ENT specialists in the country according to U.S. News & World Report — right here.
What do you enjoy during your time off?
When I’m not working, I go to the gym and spend time outside playing with my son. We go biking together. I love to cook; I don’t really follow recipes, but I love to experiment with different ingredients. My wife and son encourage me to test various dishes on them. I like to eat, and I love to cook for my family!
