Archive for February, 2011

Botox in your Vagina?

Posted by admin in Medicine in the News on February 28, 2011

I have often joked “They will stick a botulinum shot anywhere the sun shines.”

Now they just might stick it where it doesn’t.


Dr. Peter Pacik, a New Hampshire surgeon, is conducting an FDA-approved clinical trial testing the use of Botox on female patients who experience painful burning sensations and vaginal muscle contractions that make having sex nearly impossible, the news agency said. As many as 6% of women worldwide suffer from the muscle spasms caused by a reflex reaction to sex, Pacik told MSNBC.com.
Source: nydailynews.com/lifestyle/health/2011/02/25/2011-02-25_botox_may_help_women_with_sex_problems.html

These days when I read something like this I wonder how much of the story is on the level and what the “Hype factor” might be. Six percent of women affected? I don’t think so. That number is being inflated.

Then again for women with vaginal spasms, this could be helpful. It works for anal sphincter spasm. I know a few General Surgeons who were using it as opposed to surgery for the problem. Then again it will be expensive and will need to be repeated. Botulinum toxins wear off in 2-3 months on average.

Best Regards,

John Di Saia MD

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Kayte Walsh Marries Kelsey Grammer – Does Plastic Surgery Await?

Posted by admin in Beauty in the News on February 25, 2011

Kayte Walsh is now Mrs Kelsey Grammer #4. Will she have a similar love of the plastic surgeon’s knife as wife #3? She’s is young with a pretty smile. Her predecessor has a knock out body. Where might this go?

Best Regards,

John Di Saia MD

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Bigger Breasts are not always Better

Posted by admin in Beauty in the News on February 25, 2011

Source: attuworld.com/just-attu/donna-jones-has-the-biggest-boobs-in-england.html

26 year old Donna Jones has the biggest natural breasts in the UK – taking over from 32JJ record holder Rachel Aldana. Each breast weighs about the same as two average-size babies. She suffers from backache and hasn’t had a decent night’s sleep for years.

It’s not just for appearance here. This woman is in pain. Maybe it’s time for a breast reduction?

Best Regards,

John Di Saia MD

Originally posted 2008-10-24 06:30:00.

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E-mailed Question: Lifestyle Lift Rip off?

Posted by admin in cosmetic surgery pre-op tutorial on February 25, 2011

E-mailed Question:

Dear Dr,
I had my lifestyle lift in 3 months ago and I am very unhappy with the results and what I experienced. To get the lift corrected how much would it cost, I have already spent $5000.00

This type of comment regarding Lifestyle lift is quite common. Lifestyle Lift is a commercial effort, not an operation offered by one particular surgeon or practice. The company has had some scandals as well having been busted in New York for posting fake internet reviews.

Considering their low 28% positive review count (at the time of this writing) at Realself.com, these fake reviews make you wonder. The unfortunate part about this e-mail is that the lady is 3000 miles away from me and has most likely already spent the money she can afford to spend. The correction of bad plastic surgery results frequently costs more than the original surgery particularly when you seek correction elsewhere. Some things may not be correctable.

You really need to choose your plastic surgeon well the first time and watch out for advertising sourcing as a basis for that choice.

Best Regards,

John Di Saia MD

Related:

Dr D’s “Plastic Surgeon Credentialing”

Originally posted 2010-01-22 07:30:45.

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Tips on Choosing Your Health Insurance – PPO vs HMO vs EPO and a Story

Posted by admin in Insurance Coverage on February 25, 2011

Recently a patient came to the office with the need for a complicated breast reconstruction after finding that she had a Brca gene. She had already had breast surgery and radiation therapy and now was looking at complete breast removal and reconstruction. She was pretty clear that she had no money to pay for anything, but was waving around her Blue Cross PPO card like it was a VISA.

What was she even doing with a PPO card?

When patients sign up for PPO insurance, they are basically saying: “I am willing to pay more, but I want choice.” PPOs generally allow patients more selection with coverage for doctors (both in and out of network,) but patients pay a higher share of cost for that care. When you are on the cusp of expensive breast cancer surgery, a PPO card means you are going to pay thousands if not tens of thousands of dollars by the time you go through the multiple operations to remove and re-build your breasts.

HMO plans on the other hand have limited doctors (less or no coverage for out of network) and hurtles to care, but once you get in for that care, it costs you less.

EPOs tend to be somewhere in between. Now with this being said, each plan by each carrier can be quite different. Plans often have multiple deductibles for in and out of network doctors, facilities and hospitals. You really need to look into your plan before you sign up for it. But if you are looking to pay little or nothing over and above what your insurance pays, you should be looking into HMO coverage most often.

Best Regards,

John Di Saia MD

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One Third Unhappy With Cosmetic Surgery Results Survey

Posted by admin in plastic surgery news on February 24, 2011

As many as one-third of cosmetic surgery operations are performed to correct earlier errors, writes the Sunday supplement of the Väli-Suomi newspaper group. The Finnish Patient Insurance Centre receives some 200 complaints annually relating to errors made in plastic surgery.
Source: yle.fi/uutiset/news/2011/02/one-third_unhappy_with_cosmetic_surgery_results_2343729.html

Surveys like these are difficult to interpret. Who is doing this surgery? Are they real plastic surgeons? I don’t see anywhere near that high an unhappy patient rate. Then again I don’t operate upon everyone who comes through the door and I am a real residency trained board-certified plastic surgeon.

Best Regards,

John Di Saia MD

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A User reports on a $2999 Breast Implant Outfit

Posted by admin in Dr D Says No on February 23, 2011

Hi I just felt like I should post this based on my horrible experience with the “my choice medical” company. I would not recommend their services even if I hated you. First off when I called the 1800beyourbest.com website was different and could have been held for false advertising because they did not clearly indicate that you save 1000 for each procedure only if paid in cash or credit not through their financing plan. So if you finance not only do you pay financing interest but then an extra 1,000. It did however mention the small operating room fee and that there were no gimmicks. Well the Breast Aug. was 2999 pre-fee and if you got the 1,000 off. You pay 500 for a consult which they wouldn’t give back but if you go ahead with the procedure it gets applied to it. So the real cost of the procedure ended up being around 4,999 except that Dr. they sent me up with (note there’s few options in each area) works out of a house with an operating room within (shady as hell), the guy was very unfriendly barely uttered a word just took a picture and I was warned prior that he was very particular and did things only one way, his, or wouldn’t do it.
Source: messageboards.makemeheal.com/viewtopic.php?p=414948

Cheap cosmetic surgery may not be. Read the fine print.

I am very selective about the use of finance companies in my practice and don’t associate with funky companies. They can be very sneaky. When they don’t make their money the old fashioned way many resort to tricks. The “surgeon doing your breast implant operation in his house” thing was hilarious.

Best Regards,

John Di Saia MD

Originally posted 2007-08-07 08:45:00.

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Reader Laura on Scissors Left Inside Woman After Tummy Tuck

Posted by admin in plastic surgery news on February 23, 2011

Reader Laura Comment:

A French woman lived with severe pain for months due to a surgical error after a tummy tuck. Her surgeon left a 4 inch pair of surgical scissors. She went back numerous times with pain to her doctor but he just told her it was normal to feel pain after a tummy tuck. I wouldn’t have gone back to a doctor that did something like this and then acted like it was nothing. His comment that he was glad that it had happened towards the end of his career rather than the beginning is appalling. I hope this guy decides to retire and not perform any surgeries from this point forward.

A woman spent five months with a pair of surgical scissors in her stomach after a tummy tuck operation. She only realized what was causing her terrible stomach pains after she saw a piece of metal protruding from her belly button after a coughing fit. The woman in her 30s, named only as Anne, went to a cosmetic surgeon in Lyon in October for an operation to flatten her stomach following two pregnancies. But she began having severe stomach cramps within days of her apparently ‘successful’ surgery. She complained repeatedly to her surgeon at the prestigious Natecia Clinic – but was told pain was normal after the so-called abdominoplasty procedure.
Source:dailymail.co.uk/health/article-1357496/France-tummy-tuck-Scissors-Lyon-surgeon-left-inside-patient.html

Instrument counts at the end of surgery are standard. Obviously this surgical team missed that scissors. A terrible mistake. In the US, this would make a plaintiff’s attorney salivate…guaranteed money.

BTW – Significant pain is not normal five months after a well-performed tummy tuck.

Best Regards,

John Di Saia MD

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Wendy Whoppers – Breast Implant History

Posted by admin in celebrity plastic surgery on February 22, 2011

People often look to compare their own implant size or volume with that of larger breasted entertainers or porn starlets. Wendy Whoppers, a now retired adult entertainer from the eighties and nineties, did an interview in which she detailed her breast implant experience:

StS: Speaking of your career: you had several breast enlargement operations, right? How many?

WW: 4 enlargements.

StS: What was your breast size originally?

WW: 34 B.

StS: Did you pay for all of these operations, or did some Maecenas help (or maybe Blue Cross)? Can you give a general idea of how much such an operation costs?

WW: The first one –in 1989– was $2600, which a guy I was dating at the time paid for; they were 260-cc silicone implants (lower cost because it was done at my doctor’s office under local anesthesia). The second was $3200 for 800-cc silicone implants done in a surgery center, which I paid for. The third time, I had the double lumens put in and filled to 1600 cc’s, costing $3500, which I paid for. The fourth was adding more fluid to the same implants to fill them to 3000 cc’s, which was around $1000, paid for by photographer John Graham in exchange for a photo shoot. The cost was less because I was reusing the same implants and just adding more fluid to them, versus buying a whole new set of implants.

Source: bearchive.com/~behavior/v3n25/p1.html

At 5′ 1″ tall and under 100 pounds, she was quite large at the end of this. At her largest, she had dual lumen (Becker type) implants with one silicone compartment and another for saline at a 3000 cc volume. These implants are no longer made.

An important issue to point out here is that to go as large as she did required multiple operations (in her case four.) And later in life she had additional surgery to downsize.

Best Regards,

John Di Saia MD

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