Why Women are Private About Labiaplasty

Private_About_Labiaplasty_blog

While it is kinda humorous, it does kinda tell the story doesn’t it?

 

 

Best Regards,

 

John Di Saia MD

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Reader Question: Did You Do Labiaplasty on Stacie Halas?

Stacie Halas is a science teacher in an Oxnard middle school who was put on administrative leave while her bosses looked into the allegations that she was moonlighting as a porn star.

The question was probably put to me in jest, but I couldn’t tell you if I had operated upon her without her permission anyway. Have you ever heard of HIPAA? Patients have their privacy on health care information whether they are accused on moonlighting in the adult industry or not. It is not like most labiaplasty patients volunteer much private information about themselves. Their operations are pretty private in the vast majority of cases anyway.

Another equally important point is that I haven’t seen a single image identifying Ms Halas, so I wouldn’t know if I had operated upon her or not.

Best Regards,

John Di Saia MD

Originally posted 2012-03-09 07:30:29.

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Good Plastic Surgery in the OC – Refreshed Eyelid Surgery

Blepharoplasty is upper and/or lower eyelid cosmetic surgery usually performed for redundancy of the skin and fat of eyelids. Insurance companies may pay for upper lid surgery if the lids get in the way of the patient’s vision. The rate they pay for the surgeon is usually pretty poor.

Upper and Lower Eyelid Surgery Blepharoplasty

This young woman came for cosmetic blepharoplasty of the upper and lower lids. This was performed through traditional trans-cutaneous incisions allowing the removal of skin and fat. At 6 weeks she was pleased.

Best Regards,

John Di Saia MD

Originally posted 2012-09-28 07:30:17.

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Good Liposuction Results – A Man Minus Beer Belly :)

Good Liposuction Results are not an expensive laser or an ultrasound gimmick. They are obtained via good judgment and technique. This means choosing the right client and having the integrity to counsel the wrong patient. When a potential client comes in looking to get thinner without diet or exercise being involved, the right thing is to turn him away. Give a novice surgeon an expensive laser liposuction system and turn him loose, and you’ll not get good surgical results. The machine doesn’t do the surgery or choose the clients. That is the surgeon’s job.

 

Good Liposuction Results 

Good Liposuction Results in Orange County

Good Liposuction Orange County – Dr D

Here is a young OC man who wanted to jump start his physical improvement program with liposuction. His plan was to follow surgery with continued work with diet and exercise. Usually we like offering plastic surgery after weight loss. He seemed pretty serious though. The image shows him before and 4 months after liposuction with a nice result. He had a tumescent technique using a more or less standard (but well maintained) liposuction system with an experienced surgeon. No SmartLipo or other fancy tools for him. :)

Cosmetic surgery cannot take the place of diet and exercise, but can help you along. If this man had hit the cheeseburgers and his couch following his surgery, he would very well have seen his “soft” belly return.

Best Regards,

John Di Saia MD

Related:

Dr D’s Website Liposuction Section

Originally posted 2010-12-01 07:30:19.

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Non Provider Non Elective Plastic Surgery – Your Health Insurance May Pay

The games that many health insurance companies play make doctors wary of becoming a “Provider.” Provider status is nothing more than a contract in which the doctor relinquishes quite a few rights, for example the right to determine what a service should be paid. I am selective about contracting with health insurance companies for this reason. And I still do some work for insurers to which I am not contracted.

How can this work?

Some of the surgery I perform is not elective. It involves hospitalized patients who have wounds that won’t heal (or haven’t healed) without surgical help. In some of these hospitals I am the only plastic surgeon on staff.

Why does this make a difference?

If you need surgery and the only available surgeon is not a provider for your insurer, you will find your insurer may be willing to make an agreement with the surgeon for that one case. My office interfaces with the insurer and often we come to an agreement and are able to do the operation as a covered benefit. Some insurers are more receptive than others. Others simply offer an unacceptably low rate knowing no good surgeon will take it.

This is not 100%, but can work. Some patients have actually called their human resource departments at work and helped the process along too. The fact is that surgery costs your insurer money and without some pushing you might not get it. Be prepared to get involved if you want better care.

Best Regards,

John Di Saia MD

Originally posted 2011-05-05 07:30:55.

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Warning Doctors – Do Not Send A Check to the California Medical Board

License renewal has been a pretty much routine albeit expensive endeavor over the last twenty years or so. The renewal comes by snail mail. You fill out the forms and mail a check and a few weeks later your license comes. Simple.

Well no more my friends. Now the California Medical Board’s new “BreEZe” system has arrived. And believe me it is no breeze.

February 2015

Renewal paperwork arrives and the option of online renewal is offered. I figure there is plenty of time so I will just mail a check. Bad move. The instructions indicate that mailing a check is still acceptable. Nowhere on the renewal paperwork is it stated that a mailed payment is not supported. It did say that it would take weeks to process.

March 2015

No new license yet. I hear from some hospital medical staff people that the renewals are taking longer now.

We call the medical board office and they ask to which address we mailed the renewal. I just mailed it to the address indicated on the paperwork. I didn’t record the address. We are told that one of the two addresses involved a 4-6 week wait and the other was 7-10 days. They could not confirm that they received the check.

We are referred to the online Breeze system to check for the renewal. No further assistance is offered. The Breeze representative tells us that the best option is to go online and pay with a credit card. She tells us that the check will be cashed and we will have to seek reimbursement afterward. Now that’s service.

So after another 7-10 phone calls over the next week the check still had not arrived and my license was on the cusp of suspension. So I went online and paid a second time to renew my license. The good news is that it was renewed immediately.

The moral of this story: Do not pay for your medical license renewal with a check. It is slow. It is not supported. And you may end up having to do it again with a credit card online anyway and deal with the possibility of paying twice in the bargain. Time to cancel that check.

 

Best Regards,

John Di Saia MD

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Safe Breast Augmentation – How To Get Yours.

Safe Breast Augmentation?

The level of confusion regarding breast implant surgery is enormous. Can you get implant surgery without the drama?

safe breast augmentation

There are sites with scary stories of women (including this one) who went to horrifying B movie type doctors and had horrendous results. There are also stories of women who went bigger and bigger and bigger until their breast tissue just gave out and failed.

Safe Breast Augmentation is possible as long as you exercise proper judgement. Suffice it to say there are plenty of women who have had safe breast augmentation:

“Dr. D!!! They are still so awesome! They aren’t hard or sagging, almost 16 years later. Unbelievable! They look great and feel like a part of my body. You are the best and you can tell everyone I think so!!”
-G: Los Angeles, Ca. – Breast augmentation patient 2013

This woman had her breast implants placed in 1997 by yours truly. They were placed in an operating facility under her pectoral muscles and were saline-filled models of a moderate size. Now fifteen years later, she has needed no additional surgery and feels and looks great.

Beware advertising gimmicks and promises of the extreme. Choose a qualifed board certified plastic surgeon and moderate enhancement guided by his or her advice. That “happy medium” might just last you ten or more years. :)

Best Regards,

John Di Saia MD

Originally posted 2013-04-01 07:30:53.

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Dr D Shows You A Rock Hard Silicone Gel Breast Implant Capsule

A short video shows a 27 year old ruptured silicone gel implant and the calcified scar capsule the patient’s body made to try to contain it. It helps explain why some silicone breast implant patients develop rock hard breasts and what can be done to fix the situation.

It also helps explain why most often I prefer saline-filled breast implants that do not tend to encourage the formation of rock hard breasts. Seeing calcium deposition on the implant capsule (which is what makes the breasts really hard) in a woman who has never had silicone gel implants is extremely rare.

Best Regards,

John Di Saia MD

Related:

Fixing Rock Hard Implanted Breasts

Originally posted 2011-05-30 07:30:13.

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Liposuction is Not Weight Loss

Source: myfoxdfw.com/myfox/pages/News/Detail?contentId=3431786&
amp;version=1&locale=EN-US&layoutCode=TSTY&pageId=3.2.1

Dr Nahai describes a case of a young woman who had liposuction for weight loss. She probably should not have had it. The real answer (if we get follow-up) will be whether or not she maintains her weight. Most liposuction patients do not maintain weight losses unless they change their lifestyle. It doesn’t sound from this story like this girl did so.

“I almost died from (liposuction). I had it done all over and it didn’t work at all. I realized, ‘Oh, to change your body you have to eat less and go on a treadmill.’ So that liposuction landed me in the hospital.
Source: wcfcourier.com/articles/2007/06/07/pulse/television/b47c52230b180a2f862572f300483196.txt

Comic Kathy Griffin reports on her experience with liposuction. She must have had it for weight loss because in my patients I have no such stories. She did discover the reality of weight loss however. She just discovered it the hard way.

The Bottom Line:

I recommend liposuction for patients who report that their weight is stable and they are not seeking weight loss. It is a contouring procedure. When performed in such a way it is not dangerous and it works.

Best Regards,

John Di Saia MD

Originally posted 2007-06-21 20:00:00.

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Northwest Pharmacy Experience from Hell

Looking to obtain a break on my practice’s botulinum toxin of choice (Myobloc) I yielded to curiosity and ordered from a Canadian Pharmacy…Northwest Pharmacy.com. I figured we would try to break the price point of this popular product. Thankfully I used my credit card.

Botulinum toxin must be kept cold to retain its potency. We traditionally receive this product on dry ice and have never had much of a problem with effectiveness. I was promised by the pharmacy rep that this product would arrive cold within 2-5 days of shipping. Only after I gave her my credit card information did she share with me that the product would be coming from Great Britain. This was not welcome news. I was reassured that the product would be cold and usable.

The product arrived ten days later at room temperature, a completely questionable situation. The pharmacy rep said to go ahead and use it. I said nope. As I was summarizing the dispute, it occurred to me one more reason why patients having their botulinum toxin elsewhere sometimes describe such a variation in their experiences. Other practices might actually use this rotten Botox. Mine doesn’t.

For other docs thinking of ordering from Northwest Pharmacy: They were way too Type B for me. You have been warned.

Best Regards,

John Di Saia MD

Originally posted 2011-01-13 07:30:09.

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