Archive for September, 2009

Breast Cancer Reconstruction Patient in Playboy Magazine

Daily Mail has a story of a woman who posed for Playboy after a mastectomy for breast cancer and breast reconstruction.

The images at Daily Mail show her right breast after what appears to be a skin sparing mastectomy and implant reconstruction. Her left breast has been lifted and implanted for symmetry. She ha either elected not to have a nipple/areolar reconstruction on her right breast or just hasn’t had it yet.

It is nice to see reconstructive plastic surgery featured in a positive light in the media. Things can look pretty nicely certainly relative to the alternatives.

Best Regards,

John Di Saia MD

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Liposuction Surgeon Jailed Over Patient Death

The Independent has a story of a liposuction-related death in Marbella. A high profile patient died after some pretty nasty events occurred at surgery”


During her treatment at the Molding, Marbella’s biggest plastic surgery clinic, the court heard that a tube used to remove fat was placed by mistake in the patient’s abdominal cavity, puncturing her colon and cutting into her liver.

[A] court in Malaga convicted cosmetic surgeon Antonio Mena Molina of negligent homicide, sentencing him to a year in prison, fining him €120,000 (£110,000) and banning him from practicing medicine for three years.

It makes you wonder what exactly were the circumstances. Mistakes can happen, but was something not right here that made it much more likely? A criminal conviction after a plastic surgery related death is uncommon unless something else is awry at least in California. This is definitely surgical tourism gone bad.

Best Regards,

John Di Saia MD

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Reader Laura on Washington State Fake Botox and Restylane Story

Reader Question:

Source 1: komonews.com/news/local/54859762.html

Source 2: komonews.com/news/local/54913492.html

“A salon owner in Washington state has been arrested for injecting fake Botox and Restylane into her customers”

I wonder what she was injecting since the story says the vial had Chinese characters. Obviously this should only be done in a doctor’s office but should patients ask to see the vial of anything you are being injected with? What is the normal procedure in a doctor’s office?

When you allow someone to inject soft tissue fillers and/or Botulinum toxin into your body, you need to have a level of trust. Doing these things in a salon may be cheap, but can have very disfiguring and/or expensive consequences. It sounds like this material with the Chinese characters had similar inflammatory consequences as liquid silicone and needed to be cut out. This woman is disfigured and will likely remain that way.

My patients can always see the material with which I inject them. They are being treated by a board-certified plastic surgeon not a less trained injector. If you do not trust the person injecting your face, he or she should probably not be doing it. Going to a reputable plastic surgeon’s office should cut your risk even though it will cost more.

Best Regards,

John Di Saia MD

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Dr Andrew Ordon – Public Reprimand and Case in Connecticut

TMZ features a story about Dr Andrew Ordon, a plastic surgeon on Dr Phil’s “The Doctors” show. Apparently Dr Ordon has had a few problems in his past specifically with a public reprimand by the California Medical Board and a old case in Connecticut.

From the Consent Order in Connecticut [Source: http://www.ctd.uscourts.gov/Opinions/032604.HBF.Ordon.pdf] ,

WHEREAS, the Department alleges that:

1. In or about August, 1994, through and including June, 1995 respondent provided incompetent care and/or negligent care to patient Keith Balentine in that he exercised poor judgment, failed to dissuade him from obtaining further plastic surgery, and failed to adequately document and maintain medical records, which is denied by the respondent.

2. The above described facts constitute grounds for disciplinary action pursuant to the General Statues of Connecticut, 20-13(c)(4) which is denied by the respondent.

The up and the down of this case is that he was fined only $2500 by the Connecticut Medical Board in 1999. He still has a license in Connecticut. It reads like the reason for the action stems from medical records issues and not dissuading the patient from further surgery. All plastic surgeons can describe instances from the past in which patients tried to convince them to perform more surgery against their better judgment and things went poorly. This is something learned with experience.

Dr Ordon has been in practice since 1980. If this is all they can come up with in his nearly thirty years in practice, he is probably OK.

I review cases for the California Medical Board and I have reviewed much more severe violations involving others doctors. A $2500 fine is a slap on the wrist. It is pretty predictable that when you rise to some level of prominence there are those who want to bring you down.

Best Regards,

John Di Saia MD

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Jennifer Love Hewitt Shape magazine – Surgery or Photoshop?

Popeater (pics at link) ran a story on the possibility of Photoshop on some recent Jennifer Love Hewitt Shape magazine pictures. It is far more likely she had Photoshop than plastic surgery as only a month has passed since some pretty different looking photos.

Best Regards,

John Di Saia MD

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Holly Madison Used To Stuff Her Bra?

Hollywood Rag

Playboy Playmate-turned-reality TV star Holly Madison made her first boyfriend wait months for sex – so she could gradually “bring down” her bra size. Hugh Hefner’s former girlfriend wasn’t always as busty as she is in Playboy spreads and used to stuff her bra with tissue paper to look less flat. She doesn’t have that problem anymore…

Holly Madison is definitely a plastic surgery success story probably because she got good surgery and stopped when the time was right (at least the big stuff.) I wonder about the bra stuffing story here though.

Best Regards,
John Di Saia MD

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Macrolane Boob Jab – Is it Safe?

Macrolane is a hyaluronic acid based filler that is now being used in the Breasts for volume enhancement in Europe. It is very similar to the hyaluronic acid based fillers that have been used as temporary facial fillers for years now.

The questions are of course the usual: Is it safe? Does it work? Will it cause any problems?

The answers here are that we won’t know for years. It takes that long to follow side effect profiles and the like. A writer in England wrote of her experience with it however. She is not so happy as one of her breasts “hardened up” as if it had been injected with silicone gel.

Our English patient’s summation:


But I do feel the product under-delivers and does not seem to be backed up by the sort of studies that we might expect.

I would wait on this one.

Best Regards,

John Di Saia MD

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Reader Question: Too Old For Tummy Tuck?

Reader Question:

I am 64 years old and want a full abdominoplasty fairly soon. Can someone be too old to have the surgery? My health is excellent and I work out several times a week.

I have performed even extended tummy tucks in patients over 70 years of age with few problems. In my opinion, it is the patient’s overall health that either makes or breaks the operation as long as you are in good hands. You will need pre-operative clearance from your internist and of course a complete evaluation by a good plastic surgeon who is experienced in tummy tuck surgery.

Best Regards,

John Di Saia MD

Related:

Dr D’s “Tummy Tuck FAQs”

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Reader Laura’s Comment: Surgical Tourism Story

Reader Laura’s Comment:

Daily Mail

“Single mother traveled to Panama for operation to turn brown eyes blue… and was almost blinded”

Just the title of this story sounds scary to me. I’m not sure why she would risk her eyesight in this manner. I’m also not sure why the doctors went ahead with the surgery when her doctors back home told her not to have the surgery.

When a federal agency refuses to approve a procedure in the US (or in the UK in this case,) sometimes there is a very good reason. Going to unregulated countries removes this protection and exposes patients to risk. Third world countries really have little regulation of medical procedures.

People tend to think when a board certified plastic surgeon “talks down” something, the only reason is money. It isn’t.

The Bottom Line:
Research very carefully before you go to a third world country particularly to have large scale surgery, surgery not approved in your native country or surgery requiring precision and training. The reason is apparent from this case. This woman nearly lost her sight.

Best Regards,

John Di Saia MD

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Australian Government Getting into Scalpel Tourism?

News.com Au

The Australian Tourism Export Council (ATEC) wants to lure what it describes as “high-spending overseas tourists” seeking medical services to Australia.

Are they going to cover the costs of travel and additional surgery for follow-up and problems? Good follow-up particularly after large scale surgery can avoid problems. These are amongst the items that people don’t tend to consider.

There is also the tendency for patients who price shop to assume that surgery is the same when you go from surgeon to surgeon. It isn’t. As usual it is “buyer beware.” Just be careful.

Best Regards,

John Di Saia MD

Related:

A Costa Rica Plastic Surgery Nightmare

Surgical Tourism…a Bad Trip?

Reader Laura’s Question/Comment: Surgical Tourism Story

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