Good Liposuction Results can mean your future booty might be “refined.”
Liposuction is a popular procedure and when performed judiciously it can have good long lasting results. As we have discussed before it is not immune to large weight fluctuations. For patients in a reasonable weight range (plus or minus a few pounds,) it performs well in the right hands. Despite that which you see featured elsewhere good butt liposuction is not a matter of removing more, but rather removing the right amount in the right patient the right way.
Here is a case I did about ten years ago on a woman with a bit of extra (her words) “junk in her trunk.” She was later to call this “good butt liposuction” herself . No laser or other high tech gizmo was used. She did have a short anesthetic in a surgery center and there were no complications.
Good Liposuction Results
The operation made things quite a bit better. She was pleased. It did not however make her into a “thin woman.” It made her into a “thinner woman.” That is a “good liposuction result.”
John Di Saia MD
P.S. For those who have commented over the years that this or that doesn’t look much better, don’t have cosmetic surgery. If you can’t see improvement or have a picture in your head that must be your outcome, you are liable to be disappointed.
Originally posted 2013-02-22 07:30:52.
A friend of mine at a local media outlet was pitched a story about Laviv and asked for my thoughts. So I looked into it for her. We talked about it here once before, but I updated my search to be fair:
Laviv is a fibroblast cell product which is formulated as a tissue filler. The idea is new though. The company takes a sample of skin from behind the ear and use a little cell culture magic and make many new patient “cloned” fibroblasts. Then these are injected into the skin of that same patient in three parts separated by 5 weeks or so. The cool thing is that these are cells that should be identical to some of the cells the patient would have there already. Then again fibroblasts are basic cells to healing, but who is to say what a big pile of them injected below someone’s skin will do?
A key question is what is the long term effect here and that of course is not known. The FDA approval was based on a relatively small study showing better than placebo effects on nasolabial folds six months after a three treatment series. The study group was only 421 patients. There are post study approval requirements from the FDA; another 2700 patients to be followed.
The idea is very high tech and expensive. Another central question is how dangerous might it be (cancer, etc) and how long will the results (if we get any) last? How will Laviv compare to other products on the market which are ten to twenty times cheaper? The FDA pre-approval study did not compare it to anything but a lack of treatment. Not very encouraging.
I wouldn’t be getting too excited, but then new high tech stuff rarely gets me excited without some real proof behind it. We have little of that here.
John Di Saia MD
Originally posted 2012-04-10 07:30:44.
Safe Breast Augmentation?
The level of confusion regarding breast implant surgery is enormous. Can you get implant surgery without the drama?
There are sites with scary stories of women (including this one) who went to horrifying B movie type doctors and had horrendous results. There are also stories of women who went bigger and bigger and bigger until their breast tissue just gave out and failed.
Safe Breast Augmentation is possible as long as you exercise proper judgement. Suffice it to say there are plenty of women who have had safe breast augmentation:
“Dr. D!!! They are still so awesome! They aren’t hard or sagging, almost 16 years later. Unbelievable! They look great and feel like a part of my body. You are the best and you can tell everyone I think so!!”
-G: Los Angeles, Ca. – Breast augmentation patient 2013
This woman had her breast implants placed in 1997 by yours truly. They were placed in an operating facility under her pectoral muscles and were saline-filled models of a moderate size. Now fifteen years later, she has needed no additional surgery and feels and looks great.
Beware advertising gimmicks and promises of the extreme. Choose a qualifed board certified plastic surgeon and moderate enhancement guided by his or her advice. That “happy medium” might just last you ten or more years.
John Di Saia MD
Originally posted 2013-04-01 07:30:53.
Hugh Jackman as of May of this year has had three skin cancers treated. He is realistic that he will have more.
Jackman, who plays Logan and Wolverine, wore a bandage on his nose after having a basal cell carcinoma removed last week. Basal cell carcinoma is a slow-growing form of skin cancer and Jackman was treated for the same disease last year.
He told The Associated Press: “I’m realistic about the future and it’s more than likely that I’ll have at least one more but probably many more, which is not uncommon for an Aussie particularly from English stock growing up in Australia where I don’t remember ever being told to put sunscreen on.”
Don’t take it personally Hugh, my kids don’t listen much when I encourage their use of sunscreen. I am known to embarrass at baseball games, etc.
Jackman correctly attributes the skin cancer to sun exposure and his heritage. What is not mentioned in the Fox piece is that there are other preventative therapies for skin cancer useful in people who have had them already. When you have already had three skin cancers just wearing sunscreen is probably not enough to keep them from returning. Hopefully he is looking into some of the alternatives now.
John Di Saia MD
I feel so f….king stupid! I got a cheap $3000 boobjob from a billboard and am stuck with these ugly boobies. Can you fix my refund gap?
You look like you have “over the muscle” implants and the pockets are sort of “to the side.” The implants might also be a tad big for your frame. Your refund gap refers to your wide cleavage for those not familiar with the term.
These kinds of problems can be addressed by another operation. Take a look at the lady I repaired here. She also had over the muscle implants that were too large and were settling down her chest. Your cleavage can be made a bit better, but your breast shape can be improved quite a bit.
I not infrequently tell patients how their cheap boobjobs can get expensive. Get yours fixed before it gets worse and requires more work.
John Di Saia MD
Originally posted 2011-07-11 07:30:47.
At an online forum, I responded to a post by a woman who had had tummy tuck surgery elsewhere (the famous Dr “X”) and was unhappy that her tummy was not “totally flat” afterward. She was asking whether this might represent fat that her doctor hadn’t removed. At this forum they refer to the after tummy tuck appearance as the “flatlands.” Kinda cute.
Tummy Tuck surgery results vary between surgeons and patients. The reasons for this are multiple:
(1) Different surgeons work with different techniques and spend more or less effort than others to get their best result.
(2) Some patient’s tissues stretch more after being placed upon tension than others. We see this over the weeks and months after an operation.
(3) Some people are more successful than others at pushing away from the buffet.
Is has been true for as long as there has been cosmetic surgery that the most important issue for a patient to comprehend relates to reasonable expectations.
Expecting “absolutes” in a world of “relatives” is an invitation to disappointment. “Totally flat” sounds great but might be off the charts for some patients. Some surgeons are going to make more of an effort to get you there though. And what is “Totally flat” for one patient might not be flat enough for another anyway. When plastic surgery doesn’t get you where you want to be there are several issues to address regarding the cause.
It is far more productive to look at degrees of improvement and focus your pre-op conversation on what you might be able to achieve. Picking the right surgical talent never hurts either.
John Di Saia MD
Originally posted 2011-07-25 07:30:16.
An interesting philosophical conundrum arose at a sub acute hospital at which I see patients. These are not the plastic surgery patients you see on reality television. They are ill complicated patients too sick to go home. Sometimes they are people with brain injuries after having had surgery or a stroke.
What do you do when one of them gets a skin cancer?
I was asked to see such a patient recently and seeing what I believed to be an obvious skin cancer I obtained a biopsy. Another doctor seeing the patient asked me why I bothered. To him operating to remove the cancer for this patient was a “waste of resources.” I respectfully disagreed. Most skin cancers do not kill, but this one had obviously been left alone for quite a while. It had grown large and will likely leave deformity when (or if) it is removed. But not doing anything dooms the patient to a slow erosion of his facial features. It was pretty ugly. In my opinion it would have been better to remove this cancer when it was much smaller, but I didn’t see him then.
Unfortunately entertaining removal of the cancer opens more questions. The man does not have a conservator for medical affairs. Until one is appointed, consent for surgery cannot be obtained unless two doctors document an emergency. This is not an emergency.
My philosophy is to obtain evidence of cancer and present this to the patient or medical guardian with a series of options. This seems to be a matter of opinion.
The philosophy of your doctor makes a difference in your care. This is an interesting crossroads of such philosophies.
John Di Saia MD
Originally posted 2010-12-15 07:30:54.
A young bank clerk who stole £46,000 from her employer to help achieve her dream of becoming a model told police she had earned the money from working as an escort. Mother-of-one and law graduate Rachael Martin, 24, ‘spent money like water’ after getting a job with Barclays in Liskeard, Cornwall, where she was responsible for dealing with cheques.
The stolen cash paid for a breast enlargement, thought to be worth £4,000, dental work worth £1,700, and liposuction, as well as nights out, drink and drugs. She has now been jailed after stealing £46,000 in just two months from her employers.
This 24 year old law graduate stole from a bank to fund plastic surgery and nights on the town. Interestingly she by report told those who asked about the source of the money for her indulgences that she worked as a prostitute. The judge apparently had pity on her when he sentenced her. I am sure that will make the bank that is out the money quite happy.
John Di Saia MD
Originally posted 2012-10-03 07:30:49.
I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants.
The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution.
While removal of your implants for a time with later replacement might improve the problem, this is not a “slam dunk” nor is it guaranteed to completely solve it. The results vary substantially. Usually removal with a good capsulectomy is the best thing for comfort. Implant replacement at times is thwarted by recurrence of the contracture.
Then again if you leave the implants in place things will not likely improve as you have had a trial of capsulectomy and replacement already. It is true however that a woman who has had her implants removed and not replaced frequently has them put in once again down the road due to appearance issues. This is not invariably the case however. Some women actually like the look of their breasts without implants after capsulectomy and explantation. The results of such surgery vary though.
These cases need to be handled individually and with a fair amount of disclosure before surgery is performed, so that everyone comes out satisfied. I don’t have one treatment that goes for all patients on the issue due to their inherent variability.
John Di Saia MD
Originally posted 2011-05-31 07:30:35.