Archive for category “Good Plastic Surgery in the OC”

Good Plastic Surgery in the OC – A Good Redo Boob Job

Redo Breast Lift Orange County Califrnia

Here we have images of a woman I first saw a few years ago. She had had two breast implant operations before and noted after her second (an enlargement with full lift) that her left breast progressively dropped (over about a year). I recommended re-operation to re-set the lift and downsize her implants. She agreed to the lift but not the implant size decrease. Smaller implants do not weigh as much so the rate of recurrent sag should have been less. As these were silicone gel implants this is particularly important. They weigh more than saline-filled implants.

The After image was taken at 1 month. She moved Out of State, but I predict that the sag probably recurred at least to some extent.

The Lesson:

(1) Large implants are hard to keep up. Plan on smaller implants or more surgery later if you select larger implants. Large silicone implants also harden (capsular contracture) more frequently/severely than smaller implants or saline implants. This also contributes to a higher redo rate.

Best Regards,

John Di Saia MD

Originally posted 2007-05-15 07:30:21.

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Clean Smile Line Filler – Orange County California

Good Orange County Smile Line Injections

Here is a smile line filler case before and 2 weeks later from my Orange County practice. The anatomic areas treated were the Nasolabial folds and Marionette lines. Not all smile line filler results need to be scary. We used a hyaluronic acid based product.

The biggest problems with filler cases tend to revolve around the large amounts of filler that some practitioner place. Moderation leads to more natural results here. You might not get all your lines “erased” but you will look human when you leave. We look at this as a reasonable trade off. :)

Best Regards,

John Di Saia MD

Originally posted 2010-12-13 07:30:46.

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Successful Pressure Ulcer Closure

We have discussed before that my practice includes cosmetic as well as reconstructive plastic surgery. This fairly sick man was a resident at a wound care hospital at which I treat patients. He had a deep (stage IV) wound of his sacrum (lower back) that was too severe to heal without surgery. He had had a stroke and was for the most part bedridden. A consequence of this was that he was unable to sit in a chair for fear of bleeding and continued wound breakdown.

I performed a wound repair that allowed him to sit up in a chair and live in a little less pain. This isn’t pretty plastic surgery, but it did improve his lot in life for the rest of his life. He died of other causes about a year after the surgery.

Best Regards,

John Di Saia MD

Originally posted 2012-07-27 07:30:06.

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Weight Loss Tummy Tuck in 73 Year Old – Orange County, Ca

Weight loss tummy tuck surgery is tummy tuck surgery after significant weight loss. Here we have Before & After images of the oldest patient for whom I have ever performed abdominoplasty. She was 73 at the time of her tummy tuck, but a very healthy 73. She had of her own accord lost some 65 pounds and wanted her “fat apron” lifted from her tummy. After her internist cleared her for surgery, we went ahead.

weight loss tummy tuck

She recovered well and quickly after her surgery and was pleased with her outcome. This weight loss tummy tuck resulted in a loss of a few pounds. The patient had lost the majority of her weight beforehand. This is the way it usually works out. These operations are “cleanup” for the effects of large scale weight loss most often.

This woman does not look like a young woman after her surgery but looks much better than she did beforehand. That is the bottom line with cosmetic plastic surgery.

Best Regards,

John Di Saia MD

Related:

Dr D’s Website Tummy Tuck Section

Originally posted 2005-05-16 20:29:00.

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Boob Job Redo Video

Boob job redo surgery is certainly more difficult than first time cases. Looking over some of my older YouTube videos, there was a desire to fix some up a bit. I had this boob job redo video with a patient testimonial. This video is now new and improved with reduction of annoying music and re-arrangement of the elements. It tells the story better now.

The story in short was this very nice young woman had been operated by a local surgeon who reported himself as the “best of the best.” Sound familiar? He nevertheless ran into a complication and after three operations left her pretty deformed. He reported to her that “this was as good as it was going to get.” Then she found Dr D through a friend. This was not an easy case and her result is just as much due to my work as her persistence, faith and patience.

Best Regards,

John Di Saia MD

Originally posted 2012-09-20 07:30:14.

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Nice Scar Revision – Orange County California

Scar revision is a type of surgery to improve scars. Advertising makes the treatment of scars very confusing. There are thousands of products with packaging promising anything and everything. Most people with disfiguring scars know most of these products offer little help.

Some scars can be improved with surgery however: scar revision surgery. Here’s an example of a scar revision case from my Orange County Practice:

Scar revision does not help all scars but rather scars that are wide or pigmented. In small cases, the surgery can be done in the office under local anesthesia only (numbing shots.) This brings the cost down. This doesn’t make it cheap, but makes it less expensive. Lasers are usually not used in scar revision surgery as they are not of proven benefit. Lasers do increase the cost however. :)

Best Regards,

John Di Saia MD

Related:

Dr D’s Scar Revision Practice Site Page

Originally posted 2011-11-18 07:30:42.

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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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Good (but Ugly) Plastic Surgery in the OC – Good Skin Graft


“Not all plastic surgery is cosmetic surgery, but cosmetic surgery pays the bills.”
This is a plastic surgery truism. There are plastic surgeons (like me!) who split their work between the things you need (that don’t pay your surgeon so well) and the things you want (that do.) In this sense cosmetic surgery is the subsidy upon which the needed (but less well reimbursed) work is supported.

Here is an ugly plastic surgery case of an ankle wound that needed some skin to close. The patient had had an operation by an orthopedist that got complicated. The skin graft surgery will leave a scar, but the wound that would have healed slowly if at all without it healed quickly afterward. This is an aspect of good plastic surgery rarely featured on your local news program.

Something to think about when you are considering cosmetic plastic surgery:

If you support a reconstructive plastic surgeon, he may be able to stay in business to be able to help you when you might need him. That cosmetic guy won’t be.

Best Regards,

John Di Saia MD

Originally posted 2012-10-10 07:30:20.

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Good Plastic Surgery in the OC – Refreshed Eyelid Surgery

Blepharoplasty is upper and/or lower eyelid cosmetic surgery usually performed for redundancy of the skin and fat of eyelids. Insurance companies may pay for upper lid surgery if the lids get in the way of the patient’s vision. The rate they pay for the surgeon is usually pretty poor.

Upper and Lower Eyelid Surgery Blepharoplasty

This young woman came for cosmetic blepharoplasty of the upper and lower lids. This was performed through traditional trans-cutaneous incisions allowing the removal of skin and fat. At 6 weeks she was pleased.

Best Regards,

John Di Saia MD

Originally posted 2012-09-28 07:30:17.

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Good Plastic Surgery in the OC – Pretty Eyelid Surgery

Good Eyelid Surgery Orange County California

This nice lady came to the office with tired looking eyes. She had an upper and lower lid blepharoplasty with canthopexy and 4 weeks later she was looking good.

Best Regards,

John Di Saia MD

Originally posted 2012-08-16 07:30:09.

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