Kate Moss Laser Facial Peel

Contact Music Story

Kate Moss apparently had a "laser facial peel."

With the variability in the units on the market, this could really mean anything. Most of them are IPL (intense pulsed light) units and not really lasers. In my opinion, they are little better (with very rare exceptions) than the chemical peels that I do much more often.

It is not unusual to have them done for "little things" as they make only very small changes in the pigment or texture of the facial skin.

Best Regards,

John Di Saia MD



Tags

celebrity plastic surgery
Kate Moss
Kate Moss laser
Kate Moss Plastic Surgery

Too Big Boobjobs?

Too Big These Breasts?

Yikes. I never want any of my patients to hit a magazine like this.

Each of these ladies will be returning to the operating room several times over the course of their lifetimes. I just do not need that kind of track record. I have nothing against those women that might want such a result, but I don't want to be their surgeon. I seek to avoid complications.

Best Regards,

John Di Saia MD



Tags

huge breast implants

Breast Reduction Cancer Screening?

ABC Piece

A study presented at the American Society today recommends that breast reduction patients be screened for breast cancer. What exactly that means is not specified in the press release.

I don't like press releases like this. They freak patients out.

I personally send all my breast tissue from my breast reductions to pathology for a reading. In nearly ten years, this has not rresulted in a breast cancer or high risk reading. All my breast reduction patients get mammograms if they are appropriate screening age. Again I have found no breast cancers doing this in the same ten years.

The study quotes a 12% high risk lesion finding in 300 patients. Either I am very lucky, or the study is flawed or the press release incorrectly summarizes the findings. The last time I read the literature the incidence of finding a breast cancer in a breast reduction specimen was about 1%. May my luck continue.


Best Regards,

John Di Saia MD



Tags

breast cancer
breast reduction

Haloscan commenting and trackback have been added to this blog.

Breast video - I hope these are fake (Non-medical humor)

Boomnation Post

-Those without the faintest semblance of a sense of humor are warned not to click this link lest your heads spin right off your shoulders-

I think I have found the answer to that question women frequently ask:

"Do guys care if my breasts are fake."

In this video, I hope they are.

LOL,

John Di Saia MD


P.S. When I see stuff like this online, I just kinda wonder. That is the internet.


Tags

breast humor
breast video

Facial Peel For Paris?

For those who have asked:

"What do you look like after a facial peel?"




Paris Hilton may actually instruct you. (as funny as that might seem)

Dana's Dirt and Elisita have posted pictures of Ms Hilton with funny facial skin changes and what appears to be grease on her face.

Chances are she has just had a light facial peel. After such a peel the skin peels or flakes over several days to a week depending upon how deep the peel is. The ultimate effect is to reduce sun damage and acne or even facial wrinkles (again depending upon how deep the peel is.) The ointment is a dressing of sorts to assist the skin in healing.

Very likely,

JPD

P.S. I hope they took it easy on peeling her nose. The sun glasses can leave a mark where they touch the nose if peeled too deeply. I usually ask patients not to wear sun glasses for a few days after a peel if the peel is on the deep side.




Tags
celebrity plastic surgery
facial peel
Paris Hilton
Paris Hilton plastic surgery

Body Lift Surgery - In the News

NBC Story

A body lift is in the news.

I prefer to do these operations in stages to keep the wound complications to a minimum. These are the operations we do on patients who have succeeded in losing large amounts of weight.

For the lower body lift, my preferred technique is to do an extended tummy tuck and then at a second sitting do a buttock lift (if the patient wants the full effect). This interrupts the circulation less than the full "around the body incision" that is required when the operation is done all at once.

These are very cool operations, but take time and frequently need "touch ups." They are becoming a larger part of my practice.



-JPD


Tags

body lift
butt lift
tummy tuck
weight loss plastic surgery

Tyra Banks Has "Real" Breasts

Reuters Story

Well, it looks like the bar has been raised on promoting your show and proving that your breasts are sans breast implants. Tyra Banks had a plastic surgeon and an ultrasound machine on her show today to prove that her breasts are real.

I have never really thought much about her breasts being implanted, but this is an interesting turn of events anyway.

LOL,

John Di Saia MD


Tags

Tyra Banks Breasts
Tyra Banks Breast Implants

Amber Frey - another disappointment

CNN Story

People occasionally e-mail asking whether I think Amber Frey has had plastic surgery. Well, after reading this CNN story I don't think there is much to make her look good.

While I believe Scott Peterson probably did murder his wife, there seemed to be pretty little in the way of hard evidence.

Amber, on the other hand, was not the best witness to base a trip to death row upon. Either she deliberately duped a man into paying child support for a child that was not his or she was sleeping with the entire male population of central California.

I continue to be nonplussed by this woman. In my view, she is a simple opportunist.

-JPD

Silicone implant maker closer to market

Associated Press Piece

Inamed has developed a "gummie bear" cohesive gel silicone type implant that it has released in other parts of the world. These seem to be the industries' answer to the concerns over the safety of silicone. The gel is thicker than that of the older silicone gel implants. It kinda sticks together like a "gummie bear." I met a patient that had a pair of these new Inamed implants placed in Canada. These are very similar to the implants marketed as "Cohesive gel" in the United States by Inamed's competitor Mentor HS.

The relative safety of these implants relative to their "thinner gel" sisters is unknown. They probably leak to a lesser extent. The consequences of this leaking might very well be the hardening and calcification we have discussed before here. Women considering them will need to qualify under the terms of a study. This is an experiment.

I think women should have the right to participate if they wish, but do not recommend silicone gel implants for other than occasional use in my practice. I am on the Mentor and the Inamed studies, so I can offer these implants to my patients. I much more commonly recommend saline-filled implants as I believe they are safer.

Best Regards,

John Di Saia MD



Tags

cohesive gel silicone
gummie bear implant
silicone breast implant

CNN News - 'Makeover' sued over woman's suicide

CNN/Reuters Piece

"The suit claims the "Extreme Makeover" crew manipulated Williams' sister, Kellie, into making cruel statements about Williams' looks."

-She was manipulated?


"They cancelled her appearance and sent Williams home where Kellie, distraught over what she had said about her sister, eventually killed herself, according to the suit."

-Sounds as baseless as a malpractice action. A disturbed woman kills herself and it is a television show's fault.

Oh, but the million dollars will make it better, your honor. [extreme sarcasm]


Pretty amazing how plastic surgery can now involve suits for not operating.


Best Regards,

John Di Saia MD


P.S. Thanks to BP for finding this one....may the judge grant summary judgment.


Tags

extreme makeover suit
plastic surgery lawsuit

Paula Abdul - Worst Dressed List?

AOL Story

People magazine's Caryn Midler commits Paula to the worst dressed list for her Emmy's show choice of a gown showing cleavage. Lord Forbid.

I wonder what the chick reporting this atrocity looks like? Paula looks pretty damned good for a chick in her position and for supporting my breathren she gets a meaningless award from me.

LOL,

John Di Saia MD




Tags

Paula Abdul
worst dressed

News Story- "The beauty products from the skin of executed Chinese prisoners"

Could this be true?

I am not sure of the reliability of the source news piece, but this might be reason enough not to consider the use of cadaver-sourced soft tissue implants. I have not been a real fan of Alloderm, but a recent question at my forum was directed as this issue. In China, could this be plausible?


Thanks to BP for the e-mailed news flash.

Best Regards,


John Di Saia MD



Tags

human parts surgery
plastic surgery china

"Hips and Butt Getting Bigger After Tummy Tuck" - Forum Question

Another one from the forum:


The Question:


Hi Dr,
I'm just wondering what your thoughts are on this. I am 5 months po from a FTT, MR (full tummy tuck with muscle repair). I have been working out and still eating healthy as I did b4 surgery, BUT my hips and butt seem to expanding. I've been going for lymph drain massages for my tummy and while it is helping that, I can't help but wonder if it's pushing fluid to other places. Not only can I not get back into my preop size 8 jeans, but I couldn't even squeeze into a 12! I'm frustrated because I keep hearing different theories on this. Here's my 5 month pics http://www.picturetrail.com/amylynn33

An Answer:

Looking at your pictures, you look like you are doing well.

Prior to surgery did your weight fluctuate alot? Patients like this following abdominoplasty can gain this weight in new places. This can become a problem.

At this point swelling is usually coming down, although in large cases it may not be completely gone for 6-8 months. Did you have alot of liposuction with your tuck? Liposuction frequently makes swelling more pronounced for a longer period of time. Also if you smoke, try to stop it or limit it as it interferes with wound healing.

Best Regards,

John Di Saia MD

Msn's "Ugly Road To Beauty" Piece

The Slide Show (Click "Ugly Road to Beauty") - covers cheap cosmetic surgery in Mexico

I put up a web site with a story (the first) on a Costa Rica Tummy Tuck nightmare:


http://www.cosmeticsurgerydisasters.com


Out of US plastic surgery can save you money, but there is risk. Beware.

-JPD


Tags

cheap plastic surgery
plastic surgery costa rica
plastic surgery mexico

Sanity in the Vioxx Fiasco?

A Washington Post Editorial

Politicians and regulators should be asking themselves whether a system of massive cash awards to people who may or may not have been adversely affected by Vioxx is a logical, fair or efficient way to run a drug regulatory system. They should also be asking whether juries that scorn medical evidence are the right judges of what information should or should not have been on a prescription label.

Will lawmakers take notice? I couldn't be so hopeful. We need tort reform or health care will continue to suffer. That's you and yours my friends. I would also limit prescription costs al la a modified Canadian drug model, so they wouldn't get off the hook entirely. :)

-JPD


Tags

vioxx
tort reform

Botulinum Toxin Injections... A Conservative Rationale?

I had a return patient come in today to consider more Myobloc (the Botulinum toxin that I use in the office the most frequently). Her friends at her office had had alot of Botox...in their foreheads, in their eyelids, in their Crow's feet... Another doctor had done this. She wondered if she "needed" more. Well nobody "needs" this. The real question is whether or not she might benefit from more.

I discouraged her from using it for more than the central forehead (base of the nose) and a little at the crow's feet.

Why?

(1) I like people to have some facial expression. Blunting some wrinkles is OK. I don't like "Stony" faces.

(2) There is some evidence that injecting too much into the entire forehead can drop the eyebrows and lead to the desire to have a forehead lift. I am not comfortable about causing the need for a cosmetic operation that a given patient may not want.

Botox and/or Myobloc is/are fine, but there is definitely a place at which too much makes a problem.

Remember my blog= my opinion


Until Later,

John Di Saia MD


Silly Disclaimer.....like a real commercial (LOL):

The foregoing message has not been approved by any company making outrageous profits from the sale of botulinum toxins. They would rather you inject every square centimeter of your body.


Tags

botox
myobloc

Health Insurance Dodges The Bill Again

This week I received the EOB (Explanation of Benefits) from a case I did in the emergency room a number of weeks ago. EOB is certainly a misnomer here as the insurance company applied the amount of the bill in its entirety to her deductible.

Patients are often surprised when their PPO plans pay nothing and proceed to get angry at the surgeon that came out on the weekend at night to put their face back together. In this case, the young lady split her lip open surfing.

"Don't blame me for your insurance company woes. You signed up for that policy."

People often don't understand the stipulations of their insurance plans. They just know that the plan costs them money; frequently a lot of money considering these plans pay out so little. My belief is that insurance plans are often constructed in a confusing way so that people don't know what they are getting themselves into.

A few basic points:

"Deductible" - This is the amount you agree to pay (usually yearly) before the plan pays out a dime. Patients frequently increase this number to bring their premium down.

"POS" - Point of Service - These plans frequently have both HMO and PPO aspects allowing access to Out Of Network providers but better coverage for in plan providers. This is your best policy (as far as I am concerned) in the Emergency room. I get to bill at my rate and patients usually have little or no cost (in emergency room care that is).

"Co-pay" - More of your money that you agree to pay at office visits on top of the deductible.

"Provider" - A doctor that agrees to let the insurance company regulate his fee structure. This is not the good doctor Di Saia anymore thankfully. I was collecting about a third of my charges back then. Can you say "revenue negative?" Your share of cost will be less with a provider doctor. Then again as a provider doctor I was losing money and had very little time to spend with my patients. This has changed along with my newfound freedom. :)

Generally as Co-pays and Deductibles get larger, the premium gets smaller. Then again you are agreeing to less insurance really. Beware that which you sign as this seals your fate.


Until Later,

John Di Saia MD

Tags

health insurance

Tara Reid's Tummy Again - Forum Question

The Forum has been busy lately:

The Question:

I saw Tara Reid's stomach lipo mishap and I am wondering how and if that is fixable. My daughter is considering lipo and if that is just a "risk" then she may want to reconsider. Is that the result of a "risk taken" or really unskilled (or careless) surgeon? How much could it cost to repair (if possible) if that were to "happen"? Would that also be multiple surgeries to repair?? Would weight gain fix (or help) it?


An Answer:

This is difficult to say. There are patients that are “over suctioned” and look as she does. Then again there are patients that after their liposuction go and lose an enormous amount of weight and make themselves look funny. It is probably a combination of the two.

I am conservative with liposuction. This means I remove less but have very few problems such as Tara's. I have certainly not had an irregularity as bad as hers. The fact that she smokes might also have contributed to poor healing. There are several factors here.

It is best to have liposuction when your weight is stable without the goal of weight loss. This minimizes these types of freakish outcomes.

Weight gain might help the problem by "filling it out." Surgery to "fix it" can be difficult. If the area were low on her abdomen, a tummy tuck might be a good idea. Her smoking kinda makes that option less attractive. Smokers can do poorly with tummy tuck surgery.

Best Regards,

John Di Saia MD

Tags

Tara Reid
celebrity plastic surgery

"Will You Remove My Mole?"

In years gone by, I spent far too much time removing small skin lesions in the office. At the time, I was sharing space with another doctor who was profiting by any service I provided. His staff scheduled me with tons of things that simply made me no money. The facts of life are that medicine is a business and when I am paying a huge chunk of change to overhead, I need to make that back or I operate at a loss.

Patients don't understand why I cannot remove their moles for what their insurance pays and make a profit. Well, I can't. And now Medicare has stopped paying for things like this as well.

The materials used in the office for surgery (drapes, medications, needle, sutures, blades, instruments, instrument maintenance and sterilization, etc.) are not reimbursed by insurance companies.

A year or two ago, I removed a cyst from a patient's eyebrow. My costs in materials alone (not counting rent, employees, insurance, etc) were about $65. The insurance company paid $93 and 8% of that went to my billing company. This is no joke.

This is a reason why you won't see me doing cosmetic dermatology anymore.

Insurance companies must pay enough for a surgeon to make a decent profit. "Covering" a procedure at below overhead rates really means nothing except that surgeons won't operate.


Until Later,

John Di Saia MD





Tags

dermatology
Medicare
medicine business
mole

Healthcare Nightmare: Controlling the Cost of Cost Control

An excellent article on Capmag.com comes to the wrong conclusion but summarizes many of the points of argument very well.

My response:

I disagree with the conclusion that government-based healthcare is the best answer.


A few alternatives:
(1) Limit liability costs via tort reform.

(2) Unmask insurance company profits (executive salaries) to let consumers know they have been had. I love the recurring case of insurers saying they are broke and awarding executives with million in bonus cash at the same time.

(3) Burn the Medicare code. It should not be a game trying to get paid for work that has already been performed. Consider paying physicians in tax breaks for this care and the care of the disabled and indigent. Decrease administrative overhead.

(4) Then go back to a first party system with Medical Savings Accounts and insurance coverage in the way of high deductible policies for the remainder.


I have seen the Veteran's healthcare system...this is your government running healthcare. It is costly and inefficient. I would not think it would work on a larger scale. The costs would be enormous.


- John Di Saia MD

British Association Of Aesthetic Plastic Surgeons Gets It Right

The BBC News Monday reported the condemnation of the British Association Of Aesthetic Plastic Surgeons towards a men's magazine that offered to award men with a breast implant operation for their lady friends.

Cosmetic surgery is a very personal choice. People decide upon this for themselves. Handing it out as a prize particularly if the entry is made by another person is just inapproriate. I think the men doing so might have been in "hot water" with their ladies when these women start thinking why their men are not happy with their bodies. This opens doors best left closed.

I have never really been a fan of "Extreme Makeover," but at least on that show the potential patient is the one consenting to the perhaps too public display. For another to make this choice for a person seems kinda degrading.

As far as I am concerned, the Brits got it right.

John Di Saia MD




Tag

cosmetic surgery

Sean Penn Should Stick To Movies

OK on the front end I admit that this has nothing to do with plastic surgery, but I simply couldn't resist.

In a bid vaguely reminiscent of a movie, Sean Penn with his photographer on hand launched his boat to go help stranded Katrina victims. Unfortunately that movie turned out to be a bad comedy as his boat sprang a leak and began taking on water. Then the engine wouldn't start.

Actor, yes.
Political activist, maybe.
Heroic rescuer, nope!


It's harder than it looks, isn't it Sean?

-JPD




Tags

sean penn
katrina

Jamie Lee Curtis Shuns Cosmetic Surgery

I love this.

After admitting that she has had cosmetic breast surgery, liposuction and Botox, Ms Curtis has decided that since it didn't work out for her that no one else should have it.


Oh, I don't know. Maybe her motivations were wrong or her expectations. I just don't seem to see the same dissatisfaction in my patients. Then again I don't know who operated her, or her medical condition, stability of her weight or anything else.

Was she looking to liposuction as weight loss? Did she get everything under the sun treated with Botox?


We will never know, but for the record, she doesn't think you should do anything.

Now we all feel better.....


LOL,

John Di Saia MD




Tags

jamie lee curtis
celebrity plastic surgery

45.8 Million Now Lack Health Insurance

The Fox News Piece:

The US Government should not have been in the health insurance business in the first place. The meddling starting with Medicare has led to this. If the government wanted to make health insurance affordable it would do something about the costs of health care. Tort reform would be a good place to start. What good is health insurance that doesn't pay for anything except insurance company executive compensation?

Until later,

John Di Saia MD


Tags

health insurance