For more than three decades, Dr Rozina Ali has worked with anatomy in three dimensions. As a plastic and reconstructive surgeon, her career has depended on an intricate understanding of tissue, structure, proportion and movement, combined with the precision to translate what the eye sees into what the hand can achieve.
But the operating theatre isn’t the only place where Rozina has explored that relationship. Her interest in sculpture has given her another way to study the human form: looking closely at contour and volume, understanding how individual features relate to the whole, and discovering howremarkably small changes can alter what we see.
Here, Rozina reflects on what sculpture has taught her about seeing, creating and the connection between the trained eye and the trained hand.
Learning to really see
There is something rather contradictory about my hands. My handwriting has always looked like a drunken spider has wandered across the page. Yet put a knife, cannula or needle in my hand, give me a problem of the flesh to solve, and more than three decades of surgical training and practice take over.
As a plastic and reconstructive surgeon, I have spent my entire professional life thinking and working in four dimensions. Surgeons look past the surface issue and have to understand what lies beneath: skin, fat, fascia, muscle, bone; how they relate to one another; and how changing any one layer can affect everything around it. Time is the dimension that is most difficult to articulate, but we are also
unconsciously trained to account for the effects of time and gravity on our work. Surgery trained my hands, but it also trained my eye, and sculpture has become a way of exploring the relationship
between the two.
When we look at a face, we tend to think we see it as a whole: a nose, a mouth, a cheek, a jawline. Try to recreate one in clay and you quickly discover how much you haven’t really noticed. You have to start seeing the things your brain usually takes for granted: where a plane changes direction, how light falls across a contour, where volume sits, the relationship between projection and proportion, and how apparently tiny differences can alter the character of the whole face.
Sculpture taught me to look more carefully. You aren’t simply copying what is in front of you; you are trying to understand its structure sufficiently well to recreate its form in three dimensions. That feels very familiar to a plastic surgeon.
Anatomy becomes form
My surgical career began in reconstructive plastic surgery, where anatomy isn’t an abstract subject learnt from a textbook. It is something you see, touch, mould and even smell. Tissues have different qualities and behave differently; they have blood supplies, attachments, textures, movement and function. And every person presents a slightly different anatomical puzzle.
Reconstructive surgery asks you to understand all of that and then use it to solve a problem. For me, one of the greatest principles of plastic surgery has always been the primacy of form and function. It isn’t enough for something simply to look right, it has to work properly, but equally, function doesn’t mean that form is irrelevant.
That combination requires technical skill, certainly, but it also requires judgement. You have to be able to look, analyse and anticipate, and then translate what you can see in your mind into what your hands actually do. Sculpture exercises some of those same muscles, metaphorically, at least.
Training the hand
People talk about surgeons having “good hands”, as though manual dexterity is simply something you are born with. There may be some natural aptitude involved, but surgical hands are trained hands. They become better through repetition, through watching people more experienced than you, and visualising and imagining thousands upon thousands of tiny movements. You learn how much pressure to apply, how tissue will respond and when a millimetre is all that matters.
Eventually, knowledge, judgement and tissue handling begin to work together. Sculpting is obviously not surgery, clay is wonderfully forgiving in ways that human tissue most certainly is not, but I enjoy the visceral quality of it, its physicality: taking what I see or imagine and translating it through my hands.
You add volume, remove it, stand back and look again. Something isn’t quite right, so you make a tiny adjustment and suddenly the whole works better. There is both relaxation and tension, pleasure and satisfaction in that process.
The importance of proportion
One of the things both surgery and sculpture reinforce is that beauty is not created by isolating individual features. It is about relationships. A feature can be perfectly attractive in isolation and yet feel wrong if its proportions don’t work with everything around it. Equally, the tiny irregularities and asymmetries that make us individual are often precisely the things that give a face its character.
That matters enormously in my work today. Whether I am thinking surgically or non-surgically, I am not interested in imposing an idea of the perfect face onto the person sitting in front of me. I want to understand their anatomy, their proportions, their tissues and what has changed for them.
The trained eye isn’t looking for perfection. It is looking for balance, proportion, symmetry.
Knowing when to stop
There is another lesson creativity teaches you, and perhaps it is one of the most important: less is enough. You can keep working at a piece of clay indefinitely, smoothing, moving, adding, but there comes a point when another intervention doesn’t improve what is in front of you. It can begin to move you further away from the truth.
Knowing when to stop requires judgement, and the same is true in aesthetic surgery. My role isn’t to identify everything that could be changed, it is to understand what is bothering someone, assess
what the change actually is, anatomically and decide whether intervening would improve balance, proportion, symmetry. Sometimes that may mean doing just a little, sometimes a lot and sometimes it means doing nothing at all.
Preserving the person in front of you matters far more than pursuing an abstract idea of perfection.
Still learning to look
One of the joys of having worked in medicine for as long as I have is realising how much there still is to learn. My career has taken me through reconstructive microsurgery, Burns surgery, trauma and aesthetic surgery, now I’m into regenerative fat transfer and technologies that didn’t exist when I began training. The tools and techniques have changed enormously, but the need to look carefully hasn’t.
Perhaps that is why I enjoy sculpture so much. It takes me back to something very fundamental: observe, understand, mould. Look at the whole, understand the structure underneath it, appreciate
proportion and movement, and know when and how to effect the necessary change. I have learnt to trust the connection between a trained eye and a trained hand.
For someone whose handwriting still resembles the work of a drunken spider, I am grateful for my aesthetic eye and for what my hands eventually learnt to do.
