Archive for November, 2011

Another Backstreet Fake Doctor Injection Victim Surfaces

We posted previously on Oneal Ron Morris, a transsexual charlatan who has been injecting clients with his own home brew of filler agents resulting in disastrous consequences. A victim of his facial services has surfaced:

lumps and bumps

Fake Doctor Facial Injection Treatment Victim

The lumpy cheeks, misshapen chin and ballooning upper lip are still visible on Rajee Narinesingh’s face; more than two years after she says she received a backroom cosmetic procedure from a man police say performed numerous, botched, unlicensed procedures. “I had to end up going to surgery, to get me even to this point,” Narinesingh told CBS4′s Gary Nelson Monday, pointing to the disfigurement she still is trying to have reversed. Narinesingh is among multiple alleged victims of Oneal Ron Morris, a transsexual who is alleged to have performed cosmetic procedures in homes and apartments.
Source: miami.cbslocal.com/2011/11/28/new-victim-reveals-fake-docs-alleged-work/

Rajee Narinesingh apparently met Oneal Ron Morris via referral in the transsexual community. She likely did not bother to look into Morris’ credentials. Reportedly she allowed Morris to provide a series of facial injections of a concoction of commercially available agents that you could buy at Home Depot. These injections appear to have reacted with her facial tissues resulting in lumps and bumps that will likely only be able to be removed in part in order to prevent further degradation of her appearance.

Despite the fact that filler injections can be offered by non-physicians, patients need to be diligent in choosing their providers. When you go cheap, you are entertaining the potential for significant risk and may obtain results that might not be easily subject to repair. Qualified doctors do not do incredibly cheap work in hotel rooms and apartments.

When you go this route, permanent disfigurement or even death might follow. This isn’t grand standing. It is the truth.

Plastic surgery risk can be minimized, but not when you go to the dark dingy corner of a seedy motel for treatment. You need to go to a skilled professional or not go at all.

Best Regards,

John Di Saia MD

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British Women May Not Want To Age Gracefully?

The Telegraph quotes a study of British women aged 35-69 who state that they worry about their physical appearance and signs of aging an average of 36 times a day. Well they only surveyed 100 women.


The study was devised by keep-fit instructor Irene Estry and psychologist Emma Kenny to see if a looks-obsessed society creates ageism and pressure to stay youthful.
Source: telegraph.co.uk/news/uknews/6634686/Women-worry-
about-their-bodies-252-times-a-week.html

There was not much of a negative plastic surgery slant either. Interesting.

Best Regards,

John Di Saia MD

Originally posted 2009-12-10 07:30:54.

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Belotero Balance – Another Restylane?

Merz Aesthetics announced that the United States (U.S.) Food and Drug Administration (FDA) has approved Belotero Balance for the correction of moderate-to-severe facial wrinkles and folds. Belotero Balance filler is a hyaluronic acid-based cohesive gel dermal filler designed to deliver natural-looking results with little recovery time
Source: drugs.com/newdrugs/merz-aesthetics-announces-fda-approval-
belotero-balance-dermal-filler-correction-moderate-severe-2950.html

We have discussed here on multiple occasions the confusion in the facial filler market. For quite some time my opinion has been that the hyaluronic acid-based fillers are the safest. There are several on the market.

Well now there is a new one, Belotero Balance from the makers of Radiesse. The study they quote in their materials was against a Bovine based filler which not surprisingly showed that the new product was superior. That is why the Bovine products have fallen by the wayside over the last decade.

Our e-mail to the company has not been answered regarding the issues of cross-linking, lidocaine content or physician sampling.

Best Regards,

John Di Saia MD

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Good Plastic Surgery in The OC – Great Wifey Tummy Tuck

Wife's Tummy Tuck Orange County 080911

My wife Kim had an extended tummy tuck on 080911. I performed this for her. After some discussion. she decided to be more public than I could have expected about it. Some of you have already seen her YouTube video posts. Here is an image of her “Before” and 3 1/2 month “After” images. She had a little liposuction of only her lateral thighs as I am not a believer in tummy lipo at the time of a tummy tuck.

The midline abdominal scar is that of her original gastric bypass (open approach) of 15 years ago.

Best Regards,

John Di Saia MD

Related:

Dr D’s Standard of Care for the Best Tummy Tuck

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Doctors Refuse To Treat Obese Patients in Florida


In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.
Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/

While I have not specifically “refused to treat” obese patients, I have in a few cases recommended against surgery or recommended weight loss and re-evaluation later. Than again I am not in primary care and do understand what these OB/GYNs are saying. Obese patients do represent more risk when it comes to surgery and that would of course cover pregnancy and child bearing.

Take into account that insurance-based medicine does not pay anything additional for the risk certain populations pose to the medical community. This is truly uncompensated liability. It is really not surprising that some medical groups have figured it might be smart to cut that risk.

This practice has already been perceived in a discriminatory light by this story’s slant. I’d wager someone has statistically reduced management of the obese to increased risk of complications and litigation and decided to “pull the plug.” It is not discrimination. It is liability containment here.

Best Regards,

John Di Saia MD

Originally posted 2011-05-17 09:00:14.

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Reader Question: Can You Fix My Pregnancy Tweaked Belly Button?

Pregnancy, Piercing and Hernia Repair Changed This Belly Button

Reader Question:

When I was pregnant, my daughter pushed against my belly button the last couple of months and stretched it out. Then I ended up having two hernias which also stretched it out. Unfortunately I pierced my belly button when I was 15 and the skin above my belly button is now extremely loose. Can you fix this?

I am 26 and had my baby in Sept of 2010. I gained 30 pounds (healthy) and immediately had the two hernias. I think they were a result of the pregnancy or labor. I had them repaired in Jan of 2011. I am planning on having one more child. If it’s not a boy, then we’ll be having another one. Lastly, no I am not a fitness model. I’d like to be!

Belly button plastic surgery is usually referred to as umbilicoplasty. It is a routine part of tummy tuck operations as it becomes necessary when moving the position of the umbilical opening. As you have discovered, the belly button can be changed by pregnancy, weight changes and trauma which adds scarring. Belly button hernia repair is focused upon fixing the muscular layers under the skin. It usually does little for the loose skin and/or scar above that repair.

You seem to have a condition of extra loose skin with scar tissue that gives your belly button a lumpy and less than tight look. The best treatment for the whole picture here is a tummy tuck, but for that I would wait until after you have completed your childbearing. A limited umbilicoplasty might be done before that to just tuck the skin a tiny bit, but the results would not be as remarkable as those you would see with a tummy tuck. I would need to see and examine you to be able to confirm what the image has shown and predict if this might be productive for you.

Best Regards,

John Di Saia MD

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Whatever Happened to LipoZap? Reviews.

LipoZap seems to have vanished. Reviews on Realself haven’t however. It seems LipoZap has a 0% satisfaction rating.

LipoZap Reviews

I made a pretty innocuous post on LipoZap a few years ago and the company threatened to sue me. It looks like I don’t have to make any comments here do I?

Best Regards,

John Di Saia MD

Originally posted 2009-10-19 07:30:58.

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Reader Laura: Sheyla Hershey Getting Breast Implants Back

Reader Laura’s Question:
“Sheyla Hershey is back in the news again. She’s the woman who was rumored to have had the world’s largest breast implants that had to have them removed because of an infection that nearly killed her. She is reported as having gone back to surgeons in Mexico and had her breast implants replaced. She is in the process of having them re-inflated to 38MMM. Looking at the current pictures of her her breasts look deformed. Do implants this large even exist as one unit? Do you think that she has multiple implants that are making her look lumpy? She also complained about saggy skin when she had her old implants removed. Is there any reason why the saggy skin wasn’t removed with the implants?”

An infection that set in after her 30th breast enlargement operation led to 5ft 3in Sheyla undergoing emergency operation in June 2010 that left with unattractive sagging skin where her implants had been. So obsessed was Sheyla with maintaining her Guinness World Record that the loss of her implants almost drove her to suicide. ‘Not having my breasts was killing me, I didn’t know if I could make it through 2012 without them,’ she said.
Source: dailymail.co.uk/femail/article-2065621/I-feel-Woman-obsessed-
having-worlds-largest-breast-implants-tells-joy-reinflated-death-
scare.html

It is funny. Just as I write about a woman who has been (in my way of thinking) unfairly maligned for having her Labiae reduced, Sheyla Hershey returns like a phoenix to have her breast implants replaced. Her desire to have implants in the “World’s largest” class despite her tragic history of infection and hospitalization is at the least unwise. She is very likely better served with psychiatry than surgery.

On the issue of the excess skin, the fact that it was left when her infected implants were removed is the only reason she has any chance of hosting implants of any size again. As she is having surgery in Mexico, the limitations of the FDA are not in effect. The liability an American surgeon would have getting anywhere near that operation probably severely curtailed her ability to have implant surgery once again in the US anyway.

Sheyla is likely having multiple tissue expanders and/or breast implants placed and slowly over inflated to get to her goal size. As you probably know there are limitations as to how large standard FDA approved breast implants can be. At around 1000 cc each, a single unit will certainly fall short of Sheyla’s desires assuming her skin will reliably house the monster sized implants she wants. And that no pun intended is a stretch. Custom made implants are also an option when you have surgery outside of the US.

Even if she can avoid infection returning, she will at the very least look lumpy if not deformed due to the tissue loss and scarring of her previous breast surgery and infection. We can’t see her breasts very well as she is clothed. This might work to her advantage if she is able to work clothed. She was a model in the past.

Apparently Sheyla lied to her husband about the surgery and after she returned to the US, he threatened her with divorce.

Best Regards,

John Di Saia MD

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Heidi Montag at Funny Or Die

A post plastic surgery marathon Heidi Montag put up a video on plastic surgery and credit card spending. It is kinda funny. She seems to be more of a poster child for having had too much plastic surgery. It’s a living….lol.

Best Regards,

John Di Saia MD

Originally posted 2010-04-06 07:30:12.

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Reader Laura on Sheyla Hershey – “Biggest Breast Implants No More – Now Suicidal”

Reader Laura Comment:

A while back we had discussed the woman (Sheyla Hershey) … She had KKK-cup implants and went out of the country to have them made even larger and contracted a severe infection and had to have all of her implants removed as well as some of her own breast tissue. Now she’s back in the news. After having the implants removed it seems that she fell into a deep depression and tried several times to commit suicide. Her most recent suicide attempt has left her in a coma. Do plastic surgeons ever send their patients to a psychologist after a consult? What would you say are the warning signs that someone is becoming obsessed with plastic surgery or that they have a body disorder?

A Brazilian model who had the biggest breasts in the world is in a coma after allegedly taking a drug overdose. Sheyla Hershey, 30, who lives in Houston, Texas, had to have her KKK-cup implants removed last year after contracting a deadly infection during the operation to make them bigger. Since then, the mother of one has vowed to get her breasts re-done saying she feels ‘so ugly’ without them.
Source: dailymail.co.uk/news/article-1357473/Sheyla-Hershey-Model-biggest-breasts-world-coma-drug-overdose.html

Patients seeking extreme outcomes frequently are emotionally labile. Many American plastic surgeons simply avoid them for fear of liability. I would suggest the woman traveled to Brazil for her “large implant surgery” due to an inability to find a domestic surgeon who would take the case. The term you might have been seeking is “Body Dysmorphic Disorder.” I believe it doesn’t take a psychologist to see that in this case. It is pretty obvious. What a given surgeon will do with such a patient varies with his own philosophy.

While I feel for Ms Hershey’s plight, I look at the story as a point of education for other women considering breast augmentation. Many of the women who have implant surgery do not seek these extremes and do well with their implants for decades. I believe it is a patient’s choice to do what he or she will with his or her body. But as a surgeon, I like lower liability surgery that lasts. When getting into a case in which problems seem too likely, I either avoid it or at least inform the patient of the risks involved.

Yes. Doing the right thing can cost me money.

Best Regards,

John Di Saia MD

Originally posted 2011-02-17 07:30:38.

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