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
Reader – “Help Dr D, My Plastic Surgeon is an ahole!”
Posted by admin in Dr D's Truth on May 13, 2013
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.
Dr D versus the V-Loc: A Patient Story
Posted by admin in Dr D's Patients on May 13, 2013
I had a patient come for scar revision surgery who had previously some scars revised by another surgeon using the V-Loc suture device. This resulted in wide (nearly 2 cm wide) wounds at the site of groin scar revisions. I do not use these contraptions as I do not see them making me better than I am already. 
What is the V-Loc?
The V-Loc is a barbed suturing device made to save the surgeon time in closing wounds. Barbed sutures have been popular developments in the past five or so years. I have been reluctant as I have said in using them. Why change things that are working well? The V-Loc uses polyglyconate suture material (Maxon TM) which is actually a pretty good material when used properly.
I revised one of the patient’s scars using my own technique. We will see how the wound heals. Maybe the patient will allow me to share his images as his scar matures.
Best Regards,
John Di Saia MD
Originally posted 2012-01-27 07:30:13.
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.
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