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The Lack Of Evidence Behind Retinoids For Anti-Aging

Many over-the-counter (OTC) cosmetic products contain retinoids and are promoted (advertised) as anti-aging products.

An article in the February 2010 issue of the Aesthetic Surgery Journal is a review of the evidence behind retinoids in cosmeceutical products. It turns out there isn’t much. Read more »

*This blog post was originally published at Suture for a Living*

Deflated And Elated: A Breast Implant Tale

Crying, she says: “Dr. Bates, my right implant has deflated. Help!”

Don’t panic. It’ll be okay.”

We review the options and risks. Fortunately, her 9-year-old implants are covered by the 10-year plan.

“Dr. Bates, can I go bigger this time?”

Yes, that’s an option.”

Smiling, “Then let’s do it.”

*This blog post was originally published at Suture for a Living*

Plastic Surgery And The “Barbie Syndrome”

Interesting article in the Huffington Post last week by Dr. Glenn D. Braunstein: Oh, You Beautiful Doll: Plastic Surgery Risks and Rewards. The article discusses the “Barbie Syndrome” or more accurately “Body Dysmorphic Disorder.” I love this line:

And, finally, try to have realistic expectations — it is unlikely that cosmetic enhancement is going to drastically change your life — after all, you are human, and not a plastic doll.

The article reminded me of my post on Suitability. Not all patients should have surgery. Their reasons for desiring surgery, goals, and expectations should be discussed during the consultation. Risks and benefits must be weighed. 

Body Dysmorphic Disorder

  • In its simplest definition, it is an obsessive preoccupation with a slight, imperceptible, or actually nonexistent anatomic irregularity to the degree that it interferes with normal adjustment within society.
  • This disorder may be present in varying degrees. It is the most common aberrant personality characteristic seen by the plastic surgeon.
  • When postoperative dissatisfaction occurs (and in most cases, it will), it almost always is based on what the patient understood rather than what was actually said.

*This blog post was originally published at Suture for a Living*

Considering Breast Implants? Beware Of The “Double Bubble”

Recently a Staten Island woman was awarded $3.5 million after developing a double-bubble breast deformity after a breast augmentation/mastopexy surgery — commonly known as breast implants.

I don’t know if the award was warranted, but I do know that the deformity is a known risk of breast augmentation surgery. I try very hard to tell patients about possible risks of surgery, but none of us go into surgery thinking we will be the half or one or two percent. Read more »

*This blog post was originally published at Suture for a Living*

How Your Skin Tells Your Story: A Poem

In the March 3, 2010 issue of JAMA, there is a poem by Sarah Wells called “Hymn of Skin.”  While I enjoyed the whole poem, my favorite part is:

Plastic surgeon of the heavens, how I delight
in a furrowed brow, crow’s feet, age spots—
wrinkle me up a dozen times to show I lived
hard, good, funny—after all beauty, being what it is,

is only skin deep—may my soul seep through
dry scales of later hands, resting tranquil in my lap.
O omniscient dermatologist, what ingenuity,
past hurts evident in scrapes and scars—

a clumsy stumble down uneven concrete stairs,
knees and ankle raw and dripping; pockmarked cheeks
from teenage zits—all healed, in the end, but not forgotten.
How often we need reminders of where we’ve been.

*This blog post was originally published at Suture for a Living*

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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