Reader Question: Weight Loss Military Liposuction?
Posted by admin in Reader Question on May 20, 2013
Was reading your testimonials and like one of your patients who was overweight and the military, I am in the same boat. I was wondering what you could do for me to assist in my goals to stay in the military through liposuction or body contouring.
I’m not huge but all my dieting and exercise feels like it’s for nothing. I’m 225 and need to lose about 35 pounds. Is this the right move if traditional weight loss isn’t working?
Liposuction is a contouring procedure rather than a weight loss method. With the amount of weight you’d like to lose, liposuction is not going to deliver for you. I do not make it a practice of going for weight reduction with liposuction or body contouring surgery anyway.
I have performed liposuction occasionally to help military clients fulfill requirements, but focused on shape in close cases in which these men were a bit wide in the belly measurement usually. Any plastic surgeon promising weight loss from liposuction is “talking things up” rather than being truthful.
Best Regards,
John Di Saia MD
Dr D in a Prius Poll?
Posted by admin in Dr D Comedy on May 13, 2013
Initial Post 11/3/11 7:30 AM -
Hello all,
I am thinking of changing my ride. The idea of driving a Prius appeals to me. I get to use less gas which makes me feel a bit better about not contributing so much to our pollution and gas industry problems. There are a few environmentalist quirks I picked up as a Berkeley undergrad. 
The nerd in me likes efficiency and with the miles I drive I might need to stop less frequently. Some of the docs around me have commented that they are not so sure my clients will take well to their plastic surgeon driving a more green machine however.
So you can vote on it:
Update 9/26/12 – I have had my Prius for nearly a year and really love it. It is not a really sexy ride but I have been over that for years. It has been reliable and not stopping for gasoline so much has been pretty cool. The AC could be a bit stronger, but otherwise I am happy.
Best Regards,
John Di Saia MD
Originally posted 2011-11-03 07:30:41.
Reader Laura on Arm Lift (Brachioplasty)
Posted by admin in Reader Question on May 13, 2013
Reader Laura Question:
Last year over 15,000 Americans had either lipo or a surgical procedure (brachioplasty) to reduce the excess skin from their upper arms. Reports say the increase is due to the number of people having bariatric surgery and losing more than 80 pounds in a short period of time.
If people lose over 80 pounds in a slower amount of time will they have the same issues with excessive skin? Will the use of compression garments with exercise and diet help to reduce the need for surgery on excessive skin? Can anything be done beside surgery or should those considering bariatric surgery just assume that they will need additional surgery to remove excessive skin at some point in the future and plan for it? Also, is there any way to minimize the scars from brachioplasty? Not sure if having a large, long scar running from your arm pit to your elbow is really an improvement.
Arm Lift or brachioplasty surgery is more popular in the after gastric bypass plastic surgery patient group. The procedure is one in a family of operations called body lifts. Of the operations gastric bypass patients seek to mitigate their post extreme weight loss condition, brachioplasty is one of the least commonly requested. This is of course due to the nature of the scarring you have mentioned.
Extreme weight loss lends itself to skin laxity in the abdomen, arms, breasts and legs. The face tends to be preserved until these patients age. Whether the rate of the weight loss might retard the development of the laxity is not well known.
The scarring from arm lift surgery does improve over time but is hard to mitigate. The long incision length tends to be necessary to correct the laxity for which it is performed.
Best Regards,
John Di Saia MD
Related:
Dr D Guest Blogging at the OC Register on Fat Busting Gizmos
Posted by admin in Dr D article on May 10, 2013
Today I did a guest blog over at the OC Register’s cosmetic blog. The subject is my reflections on the gimmicks within the liposuction and mad fat busting markets. Go on over and check it out:
Plastic surgeon: Beware ‘fat busting’ gizmo frenzy
Best Regards,
John Di Saia MD
Originally posted 2012-06-14 07:30:26.
CDC Employee Steals for Liposuction
Posted by admin in criminal for plastic surgery on May 10, 2013
A former Centers for Disease Control and Prevention employee has been sentenced to probation for stealing from the agency to pay for cosmetic surgery and other personal expenses. Jamilah Franklin, of Marietta, was sentenced Monday to 3 years’ probation and ordered to pay $25,177 in restitution to the CDC. From July 2009 to November 2010, Franklin stole from the agency by using checks and a government credit card, court documents say. Franklin was a program manager who organized conferences and other events and was issued convenience checks for vendors who did not wish to accept a government credit card, Assistant U.S. Attorney Brian Pearce said. Franklin was found to have stolen more than $25,000, with more than $10,000 charged to her card for liposuction
Source: ajc.com/news/news/local/woman-stole-from-cdc-to-get-plastic-
surgery/nSktW/
This CDC program manager was issued convenience checks and a credit card for use in her job and used around $25000 for herself. Nice perk. Apparently she used the government credit card to pay $10000 for liposuction. I wonder what name was on the card. Did it say for government use only?
That is nice: the federal government paid for her cosmetic surgery. It sounds like she got off light as she only got probation besides being required to pay the money back.
Best Regards,
John Di Saia MD
Originally posted 2012-11-08 07:30:21.
Avoiding Botched Plastic Surgery
Posted by admin in Dr D's Truth on May 10, 2013
Plastic surgery can be so great, but the negatives are far more often featured than the positives in the media. This can tend to scare the hell out of many potential clients. The very freely used term “botched plastic surgery” tends to lend the potential patient to believe that surgeons do the wrong thing by patients frequently. Well trained and ethical ones don’t.
Here are a few simple pointers to help lead you away from the land of the botched plastic surgery patient:
(1) Do not allow doctors trained in other specialties to do your plastic surgery. You wouldn’t go to a plumber to have your car fixed would you?
(2) Get your general health in order first. Smokers and others with health issues are far more likely to not heal well after even well-performed plastic surgery.
(3) Don’t pick Dr Cheapie. You wouldn’t go to “Pick and Save” for lobster would you?
(4) Avoid surgical marathons and the doctors who proscribe them like they are handing out an Aspirin.
These points have worked well in my practice for over a decade.
Best Regards,
John Di Saia MD
Originally posted 2010-10-14 07:30:51.
Good Plastic Surgery in the OC – Satisfying Facial Dog Bite Surgery
Posted by admin in "Good Plastic Surgery in the OC" on May 10, 2013
I met “S” in the emergency department of an Orange County hospital I no longer serve. She had been bitten on the lip by a large dog and incurred a fairly nasty wound. The dog bite repair here wound was a careful cleaning, trimming and closure by yours truly in the emergency department under local anesthesia. Unlike the majority of emergency patients with poor insurance coverage, this woman paid her bill slowly over about a year in payments.
She had a very nice outcome. It is too bad I can’t afford to do more of these, but they pay poorly even when insured and most patients are not as honorable as this one was. Good plastic surgery is not always cosmetic although cosmetic surgery pays most of our bills.
Best Regards,
John Di Saia MD
Originally posted 2011-09-23 07:30:34.
Scan, Secure Horizons and the Medicare HMO Compromise
Posted by admin in Dr D's Truth on May 10, 2013
It is change your Medicare season so the advertisements are blaring for Scan, Secure Horizons and the other Medicare HMOS. Many Medicare patients do not understand how things change when they sign with a Medicare HMO. Regular Medicare patients have choices and do not need to wait for approval before receiving care.
I saw a Medicare HMO patient this month with a wound on his foot. The wound looked ready for skin grafting. As his HMO does not have a plastic surgeon under contract at the hospital where this patient was admitted, I was told he would have to wait for evaluation by their podiatry doctor. An operation I could have offered him in days waits weeks or longer. That is the HMO compromise. You wait for them to decide what you need.
Ultimately the podiatrist saw him and decided the wound would heal without surgery. It might, but it will take longer…maybe months longer. Then again passing on surgery will cost the IPA (HMOs usually contract with other health care companies called IPAs) less money and that is often the name of the game in health care.
When you change your health insurance you really don’t see the big picture unless you come to really need it.
Best Regards,
John Di Saia MD
Originally posted 2010-12-22 07:30:57.
Botulinum Toxin Injections… A Conservative Rationale?
Posted by admin in Dr D's Truth on May 10, 2013
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 you look kinda foreign.
Remember my blog = my opinion
Best Regards,
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 on daily basis until you are broke or dead.
Originally posted 2005-09-15 21:07:00.
Reader Question: Why Can’t You Doctors Tell Me What My Cost Will Be?
Posted by admin in Dr D's Truth on May 10, 2013
I hear radio commercials with the smell good plumber. Why can’t you sneaky doctors learn to do that? I need to have a skin cancer removed from my face and went to a plastic surgeon. After arranging the surgery I called to ask what I would be paying after my insurance. They said they didn’t know. How can that be?
Health insurance is just as frustrating for your doctor’s office as it is for you. Believe it or not, when I do surgery under a patient’s insurance and bill a certain amount I really do not know what the insurer will pay on the case, when they will pay or what they will tell the patient to pay. Sometimes they assign most of the bill to the patient. Other times they try to discount the bill enormously. Still other times (really rarely) they pay the whole bill. Insurers actually pay variably for the exact same billing code between different patients and these differences can be huge. It plays out as a big game over months frequently.
When asked, my office staff can tell patients what billed surgeon’s fees for a particular insurance case will be, but prefaces that with the above facts. It is not fair, but it is not our fault either. If health insurers would pay reliably and consistently, we would not be charging patients as much and would be able to tell patients what their share of cost would be in a particular case. We might be able to use our insurance billing service less (which also costs us money) and simplify matters for everyone.
The way things are, the only way we can tell patients what their share of cost for surgical services will be is for cases in which their health insurance is not involved.
Best Regards,
John Di Saia MD
Originally posted 2011-06-08 07:30:28.
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