Posts Tagged orange county
Reader Question: Redo Tummy Tuck Pictures?
Posted by admin in Dr D's Truth on April 22, 2013
I am looking into a Redo Tummy Tuck here in the OC. Why do you not have redo Tummy Tuck images on your site?
Revision plastic surgery is an uncommon part of a practice’s cases (in the right practice of course,) but a more difficult part of plastic surgery. And tummy tuck surgery is one of the larger scale operations your plastic surgeon can perform.
Because of these issues the results in redo tummy tuck surgery will vary quite a bit. Most surgeons are a bit hesitant to place these kinds of results on their web sites for fear of scaring away the “first time” tummy tuck patients. Even a good revision case result image tends to pale in comparison to an average first time operation in which a complication did not develop.
Suffice it to say that a good deal in the land of plastic surgery relates to impressions.
Best Regards,
John Di Saia MD
Originally posted 2011-06-22 07:30:21.
Top Ten Tummy Tuck Facts
Posted by admin in Dr D's Truth on March 5, 2013
Tummy Tuck surgery is almost invariably greatly appreciated by the proper patient. These top ten facts might help you figure if you are such a person. 
(1) Tummy Tuck surgery is one of the largest scale operations a plastic surgeon can offer a patient.
(2) Patients who have lost a good deal of weight or completed child bearing involving large weight gain and loss are the most common candidates. Patients do not lose much weight from the operation itself in most cases….maybe a few pounds on average.
(3) Post-operative pain used to make it necessary to admit the patient to a hospital for narcotics.
(4) Pain pumps when properly utilized can decrease pain significantly. Overnight stays often reduce risk when properly supervised.
(5) Revisions are not uncommon but can often be done in a lower key environment….such as local in the office. The revision rate varies enormously between surgeons.
(6) All tummy tucks are not alike. The work of the novice really shows in this operation.
(7) Many physicians in the OC offer these operations including plastic surgeons, cosmetic surgeons, gynecologists and general surgeons. You guess which ones look the best?
(8) When you go to the bargain basement doctor, some of what may happen may not be correctable later.
(9) Drains and pump catheters will need to be used for a week or longer. They reduce risk of fluid collections that can ruin otherwise nice results (My opinion of course.) 
(10) Smoking can really impair healing and lead to skin necrosis which commonly detracts from the quality of the result and delays wound healing sometimes for months. Don’t have the surgery if you can’t stop the cigarettes and tell your surgeon a true indication of how many cigarettes you are smoking daily.
Best Regards,
John Di Saia, M.D.
Originally posted 2011-04-20 07:30:15.
Mohs Surgery and Plastic Surgery – How Does This Work in Orange County?
Posted by admin in Dr D's Truth on March 4, 2013
Mohs surgery is surgery for the removal of skin cancer which is common in Orange County due to our “sun sitting tendencies.” It is mostly offered by dermatologists and is specifically designed to remove the cancer with a low recurrence rate. Derms generally perform it under straight local (numbing shots in the office) and it is quite profitable for them. In this case the procedure to make the hole (that is what Mohs does) pays much better than the surgery to repair that hole. Some Derms in Orange County try to use Moh’s for nearly everything as it is profitable. This is not always in the best interests of the patient.
At times a dermatologist will refer the patient to a plastic surgeon for the closure after the Mohs is complete. This can be upsetting to the patient because unless it is arranged ahead of time, the plastic surgeon may not be able to get the patient scheduled for a few days.
You may have seen people walking around with large bandages on their ears or noses. They may not have had accidents as you might have thought.
An alternative is to have the skin cancer surgery performed entirely by a plastic surgeon which can decrease the patient’s total expense and allow for anesthesia and completion of surgery in one day. The plastic surgeon may order a frozen preparation of the removed tissue in the operating room (called frozen section) and the results have a similar cure rate and often look a whole lot better. Many plastic surgeons will take cases like these as long as the cancer isn’t too small because we are paid less to remove the cancer with conventional surgery than the Derms get with Mohs.
Best Regards,
John Di Saia MD
Originally posted 2011-03-04 07:30:28.
Fixing Implanted Breasts in the OC
Posted by admin in Dr D's Patients on February 27, 2013
Redo Breast Implant Patient by Dr D - Orange County California
Breast implant surgery does not always go as planned. The reasons vary from patients seeking poor surgical talent at their local $3000 chop shop, smoking too many cigarettes or just plain having bad luck.
Much of this can be fixed or at least improved with additional surgery.
This young lady found me after having had four operations with her prior surgeon at which point he uttered those unforgettable words: “This is as good as it is going to get.”
She had poor scarring partially due to her genetics, but the poor shape and firmness was correctable. She found her way to my practice after a friend with whom I had worked in the past referred her to me. We performed a modified breast lift and implant exchange with capsule removal in a local Orange County surgical center and she achieved a nice improvement.
Fixing Bad Plastic Surgery:
** Get into the best hands you can afford and check into your surgeon’s qualifications before you let him operate upon you. Understand that redos are harder and less predictable than first time surgery.
Best Regards,
John Di Saia MD
Related:
Cosmetic Breast Surgery at Dr D’s Practice Site
Originally posted 2010-10-12 07:30:51.
Good Tummy Tuck Results with Breast Lift/Implants
Posted by admin in "Good Plastic Surgery in the OC", Dr D's Patients on February 25, 2013
Good Tummy Tuck Results Orange County California
Years ago I did some work for a great looking 40 year old mom who worked out incessantly and had a great athletic body. Despite the working out though, her tummy had some changes from her pregnancy years before and her breasts were a bit small and droopy for her tastes. After a few years and two operations (Breast lift/implants and a tummy tuck,) she sent me this bikini image with a thank-you note.
Plastic surgery can work out well when done properly in the right patient. These are good tummy tuck results, but in reality all plastic surgery results vary. Only few patients get this kind of “knock it out of the park” result. They tend to be the people who are already in great shape. There is no overemphasizing doing your part.
Diet and exercise make you a better candidate for surgery anyway.
Best Regards,
John Di Saia MD
Originally posted 2011-06-24 07:30:43.
Low Maintenance Breast Implants – Are They Doable?
Posted by admin in Dr D's Truth on February 7, 2013
Low Maintenance Breast Implant
Surgery – Is this achievable?
Reader Question:
I am looking into getting breast implants but want to keep redo surgeries to a minimum. Some of my friends have had 2-3 boob jobs in ten years, so I am not going to their doctor. I saw a few of your patients online saying that the implants you put in they kept for ten years. I want to get a worry-free boob job?
Thanks for the compliment.
There are several things you can do to reduce your risk for the need/desire for re-operation after breast implant surgery:
(1) Have surgery by a good qualified surgeon. In my book, that means a good ABPS board-certified plastic surgeon.
(2) Request guidance from your surgeon regarding the volume to which you can go safely. The leading cause of poor outcomes with implants that I see is the placement of implants too large for a woman’s available soft tissue coverage. Good surgeons know this although many fear “losing the case” if they share their concerns.
(3) Choose saline-filled implants and have them placed beneath your pectoral muscles. Silicone gel is another option but I feel the breast hardening rate (capsular contracture} is higher with them. Capsular contracture is also higher in some other cases that you may want to review before surgery.
(4) If you have any degree of breast sag, talk about breast lift surgery as an option before you have your operation.
Best Regards,
John Di Saia MD
Originally posted 2011-04-22 07:30:34.
Reader – “Help Dr D, My Plastic Surgeon is an ahole!”
Posted by admin in Dr D's Truth on February 1, 2013
Reader Question:
I know you can’t fix this but can you help me cope? My plastic surgeon is an ahole. He has no time for me now that he has operated. He just ignores my concerns. I look OK but I want to do what I can to get the best result possible. He doesn’t care about me.
I am in Orange County. I so wish I knew you before I let this toad touch me! He is a short arrogant little twit though in Laguna Hills. I don’t regret my plastic surgery just my choice of a plastic surgeon.
I frequently remind people to choose carefully when they are in the market for a plastic surgeon. Once surgery has been performed it is hard to switch. Many docs will not accept patients who present liability challenges from the onset. This includes fresh post-ops and people who look like they might sue someone.
The first thing is to try to deal with the surgeon you have. Try to get through to him. How was he when you first met? Docs who never have time for their patients before surgery frequently don’t afterward.
Maybe you can develop a relationship with a contact person in the office and get what you need from that person? Otherwise you can try to call around and find another local surgeon who can help you. Try to choose better this time.
Best Regards,
John Di Saia MD
P.S. I think I know who you might be writing about, but I can’t put his name here for obvious reasons.
Originally posted 2011-03-17 07:30:34.
“Can You Fix My Cheap Boobjob Refund Gap?”
Posted by admin in Dr D's Truth on January 23, 2013
I feel so f….king stupid! I got a cheap $3000 boobjob from a billboard and am stuck with these ugly boobies. Can you fix my refund gap?
You look like you have “over the muscle” implants and the pockets are sort of “to the side.” The implants might also be a tad big for your frame. Your refund gap refers to your wide cleavage for those not familiar with the term.
These kinds of problems can be addressed by another operation. Take a look at the lady I repaired here. She also had over the muscle implants that were too large and were settling down her chest. Your cleavage can be made a bit better, but your breast shape can be improved quite a bit.
I not infrequently tell patients how their cheap boobjobs can get expensive. Get yours fixed before it gets worse and requires more work.
Best Regards,
John Di Saia MD
Originally posted 2011-07-11 07:30:47.
Reader Question – Labiaplasty Under Age 18?
Posted by admin in Dr D's Truth on December 27, 2012
Reader Question:
I am 16 in Orange County and want a labia reduction. Can I have it without telling my parents?
For those of you who may not know, labiaplasty (sometimes called labioplasty) is an operation to change the shape of the labiae, a woman’s outer genitals. It can be performed for cosmetic or functional concerns. Some women with large labiae experience pain with tighter garments and in rare circumstances they can get in the way of sexual relations. The operations are different things to different surgeons and have been controversial to say the least.
Quite a bit in the practice of surgery of the privates is a matter of the surgeon’s philosophy. This includes the design and scope of the operation as we’ve mentioned. Traditionally for any surgery on a patient under the age of legal consent, a legal guardian (usually a parent) must consent.
Labiaplasty surgery modifies a patient’s private anatomy permanently. Although I take the chance of being criticized here, I would say a parent’s consent for an underage patient strikes me the wrong way. Unless the circumstances are very unusual, I would rather wait for the patient to reach the age of legal consent before making such a decision about permanent modifications to her privates. A mother’s consent to reduce her daughter’s genitalia just doesn’t seem right.
As an aside, this situation has not materialized in my labiaplasty practice and I have been doing them for over 10 years.
Best Regards,
John Di Saia MD
Originally posted 2011-04-14 07:30:03.
Pressure Wound Surgery in Orange County
Posted by admin in Dr D's Truth on December 13, 2012
When I tell people I have a hybrid plastic surgery practice, I am not talking about a fuel efficient car. I am talking about the fact that I do both cosmetic surgery and medically-necessary surgery. Part of the medically-necessary surgery includes the repair of pressure wounds (also called decubitus ulcers.)
Not only is this type of surgery not cosmetic, it can be pretty ugly. It is surgery to assist often long standing wounds in healing in often significantly ill patients. If possible such a wound is repaired using tissue from adjoining areas of the body called fasciocutaneous and musculocutaneous flaps after scar and debris is cut away. This isn’t pretty, but the patient was pretty happy to not have an open wound afterward.
I do these at an LTAC in Santa Ana at which good wound care nursing services are available before and after surgery. Not all patients are candidates for surgical correction. Often these patients have had these wounds for months or years at the time they are referred for possible surgery.
Below are images showing an example case I did years ago (after “Page 2″ so those who don’t like pictures of wounds can pass.)
Originally posted 2011-07-13 07:30:57.
Dr D – Your Orange County Surgeon
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