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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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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Dr D’s Plastic Surgery Android App

Dr D wrote a simple plastic surgery app for the android. It shows some images of his patients as well as those of a few other surgeons and asks a little trivia about the blog. It’s a gag. Play it if you are game.

Download the app here

Best Regards,

John Di Saia MD

Originally posted 2010-12-29 07:30:58.

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Dr D’s “Kim Kardashian – 3 Plastic Surgery Stories”

Kim Kardashian – 3 Plastic Surgery Stories Mp3

Kim Kardashian has been doing a media tour and her story on plastic surgery keeps changing. A little comedy seemed only fair.

Best Regards,

John Di Saia MD

Originally posted 2010-05-28 07:30:04.

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Fish Oil vs Flax Seed Oil – Dr D’s Take

Being that heart disease is in my genes, I try to keep the cholesterol and fats down. Over the last ten years this has led me through Mevacor, Zocor and Lipator to Tri Cor.

Well Niacin has improved over the last twenty years. I remember the nasty flushing and itching when I tried even tiny amounts as a college student. Well now the flushless stuff seems to work pretty well. I have added two to three grams a day to my regimen.

At some point, any health conscious person is going to run into the consideration of Omega 3s, and that pretty much translates to Flax Seed oil versus Fish Oil. So I tried a bit of each…a few different formulations.

Well Fish Oil farts are pretty nasty. I got them with enteric and non enteric coated fish oil. Flax Seed oil gives you enough of one Omega 3 for you to make the others you need. So I think for the most part Flax wins the debate there.

Best Regards,

John Di Saia MD

Originally posted 2013-06-17 07:30:16.

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Reader Question: Acne Scarring Treatment

Hello, Dr Di Saia,

I’ve had acne for a few years (it is now almost completely gone) and I am now left with a few but noticeable facial scars. What is the best way to deal with them? What fillers would you recommend? Would a chemical peel or microdermobrasion be enough?? (I personally don’t think it would be). I am 19, by the way. Thank you for your professional advice!

Acne scarring is an extremely variable problem. The treatment depends upon severity and skin type. A single facial peel will likely not be enough to improve any, but the lightest of cases. You really need an individual professional evaluation regarding peels, fillers, and other surgical options as they pertain to your specific case.

Best Regards,

John Di Saia MD

Related:

Basic Skin Care

Originally posted 2005-07-24 15:35:00.

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