Dr D versus the V-Loc: A Patient Story

January 27th, 2012 by admin No comments »

I had a patient come for scar revision surgery who had previously some scars revised by another surgeon using the V-Loc suture device. This resulted in wide (nearly 2 cm wide) wounds at the site of groin scar revisions. I do not use these contraptions as I do not see them making me better than I am already. :)

What is the V-Loc?

The V-Loc is a barbed suturing device made to save the surgeon time in closing wounds. Barbed sutures have been popular developments in the past five or so years. I have been reluctant as I have said in using them. Why change things that are working well? The V-Loc uses polyglyconate suture material (Maxon TM) which is actually a pretty good material when used properly.

I revised one of the patient’s scars using my own technique. We will see how the wound heals. Maybe the patient will allow me to share his images as his scar matures.

Best Regards,

John Di Saia MD

Jessica Biel – It looks Like “No” on Breast Implants

January 26th, 2012 by admin 3 comments »

Bitchpleaz/pics

Jessica Biel, finally takes it off for the big screen in her new role as a stripper in the film Powder Blue.

For those who have asked, by the looks of things now she has no breast implants. She does have a great figure.

Best Regards,

John Di Saia MD

Originally posted 2009-05-05 07:30:25.

Joan Rivers on Plastic Surgery Again

January 26th, 2012 by admin No comments »

As for her much-discussed quest for eternal youth, Joan admits she “doesn’t know” exactly how many times she’s been under the knife. Still, the show reveals she’s received over 700 cosmetic procedures, including regular Botox and collagen injections. “I used to have a friend who was a plastic surgeon…so, like, every two years, we’d do a tune-up…fix this, fix that,” she recalled. “So it’s been a lot, but it’s never been like, ‘Facelift!’ — if that makes any sense.”
Source: huffingtonpost.com/2012/01/23/joan-rivers-premiere-party-
gay-fans-_n_1224458.html

Joan Rivers pretty much cannot be interviewed without the subject of plastic surgery being raised. I have always found her uncommonly transparent on the issue which is the opposite of most entertainers. Then again she is a comedienne.

At nearly eighty years old, a question of note would be how might she look if she had never had any work done. That is a very difficult question to answer without a good forensic anthropologist around anyway. :)

Best Regards,

John Di Saia MD

Dr D is a Mythbuster at USAToday.com

January 24th, 2012 by admin No comments »

One of my posts on fat reducing technologies was featured in a post at USA Today.com. I am a myth buster. lol.

It was listed with quite a few others but it seems kinda cool anyway.

Best Regards,

John Di Saia MD

Demi Moore & 3 Million Dollars for Plastic Surgery

January 24th, 2012 by admin No comments »

Celebitchy

From Hello magazine:

Do you get irritated by all the rumours suggesting you paid $3 million for surgical procedures on your face and body?
“Yes, it’s irritating – and it’s also not true. But to fight it feels futile because it just perpetuates the myth. The truth is I have no problem with enhancing one’s looks or fixing something that’s changed. It’s always an option, but I can’t see me ever getting something like that done.”

I think she was probably refuting the price tag, not the surgery. Really how could anyone spend that much or maybe I should re-phrase to say I would like to apply to be her surgeon. ;)

Best Regards,

John Di Saia MD

Related:

“Demi Moore $600,000 On Plastic Surgery?” Post

Originally posted 2008-12-03 08:30:00.

Reader Laura on Janice Dickinson Rippling Too

January 24th, 2012 by admin No comments »

Reader Laura’s Comment:
“Janice Dickinson was seen out partying. The pictures accompanying this story seem to show that both of her implants are rippling badly (pictures 2 & 3). Is this because of the age of the implants or just because there was so little breast material to work with in the first place? What could she have done to avoid this?”

Pic Source: dailymail.co.uk/tvshowbiz/article-1387114/Janice-Dickinson-isnt-interested-acting-age-steps-outfit-leaves-VERY-little-imagination.html

The paparazzi must be busy because we are seeing more rippling these days. We just commented on Victoria Silvstedt’s Rippling Images.

Rippling is just the appearance of a breast implant under thin soft tissue cover. It tends to occur in women with relatively little soft tissue coverage who have had larger implants placed relative to that amount of tissue coverage. It happens more with saline implants and “Over the muscle” placement, but can occur with silicone gel “Unders” if the patient is thin enough and/or the implants are large. Keeping the implant size smaller and going under the muscle tends to limit it.

The good news is that Ms Dickinson is really not rippling too badly. In the more obvious rippling cases, the ripples appear over more of the breast(s) with relatively little movement. I only see her ripples well in one of the images near the top of her implants. It is all relative.

Best Regards,

John Di Saia MD

Originally posted 2011-05-17 07:30:54.

Reader Laura on PIP Breast Implants and Breast Implant Insurance

January 24th, 2012 by admin No comments »

Reader Laura’s Comment:

“After the PIP scandal there is some talk in England about offering insurance for breast implants. I guess that some women were able to get the NHS (England’s health system) to pay for their implants rather than having to pay for them themselves but there are others who paid for them themselves. The NHS is covering the cost of having the PIP implants replaced that they paid for in the first place but not for those that didn’t go through the NHS. There is also the issue that some clinics where the women paid for their implants themselves are refusing to replace the implants for free or are no longer in business. What protections are in place in the US for women if something like the PIP scandal happens here?”

An insurance scheme for cosmetic surgery patients could be introduced in the wake of the breast implant scandal. Professor Sir Bruce Keogh, who is leading a government review into the risks from faulty breast implants said the scheme would protect consumers. He said today that he favours a protection fund, paid for by the industry, that could be drawn on if the industry hits trouble or another major scandal erupts. However, there are fears that cosmetic surgery companies will simply pass the costs on to patients, in the form of higher bills for treatments.
Source: dailymail.co.uk/health/article-2089377/Cosmetic-surgery-
insurance-introduced-wake-breast-implants-scandal.html

PIP breast implants were made cheaply. Then again they were sold at a lower cost than their competitors. Why should their competitors be forced to pay insurance premiums for problems with faulty products made by someone else?

Breast implants are used for cosmetic and reconstructive purposes. Here in the US, insurers routinely pay for problems in cases in which the reasons for implantation were reconstructive. This is less commonly the case for implants placed for cosmetic purposes. The insurance industry also actively seeks to exclude insuring women who have breast implants. Some health insurance policies specifically exclude conditions arising from breast implant problems.

Your other question was concerning the doctors who placed the implants: Why should they operate free of charge to correct problems with implants that were approved at the time they used them?

The faulty implants are the fault of the company that made them. Expecting implant companies to not pass the cost of any additional insurance to their customers in pretty naive. Businesses do this. Pretty much only doctors are restricted from usual business practices like this…in many cases anyway. Doctors are lousy businessmen.

Issues of insurance in plastic surgery are usually complicated. When taken as a whole they become hard to administer fairly.

Best Regards,

John Di Saia MD

Breast Implant Death by Non-Plastic Surgeon

January 23rd, 2012 by admin 2 comments »

FRAMINGHAM — With her family and their attorney declining to speak publicly pending a planned malpractice lawsuit, it’s unclear why Adriana Paula Da Silva Toledo chose Dr. Sanjeev Sharma to enlarge her breasts with implants. Perhaps the Framingham housekeeper was attracted to the prices offered at Sharma’s Destination Beauty MedSpa on Rte. 9: $3,900 for saline implants and $4,900 for silicone, all-inclusive. A nearby plastic surgeon would have charged $4,400 or $5,600, respectively, plus another $1,800 for anesthesia and the use of a hospital operating room.

Sharma had a clean record, a state medical license and a citation from the MetroWest Chamber of Commerce, but maybe Toledo didn’t realize his only board certification was in family medicine and that he had gotten his start in plastic surgery with a two-day course in California. Perhaps she didn’t care.

Source: milforddailynews.com/lifestyle/health/x66785390/Following-
death-plastic-surgeons-raise-concerns-about-certification

She didn’t live long enough to care. The allure of cash business is an understandable attraction for the non-plastic surgeon to venture into cosmetic surgery. The laws as we have said before generally feature loopholes that allow this as well.

In this marketplace it is the potential patient who must educate herself in order to avoid the risk that this patient realized: death.

To many in medicine it seems common sense that surgery should be performed by surgeons. This doctor was a family practice doctor with a whole 2 days education in plastic surgery so this story reads.

When the price seems too good to be true, you must check the surgeon even more carefully. That which you do not know can hurt you especially in cosmetic surgery.

Best Regards,

John Di Saia MD

Reader Laura on Kate Winslet an Anti-Plastic Surgery Actress

January 20th, 2012 by admin No comments »

Reader Laura’s Comment:

Kate Winslet has recently given an interview where she claims that plastic surgery goes against her morals. I can understand her to wanting to have a frozen face but I’m not sure what plastic surgery has to do with morals. Emma Thompson & Rachel Weisz has also come out in this article and said that they are against themselves getting plastic surgery. Do you see a trend of actresses in CA cutting back on getting Botox as well as surgery? Do you think that there will be fewer actresses getting or admitting to having plastic surgery as they age?

Source: telegraph.co.uk/news/celebritynews/8700007/Kate-Winslet-Cosmetic-surgery-goes-against-my-morals.html

Being publicly against plastic surgery is in fashion with many of the Hollywood elite.

When looked at historically, many of the same actresses who speak in such a manner have had plastic surgery themselves. Kate Beckinsale is a good example. She spoke against plastic surgery, but was a former breast implant client.

In this case Kate Winslet herself looks to have probably had a nose job in the 90′s sometime. I am sure she would say that in her case it wasn’t cosmetic. We hear that a lot from the Hollywood types.

I take that which actresses say in a comedic light particularly as it applies to plastic surgery.

Do I think that this latest anti-plastic surgery statement will change anything?

If it causes people to pause before having too much done it might be a good thing. I still believe the biggest problems in plastic surgery today are overindulgence and poor judgement. If either of these issues is affected, it might be beneficial. Some people do listen to celebrities even if they don’t always listen to themselves.

Best Regards,

John Di Saia MD

Originally posted 2011-08-24 07:30:19.

Buffalo Teachers Get Free Cosmetic Surgery on the Taxpayer

January 20th, 2012 by admin 1 comment »

Public school teachers in Buffalo can get botox, liposuction, hair removal, and various other nips and tucks from plastic surgeons — all completely free. And taxpayers are footing the bill.

The Atlantic reports the perk is part of a self-insured rider in its teachers’ contracts. There’s no co-pay, so the school district pays for the cosmetic surgery procedures completely.

Though the bill was less than $1 million in 2004, the annual cost is now estimated at $5.4 million and, in 2009, teachers enjoyed $9 million worth of plastic surgery. The Buffalo News says nine out of 10 procedures were skin treatments that year, and 10 out of 10 were elective.
Source: syracuse.com/news/index.ssf/2012/01/
buffalo_teachers_get_free_plas.html

I have never seen an insurance rider like this. The only teacher who gets free cosmetic surgery from me is my wife and taxpayers are not paying for it.

What might be worse is that this is an old program. Huffington Post [huffingtonpost.com/2010/10/28/ taxpayers-paid-9m-for-ny-_n_775549.html] featured a story on it in 2010 and it is still an active program. Apparently eight surgeons get the business and one apparently billed the program $4.3 million. I knew I was in the wrong state! ;)

Best Regards,

John Di Saia MD

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