May 13th, 2011 by John Di Saia, M.D. in Opinion
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A mother called the office today. Her daughter had breast implants placed by a surgeon in another state and the two ladies are not happy. They called for a second opinion.
It is dicey dealing with situation like this as a second opinion consultant. The first question is whether or not the first surgeon did anything wrong. A botched boob job is not any boob job that the patient or mother do not like. “Botched” indicates fault. Sometimes there is fault on the part of the surgeon and sometimes there is not. Sometimes patients ask for surgery on the cheap and decline breast lifting or other associated surgery that might have made things look better. Sometimes the patient choose a surgeon of limited skill or qualifications. Sometimes infection, cigarette smoking or scarring can distort an otherwise good procedure. It is not always clear.
The second question for a consultant is whether or not the patient wants him or her to fix things or just wants to return to the original surgeon. No smart consultant wants to end up embroiled in a patient’s lawsuit with the original doctor. It is a waste of time and time is money.
*This blog post was originally published at Truth in Cosmetic Surgery*
May 8th, 2011 by John Di Saia, M.D. in Health Tips, True Stories
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It frequently amazes me how patients can be wowed by technology and advertising hype. The attraction of newer technology in particular helps part many people from their money at times. The SmartLipo system is one of the laser-assisted liposuction systems on the market. I have blogged on it before having used it quite a bit a few years ago.
The system is being marketed with phrases like “almost anyone can be a good candidate for SmartLipo.” That is simply BS.
I saw an attractive young woman in the office who had had Smartlipo on her lower back. It looked like the Geiko Gecko had done it. Her smooth contour had been made irregular and discolored despite the fact that the surgery had happened quite a while prior. Her ribs had been a bit exposed by the loss of some of the fat that would normally have laid over them. Early lipo results do change, but this wasn’t something that was going to improve over time. I have seen worse but this was so unnecessary.
SmartLipo Led to a Dent
Why did this happen? Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
May 7th, 2011 by RamonaBatesMD in Health Tips
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Here’s the tweet I posted Sunday evening:
I’ve told pts this for years now>>> Liposuction Study Finds That Lost Fat Returns – http://nyti.ms/kheltN
The New York Times article reports on a liposuction study published in the April issue of the journal Obesity (full reference below). The NY Times article uses this photo as graphic illustration
and a quote from a plastic surgeon who says he is surprised.
Dr. Felmont Eaves III, a plastic surgeon in Charlotte, N.C., and president of the American Society for Aesthetic Plastic Surgery, said the study was “very well done,” and the results were surprising. He said he would mention it to his patients in the context of other information on liposuction.
I have told my patients for years to consider the fat cells in their body as drawers or storage bins. If I take away some of the drawers and they continue to take in “fat” that needs to be stored, the body will put it somewhere. If there are now fewer drawer options in the saddlebag or abdominal region, then where will it go? Most likely the upper body, etc. Read more »
*This blog post was originally published at Suture for a Living*
May 3rd, 2011 by RamonaBatesMD in News, Opinion
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There was a lovely news article on the first California hand transplant patient in the LA Times earlier this week: Hand transplant patient speaks (bold emphasis is mine)
Emily Fennell, 26, last month became the first person in California to have the revolutionary surgery. Six weeks and many hours of therapy later, she has no regrets. …..
On March 5, Fennell became the first person to undergo a hand transplant in California and the 13th nationwide to have the revolutionary surgery. . ….
“It’s crazy how good it looks,” she said at her occupational therapy session one morning last week at UCLA, where she spends about eight hours a day working on learning how to move her new hand and fingers. “I knew the match wouldn’t be perfect, but if you didn’t know what happened, you’d think I just had some kind of orthopedic surgery.” ….
Doctors told her that the biggest risk from the surgery comes from the side effects of lifelong use of strong immunosuppressant medications, which can cause high blood pressure, kidney or liver damage, elevated cancer risks and lower resistance to infections. …..
“I decided the benefits were worth those risks,” Fennel said. She has adjusted well to the medications. …. Read more »
*This blog post was originally published at Suture for a Living*
May 1st, 2011 by John Di Saia, M.D. in News, Opinion
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This MSN article states that doctor-owned hospitals are on the rise. In California, the opposite is the case. The hospital business is a lousy business in which to be. I would rather open a surgical facility. I had an opportunity to be a part of a group that bought a hospital a few years ago and passed.
In California, real medicine is going into the toilet as doctors realize that the work they have put in to get educated makes practicing fairly unrewarding. Niche markets and gimmicks are replacing the conventional medical landscape. That’s the reason we have so many non-plastic surgeons turning to cosmetic work. The bottom line is that you need to pay doctors enough so they can make a decent living or they will find something else to do.
Sad but true.
*This blog post was originally published at Truth in Cosmetic Surgery*
