Increase in Labiaplasty Time magazine says? Dr D’s Take…..

More surprising perhaps, was the 49% increase last year in labiaplasty, a procedure to reduce the size of or repair the labia minora, the inner labia of female genitalia.
Source: http://time.com/3842179/plastic-surgery-trends/

So I do labiaplasty surgery. What do I think when I read statistics like this?

I think talking about it sells magazines. Do I think it represents the fall of Western civilization? Do I feel badly as a surgeon who does this kind of work? No.

I do not talk women into surgery. I do not make negative comments about their genitalia in order to operate upon them.

I look. I listen. If after the above I think I can help the woman, then I offer surgery.

I do not operate upon everyone. I do other kinds of surgery besides labiaplasty.

And even though the last four paragraphs started with “I,” the surgery is not for me. It is for and about the women who come for consideration. It is all about them.

Best Regards,

John Di Saia MD

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WoundsCare.org & Dog Bite Plastic Surgery

It has been mentioned to me more than once that my blog covers a good deal that is not cosmetic surgery despite the name. My practice site has also straddled the boundary between cosmetic plastic surgery and the less attractive reconstructive surgery.

To address the issue I am starting a new site WoundsCare.org:

WoundsCare.org logo

This site (which at present is just a tack on to my practice site) will center upon the wound patients I see and the surgery that often follows. The images will be somewhat graphic but will go to illustrate important points for those faced with less than cosmetic reconstructive plastic surgery. The first image will be placed after the page break for those who would rather not go there. :)

Best Regards,

John Di Saia MD

Originally posted 2014-01-07 07:30:08.

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Tanning Industry Fights Image Problem – Dr D’s Take

The tone is tongue-in-cheek but it’s part of a defiant campaign to defend the $4.9 billion industry against mounting evidence of its questionable business practices and the harm caused by tanning. And, in an extraordinary touch, it is portraying doctors and other health authorities as the true villains – trying to counter a broad consensus among medical authorities that sunbed use increases the risk of skin cancer including melanoma, the most lethal form.
Source: openchannel.nbcnews.com/_news/2012/08/23/13415540-embattled-
tanning-industry-fights-back-taking-its-cues-from-big-tobacco

For a surgeon who has cared for a fair share of skin cancer over the last twenty years, this campaign by the tanning industry is a bad joke. While I understand that money is being made in tanning, it is in my eyes undeniable that tanning causes cancer.

Parts of the article bother me more than others. There is apparently a “Breast Cancer Natural Prevention Foundation, which promotes vitamin D for breast cancer prevention:”

The founders include Dr. Sandra K. Russell, an obstetrician-gynecologist who appeared in advertisements for Smart Tan wearing her lab coat and a stethoscope.

One such ad features a picture of the doctor in her white coat saying: “It’s more sensible for me to tan in a controlled environment.”

Wow. I wonder if she is a paid endorsement or she owns tanning salons. I think of her as a Judas priest. You can get Vitamin D in a pill that doesn’t cause skin cancer. Trying to promote tanning as healthy is like trying to promote cyanide as good nutrition.

Tanning and the use of tanning beds are a risk. If you want to take that risk fine, but some of you are going to get cancer.

Best Regards,

John Di Saia MD

Originally posted 2012-08-23 07:30:11.

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Good Tummy Tuck Results : In an Athlete

Good tummy tuck results in an athlete can be difficult. The surgery needs to be carefully modified and proscribed specifically in very fit clients. Below is a “Before & After” of an athletic woman who could not lose the loose “pudge” in her tummy. The portion of this extra flab near the panty has been called mother’s apron. The medical term is pannus. This patient did not have a very loose or prominent pannus, but was bothered by it. Although she was quite fit, she came wondering whether an “athlete tummy tuck” might be beneficial.

 

Good Tummy Tuck Results 

good tummy tuck results Orange County California

Good Athlete Tummy Tuck

 

Upon examination, a belly button hernia was also found with a lot of muscular wall thinning nearby. This was likely a derivative of child bearing. A tummy tuck with abdominal hernia repair was performed and at 5 months she was pleased.

 

 

 

Best Regards,

John Di Saia MD

Related:

More of Dr D’s Tummy Tuck Pictures

Originally posted 2010-12-20 07:30:45.

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Dr D’s “Trout Pout – Celebrity Fish Lip Fillers?”

Dr D’s Trout Pout Comedy Bit Mp3

Dr D pokes fun at the current practice of Lip Fillers and the tendencies of some celebrities to end up resembling fish after their placement.

Best Regards,

John Di Saia MD

Originally posted 2010-07-14 07:30:38.

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Quality Earlobe Repair – Orange County California

Earlobe repair for tears (mostly from earrings) are pretty common. For the simple ones repair can be done in the office under local anesthesia (numbing shots.)

Good Earlobe Repair

The picture above is a before and after earlobe repair from a case in our South Orange County office. The larger repairs from plugs and infection problems with tissue loss are more complicated. Health insurance usually doesn’t cover this type of work, but single-sided simple repairs are not terribly expensive.

Best Regards,

John Di Saia MD

Related:

Earlobe Repair at Dr D’s Practice Site

Originally posted 2010-10-18 07:30:46.

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Reader Question: Failed Pressure Ulcer Surgery

Reader Question:

My husband is a T3 sci (1994) and up until 2007 had been decubitus ulcer free. Since 07 however, we have been on a roller coaster ride trying to treat a sacral stage 4. We just finished a month long stay at a hospital in WI where our plastic surgeon unsuccessfully attempted repair of this wound. It was our 3rd surgery on the area. I can say that the previous 2 surgeries may have not resulted in long term repair due to my husband being a bit too over eager to get back in his chair to return to work. At this time however, we have had him planted in a low air loss mattress since November 18th – his last surgery date. His wound was not closed this last surgery by the dr – he came out surgically debrided with a wound vac in place. We continue to use this approach at this time. At our first follow up appt our surgeon stated that we were facing living with this opening the rest of my husband’s life. I am mid 30s my husband mid 40s, we have a 5 year old and we want to live life. Do we need to just come to grips with this wound and accept it, or do you think there are surgeons/procedures out there that could help us?

There are a few things that pretty much doom pressure ulcer surgery to failure or recurrence. One near the top of the list is non-compliance. Pressure ulcer surgery takes a motivated patient to have a good chance of success. The patient must stay off the wound after surgery sometimes for months to allow it to strengthen to the point that it can withstand the pressures of daily life without breaking down. This is just a fact.

I would say that while I completely understand your desire to get on with life, an ulcer that has been there for years will have a very high chance of recurring even assuming that there is tissue available to attempt to close it.

Wound vacs are helpful but in very large wounds very rarely obtain closure by themselves. I would say have a long talk with your husband about what you are both willing to do to get closure of the wound. Then if he seems willing to stay off of it long term, I would seek the opinion of another good plastic surgeon with experience closing these types of wounds for options as to what might be possible. Do not be dismayed if the surgeon is unwilling to provide assurances of success. With your husband’s long wound history I would be suspect of one who didn’t. Tests might be needed before additional surgery. Go in with an open mind.

Good luck to you both. These wounds try the patience of your surgeon just as they try yours believe me.

Best Regards,

John Di Saia MD

Originally posted 2012-02-03 07:30:51.

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Top Ten Tummy Tuck Facts

Tummy Tuck surgery is almost invariably greatly appreciated by the proper patient. These top ten facts might help you figure if you are such a person. 😉

(1) Tummy Tuck surgery is one of the largest scale operations a plastic surgeon can offer a patient.

(2) Patients who have lost a good deal of weight or completed child bearing involving large weight gain and loss are the most common candidates. Patients do not lose much weight from the operation itself in most cases….maybe a few pounds on average.

(3) Post-operative pain used to make it necessary to admit the patient to a hospital for narcotics.

(4) Pain pumps when properly utilized can decrease pain significantly. Overnight stays often reduce risk when properly supervised.

(5) Revisions are not uncommon but can often be done in a lower key environment….such as local in the office. The revision rate varies enormously between surgeons.

(6) All tummy tucks are not alike. The work of the novice really shows in this operation.

(7) Many physicians in the OC offer these operations including plastic surgeons, cosmetic surgeons, gynecologists and general surgeons. You guess which ones look the best? 😉

(8) When you go to the bargain basement doctor, some of what may happen may not be correctable later.

(9) Drains and pump catheters will need to be used for a week or longer. They reduce risk of fluid collections that can ruin otherwise nice results (My opinion of course.) :)

(10) Smoking can really impair healing and lead to skin necrosis which commonly detracts from the quality of the result and delays wound healing sometimes for months. Don’t have the surgery if you can’t stop the cigarettes and tell your surgeon a true indication of how many cigarettes you are smoking daily.

Best Regards,

John Di Saia, M.D.

Originally posted 2011-04-20 07:30:15.

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Reader – “Help Dr D, My Plastic Surgeon is an ahole!”

Reader Question:

I know you can’t fix this but can you help me cope? My plastic surgeon is an ahole. He has no time for me now that he has operated. He just ignores my concerns. I look OK but I want to do what I can to get the best result possible. He doesn’t care about me.

I am in Orange County. I so wish I knew you before I let this toad touch me! He is a short arrogant little twit though in Laguna Hills. I don’t regret my plastic surgery just my choice of a plastic surgeon.

I frequently remind people to choose carefully when they are in the market for a plastic surgeon. Once surgery has been performed it is hard to switch. Many docs will not accept patients who present liability challenges from the onset. This includes fresh post-ops and people who look like they might sue someone.

The first thing is to try to deal with the surgeon you have. Try to get through to him. How was he when you first met? Docs who never have time for their patients before surgery frequently don’t afterward.

Maybe you can develop a relationship with a contact person in the office and get what you need from that person? Otherwise you can try to call around and find another local surgeon who can help you. Try to choose better this time.

Best Regards,

John Di Saia MD

P.S. I think I know who you might be writing about, but I can’t put his name here for obvious reasons.

Originally posted 2011-03-17 07:30:34.

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How to Get Dr D To Not Operate On You

People sometimes surprise me. A lady e-mailed me recently after I had seen her a year or so ago. There are good things and bad things about seeking care at a small practice. We remember you.

This lady originally came for a reconstructive operation that her insurance would not cover. Plastic surgeons cannot guarantee that an insurance company will approve surgery or pay for what you want. When we were unable to get her operation pre-approved, we lost contact with her.

Later on, she became angry when her insurance assigned her consultation bill to her. She had an unmet deductible. She proceeded to drag her feet and not pay this bill. Eventually she mailed partial payment with a nasty letter basically saying “this is all he is worth.” We left it alone even though we did not collect the amount we billed.

Now more than a year later, she is e-mailing asking if we can do her operation. Now why would I want to do that?

Understand that surgeons are people too. If you treat yours with disrespect, why would he want to take care of you?

Best Regards,

John Di Saia MD

Originally posted 2012-09-10 07:30:41.

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