Lovely Marissa Everhart

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Lovely Marissa Everhart modeling one of our new workout tops. :)

Just some pretty scenery

Best Regards,

John Di Saia MD

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Dr D’s Top Ten Celebrity Boob Jobs Comedy – Heidi Montag

Heidi Montag Top Ten Celebrity Boob Jobs Bit Mp3

This is part I of a series of Dr D comedy podcast bits. Here we poke a little fun at Heidi Montag and the blog (of course.)

Best Regards,

John Di Saia MD

Originally posted 2010-05-07 07:30:25.

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New ocbody.com shirt with a pretty new #boobjob in it

New ocbody.com shirt with a pretty new <a href='http://twitter.com/search?q=boobjob'>#boobjob</a> in it

Originally posted 2014-06-28 15:55:53.

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Will You Remove My Mole Under Health Insurance?

In years gone by, I spent far too much time removing small skin bumps 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. [Meanwhile his stuff diverted some of my better business into his schedule as opposed to mine.]

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 frequently don’t understand why I cannot remove their moles for what their insurance pays and make a profit. Well when your insurance pays for a janitor, you can’t always have a surgeon.

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; not at insurance rates anyway.

Best Regards,

John Di Saia MD

Originally posted 2005-09-11 08:30:00.

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VA Doctors Sued Over Mocking in the Operating Room

Reston, Va. — “And really, after five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit,” a doctor can be heard saying in a recording at the center of a lawsuit.

A patient in Virginia received $500,000 after the operating team mocked him while he was under anesthetics during a routine colonoscopy.

The patient said he had his phone set to record the post-operation instructions given to him before he was put to sleep. He forgot to turn off his phone during the procedure, though,

Source: http://abc13.com/health/listen-patient-records-doctors-mocking-him-during-surgery/802568/

It is true that some doctors make not-so-wonderful comments about their patients in the operating room. Usually the caliber of the comments does not rise to wholesale mocking though. A technical cell phone mistake on this patient’s part netted him a half a million dollars. Without the recording it is doubtful that he would have proven anything.

Best Regards,

John Di Saia MD

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Why Tara Reid had a Ripply Stomach

Tara Reid’s ripply stomach was an internet phenomenon for years. She had obviously had liposuction. What went wrong?

More likely than not, overzealous liposuction left those marks. This is really irregularity in the fatty layer beneath the skin. In order to maintain a smooth contour to the skin, there needs to be fat between the skin and muscular layer. Preferably, this layer should be even.

Here is an image of a woman that came to the office requesting that I repair her abdomen after a well-known plastic surgeon had performed liposuction:

Her smoking history made surgery ill-advised, therefore I was unable to help her.

The bottom line is that it is best to be conservative in liposuction cases. We don’t want to take all the fat. You need just a bit and this is why.

Best Regards,

John Di Saia MD

 

 

 

 

Dr D’s Liposuction Facts 

Originally posted 2005-05-14 08:47:00.

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Immediate Laser Treatment Minimizes Scars – Really?

Detroit — Treating the edges of a surgical wound with a fractional carbon laser immediately before closing the wound — rather than the more traditional method of waiting months to resurface surgical scars — will minimize scarring later, Reuters Health reports.
Source: archderm.ama-assn.org/cgi/content/extract/147/9/1108

People need to be wary of studies quoted to support absolute statements. There are few real absolutes in science. There are far more in advertising. The study quoted here reflects the interpretation of ten patient photographs after skin procedures performed by dermatologists in which half a wound was treated with a laser.

The conclusion that immediate fractional carbon laser treatment will make scars less appreciable later is premature to say the least. The second supposition that using a laser months after an operation for scar treatment is standard is spurious as well.

What does the study prove?

Perhaps that more study might be indicated to determine whether or not patients who have procedures by dermatologists might benefit by scar treatment. With a small sample of just ten patients, no other conclusions are reasonable. Making a broad-based absolute conclusion based on this tiny little study is not good science, but it could make some people some money. Expecting exaggeration of the results is expected in that light. :)

Problems?

(1) Scar formation varies in the first place by the surgeon and problem for which the surgery was performed. I personally don’t refer many patients for laser treatment. They don’t tend to benefit by it. This includes some pretty profoundly wounded people such as trauma patients.

(2) No health insurance company will pay for this. That is why they don’t cover scar treatments and surgery by plastic surgeons.

Best Regards,

John Di Saia MD

Originally posted 2011-10-27 07:30:22.

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Finding the Best Plastic Surgery Online

Just for the sake of comparison I did some web searching looking into the blogosphere for the “best plastic surgery.” What I found were spun articles and nonsensical gibberish probably created to capture the computerized eye of the search engines. It seems that these days all anyone is trying to do online is capture search engine results. The problem when you are an actual person interested in plastic surgery is that searching “best plastic surgery” might just give you the worst.

First of all, when looking into the “best plastic surgery,” you are really better served by looking into your procedure of interest as we do not all specialize in everything. Who does?

What is not always so evident is the online recommendations (and negative tirades as well) can be faked. So can the appearance of that doctor who looks like a rock star online on his site. Remember Lifestyle Lift and the State of New York? The company paid a $300,000 fine for faking reviews on the internet. It still amazes me that they are still in business. Their site looks pretty slick though.

Do you honestly think the Google knows the difference between a good tummy tuck and a not-so-good tummy tuck? Search engine results are a keyword mediated computerized lottery. Some of those results are paid results too and appear higher not based on quality, but based on dollars. The bottom line is that you can get starter information from searching online, but then the work really begins.

I have written online on how potential patients might screen a potential plastic surgeon. Please do so before consenting to surgery rather than trust the veracity of a potentially fateful search engine result.

Best Regards,

John Di Saia MD

Originally posted 2012-01-05 07:30:25.

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Tsa Body Scanners, Exposure and Cancer

Amongst those issues argued as the tsa body scanner debacle ensues is risk. The bottom line is that to expose the public in a massive way to radiation exposes them to risk. Widespread and frequent radiation exposure of this type has not been implemented before, and the effects will likely take many years to reveal themselves. In essence if we continue this policy, we won’t know the long term effects until decades later.

We have a historical example however; that of “low dose” radiation exposure for acne. In the 1950’s, it became popular in some countries to submit people suffering form acne to “low dose” radiation exposure as treatment. It worked in many cases. Here is an Australian case example of a patient who later developed many cancers.

I have seen occasional patients (it wasn’t as common in the US) who had had radiation treatment for acne as children and without much history of sun exposure developed massive numbers of skin cancers as well as other malignancies. There is also some evidence of increased risk for breast cancer and sarcomas. At the time of the actual “treatments,” these risks were of course unknown. Who is to say our current tsa scanner policy is not going to produce another such group of patients in the decades to come?

Profiling might not be politically correct, but massive scanner exposure even in minute amounts seems likely to increase cancer rates. Profiling will not. This is simple folks.

Best Regards,

John Di Saia MD

Originally posted 2010-11-24 09:00:07.

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Nasal Mohs Patient & The Politics of Doing The Right Thing

Recently I saw a patient with a small superficial basal cell cancer on the rim of her nose (the Nasal Ala.) She was referred by a dermatologist who had scheduled her for Mohs Surgery and wanted my help with reconstruction of the wound that would result from the Mohs surgery. I saw her before her Mohs surgery.

It is true that reconstruction in this area frequently leaves less than attractive results and that there are alternatives that might obviate her need for surgery namely topical chemotherapeutic creams. They only work for superficial disease which her biopsy indicated she had. I have used them before and they have worked pretty well but they do require a lot of follow-up visits.

At the risk of angering the local dermatologist I suggested that the patient speak with her about this possibility before her scheduled Mohs operation. It is true that that a surgeon working with his mind as opposed to with his hands makes less less money, but it is the right thing to do. The patient actually decided to have the Mohs surgery anyway.

I always wonder when I do these things if I am annoying the referring doctors and I may do so on occasion. The focus should be on what’s best for the patient, but business can distort that in some cases.

Best Regards,

John Di Saia MD

Originally posted 2010-08-23 08:00:27.

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