Archive for April, 2012

Reader Question: Silicone Lips Treatment?

Reader Question:

My friend has ridiculous silicone (liquid injected years ago) lips. What can be done to help?

Facial filler injections are much safer today than they have been in the past. The main reason is that the filler agents themselves have improved. This of course assumes that your injector chooses wisely for you. The volume injected is the most common problem these days.

We still read of silicone injections and the mess they can produce. The main reason is that injected silicone tends to become encased in scar and these scar/silicone lumps frequently grow over time. This happens noticeably in old silicone injected in lips frequently. It is a hard problem to address although it can produce a story line for your reality show. Just ask Lisa Rinna. :)

All kidding aside, the problem is usually addressed by excision (cutting out the silicone) if conceivable. This is not always possible due to the lack of healthy tissue available to reconstruct the lips to make them look normal.

The moral of this story is: “Just say ‘No’ to silicone injections.”

Best Regards,

John Di Saia MD

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Gummy Bear Breast Implants – Exaggeration Iterated

The gummy bears have finally arrived, and I’m not talking about chewy candies. Gummy bear also happens to the the nom-de-boob of the next-generation silicone breast implant, so called because the gel inside is firmer than in current models.

Picture it like this. If you were to cut open implants now on the market, the clear gel inside would slowly form a puddle on the table. But not so with the gummy bears. “If you removed the shell covering, the silicone inside would retain its shape,” says Grant Stevens, a plastic surgeon in Marina del Rey, California, who participated in trials of two brands and claims he gave them the nickname. “I got tired of explaining to patients that they’re sort of like Jello—which, when you cut it in squares, holds its shape. One day I just said, ‘They’re like gummy bears.’” Soft, but not runny.

Source: allure.com/beauty-trends/blogs/daily-beauty-reporter/2012/04/new-the-gummy-bear-breast-impl.html

When I first started writing this site one of the main goals was to spread truth over and above hype. The problem with plastics is that hype gets airtime. Here we go again:

Gummy bear or cohesive gel silicone-filled breast implants have been with us since Mentor H/S got them approved years ago. This press release iterated as an Allure piece is a bit misleading in that regard. What should be written is that there is a new cohesive gel implant in town by the maker Sientra. We told you about these new implants here.

Cohesive gel implants are an improvement over the older generation silicone gel breast implants that your mother might have had placed fifteen years ago. They are not however without risk over and above that of saline-filled breast implants.

Why?

Silicone gel implants weep or leech silicone gel into a woman’s body. Gummy bears probably do this to a lesser extent than their predecessors, but saline filled implants don’t do it at all. For that reason in my practice it is saline-filled implants 3 to 1 over silicone gel implants. When we do use silicone gel we do use Cohesive gel implants however.

Best Regards,

John Di Saia MD

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Whitney Houston – Scars at Autopsy Reveal Cosmetic Surgery

The 48-year-old was also scarred by decades of cosmetic surgery, alcohol-fueled fights and falls.

She had marks on her stomach, chest and upper left thigh believed to be from cosmetic procedures. A scar on her left forearm may also have been self-inflicted.

Source: nypost.com/p/news/national/whitney_houston_body_ravaged_reveals_RDiLw8SpFnsJj4lYtAJqtN#ixzz1rUkoPfFn

So lets take inventory:

(1) Stomach scars: Probably a tummy tuck. Liposuction scars are usually small and probably would have escaped the eye of the pathologist.

(2) Chest scars: Probably a breast augmentation plus or minus breast lift surgery.

(3) One upper thigh: Probably a scar revision. Maybe not cosmetic. Cosmetic procedures usually occur on both sides.

(4) Left forearm scars: Probably from cutting. Kinda sad. Whitney had a hard life.

Best Regards,

John Di Saia MD

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Dr D Interview on MedicalSpaMd.com

Source: http://medicalspamd.com/the-blog/2012/3/24/dr-john-di-saia-plastic-surgeon-blogger-in-orange-county-cal.html

Thanks to MedicalSpaMd.com for the pleasure of the interview. Being that I am low on gimmicks, they seemed to take it pretty well. Check out my answer when they asked me about the lasers I use in the office. :)

Best Regards,

John Di Saia MD

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Clay Aiken – Plastic Surgery Talk

“I had surgery on my jaw for a TMJ (Temporomandibular joint) disorder thing and I had them suck the fat out of my chin while they were in there,” the 33-year-old Season 2 “American Idol” runner-up revealed.

Adding, “I was like, ‘You know what, while I’m already down, go ahead and take the vacuum in there and suck the fat out of my chin.”

Source: news.yahoo.com/clay-aiken-admits-having-plastic-surgery-
had-them-173328459.html

Plastic surgeons do not do TMJ surgery. Well give Clay a break. He has a new CD to push.

While I don’t really begrudge a celebrity for using his plastic surgery history to get press to push his latest product, I am not so sure I buy the TMJ thing. Then again he might have gone to a maxillofacial surgeon. Some of them have picked up facial aesthetic work over the years.

He might have also picked up the facial filler bug. His nasolabial folds (laugh lines) are more shallow than they were years ago. This is not the way it usually happens without some help. :)

Best Regards,

John Di Saia MD

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Lara Flynn Boyle – Plastic Surgery Talk

The actress, who rose to fame for her role in the 90′s mystery drama Twin Peaks, stepped out in Los Angeles Saturday with painful-looking, swollen lips. Clad in a white puffer jacket, jeans and a walking cast on her left leg, the star’s over sized mouth channeled the fillers-enhanced pouts seen on a few of her Hollywood colleagues.

Source: usmagazine.com/celebrity-news/news/pic-lara-flynn-boyle-
steps-out-with-puffy-swollen-face-201224


Is Lara Flynn Boyle a user of plastic surgery?

Well as usual that depends upon what you want to call plastic surgery.

Is Ms Boyle a user of facial fillers?

Well looking at images over the last few years: Yes.

Her lips change shape and volume a lot which is a telltale sign of filler use. And her latest image shows central upper lip swelling most likely from very recent filler injections. They probably shot her as she left her doctor’s office.

Is this Bad plastic surgery?

Not necessarily. Fillers when first injected can look puffy. It depends upon how much is injected. It is all technique and patient preference. Some patients want more than I might think advisable.

Swelling settles down over time. How you look a week or two after a filler injection episode is much more telling than how you look immediately afterward even if things are done well.

Best Regards,

John Di Saia MD

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Reader Laura on Brooke Shields, Daryl Hannah and Melanie Griffith

Reader Laura’s Comment:

This story shows and discusses the appearance of Brooke Shields, Daryl Hannah and Melanie Griffith. Looking at the pictures of Brooke Shields I was wondering if you think that she might have had some surgery done to her eyes. I know your face will change as you age but her eyelids seem to be higher and her eyes more open from when she was younger. What do you think she has had done. Also, what is your opinion of the quality of work done on these ladies faces?
Source: dailymail.co.uk/femail/article-2091965/Six-marriages-dangerous-lovers-stints-
therapy–barely-wrinkle-them.html

Despite the fact that it is easy to throw stones at Hollywood celebrities who perhaps indulge themselves with everything and anything, the way a patient’s face ages after plastic surgery is not caused by that surgery alone.

Of the three women Brooke Shields appears to have had the least surgery and she looks pretty good. Daryl Hannah still appears to be overindulging in facial fillers and Melanie Griffith appears more natural than previously probably because of her decision to have fewer fillers.

The key to having a positive experience with cosmetic work is getting quality work as you have mentioned but also obtaining quality advice and following it. Some patients are hell bent on too much surgery and as we so commonly see, often they look less attractive than those who “take it easy.” Then again surgeons get paid to operate. When I say “No” to surgery it costs me revenue even when it is the right thing to do for the patient. Integrity costs a surgeon money so relatively few surgeons have it. :)

Best Regards,

John Di Saia MD

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Deena Nicole Cortese Forgot About Her Nose Job Too

“Jersey Shore” star Deena Nicole Cortese has denied recently undergoing any new plastic surgery, following new speculation that she has drastically altered her appearance.

“I have not got any plastic surgery … yes in the past I have had a nose job.” Cortese recently wrote via her Twitter page.
Source: global.christianpost.com/news/jersey-shore-star-deena-
cortese-denies-plastic-surgery-admits-nose-job-72380/

Don’t feel too badly Deena. Diane Keaton forgot about her nose job too.

And then a few days later….

there was nothing really wrong with her teeth which have since been replaced with Hilary Duff’s first pair of veneers from out of the trash.
Source: amygrindhouse.com/deena-cortese-teeth.html

Deena released this image on her twitter account while denying having had work so I had to take a look. Her veneers are a bit bright for my tastes. Any brighter and she won’t need headlights on any car she’s driving.

Looking at her image I see changes in her upper eyelids and brow position as well as her upper lip and maybe her facial folds. I’d say she’s had upper eyelid surgery, probably a forehead lift and facial fillers. Stay tuned to her twitter @DeenaNicoleMTV for more changes; well at least whether or not she’s starts coming clean on them.

Typically the reality show gals tend to be more forthcoming on their plastic surgery usually as a source of quick PR. Mainstream talent denies it all more often than not.

Best Regards,

John Di Saia MD

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