Archive for category technical
Why I Keep Comments Off (Approval)
Folks when you do controversial operations like Labiaplasty and write about them (and other stuff of course) on your blog and/or YouTube, you just keep comments as “after approval only.”
This weekend I had a few comments validating that position with pretty rude stuff.
Many of the “anti-plastic surgery” lefties amaze me:
Liberals commonly present themselves as the party/group of tolerance, but if you present something with which they do not agree, they respond with personal attacks. It is kinda like politics. Somehow by taking care of people in a way the patients appreciate, I am a “bad guy.”
There are women who desire labiaplasty and I serve some of them. Some of the more vociferous opponents would deny these women the right to do with their bodies as they wish. I do not talk patients into anything. They come to me with concerns and I address them. Simple.
Best Regards,
John Di Saia MD
Originally posted 2008-07-06 07:30:00.
Reader Question – Breast Reduction and Post-op Fullness
I am going to have a breast reduction soon but have always loved my breast fullness. Is there a way that they can be reduced and remain full?
Young women with particularly large breasts retain some of that fullness after breast reduction, but it does vary with the technique and target size. This is something to discuss with your surgeon before surgery and to confirm with some images of patients he or she has previously operated.
Take into account that larger reduction results have more of a tendency to become droopy as well. Gravity has a tendency to win if things are left too large.
This one like many thing in plastic surgery is relative….relative to how
small you go and how exactly it is done.
Best Regards,
John Di Saia MD
Originally posted 2010-03-31 07:30:24.
Nipple Reduction or Areola Reduction?
Patients occasionally come in asking about nipple reduction. There is frequently confusion regarding what is to be reduced.
The nipple is the protruding central part of the breast (usually.) It is adjacent to the pigmented surrounding area, the areola. Sometimes the nipple protrudes too much or the areola seems too wide. A nipple reduction is technically the reduction of the central nipple. The areola can also be reduced and this is sometimes done at the time of a breast lift or reduction. Nipple reduction can result in some numbness, but can frequently be done as a small scale procedure under local.
Best Regards,
John Di Saia MD
Originally posted 2010-04-02 07:30:43.
Tumeric as a Wound Dressing?
This nice elderly Chinese gentleman with a hand wound became a patient. Like many Asian patients he uses some Eastern remedies in his daily life.
I have not seen the use of tumeric before for open wounds. This gentleman has been using it regularly for this hand wound as a dressing. He does not wish to have the wound treated with a skin graft. It is taking a while to heal and it is hard to tell if this is because of the tumeric, his age or use of the hand as he walks with a cane.
Some Eastern remedies seem to work pretty well. I am not sure this is one of them, but it is his hand.
Best Regards,
John Di Saia MD
Originally posted 2010-02-19 07:30:12.
Exercise Instead of Breast Reduction/Lift?
Posted by admin in Dr D's Truth, technical on June 10, 2011
Women sometimes are sold on the idea that exercises will lift their breasts so breast reduction or breast lift surgery can be avoided.
Exercise can lead to weight loss and weight loss can hep reduce breast fullness. This will not lift the breasts however. Sometimes weight loss will make the breasts sag more, but it will not lift them. Exercise does not tighten the skin. If your trainer is telling you exercise will lift your breasts, find another trainer.
I usually recommend that my patients get their weight into a range that they can maintain, then consider whether or not surgery might be a good thing for them.
Best Regards,
John Di Saia MD
Originally posted 2010-01-29 07:30:49.
Reader Question – Buttock Lift Technique to Not Lift Crack
Reader Question:
I noticed in the surgical buttock lift photos by the doctor that the scar doesn’t join at the top of the buttock crack. I’ve seen photos of patients who had this procedure with another doctor who did join the scar in the center, and the patients ended up with an awful elongated butt crack. I’m wondering if the doctor purposefully doesn’t join the scars in the center in order to avoid this outcome?
Different doctors use different techniques in their surgical practices. The appearance of the wound at closure hints to the technique but does not always make that technique obvious.
My body lift / buttock lift technique involves more than the scar. You will want to carefully evaluate your surgeon’s “Before & After” images as you choose who to employ for your operation. Body lift surgery is large in scale and can entail revisions. This is one of the reasons I usually stage my lower body lifts as two main operations of which the buttock lift is the second.
Best Regards,
John Di Saia MD
Related:
Reader Question – When Do You “Need” More Than Just Breast Implants?
Posted by admin in breast implant pre-op tutorial, technical on December 24, 2010
Reader Question:
I want my areolae to be closer in size. Do you think my small one will stretch and get bigger when I do get implants? And would the big one be able to be reduced in size with a crescent lift scar or would it have to be cut all the way around to reduce the circumference? Would it even make sense to just get implants now and see what happens then do a little crescent lift/areola reduction later only *if* I need it? Or better to get it all done at once? And looking at my areola (the color of it and my skin, its shape, etc) do you think my areola scar would turn out ok?
A basic question with any cosmetic procedure involving paired body parts is:
“How close is close enough?” versus “How much surgery is acceptable?”
You have breasts with some differences between them that implant placement alone is not going to correct. If you recall this was one of the issues I had with your “photoshopped” implant prediction collage. That image made your breasts larger and more similar; more than I saw breast implant placement alone doing for you. Does that mean you “need” more than implants? The answer depends in part upon your answer to the question in bold above.
When you have your implants placed, both areolae are going to stretch. Your left breast is going to appear a bit differently than your right because the skin envelopes around each breast are a bit different. The degree to which these things will happen or bother you is difficult to predict. I would probably do the simple implantation surgery and let things heal before doing more surgery. It is difficult to tell without examining you and making some measurements.
If you do want the areola size changed a reduction can be either part or all the way around depending upon how much is to be addressed. Trying to reduce it at the time of implant placement risks it stretching again as your breast skin stretches to accommodate the implants. One of the forms of breast lift surgery might be in order down the line depending upon how the stretching of implantation goes.
Best Regards,
John Di Saia MD
Related:
Stretched Earlobe Plug Repairs – Not Your Regular Earlobe Tear
I see patients for earlobe repairs pretty commonly especially since I put some pictures online including a ear plug wound I fixed a few years ago.
Recently I saw a nice young gal with a really stretched ear lobe from wearing plugs. They were so large I had to figure new ways to close them and they will not look a nicely as smaller plug holes I have fixed in the past.
The Moral Of This Story: If you wear ear plugs, either plan on keeping the holes or try to keep the plugs to the less than gigantic size.
Best Regards,
John Di Saia MD
Originally posted 2009-10-01 07:30:30.
Reader Question – I am 30. Recommendations?
Reader Question:
I have just hit my magic number 30 birthday and am looking into fillers, lasers, and/or botox for my face. I have fine nose/mouth lines and between my eyebrows and on my forehead and crow’s feet. These are fine lines. I am not a smoker and I am pretty good about using sunscreen, but I would like to do something about the damage already on my face and preventative maintenance for the future. Any thoughts?
Happy birthday Becca. My general recommendation is to stay conservative in the strength and amount of work that is done for prevention. There are no good studies showing how people age with these treatments over time. There are well publicized cases however of people who have clearly gone too far and/or tried unadvised treatments. New is not always better or even safe in plastic surgery. Seek expert advice and treatment.
That translates to perhaps some light facial peels, a little botulinum toxin between the eyebrows and maybe a touch of filler at the upper lip line. I would need to see you to specifically make recommendations for you in particular, but these would likely be my starting points.
Best Regards,
John Di Saia MD
Originally posted 2009-11-24 09:00:44.
Don’t Want Your Breast Implants Anymore? – Have Them Out
In the office we have had a noticeable increase in requests for breast implant removal without replacement. Women are naturally concerned about what things will look like afterward and this does vary quite a bit.
Not everyone needs or wants a breast lift afterward. If the patient’s implants are not too large and are saline-filled, often the operation is quite simple and leaves nice results. On the other hand, old silicone gel implants or their remnants can leave a mess in there. This can require more surgery to repair.
Best Regards,
John Di Saia MD
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