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Latest Posts

A Hybrid Plastic Surgery Practice

When I tell people I have a hybrid plastic surgery practice, I am not talking about a fuel efficient car. I am talking about the fact that I do both cosmetic surgery and medically-necessary surgery. Part of the medically-necessary surgery includes the repair of pressure wounds (also called decubitus ulcers.)

Not only is this type of surgery not cosmetic, it can be pretty ugly. It is surgery to assist often long standing wounds in healing in often significantly ill patients. If possible such a wound is repaired using tissue from adjoining areas of the body called fasciocutaneous and musculocutaneous flaps after scar and debris is cut away. This isn’t pretty, but Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

The Most Popular Plastic Surgery Procedures By Age Group

The American Society of Aesthetic Plastic Surgery publishes statistics every year indicating which cosmetic operations are on the rise. A journalist at the OC Register asked a group of plastic surgeons why this might be. Being that I am opinionated (why do you think I blog here,) I figured I’d take a shot at some of these:

I. Statistic: TEENS – Nosejobs and Otoplasty (commonly referred to as “ear pinning”) on the rise

Dr D: Part of the development of the teen psyche involves becoming aware of social norms. As they do this, they also become aware of differences and develop standards of beauty. Many of these teen nose jobs are justified as medically-needed, but appearance usually factors in. Otoplasty is a similarly social operation.

II. Statistic: YOUNG ADULTS – Breast implants. Ages 19-34. 166,000 a year. (ASAPS)

Dr D: “Beauty standards” are important motivators here as well. Young adults in the workplace (and social groups) see those around them doing these things and often being complimented. Some of these patients may also be seeking after childbirth “body repair.”

III. Statistic: EARLY MIDDLE AGE – Liposuction. Ages 35-50. 143,000 a year. (ASAPS)

Dr D: A slowing metabolism in this age group combined with more involved work schedules (with increased sedentary time) equals increased trouble “holding back the fat.” Liposuction is easy and can help with that. Add some post-pregnancy issues here as well.

IV. Statistic: YOUNG ADULTS – Botox. Ages 19-34. 371,000 a year. (ASAPS)

Dr D: The fad of Botox use in the really young is an advertising phenomenon as there is no good reason for young people to do this other than to “feel” hip.


My opinions of course. :)

*This blog post was originally published at Truth in Cosmetic Surgery*

Medical Mythbuster: Mold in Saline Breast Implants

I read online a woman telling about how her saline breast implants got mold and she had terrible problems. Does this happen very often?

A few years ago I put up a YouTube video of my experience with silicone gel breast implants. Now every six months to a year somebody posts a comment about how saline implants are just as dangerous. A frequent portion of that response is a statement about a moldy saline implant. My response is and always has been, if saline implants are so often affected by mold, then why have I never seen it?

I have been implanting (and at times removing) breast implants for over 15 years. You would think if something was a dangerous and common phenomenon that I would be seeing it. I haven’t. Not even once.

A saline implant when left on a table outside of your body can develop mold, but this doesn’t seem to happen inside patients. The difference is probably that when implants are properly placed inside a woman’s breasts, her immune system helps protect them from such problems. Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Plastic Surgeon Outlines Key Points For Women Considering Labiaplasty

Reader Question:

I want to get the [labiaplasty] surgery because I’m really embarrassed about the way I look… but I’ve read online that some experienced really bad results and ended up having pain for the rest of their lives… due to nerves getting trapped and stuff… how common is this? Do you make sure that no nerves get trapped? Because I believe that sensitivity is more important than the look… and how much do you usually remove? the bare minimum or…? I’m afraid of being embarrassed that I got this operation if I go through with it.

Labiaplasty is a serious consideration. The online reflections of all patients who have had surgery however encompass a multitude of different operations.

It is my belief that Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Can Botox Be Done Well?

Reader Question:

All I see online is bad Botox stories.  Can this ever be done well? Why is it so popular?

Botulinum toxin injections temporarily paralyze muscles where they injected. While this sounds scary, it can be done to reduce certain facial movements that make people look concerned (the look of consternation,) and older (crow’s feet,etc). As is usually the case in plastic surgery, too much of an otherwise good thing can make people look weird. Just look at Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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