Guess the Cup Size?

Here is a fun little quiz. Can you guess the cup size?

I'll post the answer later this weekend.

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Guess the Cup Size?

Here is a fun little quiz. Can you guess the cup size?

I'll post the answer later this weekend.

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Reconstructing Michael Jackson

A long time ago I promised to explain how I would 'fix' Michael Jackson's nose. Well, if it has been operated on as many times as I think it has, his nose is now a scarred-up mess.
The best way to recontruct a nose like his would be to treat it like a cancer reconstruction. We can remake the soft tissue (skin and fat) of a nose by transferring the skin from the forehead down to the nose. This entails two surgeries. During the first surgery we lift up the skin of the forehead (into a shape to fit the nose) and swing it down to what's left of the nose. We temporarily keep the skin attached to the forehead, where the blood vessels continue to supply blood to the transferred skin. This connection is left for about 3 weeks, to allow new blood supply to develop from the nose to the new transferred forehead skin.
Yes, for three weeks the person walks around with the skin of the forehead attached via a 'bridge' to their nose. It's a pretty strange sight.
After these three weeks, the patient goes back to surgery, where the connection is divided at the forehead and the skin is 'inset' into the nose, giving him a new, softer, larger nose. Now, Michael may also need some nasal support if a good portion of his cartilage and/or bone has been removed. This would likely entail grafts of bone or cartilage from his ribs, a somewhat painful procedure I rarely perform.
The "Paramedian Forehead Flap" is probably the best way to take today's Michael back to the 80's Michael. During the time of his healing, he would be no PYT.



Photo credit: prphotos.com
For more information on the Paramedian Forehead Flap, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.

Reconstructing Michael Jackson

A long time ago I promised to explain how I would 'fix' Michael Jackson's nose. Well, if it has been operated on as many times as I think it has, his nose is now a scarred-up mess.
The best way to recontruct a nose like his would be to treat it like a cancer reconstruction. We can remake the soft tissue (skin and fat) of a nose by transferring the skin from the forehead down to the nose. This entails two surgeries. During the first surgery we lift up the skin of the forehead (into a shape to fit the nose) and swing it down to what's left of the nose. We temporarily keep the skin attached to the forehead, where the blood vessels continue to supply blood to the transferred skin. This connection is left for about 3 weeks, to allow new blood supply to develop from the nose to the new transferred forehead skin.
Yes, for three weeks the person walks around with the skin of the forehead attached via a 'bridge' to their nose. It's a pretty strange sight.
After these three weeks, the patient goes back to surgery, where the connection is divided at the forehead and the skin is 'inset' into the nose, giving him a new, softer, larger nose. Now, Michael may also need some nasal support if a good portion of his cartilage and/or bone has been removed. This would likely entail grafts of bone or cartilage from his ribs, a somewhat painful procedure I rarely perform.
The "Paramedian Forehead Flap" is probably the best way to take today's Michael back to the 80's Michael. During the time of his healing, he would be no PYT.



Photo credit: prphotos.com
For more information on the Paramedian Forehead Flap, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.

Trial lawyers' ability to second guess the FDA on medical devices "neutered"

The US Supreme Court (SCOTUS) has dramatically shifted the balance of power in product liability lawsuits for makers of medical devices. By an 8-1 margin last week, the Justices decided that the tort system should not be a system that second guesses the scientific evaluations of the FDA on medical device designs. In the "Riegel Case", the Supreme Court concluded that the premarket approval process (PMA) would bar patients from later filing lawsuits.

This week they're hearing similar arguments over pharmaceuticals in Warner-Lambert v. Kent , a case from Michigan, click here to read about. The case was brought by plaintiffs who claim they were injured as a result of taking the diabetes pill, Rezulin, which has since been withdrawn from the US market. The plaintiffs claim the company withheld evidence from the F.D.A. of potential dangers to the liver that might have led the agency to deny an approval. They fighting against existing precedent from a 2001 case where the Supreme Court held that plaintiffs cannot sue based upon claims that a manufacturer defrauded the F.D.A.

While no one would reward fraud by industry, this claim has exploded by trial lawyers in all these cases and frequently comes down to statistical hair-splitting of published data rather then some "smoking gun" company memo. Even liberal jurist Steven Breyer has expressed frustration and skepticism of using state or federal courts to "retry" the FDA approval process before people unqualified to understand or interpret most of the studies and data that will be argued over. He posed the rhetorical question of who should be the arbiter of product safety during oral arguments yesterday,

An expert agency (the FDA) on the one hand or 12 people pulled randomly for a jury role who see before them only the people whom the drug hurt and don’t see those who need the drug to cure them?

This whole debate relates a little to the whole breast implant controversy from two decades ago where trial lawyers pulled off a multi-billion dollar shakedown of Dow Corning and others based on innuendo. We now have compelling safety studies from all over the world and universal treatment of these products by every western government health agency. It would appear these recent SCOTUS decisions would put the final stake in product liability cases relating to approved breast implant designs or materials. It's a little moot anyway, as trial lawyers largely haven't taken implant cases for years anyway as they're aware of the consensus body of of literature and know there's no money in it.

Rob

Britney Spears Aged?

This past Friday I was featured on TMZ TV, regarding the recent Britney Spears age progression photos circulating the web. The photo to the left is what a website (ageprogression.org) believes she will look like at age 36.
I don't think this is accurate at all. If anything, she will look like her mother, Lynne Spears, who looks nothing like this horrible photo. If you really want to see something pathetic, check out what they predict she'll look like at 46.

Story credit: The Superficial

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Britney Spears Aged?

This past Friday I was featured on TMZ TV, regarding the recent Britney Spears age progression photos circulating the web. The photo to the left is what a website (ageprogression.org) believes she will look like at age 36.
I don't think this is accurate at all. If anything, she will look like her mother, Lynne Spears, who looks nothing like this horrible photo. If you really want to see something pathetic, check out what they predict she'll look like at 46.

Story credit: The Superficial

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

The "Donda West Law"

California assemblywoman Wilmer Amina Carter (D-Rialto) has announced legislation to require preoperative clearance for all patients undergoing cosmetic surgery. This proposal, dubbed the "Donda West Law," is meant to save patients from future harm done by cosmetic surgery, and has been given the blessing by Donda West's son, rapper Kanye West (according to the Daily Bulletin).
This is a very interesting bill, considering less than a year ago the California legislature passed a law permitting oral surgeons (DDS dentists) to perform all forms of facial plastic surgery. Instead of forcing surgeons to make their patients undergo preoperative testing (some young, healthy patients may not need it), maybe they should instead make sure that anyone performing plastic surgery is a real, board-certified plastic surgeon? Unfortunately, the lobbyists won't allow that. Oh, how frustrating...

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

The "Donda West Law"

California assemblywoman Wilmer Amina Carter (D-Rialto) has announced legislation to require preoperative clearance for all patients undergoing cosmetic surgery. This proposal, dubbed the "Donda West Law," is meant to save patients from future harm done by cosmetic surgery, and has been given the blessing by Donda West's son, rapper Kanye West (according to the Daily Bulletin).
This is a very interesting bill, considering less than a year ago the California legislature passed a law permitting oral surgeons (DDS dentists) to perform all forms of facial plastic surgery. Instead of forcing surgeons to make their patients undergo preoperative testing (some young, healthy patients may not need it), maybe they should instead make sure that anyone performing plastic surgery is a real, board-certified plastic surgeon? Unfortunately, the lobbyists won't allow that. Oh, how frustrating...

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

The ghost of "Bond Girls" past - What you can learn from Britt Eklund's aging face

You know you're having a bad week when you end up as a featured celebrity on Awful Plastic Surgery. Britt Eklund, former James Bond uber-chick, agent Mary Goodnight from 1974's "The Man With the Golden Gun" (the definitive Roger Moore-era Bond picture for my money), was the guest of honor last week with Awful Plastic Surgery zeroing in on her "trout pout" from over augmented lips. Poor Britt is still stinging from being voted in Entertainment Weekly (here) as the "6th Worst Bond Girl" in 2006 (Denise Richards character, Dr. Christmas Jones, the hot pants wearing nuclear physicist takes top honors for "The World Is Not Enough" BTW)

In 2007 that is usually achieved with an off the shelf filler like Juvederm or Restylane, while in years past it would have been collagen, fat grafts, or the occasional Gore-Tex implant.

Yeah, I guess her lips are pretty noticeably enlarged, but it was probably the least of her features that I zoned in on. She's got a very instructive feature on facial aging. Take note of her upper eyelids from her 20's versus her late 50's.

In her youth, she has full eyelids with very little upper lid skin showing. Presently, she has fairly hollowed out lids and lots of eyelid skin visible. These changes can happen naturally, but they're also the byproduct of classic upper lid blepharoplasty surgery. Many patients come in with the idea that a youthful eye should show lots of lid skin, such that they can apply lots of eyeshadow in that area.

Survey fashion magazines and take note of the models eyes. You'll see the same phenomena in that a youthful lid is full, quite often low, and shows little skin. We've undergone dramatic reinterpretation of oculoplastic procedures in recent years to recognize the actual problems. Gone is the axiom of taking as much skin, muscle, and fat so as to make the lid completely flat, even when the patient requests it. Many eyelid super specialists like Dr. Steve Fagien from Boca Raton,FL (the most elegant and logical speaker on this for my money) have gone to minimalist approaches resecting tiny amounts of skin, while using fat redraping,fat grafts, or fillers to augment the area.

Rob

Hype or Reality?

Here are a few links for information on two popular cosmetic procedures:
1. The Lifestyle Lift - Check out my post from a few days ago. It posted a bit late, so if you missed it, click here.
2. Mesotherapy and fat injections - As a member of their editorial advisory board, I've written an article in Plastic Surgery Products Magazine on these controversial procedures. Click here for the online article.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Hype or Reality?

Here are a few links for information on two popular cosmetic procedures:
1. The Lifestyle Lift - Check out my post from a few days ago. It posted a bit late, so if you missed it, click here.
2. Mesotherapy and fat injections - As a member of their editorial advisory board, I've written an article in Plastic Surgery Products Magazine on these controversial procedures. Click here for the online article.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Christie Brinkley Afraid of Plastic Surgery?

According to a recent interview, model Christie Brinkley was scared away from plastic surgery after seeing a facelift performed on a reality television show:

Brinkley, 54, reveals, "I don’t rule it out, I’m just a chicken. I stumbled upon a (TV) channel once, where I actually saw the guy (surgeon) with his hand inside the person’s cheek. I just don’t think I would be brave enough for that."

While plastic surgery is definitely not for everybody, it's very easy for one of the world's most beautiful women to say something like this since she doesn't need it anyway!

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Christie Brinkley Afraid of Plastic Surgery?

According to a recent interview, model Christie Brinkley was scared away from plastic surgery after seeing a facelift performed on a reality television show:

Brinkley, 54, reveals, "I don’t rule it out, I’m just a chicken. I stumbled upon a (TV) channel once, where I actually saw the guy (surgeon) with his hand inside the person’s cheek. I just don’t think I would be brave enough for that."

While plastic surgery is definitely not for everybody, it's very easy for one of the world's most beautiful women to say something like this since she doesn't need it anyway!

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Bedsores and surgery - an exercise in futility?

A little blurb in today's New York Times "Fighting Bedsores With a Team Approach" got me thinking about pressure sores

In the Plastic Surgery and wound care literature there are literally thousands of papers published re. to the surgical treatment of pressure sores ulcers. Many very elegant operations where soft tissue and muscle flaps are rotated to cover these wounds have been described.

These ulcers add an estimated burden nearly $10 Billion USD of expenditures and an additional 2.2 million Medicare hospital days to the United States healthcare system. The cost of treatment of large ulcers can approach nearly $50,000, depending on the stage of development. For reconstructive surgery candidates, costs might be an additional $25,000+ per patient in surgical charges. The actual costs of preventing and treating pressure ulcers in hospitals are not easy to figure as costs are distributed across many providers and settings for nursing and clinical care, but the likely overall costs are stunning, with perhaps 5% or more of our total healthcare costs attributable in some way to patient care involved with these wounds.



What's the dirty secret about these wounds?

Almost all approaches besides letting these wounds heal by scarring (secondary intention) have abysmal track records. Data from medicare patients and from the VAMC have suggested that in excess of 90% of these reoccur within a year. When you consider the tremendous expense of these surgeries and post-operative convalescence, you have to wonder why we've treated these the way we have. Increasingly, you're seeing more plastic surgeons no longer attempt such aggressive closures which is evidence-based medicine at work.

If you are going to try to close these wounds, you've got to pick your spots. The only people I consider good candidates for closure are high functioning young paraplegics and older patients who have a reversible condition that led to the ulcer (ie. a hip fracture). A patient who can't relieve pressure themselves is an absolute contraindication in most instances to me.


As developing pressure sores are one of the indicators of quality that hospitals are being penalized for by the feds, we're seeing alot more of these documented. Many of these patients are nursing home medicare beneficiaries who bring with them multiple medical comorbidities, thin skin, immobility, incontinence, and nutritional problems. It is literally impossible to prevent breakdowns over bony areas and that shouldn't be the goal. We should try to prevent them from progressing to advanced stages for pragmatic care of these patients.

Lawsuits over pressure sores are a growth industry for the trial lawyers. Frequently when you talk to patients' families, they have poor understanding of the how's and why's of why these wounds develop which contributes to their anger sometimes and leads to them suing the nursing home or hospital. I try to explain it in simple terms with the concept that it is unrealistic in vulnerable patients to prevent pressure sores indefinitely as it is impossible to deliver perfect nursing care 24/7/365. Breakdowns are inevitable and should be expected, and the goal should be to minimize the damage.

Rob

Is the State of Plastic Surgery Changing?

I had a conversation with another local plastic surgeon yesterday and he lamented about the state of plastic surgery today. He's been around a bit longer than I have and said he's seeing things changing in our area. "People are advertising rock-bottom prices and red-tag sales," he stated. We're seeing a large number of non-plastic surgeons performing plastic surgery in the metro Detroit area, and the numbers of these practitioners appears to be increasing by the month. The worsening economic climate has probably pushed more and more non-plastic surgeons into our field.
I picked up a local glossy magazine and saw a special advertising section, featuring lasers and cosmetic plastic surgery. Many people see the large, glossy ads and automatically assume that means the physician is a reputable, board-certified plastic surgeon. So who are these doctors?

One is an osteopathic physician whom I think may be ENT-trained and fellowship trained in cosmetic surgery.
One is an internal medicine physician who is advertising liposuction.
One is an emergency room physician who is advertising all types of cosmetic plastic surgery.
One is an osteopathic board-certified plastic surgeon.
Two are plastic surgeons certified by the American Board of Plastic Surgery.

All of the ads are very convincing and well-written. No wonder patients get confused on who to actually go to!

Photo credit: plasticsurgeryhumour.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Is the State of Plastic Surgery Changing?

I had a conversation with another local plastic surgeon yesterday and he lamented about the state of plastic surgery today. He's been around a bit longer than I have and said he's seeing things changing in our area. "People are advertising rock-bottom prices and red-tag sales," he stated. We're seeing a large number of non-plastic surgeons performing plastic surgery in the metro Detroit area, and the numbers of these practitioners appears to be increasing by the month. The worsening economic climate has probably pushed more and more non-plastic surgeons into our field.
I picked up a local glossy magazine and saw a special advertising section, featuring lasers and cosmetic plastic surgery. Many people see the large, glossy ads and automatically assume that means the physician is a reputable, board-certified plastic surgeon. So who are these doctors?

One is an osteopathic physician whom I think may be ENT-trained and fellowship trained in cosmetic surgery.
One is an internal medicine physician who is advertising liposuction.
One is an emergency room physician who is advertising all types of cosmetic plastic surgery.
One is an osteopathic board-certified plastic surgeon.
Two are plastic surgeons certified by the American Board of Plastic Surgery.

All of the ads are very convincing and well-written. No wonder patients get confused on who to actually go to!

Photo credit: plasticsurgeryhumour.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

2008 Plastic Surgery Board Certification data

The American Board of Plastic Surgery has released it's 2008 data on it's most recent board-certification testing applicants. Board certification takes passing both a written exam followed by an oral examination in the next 1-2 years.

The failure rate for each exam traditionally hovers around 20% (19.6% for the written and 21.4% for the orals in 2007), which is highest among all the surgical specialties certification processes, and continues to reaffirm the general opinion that the ABPS exam is the most difficult to pass. Another thing to keep in mind is that due to the intense competition for training spots, even those 20% who failed either exam were likely among the top-performing students in their medical school classes (for those who were in "integrated" programs where you start out of medical school) or in their prerequisite surgical residencies.

You can check your doctor's board-certification status for free at the American Board of Medical Specialties (ABMS)site (click here). The ABMS is the American gold-standard for physician accredidation and is what people are referring to when they talk about "board certification". Please note that organizations like the American Academy of Cosmetic Surgery, The American Board of Cosmetic Surgery, and the American board of Cosmetic Gynecology(?)are not (and likely will never) be recognized by the ABMS.

The celebrity blog, Knifestyles of the Rich and Famous (LOVE that name!) had a post in December, "Doing Due Dilligence", (click here to read), which gives a little overview for the laypeople on this topic that's worth reading.

Rob

Coco - Buttock Implants?

I've received a few emails asking me to comment on Nicole Austin, a.k.a. Coco, wife of actor Ice T. Does she have buttock and breast implants?
Coco is 28 years old, 5 feet, 2 inches tall and weighs 135 lbs. It appears that much of that weight is concentrated in her breasts and buttocks. According to IMDb, she has 39DD breasts.
In my opinion, it is very likely that she has both buttock and breast implants, since they are so disproportionately large compared to her small frame. The shape of her buttocks (jutting out unnaturally) makes one think that they are the result of solid silicone implants. That being said, I have seen many women in my office who have naturally, disproportionately large buttocks, so you never really know for sure.
One thing is almost certain: Many of her photos are airbrushed to remove cellulite that most women have. The only way to really improve that is via anti-cellulite treatments, such as Dermosonic.

For my post on whether Kim Kardashian has buttock implants, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share

Coco - Buttock Implants?

I've received a few emails asking me to comment on Nicole Austin, a.k.a. Coco, wife of actor Ice T. Does she have buttock and breast implants?
Coco is 28 years old, 5 feet, 2 inches tall and weighs 135 lbs. It appears that much of that weight is concentrated in her breasts and buttocks. According to IMDb, she has 39DD breasts.
In my opinion, it is very likely that she has both buttock and breast implants, since they are so disproportionately large compared to her small frame. The shape of her buttocks (jutting out unnaturally) makes one think that they are the result of solid silicone implants. That being said, I have seen many women in my office who have naturally, disproportionately large buttocks, so you never really know for sure.
One thing is almost certain: Many of her photos are airbrushed to remove cellulite that most women have. The only way to really improve that is via anti-cellulite treatments, such as Dermosonic.

For my post on whether Kim Kardashian has buttock implants, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share

What plastic surgery can change your look the most?

Imad Mughniyeh was a terror suspect recently killed in Syria. This is big international news, since he was wanted for the killings of hundreds of Americans. What does he have to do with plastic surgery? Well, according to reports, he supposedly had plastic surgery to change his appearance. This got me to thinking: Which plastic surgery would change a person's appearance the most?

I think the one thing that would change a man's appearance the most if the growing or removal of facial hair. After this, I would have to say maybe a rhinoplasty? (See Michael Jackson and Ashlee Simpson). Or possibly a browlift (see Greta Van Susteran). What do you think?

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

What plastic surgery can change your look the most?

Imad Mughniyeh was a terror suspect recently killed in Syria. This is big international news, since he was wanted for the killings of hundreds of Americans. What does he have to do with plastic surgery? Well, according to reports, he supposedly had plastic surgery to change his appearance. This got me to thinking: Which plastic surgery would change a person's appearance the most?

I think the one thing that would change a man's appearance the most if the growing or removal of facial hair. After this, I would have to say maybe a rhinoplasty? (See Michael Jackson and Ashlee Simpson). Or possibly a browlift (see Greta Van Susteran). What do you think?

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Lifestyl- Lift

Most of you have probably seen ads for the Lifestyl- Lift, promising fantastic facelift results in an hour. For more information on the Lifestyl- Lift, check out these very interesting sites:

My Lifestyle Lift Diary
Plasticized.com - Page 1, Page 2
NBC San Diego investigation
Infomercial Scams.com

I do not perform the Lifestyl- Lift. I am spelling it this way on purpose.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Lifestyl- Lift

Most of you have probably seen ads for the Lifestyl- Lift, promising fantastic facelift results in an hour. For more information on the Lifestyl- Lift, check out these very interesting sites:

My Lifestyle Lift Diary
Plasticized.com - Page 1, Page 2
NBC San Diego investigation
Infomercial Scams.com

I do not perform the Lifestyl- Lift. I am spelling it this way on purpose.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dolly Parton's "Shock and Awe" Breast Implants

Dolly Parton has recently announced a postponement of her tour due to a back injury, possibly stemming from her huge breasts. She has recently nicknamed them "Shock and Awe." According to the Huffington Post, she stated:

"I know I have been breaking my neck and bending over backwards trying to get my new Backwoods Barbie CD and world tour together, but I didn't mean to hurt myself doing it! But hey, you try wagging these puppies around a while and see if you don't have back problems. Seriously though, the doctors said I will be good as new in a few weeks & I can't wait to get back out there!"

Her breasts are so large in proportion to her frame that if they were real, many insurance companies would pay for her to have a breast reduction for medical reasons. Maybe she should rename her breasts "Ache and Pain!"

To view a video of a breast augmentation I performed on Fox News, click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dolly Parton's "Shock and Awe" Breast Implants

Dolly Parton has recently announced a postponement of her tour due to a back injury, possibly stemming from her huge breasts. She has recently nicknamed them "Shock and Awe." According to the Huffington Post, she stated:

"I know I have been breaking my neck and bending over backwards trying to get my new Backwoods Barbie CD and world tour together, but I didn't mean to hurt myself doing it! But hey, you try wagging these puppies around a while and see if you don't have back problems. Seriously though, the doctors said I will be good as new in a few weeks & I can't wait to get back out there!"

Her breasts are so large in proportion to her frame that if they were real, many insurance companies would pay for her to have a breast reduction for medical reasons. Maybe she should rename her breasts "Ache and Pain!"

To view a video of a breast augmentation I performed on Fox News, click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Brittany Murphy's Lips are Huge

The lips can swell up considerably after augmentation using injectables like Restylane. There seems to be a tendency for stars to go out in public with either their lips significantly swollen or just plain overdone. Brittany Murphy appears to be a prime example of this. The photo on the left is recent, the photo on the right is from 2006. Why do her lips look so overdone?


Because the top lip is huge. Many patients (and possibly surgeons) believe that the top lip should be larger than the lower lip. Unfortunately, this lip ratio only works naturally for ducks.

Lip augmentation can be very tastefully done, and can really enhance a person's appearance. It's very possible that she is just really swollen, and things will settle down nicely. Most injections are temporary anyway.

Photo credit: Daily Mail, wallpaperbase.com

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Brittany Murphy's Lips are Huge

The lips can swell up considerably after augmentation using injectables like Restylane. There seems to be a tendency for stars to go out in public with either their lips significantly swollen or just plain overdone. Brittany Murphy appears to be a prime example of this. The photo on the left is recent, the photo on the right is from 2006. Why do her lips look so overdone?


Because the top lip is huge. Many patients (and possibly surgeons) believe that the top lip should be larger than the lower lip. Unfortunately, this lip ratio only works naturally for ducks.

Lip augmentation can be very tastefully done, and can really enhance a person's appearance. It's very possible that she is just really swollen, and things will settle down nicely. Most injections are temporary anyway.

Photo credit: Daily Mail, wallpaperbase.com

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Selma Blair

It seems every time I open US Weekly or In Touch Weekly I see a photo of Selma Blair. Here is another one. I actually met Selma Blair during my college years. She attended my alma mater Kalamazoo College for a year or two and was an acquaintance of mine. I found her to be friendly, somewhat quirky, and, at times, hilarious. She once turned down one of my best friends for a date, stating she had to attend the "Governor's Ball." It's nice to see she has established great success as an actor. She still looks like she did over 15 years ago.

Do I think she's had plastic surgery? No, nothing that I can tell. She's a cool gal though...

Photo credit: prphotos.com

Thanks for reading,
Michigan-based Plastic Surgeon
Anthony Youn

Selma Blair

It seems every time I open US Weekly or In Touch Weekly I see a photo of Selma Blair. Here is another one. I actually met Selma Blair during my college years. She attended my alma mater Kalamazoo College for a year or two and was an acquaintance of mine. I found her to be friendly, somewhat quirky, and, at times, hilarious. She once turned down one of my best friends for a date, stating she had to attend the "Governor's Ball." It's nice to see she has established great success as an actor. She still looks like she did over 15 years ago.

Do I think she's had plastic surgery? No, nothing that I can tell. She's a cool gal though...

Photo credit: prphotos.com

Thanks for reading,
Michigan-based Plastic Surgeon
Anthony Youn

No Mom, no one has died from me giving them BOTOX.

Talk about the "Law of Unintended Consequence", the Drudge Report , highlighting a newswire link about the FDA looking at BOTOX-related deaths, has stirred up a bit of anxiety about one of the world's most popular cosmetic medicines. I've gotten a few patient emails over the last week asking about this. It even generated a phone call from my mother asking "Did you hear the FDA banned Botox?"

The newswire blub (here) doesn't really make clear what is being talked about with the "BOTOX deaths". The fatalities associated with have NOT been associated with cosmetic uses for wrinkles. The handful of deaths has mostly been in people being treated with high doses (MUCH in excess of cosmetic doses) for esophageal motility disorders and for spastic contractures in children with cerebral palsy.

Your esophagus is essentially a muscular tube, and botox has been used to relax overactive or chronically contracted muscle. A consequence of this is that you can facilitate aspiration of secretions into the lungs and cause acute repiratory distress. Like I mentioned before re. Donde West's death (see here) after cosmetic surgery, this type of aspiration was what I think was the reason she died suddenly.

Rob

Madonna - Plastic?

What looks unnatural about this recent photo of Madonna? Here's my take:
1. Her forehead, glabella (between the eyebrows), and eyes look virtually wrinkle-free. This is very unusual in a woman her age. My guess is that her plastic surgeon does a nice Botox job.
2. Her cheeks are very soft and full for someone with such low body fat. This can be a possible result of Fat Grafting or Sculptra Injections. My comments on her recent "bruise" photos can be seen in last week's In Touch Weekly.
3. She has a very nice jawline for someone her age. Has she had a possible well-done facelift?

Overall, I think she looks fantastic. What material is the Material Girl made of? Maybe Plastic?

Photo credit: dlisted.com

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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Madonna - Plastic?

What looks unnatural about this recent photo of Madonna? Here's my take:
1. Her forehead, glabella (between the eyebrows), and eyes look virtually wrinkle-free. This is very unusual in a woman her age. My guess is that her plastic surgeon does a nice Botox job.
2. Her cheeks are very soft and full for someone with such low body fat. This can be a possible result of Fat Grafting or Sculptra Injections. My comments on her recent "bruise" photos can be seen in last week's In Touch Weekly.
3. She has a very nice jawline for someone her age. Has she had a possible well-done facelift?

Overall, I think she looks fantastic. What material is the Material Girl made of? Maybe Plastic?

Photo credit: dlisted.com

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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AskMen.com's Top 99 Most Desirable Women

Askmen.com has recently posted their list of the Top 99 Most Desirable Women. Click here for the list, from 99 to 1. Here are the top ten, for your information:
10. Adriana Lima
9. Marisa Miller
8. Rihanna
7. Jessica Biel
6. Scarlett Johansson
5. Jessica Alba
4. Eva Mendes
3. Kate Beckinsale
2. Alessandra Ambrosio
1. Katherine Heigl

Of the top 10, I have only seen Kate Beckinsale up close and personal (no, not in a plastic surgery office). I can confirm that she is, indeed, "most desirable." It's too bad there doesn't appear to be anyone older than their early 30's on this list.
For their list of top 49 men, click here. Why am I not on that list?? Oh yeah, because I'm not rich and famous....(yet?)

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

AskMen.com's Top 99 Most Desirable Women

Askmen.com has recently posted their list of the Top 99 Most Desirable Women. Click here for the list, from 99 to 1. Here are the top ten, for your information:
10. Adriana Lima
9. Marisa Miller
8. Rihanna
7. Jessica Biel
6. Scarlett Johansson
5. Jessica Alba
4. Eva Mendes
3. Kate Beckinsale
2. Alessandra Ambrosio
1. Katherine Heigl

Of the top 10, I have only seen Kate Beckinsale up close and personal (no, not in a plastic surgery office). I can confirm that she is, indeed, "most desirable." It's too bad there doesn't appear to be anyone older than their early 30's on this list.
For their list of top 49 men, click here. Why am I not on that list?? Oh yeah, because I'm not rich and famous....(yet?)

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Mariah Carey - $150,000 of plastic surgery??

Mariah Carey is really looking great lately. Check out this link for my comments on her possible plastic surgery. Click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Mariah Carey - $150,000 of plastic surgery??

Mariah Carey is really looking great lately. Check out this link for my comments on her possible plastic surgery. Click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Brad and Angelina Top Plastic Surgery Poll

A survey by the International Society of Aesthetic Plastic Surgery found that more people request to look like Brad Pitt and Angelina Jolie than any other Hollywood celebrity.
The informal poll of 20,000 plastic surgeons in 84 countries asked which celebrity body parts were the most requested.
Some of the results:
1. Angelina Jolie was the overwhelming choice for most requested smile and lips, followed by Julia Roberts.
2. Jolie's eyes and cheeks were also the most requested.
3. The most requested buttocks: Jennifer Lopez
4. The most requested breasts: Pamela Anderson
5. The nose everyone wants: Nicole Kidman (sorry Ashlee Simpson!)
6. The most requested male abs: Brad Pitt, followed by Matthew McConaughey
7. Many people also requested Brad Pitt's nose, eyes, chin, buttocks, lips, cheeks, and forehead.
8. A significant percentage of people request NOT to look like Pam Anderson, Dolly Parton, or Victoria Beckham.

I would have to agree with most of the findings EXCEPT:
- I've never had a patient request that I make her breasts look like Pam Anderson's. In fact, I find that most patients are afraid they'll wake up after surgery with "Baywatch Breasts."
- I've never had a patient ask for Nicole Kidman's nose, but many who have asked for Ashlee Simpson's.
- I find that many patients who seriously want to look like a celebrity can be a bit on the nutty side, and would be better treated in a psychiatric clinic than a plastic surgery office.

Story credit: United Press International
Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Brad and Angelina Top Plastic Surgery Poll

A survey by the International Society of Aesthetic Plastic Surgery found that more people request to look like Brad Pitt and Angelina Jolie than any other Hollywood celebrity.
The informal poll of 20,000 plastic surgeons in 84 countries asked which celebrity body parts were the most requested.
Some of the results:
1. Angelina Jolie was the overwhelming choice for most requested smile and lips, followed by Julia Roberts.
2. Jolie's eyes and cheeks were also the most requested.
3. The most requested buttocks: Jennifer Lopez
4. The most requested breasts: Pamela Anderson
5. The nose everyone wants: Nicole Kidman (sorry Ashlee Simpson!)
6. The most requested male abs: Brad Pitt, followed by Matthew McConaughey
7. Many people also requested Brad Pitt's nose, eyes, chin, buttocks, lips, cheeks, and forehead.
8. A significant percentage of people request NOT to look like Pam Anderson, Dolly Parton, or Victoria Beckham.

I would have to agree with most of the findings EXCEPT:
- I've never had a patient request that I make her breasts look like Pam Anderson's. In fact, I find that most patients are afraid they'll wake up after surgery with "Baywatch Breasts."
- I've never had a patient ask for Nicole Kidman's nose, but many who have asked for Ashlee Simpson's.
- I find that many patients who seriously want to look like a celebrity can be a bit on the nutty side, and would be better treated in a psychiatric clinic than a plastic surgery office.

Story credit: United Press International
Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.: