April 22nd, 2011 by John Di Saia, M.D. in Health Tips, Opinion
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Reader Question:
I am 16 in Orange County and want a labia reduction. Can I have it without telling my parents?
For those of you who may not know, labiaplasty (sometimes called labioplasty) is an operation to change the shape of the labiae, a woman’s outer genitals. It can be performed for cosmetic or functional concerns. Some women with large labiae experience pain with tighter garments and in rare circumstances they can get in the way of sexual relations. The operations are different things to different surgeons and have been controversial to say the least.
Quite a bit in the practice of surgery of the privates is a matter of the surgeon’s philosophy. This includes the design and scope of the operation as we’ve mentioned. Traditionally for any surgery on a patient under the age of legal consent, a legal guardian (usually a parent) must consent. Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
April 15th, 2011 by RamonaBatesMD in Opinion, Research
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I’ve spent some time thinking about this survey. I couldn’t find any better information on the survey than the press release from the University of the West of England (UWE). Perhaps in the future it will be published in a journal for better review.
The survey was apparently done by the new eating disorder charity The Succeed Foundation in partnership with the University of the West of England (UWE). The editor’s notes indicate 320 women (ages 18 – 65 years, average age 24.49) studying at 20 British universities completed The Succeed Foundation Body Image Survey in March 2011.
Notably, the survey found that 30% of women would trade at least one year of their life to achieve their ideal body weight and shape. Read more »
*This blog post was originally published at Suture for a Living*
April 7th, 2011 by RamonaBatesMD in Research
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I must say when I first read the title of this article (full reference below) I thought it was a joke. Apparently, I was just unaware this syndrome exist.
The authors state, “The finding of frontal bossing, deep radix, straight nasal dorsum, and an over projection of the nasal tip constitutes the angry face syndrome.” (photo credit, from article)
The authors note, “When the syndrome components of frontal bossing, a deep radix, and nasal tip projection are present but include a significant nasal dorsal hump (instead of a straight dorsum), the angry face syndrome does not apply. Somehow the dorsal hump negates the message of anger to the observer.”
Their solution is a rhinoplasty Read more »
*This blog post was originally published at Suture for a Living*
April 6th, 2011 by DrRich in Health Policy, Humor, Opinion
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In an earlier post, DrRich offered several potential strategies for doctors and patients to consider should healthcare reformers ultimately succeed in their efforts to make it illegal for Americans to seek medical care outside the auspices of Obamacare. To those readers who persist in thinking that DrRich is particularly paranoid in worrying about such a thing, he refers you to his prior work carefully documenting the efforts the Central Authority has already made in limiting the prerogatives of individual Americans within the healthcare system, and reminds you that in any society where social justice is the overriding concern, individual prerogatives such as these must be criminalized. Indeed, whether individuals will retain the right to spend their own money on their own healthcare is ultimately the real battle. The outcome of this battle will determine much more than merely what kind of healthcare system we will end up with.
DrRich, despite his paranoia on the matter, is a long-term optimist, and believes that the American spirit will ultimately prevail. So, to advance this happy result DrRich (in the previously mentioned post) graciously offered several creative options that could be employed to establish a useful Black Market in healthcare, which will allow individuals to exercise their healthcare-autonomy against the day when such autonomy again becomes legal. His suggestions included offshore, state-of-the-art medical centers on old aircraft carriers; combination Casino/Hospitals on the sovereign soil of Native American reservations; and cutting-edge medical centers just south of the border (which would have the the added benefit of encouraging our government to finally close the borders to illegal crossings once and for all).
As entertaining as it might be to imagine such solutions, a readily available, though much more mundane, option exists today, which is to say, medical tourism. Read more »
*This blog post was originally published at The Covert Rationing Blog*
March 31st, 2011 by John Di Saia, M.D. in Opinion
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For years I have avoided Medicare breast reductions for a number of reasons:
(1) Poor pay for hours of work. An average breast reduction when done to a high standard usually takes 3-4 hours. I do not staple the closure.
(2) Medicare patients due to their age are at higher risk for wound healing problems.
(3) 90 day global fee period – These patients routinely need follow-up care and that care is not billable.
Recently I ignored my better judgment and performed the operation for a lady in whom back pain (ICD-9 724.5) and back surgery had been long term problems. She also had a pretty nasty rash (ICD-9 692.89 Dermatitis and eczema [in the infra-mammary fold]) under her right breast that just wouldn’t go away. These of course were all in addition to the usual diagnosis of large breasts (ICD-9 611.1 Hypertrophy of breast.)
Medicare showed me yet another reason for my hesitation to do these cases when they denied payment for the operation saying it was not medically indicated. They will probably pay on appeal, but the thought that I should have to appeal the case adds insult to injury.
*This blog post was originally published at Truth in Cosmetic Surgery*
