Posts Tagged ugly plastic surgery
Practicing plastic surgeons have work that varies substantially from that which is portrayed on television. After a week of back and forth ugly and pretty plastic surgery, I indeed feel like Dr Jeckel and My Hyde.
No. Let your heart not be troubled. I have not transformed into a hideous beast from the mild mannered doctor. Most who know me would say I did not start off as the mild mannered doctor anyway, but I digress…..
Working in my practice is a frequent trip between extremes. In one corner we have people looking to look prettier in a number of different ways. This week that included a woman who despite working out frequently wanted a slimmer tighter tummy. She had a tummy tuck to start the week and is doing quite well as the week ends.
In the other corner of my practice is the repair of wounds that are either open, infected or just plain won’t heal. This is anything but pretty work: my “Mr Hyde” activity. I do not change physically of course, but the nature of the work certainly does. In these cases a successful healed wound is frequently not pretty, but is the goal. The focus is different.
This goes to support my long held belief that it is better to be looking for a plastic surgeon because you want one, rather than to need one.
John Di Saia MD
Originally posted 2012-08-16 07:30:08.
“Not all plastic surgery is cosmetic surgery, but cosmetic surgery pays the bills.” This is a plastic surgery truism. There are plastic surgeons (like me!) who split their work between the things you need (that don’t pay your surgeon so well) and the things you want (that do.) In this sense cosmetic surgery is the subsidy upon which the needed (but less well reimbursed) work is supported.
Here is an ugly plastic surgery case of an ankle wound that needed some skin to close. The patient had had an operation by an orthopedist that got complicated. The skin graft surgery will leave a scar, but the wound that would have healed slowly if at all without it healed quickly afterward. This is an aspect of good plastic surgery rarely featured on your local news program.
Something to think about when you are considering cosmetic plastic surgery:
If you support a reconstructive plastic surgeon, he may be able to stay in business to be able to help you when you might need him. That cosmetic guy won’t be.
John Di Saia MD
Originally posted 2012-10-10 07:30:20.
We have discussed before that my practice includes cosmetic as well as reconstructive plastic surgery. This fairly sick man was a resident at a wound care hospital at which I treat patients. He had a deep (stage IV) wound of his sacrum (lower back) that was too severe to heal without surgery. He had had a stroke and was for the most part bedridden. A consequence of this was that he was unable to sit in a chair for fear of bleeding and continued wound breakdown.
I performed a wound repair that allowed him to sit up in a chair and live in a little less pain. This isn’t pretty plastic surgery, but it did improve his lot in life for the rest of his life. He died of other causes about a year after the surgery.
John Di Saia MD
Originally posted 2012-07-27 07:30:06.
From my Instagram here is a series of images of a thigh with wounds from probable drug abuse and infection over years. Two wounds on the pictured leg were cleaned surgically (debridement) and grafted with shavings of the patient’s skin. In one image the grafts appear covered with foam dressings (stents) awaiting adherence before stent removal. The third image is of the newly adherent and healing grafts. Without graft surgery these wounds would have taken months if cared for properly under ideal conditions to heal. This is not pretty cosmetic plastic surgery, but is rather a needed and underpaid aspect of plastics that fewer and fewer plastic surgeons practice.
John Di Saia MD
Originally posted 2012-08-17 07:30:12.
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.