January 30th, 2012
Dr. Jacobs in Surgery
With very few exceptions, cosmetic plastic surgeons work in very shallow areas of the body. A liposuction operation, for instance, takes place just under the skin. Nonetheless, nerves large and small exist where they work, so some numbness is created in many plastic surgery procedures.
After liposuction of the abdomen or the infamous “love handles”, for instance, the surface of the skin in the treatment area can be slightly numbed, often like the tingling feeling of a hand or foot that goes to sleep.
Of course, board-certified plastic surgeons know the locations of major nerves in the body and work around them. It’s not for nothing that board certification requires four to seven years extra surgical training after receiving the M.D. degree!
Major nerves that control muscles are very important and, if damaged, can lead to a weakness of the muscle it serves. In the worst cases, the muscle just no longer responds.
For the most part, the numbness is usually very minor and goes away as nerves regenerate to return normal sensations. Recovery of sensation can take anywhere from several weeks to six months.
Numbness can also result when a nerve is:
- Stretched
- Cut
- Cauterized
- Affected by ultrasonic liposuction
For instance, one of the most serious effects of nerve damage in a forehead (or brow) lift is the ability to close the eyelids.
Conversely, if an upper eyelid lift is muffed, the patient may also not be able to shut his or her eyelids. However, in most cases of an upper eye lid lift patient not being able to close the eyes, the cause is usually removing too much eyelid skin instead of nerve damage.
A more fumble-thumbed practitioner during a facelift can leave not only facial numbness but:
- A loss of facial expressions like smiling
- Drooping of facial features
- Asymmetry of the face
Breast augmentation surgery can lead to either decreased sensation of the nipples and numbness of the incision site. However, a breast reduction and breast lift – because the nipples are surgically released from their natural position and moved to a higher area – can lead to a loss of feeling in the nipples.
In gynecomastia (or, male breast reduction) surgery, it is very common to see temporary numbness of the nipples and surrounding skin for a number of months after the operation.
Tags: before and after plastic surgery pictures, board-certified plastic surgeons, breast augmentation, breast lift, brow lift, cosmetic plastic surgeons, Cosmetic surgery, face lift, gynecomastia, liposuction, male breast reduction., plastic surgery procedures, upper eyelid lift
Posted in After Plastic Surgery | No Comments »
January 24th, 2012
Cosmetic Surgery in Paradise? Caution!
Medical tourism in up-and-coming nations like Thailand, Turkey. Costa Rica, Mexico and India is still highly touted.
Ads show sparkling facilities, spacious recovery rooms, and smiling plastic surgeons, some of whom are trained and experienced in the U.S. or the U.K. along with those low, low fees that allow you to pony up for a plane ticket, pay for surgery and still beat plastic surgery costs in America.
But virtually all ads for overseas surgery in any nation almost always leave out some vital information about having cosmetic surgery in what is often billed as a tropical paradise.
The first consideration is this: is the operation you are requesting appropriate for you – or is there a better or alternative choice that you have not considered?
Here are the top seven questions you should ask directors of medical tourism companies before plunking down any of your hard earned cash for surgery in a foreign land.
- Who does the physical exams to make sure you are healthy enough for any surgery?
Patients often screened out for cosmetic plastic surgery are those with heart and blood pressure woes. Surgery that requires long incisions — like tummy tuck – is often turned down for diabetes patients.
- Is your surgeon board certified? If so, by whom?
While some overseas cosmetic plastic surgeons have American board certification, the certifying process is often different and less familiar for emerging nations like Korea, India, China and the nations of the former Soviet empire.
- Same question about a board-certified anesthesiologist: Where was he or she trained?
- One of the top surgery certification organizations, The Joint Commission, is inspecting and certifying more International hospitals and outpatient surgery centers, but will you be in one?
- What will I do if a complication happens after I return home? Will a physician here handle it or must I return to the original, foreign cosmetic surgeon? Who covers the air travel and fees in that instance?
- If something goes really bad, will I have legal redress in a foreign country?
- How long must I stay in the foreign nation before going home? And will my procedure prevent me from enjoying the vacation possibilities, if any?
With some plastic surgery procedures, time in the sun is not a good idea. With other procedures that involve longer incisions, like female breast reduction, traveling by jet is not advisable for at least ten days
- Finally, consider this: the richest, most powerful people in the world including heads of nations, celebrities, Nobel laureates, Arabian potentates – people who can afford any surgery, anywhere – usually choose a U.S.-based plastic surgeon.
Tags: appropriate surgery, cheap surgery, difficult complications, flying & surgery., hospital inspections, Medical tourism, overseas vacations, surgical training, tropical vacations
Posted in Before Plastic Surgery | No Comments »
January 10th, 2012
Picture Perfect Faces
Recently on Good Morning America, bride-to-be Linsey Ray told how she opted for:
- A pre-nuptials tummy tuck
- A breast lift
while dropping $20K and foregoing a dream honeymoon in some tropical paradise. The wedding itself cost another 20 grand.
(Watch a GMA video about Miss Ray’s cosmetic plastic surgery.)
Given we’ve just started a new year, it may seem a tad early to be planning for June weddings. But the bride-to-be is not the only one interested in looking good in wedding pictures, some of which last for generations.
Consequently, many wedding planners report the average wedding budget of $25,000 to $30,000 should be augmented by a few more dollars to allow for cosmetic surgery.
For, timing is everything. Lindsey Ray, for instance, had to allow six weeks for healing before she could try on wedding gowns.
Typically, the mother of the bride is interested in facial rejuvenation with the ideal being a face lift while the bare minimum is Botox to remove crow’s feet, worry lines and other wrinkles. Some settle for chemical peels which require weeks of recovery time due to redness and swelling.
The bride-to-be usually springs for breast augmentation, breast lift and liposuction while the father of the bride usually looks into blepharoplasty, nose jobs and neck lifts.
One other engaged woman had suffered the slings and arrows of massive breasts for years; she knew she would probably pop out of any strapless wedding dress. So she had a breast reduction in November of one year for her wedding the following March. The bride-to-be then had a wonderful selection of strapless gowns in April.
To make sure you have a natural look, you’ll want to allow about two weeks for upper eye lift while a month should suffice for nose job and neck lift healing. However, the final shape of nose surgery reveals itself after a year.
What about Grooms? One study of plastic surgery and weddings revealed that soon-to-be-married men are most sensitive about their ears so otoplasty, or ear pinning, is popular. In the U.S., the numbers of otoplasty increased nine percent in 2010 to 208,764.
If you let June sneak up on you, some quick facial fixes can help. Some facial fillers show immediate results including:
- Juvederm
- Restylane
- Radiesse
- Artefill
While Artefill provides permanent improvements, the other three fillers listed above dissolve back into the body
Radiesse shows improvements immediately but lasts as long as two years in some cases.
(Here’s more about popular facial fillers.)
Tags: brides-to-be, facial fillers, grooms, June brides., looking better, male surgery, mothers of brides, nuptial budgets, surgical healing, wedding photos, wedding planners
Posted in Before Plastic Surgery | No Comments »
January 2nd, 2012
After Surgery
If you’ve ever scheduled cosmetic plastic surgery, you probably noticed there are quite a few concerns about how you get to and from the surgery center and then back to the doctor’s office the next morning for a quick checkup to see if an infection has set in overnight.
It’s because in most cases after receiving IV sedation or general anesthesia, you certainly won’t be able to drive yourself home after surgery. Even the next morning, safe driving is still questionable.
A new study from the American Society of Anesthesiologists sheds a tad more light on how people tend to drive after a short-acting anesthetic.
It’s important because many people have short cosmetic plastic surgery procedures under locals only and then leave the cosmetic surgeon’s office. The shorter procedures include:
- Upper eyelid lift
- Minor liposuction
- Non-surgical rhinoplasty improvements via injection
- Facial fillers into numbed skin
It turns out that older drivers are more cautious than younger motorists just after minor surgery.
In the study, researchers rounded up 198 patients who had a minor surgical procedure while under IV sedation. But not to worry, the study subjects were not turned loose in their own cars.
Instead, they were tested on a driving simulator, both before and after surgery.
Sharp-eyed researchers then marked each driver like strict traffic cops on how much they weaved on the electronic road and the number of times they blew simulated red lights or caused accidents in hyperspace.
Results? According to Dr. Asokumar Buvanendran, the lead researcher, the amount of automotive weaving before and after surgery differed little. So the researchers assumed most the anesthetic drugs had worn off by the time the driver-patients hit the road.
Dr. Buvanendran also wanted to know if post-surgical pain, if any, made a difference to younger and older drivers after plastic surgery procedures.
Older drivers motored along slower and had better overall scores because they could make corrections quicker when the driving machines caused the driver to weave.
Researchers concluded that patients who are a bit longer in the tooth – having been there and done that – were more aware of the effects of anesthesia than younger post-surgery drivers.
Dr. Buvanendram says the study was done because all types of ambulatory surgical procedures are becoming more common as are more short-acting anesthetics. So some drivers may hit the road sooner than the usually recommended 24-hour waiting period.
(Read more about driving after cosmetic plastic surgery.)
Tags: anesthetics, good driving, light sedation, medical studies, office surgery, outpatient surgery., Surgery scheduling, surgical recovery, traveling to doctors
Posted in After Plastic Surgery | No Comments »
December 21st, 2011
Breast Augmentation Greeting Card
Giving plastic surgery as gifts can be problematic. Maybe the person:
- Does not want rejuvenation surgery
- Would be insulted that you think so
- Is not be healthy enough for cosmetic surgery
But if you know somebody who has already had cosmetic plastic surgery, some T-shirts and special greeting cards are available.
With at least 12.6 million U.S. women having had a cosmetic procedure during 2010, it’s now possible to buy on-target greeting cards for plastic surgery patients. Or for the patients themselves, stylish, made-just-for-girls T-shirts announce – in rhinestones, no less – the completion of a cosmetic plastic surgery procedure.
While some patients like to keep mum about a pending or recent surgical rejuvenation, others are more open about it, writing up their experiences in blogs, posting surgery results and progress on Internet bulletin boards. Not to mention telling everybody they know and even many they do not know.
All those open communications may be a good hint that the newly rejuvenated person with a recent breast lift may enjoy receiving a card that says: “I thought you needed a lift!” When the card is opened, the recipient sees another sketch with the caption, “But it looks like your plastic surgeon already took care of you.”
Another popular card, intended for the post face lift patient says: “You look like a million bucks!” The message inside the card reads: “I hope it didn’t cost that much to look that good!”
A card for breast augmentation patients declares along with a sketch of a busty cartoon figure: “Congratulations on the twins!” Pop open the card and it says: ‘They make a good addition to the family.”
Another popular card, great for liposuction patients with a sense of humor, shows two cartoon figures of women sitting at a table, saying: “I thought we could sit around and chew the fat!” Open the card and the message is: “But since you just had liposuction, that’s probably not a good idea.”
Yet other greeting cards are for:
- Rhinoplasty patients: “Your nose job looks great!”
- Sclerotherapy recipients: “You’re so Vein!”
- Botox patients
The card shows two women spraying each other with starch. The inside caption reads: “You’re now wrinkle free!”
Black tee-shirts with rhinestone lettering are available from the same company (LiftMeUpCards.com). Sample slogans say:
- Nipped/Tucked in the USA
- Work in Progress
- I’m under Construction (good for rhinoplasty patients with a nasal splint still in place)
- I Love the New Me!
- “ “ my New Boobs!
Where are the gifts for guys? There are none; men remain tight-lipped about their cosmetic procedures.
Nose Job Patient T-shirt
After cosmetic plastic surgery Tshirt
Tags: : Gift giving, appropriate gifts, clever cards, greeting cards, looking better, non-talkative men., popular T-shirts, rejuvenation surgery, talkative patients
Posted in After Plastic Surgery | No Comments »
December 19th, 2011
Some plastic surgeons, being excellent at body and general mechanics, are able to see new ways of doing things and have invented surgical tools.
Some years ago, we noticed during gynecomastia surgery that the liposuction part of the operation was very difficult and did not remove much breast tissue.
The reason? Standard liposuction instruments are blunt tipped (like a bullet) and do not easily penetrate the thick, fibrous tissue in the male chest.
We decided to design a cannula with a tip that could more easily penetrate the tissues — similar to the prow of a ship which allows it to pass more easily through water.
We then realized that once the tissue was penetrated and partially sucked into the holes on the end of the cannula, that fibrous tissue (unlike fat) needed to be cut free to be suctioned out of the body. Thus, we added a sharp edge to the holes.
Finally, we realized that cutting on a bias (or diagonal) is better than cutting straight across. Think of the blade of a guillotine — it is diagonal, not straight across (it wouldn’t work too well that way). Thus, we added diagonally oriented holes — with sharp edges.
The result: a remarkably efficient liposuction cannula (pictured below) which can remove both fat and breast tissue during a male breast reduction procedure. Using this cannula allows the surgeon to:
- reduce operating time
- minimize the size of the incisions needed for the operation
- remove almost all of the excess tissue quickly and easily
(Read more about our gynecomastia tool.)
According to the Mother Nature Network, other surgical tools and techniques have slightly more curious beginnings, like:
In the 10th century, Muslim surgeon al-Zahrawi started using catgut as sutures after he saw his pet monkey swallow some strings from his lute. The pet remained healthy so al-Zahrawi started using catgut to repair internal injuries.
Nitrous oxide, first produced in 1794, was first used at “laughing gas parties” in England. In 1844, an American dentist saw nitrous oxide used on giggling members of a circus sideshow audience and later tried it on a patient to alleviate dental pain.
English doctor Henry Hill Hickman noticed the numbing properties of carbon dioxide while trying it on animals. He may have not have known that too much carbon dioxide could suffocate. Later, after scientists read and dismissed Hickman’s articles, they tried nitrous oxide, ether, and chloroform. Today, Hickman is considered the father of anesthesia.
Dr. Harry Coover, a Kodak scientist working on a way using glue to attach sights to rifle barrels, came up with glue known as “cyanoacrylates.” It did not work on gun sights, but found use on WW II airplane canopies. During the Vietnam War, his glue — now known as “Super Glue” — was used in place of stitching and suturing to close battle wounds. In 1998, the FDA approved the use of skin glue on everybody.
The first device to skip needle suturing in 1900s was a surgical stapler. Back then, it weighed eight pounds and took two hours to prepare. Even worse, it required several hours to staple a wound shut. The device has been extremely streamlined since then.
Tags: Accidental discoveries, flatter chests, looking better, male operations, medical innovations., serendipity, Surgical inventions, surgical tools, treating wounds
Posted in Male Breast Reduction Surgery | No Comments »
December 15th, 2011
DR. Jacobs in Surgery
With 252,261 nose reshaping procedures being the top invasive facial surgery for 2010, (according to the American Society of Plastic Surgeons), many more people are asking about rhinoplasty.
Among those questions are many myths. Among the top 10 are:
Modern anesthetics keep the pain away. Recovery is also virtually pain-free.
- Any plastic surgeon can perform rhinoplasty.
Given that rhinoplasty is done in plastic surgery training after the M.D. degree, technically, yes. But it’s best to find a rhinoplasty surgeon who performs it weekly and has done it for about 10 years. The nose job is the most intricate and challenging of all cosmetic plastic surgery procedures to learn.
Not so. An attractive nose fits in with the face and provides the patient with a more attractive profile. You’ll look more refreshed and rested, not “done.”
- People of any age can have a nose job.
Not really. The nose is still growing until about 13 or 14 for girls, about 15 for boys.
- Only the rich can have rhinoplasty.
According to the annual statistics compiled by The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) the average surgeon fee for rhinoplasty in the U.S. is $5446.
- Rhinoplasty yields an absolutely perfect nose.
Even in the best of hands, a surgeon can only work with what he is given. Results often depend on bone structure and skin, healthy breathing and previous nose jobs, if any. Besides, most people are happy with a 96 to 98 percent improvement.
- Nose jobs are only for the super vain.
Actually, if you have a deviated septum (the thin cartilage wall separating the two nostrils) or a broken nose that healed badly, rhinoplasty may correct septum woes or the badly twisted nose resulting from a fracture.
- Rhinoplasty results show up quickly.
While you can probably go back to work in seven to ten days, count on a year before the nose shows its final shape.
- Nasal surgery equals black eyes!
Some patients do have under eye bruising – while many do not. But it’s temporary in any case.
- What if the plastic in the nose job melts?
Not to worry. The second word in the phrase “plastic surgery” comes from a Greek word, plastikos, which refers to “molding” or “forming.”
Actually, your rhinoplasty surgeon works only with your own tissues including flesh, muscle, bone and cartilage.
Tags: attracting attention, costs of plastic surgery, doctor abilities, flattering profiles, looking better, medical pain, medical techniques., perfect surgeries, surgical bruising, surgical myths, surgical results
Posted in Rhinoplasty | No Comments »
November 15th, 2011
Facial injectables
In business and in life, nothing succeeds like success.
Pharmaceutical manufactures quickly noted that nonsurgical cosmetic rejuvenation procedures had become the major trend with consumers.
Also not escaping attention were the 5.4 million cosmetic surgery patients using Botox for wrinkle removal in 2010, according to statistics compiled by the American Society of Plastic Surgeons (ASPS.)
Other, popular no-knife cosmetic surgical procedures include:
- Laser skin resurfacing
- Soft tissue fillers like Juvederm, Restylane and Radiesse
- Cellulite treatment like Velosmooth and Endermology
- Fraxel
Earlier this year, another wrinkle remover, Dysport, joined the fray, causing a which-is-better?-Coke-or-Pepsi type competition between the two.
And because imitation is the ultimate form of flattery, yet another wrinkle remover– very much like the other two – has entered the cosmetic surgery marketplace.
Known as Xeomin (it’s pronounced “Zeomin”), it is specially approved for reducing the frown line wrinkles on your brow just between your eyes, an area technically known as the glabellar lines or, to many cosmetic plastic surgeons, “The 11’s”. (Really! Scrunch up your eye brows and two vertical lines, like a number 11, should show there.)
Xeomin could also be used “off-label” for crow’s feet, forehead wrinkles and “smoker’s lines”, the small vertical lines above the normally aging lip.
Benefits? Xeomin claims the following:
- Does not have to be refrigerated; that may help in shipping and a longer shelf life
- Has no other additives, risking less chance of antibody formation in the patient and consequent Xeomin resistance
- Has been used in Germany for three years with no complaints
- Works like Botox, wearing off in about three months
- Shows results in about a week after injection
Even more important than your actual choice of wrinkle removing brands are the person who injects it and where the substance is injected.
Experts say you should avoid:
- Beauty salons
- Malls
- Home injection parties
- Medi-spas with no physician supervision
Wisest choice: the office of your plastic surgeon or dermatologist.
Any injection procedure is officially known as “provider dependent” which refers to the skill (or lack thereof!) of the person handling the syringe. Best choice: a board-certified plastic surgeon or dermatologist.
According to the manufacturer, you know you’ve got the real thing when the Xeomin package carries a small warning notice that the substance has a rare risk of spreading under the skin, away from the injection site. Other common risks include:
- Bleeding and bruising at the injection site
- Itching, swelling or shortness of breath
Tags: Botox & Dysport, competing medicines, Crow’s feet, FDA clearance, looking younger, new products, quick results, smokers’ lines., smoother faces, wrinkle fighters
Posted in Plastic Surgery in the News | No Comments »
November 8th, 2011
Tat Removal: Weeks of Work
Many plastic surgeons and an equal number of dermatologists spent appointment after appointment erasing tattoos for a person who has matured beyond the need for colorful skin ink.
But now a transferable – and temporary — medical tattoo has come along that can actually do something besides shock parents and put off employers.
A two-inch-square “wearable electronic” device looks like a modern tat but tracks bodily functions like your heartbeat, brain waves and the activity of your muscles. (Read more about the scientific medical tattoo.)
You may not mind having that tattoo on your arm — for a while, at least. But most cosmetic plastic surgeons and other medical professionals — knowing the time and pain required to remove a tattoo — have always wondered what could be the motivation for getting the tat in the first place?
That was actually answered back in 1996 and still sheds light. Lone Star state researcher Myrna Armstrong, EdD, teamed up with a medical doctor who operated a laser center that removed tattoos.
Dr. Armstrong is a professor of Nursing at the Texas Tech University of Health Sciences Center in Lubbock.
The researchers asked 105 tattooed people between 17 and 62 two questions:
- What was the motivation for getting the tattoo?
- Why did they want the tat taken off?
More women than guys want their tattoos removed; but almost everybody wants the skin markings taken off because too many people make belittling remarks about the tats which are frowned on by some (READ: high paying) employers. Wild and crazy tattoos are not seen as signs of stability among bankers, stock brokers, accountants, engineers, lawyers, insurance agents and in quite a few other professions.
Most got a tattoo around age 20 because they wanted to feel unique, show a sense of independence and wanted some experience like joining the Marines to stand out or to mark a special occasion like a marriage.
The typical age of tattoo removal was between 24 and 39.
The motivation for removal by a plastic surgeon? According to the questionnaires:
- Half were just embarrassed
- A third said tattoos lowered their body image
- Another third said not all clothes could hide the tat.
Many employers require tattoos to be covered so if clothes can’t mask the skin markings something else, like a daily change of Band-Aids, must be used.
- One-quarter felt singled out by having a tattoo
(Results are way over 100 percent because some checked multiple answers.)
Many of our readers are body builders. If you have a tat, tell us why!
Tags: belittling remarks, body tattoos, feeling embarrassed, feeling unique, finding jobs, health surveys, low image, singled out., tat removal, upscale employers, Young lifestyles
Posted in Unusual plastic surgery | No Comments »
October 31st, 2011
Also for Plastic Surgery?
It’s no secret that money is tight in our national economy. It’s a paradox because corporations are loaded with cash and people everywhere – despite their circumstances — are paying off credit cards, promising not to load them up again.
Perhaps in connection, an old financing method has become new again as many people in the market for a cosmetic surgery procedure have decided to use layaway, the 1950-ish plan widely used in department stores before credit cards became popular.
Layaway allowed you to select an item and pay for it a little at a time. Once the item was paid for, you took it home.
Layaway cosmetic surgery is springing up all across the landscape because your fee goes toward the surgery costs, with no credit card fees or interest involved. Our New York City plastic surgery practice has had several patients opt for layaways of sorts, making a down payment and then paying off the surgery – before actually having it — in six months.
However, if you use a credit card, the credit firm charges the surgeon anywhere from two to five percent the cost of the surgery. The finance company then charges the consumer interest on the loan.
If you come into an early inheritance or win the lottery and have cash on hand, you can offer the surgeon cash in full, minus a three percent discount. Some offices will accept, others won’t. But if you don’t ask, you’ll never know.
The truly important thing: limit your haggling to board-certified plastic surgeons because it’s like having an insurance policy. If a procedure is botched in lesser trained hands, the cost can be three to five times the amount of your original procedure.
Patients who have used layaway plastic surgery for, say, a face lift or a rhinoplasty, report they have an inducement to make wiser spending choices as time goes by, making little cuts here and giving up small pleasures there. Then, they divert those funds to the layaway.
Too often, when we make a large credit card purchase, we just add the payments onto what we are already spending.
Virtually all cosmetic plastic surgery increases self-confidence, a quality people need in bushel baskets when job hunting.
Just imagine how much more self-confidence you’ll have with no credit card bills dangling over your now good-looking head or body!
Posted in Plastic Surgery in the News | No Comments »
