The American Society of Plastic Surgeons meeting in San Francisco last month was loaded with great presentations in the meeting halls, intriguing new products in the exhibits, and, for me, enlightening personal meetings with many of you.

On the first full day of the meeting, there was a panel discussion about the “controversial barbed sutures.” This was originally billed as the “controversial contour threads,” but the powers that be came to realize that Contour Threads™ is in the process of becoming a registered trademark, so the title was changed at the last minute.

There’s no doubt that the use of barbed sutures in place of conventional facelifts is controversial. I’ve seen photos that reveal some less-than-ideal results. So I was expecting something of a knock-down, drag-out fight among the participants. But it turned out that all of the panelists had used the sutures extensively for anywhere from 1½ to 15 years, generally with good results. The major take-away lesson from this panel is that, despite the perception (intentional or otherwise) that the use of the sutures is a noninvasive procedure, it’s becoming increasingly evident that the better results are being obtained with an “open” procedure, which is unmistakably invasive.

Two days later, there was a similar panel discussion: “surgical facial rejuvenation without major surgery.” Four surgeons presented their views about and clinical experiences with procedures ranging from various short-scar approaches to pinch blepharoplasties to Z-plasties to the aforementioned barbed sutures. There was even an overview of the so-called “lunchtime” and “weekend” facelifts that many surgeons don’t consider to be facelifts at all.

Again, my major conclusion is that there’s still no such thing as a free lunch, too much chocolate, or a nonsurgical facelift.

Immediately after the session about barbed sutures, there was a panel discussion about surgeon responses to natural disasters. In the most memorable presentation, Bernard M. Jaffe, MD, of New Orleans gave a detailed, moving, and inspirational account of how the medical staff at Tulane University Hospital responded in the aftermath of Hurricane Katrina. Suffice it to say that all patients were evacuated safely and no lives were lost. But how the staff and other emergency responders accomplished this in a hospital with no power or other utilities, and submerged in water up to the second floor, is a story that everyone should know about.

Jaffe also related what I believe are two important (and not intuitive) pearls for preparedness for communications in times of emergency:

• Have cell phones on hand registered in area codes other than your own. None of the New Orleans-based cell phones worked after Katrina hit.

• Keep a database (on paper and electronically) of the private e-mail addresses of all hospital staff. When the institutional servers go down, these can be accessed from any computer.

What else did I learn in this session? That the meeting attendees evidently didn’t think that it was very important. The huge ballroom was virtually empty, and it only began to fill up as the time for the next session—on breast reconstruction—approached. Of course, breast reconstruction is extremely important, but how many of you would really know what to do if a major emergency were to hit your city or town? And why did attendees place disaster response so low on their priority lists?