Lara Flynn Boyle - What Happened to Her?

Wow. What has happened to actress Lara Flynn Boyle's face? Her face is so puffy it is almost unrecognizable.

I feel really bad for her. I can only think of one medical reason why her face would be this puffy: steroids. If she is not on steroids for some particular reason (rheumatoid arthritis or other auto-immune disease) then it is very likely her plastic surgeon has been a bit over-zealous with fat grafting, Sculptra, or even liquid silicone injections, like what Priscilla Presley has had. For the record, I perform fat grafting and Sculptra injections quite often, and have never seen a result like hers from these relatively safe and conservative treatments. With her history of plumped-up lips, I would bet on some plastic surgery as being the cause of her unusual appearance, however. Her puffy face is not due to weight gain, as she looks as small as ever.

She may very well have BDD, or body dysmorphic disorder. This is a psychiatric condition where a person looks in the mirror and sees something that everyone else doesn't see. It can lead some people to undergo excessive amounts of plastic surgery in a misguided attempt to correct deformities that aren't there in the first place.

For her sake, I hope she gets some professional help, and not of the plastic surgery kind.

Photo credit: dailymail.uk

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

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Lara Flynn Boyle - What Happened to Her?

Wow. What has happened to actress Lara Flynn Boyle's face? Her face is so puffy it is almost unrecognizable.

I feel really bad for her. I can only think of one medical reason why her face would be this puffy: steroids. If she is not on steroids for some particular reason (rheumatoid arthritis or other auto-immune disease) then it is very likely her plastic surgeon has been a bit over-zealous with fat grafting, Sculptra, or even liquid silicone injections, like what Priscilla Presley has had. For the record, I perform fat grafting and Sculptra injections quite often, and have never seen a result like hers from these relatively safe and conservative treatments. With her history of plumped-up lips, I would bet on some plastic surgery as being the cause of her unusual appearance, however. Her puffy face is not due to weight gain, as she looks as small as ever.

She may very well have BDD, or body dysmorphic disorder. This is a psychiatric condition where a person looks in the mirror and sees something that everyone else doesn't see. It can lead some people to undergo excessive amounts of plastic surgery in a misguided attempt to correct deformities that aren't there in the first place.

For her sake, I hope she gets some professional help, and not of the plastic surgery kind.

Photo credit: dailymail.uk

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

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A big (non) decision by the Supreme Court with huge universal health care implications

A nerdy public policy-wonk post today!

Despite a surprisingly brief blurb on the AP wire & broadcast news media, there was a very important move last week by the Supreme Court of the United States (SCOTUS) about the future of health care in this country. The court refused to hear an appeal by the American Association of Retired Peoples (AARP) about a companies ability to terminate health care benefits when a retired former employee becomes eligible for Medicare at 65. The AARP is one of the most powerful political lobbies in the United States, and this is a pretty big defeat for them.
The court's action upholdsa a rule adopted last year by regulators that says the "coordination of retiree health benefits with Medicare" is exempt from the anti-age-bias law.


This case has pitted the interests of younger employees and unions against retirees over the dwindling budget for job-related benefits. In recent years, many employers have pulled back from providing these kind of benefits to their retirees because of the soaring cost obligations. But until Monday it had been unclear whether it was illegal to use a worker's age -- in this instance, 65 -- to trigger a reduction in benefits.

"In some cases, it's become a millstone around their necks," said Jack Kyser, chief economist of the Los Angeles County Economic Development Corp. "Corporations aren't all heartless, but in many cases, you're competing with multinational corporations that don't have quite the obligations that domestic firms have."

This decision not to hear the appeal is interesting because it's going to grease the skids for a large shift of healthcare obligations from the private sector to the feds. As I remained convinced that we're quickly moving towards "Medicare for all" as the eventual American adoption of universal health coverage, the incorporation of more people under it's existing umbrella seems another move in that direction.


Rob

Did 14 Year Old Ali Lohan Get Her Lips Plumped?

Did Lindsay Lohan's 14 year old sister Ali Lohan have her lips augmented? Looks like it. This is a bit disturbing in two ways:
First, what plastic surgeon would inject lip filler into a fourteen year old girl?
Second, what mom would consent to have her fourteen year old daughter have a lip augmentation procedure?

While the risks of lip augmentation with a common filler like Restylane or Juvederm are minimal, this is a very unusual procedure to perform in a minor. I do not think it is right to perform ANY cosmetic surgery on minors, unless it is to fix a real deformity. This is not a good thing to teach our young teens. Normal sized lips are not a deformity.

The Lohan family has got some issues.

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

Did 14 Year Old Ali Lohan Get Her Lips Plumped?

Did Lindsay Lohan's 14 year old sister Ali Lohan have her lips augmented? Looks like it. This is a bit disturbing in two ways:
First, what plastic surgeon would inject lip filler into a fourteen year old girl?
Second, what mom would consent to have her fourteen year old daughter have a lip augmentation procedure?

While the risks of lip augmentation with a common filler like Restylane or Juvederm are minimal, this is a very unusual procedure to perform in a minor. I do not think it is right to perform ANY cosmetic surgery on minors, unless it is to fix a real deformity. This is not a good thing to teach our young teens. Normal sized lips are not a deformity.

The Lohan family has got some issues.

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

Jessica Lange, Dr. Rob Oliver, and Callgirl Ashley Dupre (There's a diverse mix of people!)

A couple quick links for you to check out in your spare time:

1. Has Jessica Lange had plastic surgery? Read what her publicist said to the Minneapolis Star-Tribune, as well as my thoughts. Click here.

2. Dr. Rob Oliver provides an insightful commentary on the recent death of a teenager during a plastic surgery procedure. Click here.

3. Did call girl Ashley Dupre (Youmans) get a rhinoplasty? Click here for Awful Plastic Surgery, click here for Make Me Heal.com. I've also read that she has gotten breast implants.

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

Jessica Lange, Dr. Rob Oliver, and Callgirl Ashley Dupre (There's a diverse mix of people!)

A couple quick links for you to check out in your spare time:

1. Has Jessica Lange had plastic surgery? Read what her publicist said to the Minneapolis Star-Tribune, as well as my thoughts. Click here.

2. Dr. Rob Oliver provides an insightful commentary on the recent death of a teenager during a plastic surgery procedure. Click here.

3. Did call girl Ashley Dupre (Youmans) get a rhinoplasty? Click here for Awful Plastic Surgery, click here for Make Me Heal.com. I've also read that she has gotten breast implants.

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

Teenager Dies During Breast Surgery

An 18 year old recently died during a breast surgery in West Boca Raton, FL. Apparently, 18 year old Stephanie Kuleba was undergoing a procedure to correct her breast asymmetry when she went into malignant hyperthermia and died shortly thereafter.

This is a very unusual situation. Malignant hyperthermia is not a common condition, and the vast majority of plastic surgery performed on healthy people is not associated with a complication, much less a death. This tragedy does highlight the fact that plastic surgery is SURGERY, and must be taken very seriously.

I've been interviewed about this subject and others (Priscilla Presley) on the O'Reilly Factor on the Fox News Channel tonight at 11pm EDT. Check it out if you get a chance!

Story credit: wisn.com
Photo credit: jupiter images

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

Teenager Dies During Breast Surgery

An 18 year old recently died during a breast surgery in West Boca Raton, FL. Apparently, 18 year old Stephanie Kuleba was undergoing a procedure to correct her breast asymmetry when she went into malignant hyperthermia and died shortly thereafter.

This is a very unusual situation. Malignant hyperthermia is not a common condition, and the vast majority of plastic surgery performed on healthy people is not associated with a complication, much less a death. This tragedy does highlight the fact that plastic surgery is SURGERY, and must be taken very seriously.

I've been interviewed about this subject and others (Priscilla Presley) on the O'Reilly Factor on the Fox News Channel tonight at 11pm EDT. Check it out if you get a chance!

Story credit: wisn.com
Photo credit: jupiter images

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

Anesthesia related death during plastic surgery

From the Palm Beach Post comes the tragic death of Florida teen, Stephanie Kuleba, from a rare allergic reaction to inhalation anesthetics called malignant hyperthermia (MH). Wikipedia describes it succinctly as a idiosyncratic reaction that "induces a drastic and uncontrolled increase in skeletal muscle oxidative metabolism which overwhelms the body's capacity to supply oxygen, remove carbon dioxide, and regulate body temperature, eventually leading to circulatory collapse and death if untreated."

There's really no way to screen for this process and a patient can die quickly. Most surgeons and anesthesiologists may go their entire career and never see a true case of it. I was talking to one of my colleagues the other day about office based surgery and he said he was unlikely to return to doing that after seen a near fatal MH on a cosmetic surgery case he was doing in an ambulatory surgery center adjacent to a hospital.

I'm not sure what the take home message from this is. It's such a rare event that it's hard to justify having exotic protocols at all times in low risk procedures. Most office surgery suites maintain a supply of Dantrolene, a medicine to treat MH which is almost $2500 per dose and must be restocked often to stay current. There's plenty of adverse events more common then MH, but we don't have aortic balloon pumps or cardiac bypass machines routinely laying around for that. It already sounds like that the family has hired an attorney who is already assuming an aggressive posture in his comments to the media so I'm sure we'll see some legal proceedings even if perfect care for MH was instituted.

Rob

'Tis the season for - Chocolate Bunny Melting

Happy Easter from Plastic Surgery 101!

Courtesy of YouTube, some stylish chocolate bunny immolation. You know, artsy types are just different then the rest of us!





Cheers!
Rob

Did "Dr. Jiffy Lube" Treat Priscilla Presley?

There is an interesting story from TMZ.com which speculates that a man posing as a cosmetic surgeon injected Priscilla Presley with industrial, low-grade silicone used in auto parts...possibly at Lionel Richie's home! According to the story:


Priscilla... went to Dr. Daniel Serrano around 2003. Serrano was a good-looking doc from Argentina who... started giving them what he claimed were miracle injections that worked better than Botox. In fact, Serrano was injecting industrial, low-grade silicone similar to what's used to lubricate auto parts... Several women, including Shawn King, Larry's wife, and Diane Richie, Lionel's wife at the time, held injection parties in their homes, with Serrano needling them with the non-FDA approved drug that he had smuggled in to the U.S.


Silicone is not approved by the FDA for cosmetic injection into the face, although it has been used for that purpose in the past. This can create granulomas (a massive inflammatory response), infections, permanent deformity, and rejection with open sores and scarring. Because of these problems, I am not a fan of long-lasting or permanent fillers, but prefer injectables such as Restylane, Perlane, or Juvederm, which typically disappears within 6-12 months.


For the rest of the Priscilla Presley story on TMZ.com, click here.

Photo credit: prphotos.com


Thanks for reading.

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

Did "Dr. Jiffy Lube" Treat Priscilla Presley?

There is an interesting story from TMZ.com which speculates that a man posing as a cosmetic surgeon injected Priscilla Presley with industrial, low-grade silicone used in auto parts...possibly at Lionel Richie's home! According to the story:


Priscilla... went to Dr. Daniel Serrano around 2003. Serrano was a good-looking doc from Argentina who... started giving them what he claimed were miracle injections that worked better than Botox. In fact, Serrano was injecting industrial, low-grade silicone similar to what's used to lubricate auto parts... Several women, including Shawn King, Larry's wife, and Diane Richie, Lionel's wife at the time, held injection parties in their homes, with Serrano needling them with the non-FDA approved drug that he had smuggled in to the U.S.


Silicone is not approved by the FDA for cosmetic injection into the face, although it has been used for that purpose in the past. This can create granulomas (a massive inflammatory response), infections, permanent deformity, and rejection with open sores and scarring. Because of these problems, I am not a fan of long-lasting or permanent fillers, but prefer injectables such as Restylane, Perlane, or Juvederm, which typically disappears within 6-12 months.


For the rest of the Priscilla Presley story on TMZ.com, click here.

Photo credit: prphotos.com


Thanks for reading.

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

Maxim's List of Scariest Celebrity Faces

I happened upon (via a link from Cityrag.com) a list that Maxim.com has compiled of the Top 11 Scariest Celebrity Faces. Click here to start browsing it.

Most of these faces appear to have been altered by overdone plastic surgery, although there are a few which do not appear to be the result of plastic surgery gone wrong.

I understand that Gary Busey was in a terrible motorcycle accident some time ago, which caused significant brain damage and possibly also facial bone fractures. The head injury could explain his extra-friendly behavior to Jennifer Garner on the red carpet of the Oscars, and an orbit fracture can explain the asymmetry in his eyes. He may have a condition of his left eye called orbital dystopia, which occurs when the floor of the eye socket is fractured, causing the eyeball to migrate downward. It is frequently combined with enopthalmos, where the eyeball becomes sunken in due to similar factors. It can be improved via facial recontruction surgery, often using bone from his skull or a titanium plate to remake the floor of his eye socket. So that may explain Gary Busey being on this list.

As for Willem Dafoe, I don't think he's had plastic surgery. He just looks creepy.

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

Maxim's List of Scariest Celebrity Faces

I happened upon (via a link from Cityrag.com) a list that Maxim.com has compiled of the Top 11 Scariest Celebrity Faces. Click here to start browsing it.

Most of these faces appear to have been altered by overdone plastic surgery, although there are a few which do not appear to be the result of plastic surgery gone wrong.

I understand that Gary Busey was in a terrible motorcycle accident some time ago, which caused significant brain damage and possibly also facial bone fractures. The head injury could explain his extra-friendly behavior to Jennifer Garner on the red carpet of the Oscars, and an orbit fracture can explain the asymmetry in his eyes. He may have a condition of his left eye called orbital dystopia, which occurs when the floor of the eye socket is fractured, causing the eyeball to migrate downward. It is frequently combined with enopthalmos, where the eyeball becomes sunken in due to similar factors. It can be improved via facial recontruction surgery, often using bone from his skull or a titanium plate to remake the floor of his eye socket. So that may explain Gary Busey being on this list.

As for Willem Dafoe, I don't think he's had plastic surgery. He just looks creepy.

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

Do Americans want fee for service medicine?

There's an article on Salon.com about health kiosks in places like Walgreen's and Wal-Mart called "Wal-Mart can be good for your health!".

This is a hot topic in medicine as it gets into a number of hot topics

• Who will own these clinics? (doctors or industry)




• Who will staff & oversee these?




• What affect will this have on continuity of care?




• What affect will this have on the financial sustainability of medical practices when routine patient visits are siphoned off to these clinics?

One theme that jumps out at me, particularly when you read the reader comments section to the article, is that people are schizophrenic when they think about this (ie. Is medicine a business or nonprofit public utility?) and look at this from a completely different perspective than health care providers.

A number of complaints arise which basically boil down to that "the competition these clinics provide against doctor's office visits will be good and result in better service". This pretends that medicine is some true market economy rather then a corporate & federally-rigged game of Jenga. The winner of this "competition" gets the privledge of working much harder for much less money for much more aggrevation.

If you want to send a primary care doctor thru the roof, complain about having to pay a co-pay for and office visit and about not being able to be seen at a moment's notice. There's little understanding (or sympathy) for exactly how much our system is squeezing physicians to achieve savings in our health care system.

Particularly offensive to me is a Minnesota internet start up company I read about called CAROL, whose business model is essentially to try and turn medicine into Priceline.com

“We want to let consumers define value,” said Tony Miller, Carol’s founder and chief executive. “We don’t have care competition in the marketplace today.”The free site, which went live in January, generates revenue from health-care providers who become “tenants” on the site. When a consumer sets up an appointment with a clinic or doctor on Carol.com, the provider pays the site a fee.

Great! We were missing one more layer of capitalists strip mining the health care system.

Rob

Priscilla Presley - Plastic Surgery

Priscilla Presley has gotten quite a bit of attention lately due to her moves on Dancing with the Stars and her plastic surgery. Awful Plastic Surgery has a post which shows a chronological progression to her aging. Click here for a post from this blog two years ago which gave my opinions on her. She used to look so good...

Photo credit: prphotos.com

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

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Priscilla Presley - Plastic Surgery

Priscilla Presley has gotten quite a bit of attention lately due to her moves on Dancing with the Stars and her plastic surgery. Awful Plastic Surgery has a post which shows a chronological progression to her aging. Click here for a post from this blog two years ago which gave my opinions on her. She used to look so good...

Photo credit: prphotos.com

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

Share |

Dr. Youn on the Fox News Channel tomorrow at 9:45 am

For anyone interested, I am going to be interviewed on America's Newsroom on the Fox News Channel at 9:45am tomorrow morning (Friday March 21st). I'll be discussing the "Boob Jab" (see post below).

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

Dr. Youn on the Fox News Channel tomorrow at 9:45 am

For anyone interested, I am going to be interviewed on America's Newsroom on the Fox News Channel at 9:45am tomorrow morning (Friday March 21st). I'll be discussing the "Boob Jab" (see post below).

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

Boob Jab or Bust?

The Boob Jab is a new procedure which is gaining popularity outside the United States. Apparently it is a nonsurgical method of breast augmentation, where a hyaluronic acid injectable filler called Macrolane is injected via a 20 cm needle into the breast to augment it. The procedure costs $4000-7000 and lasts approximately 12-18 months.

What do I think of this? There are some very important questions to consider with it:
1. To my knowledge, hyaluronic acid is not FDA approved for injection into the breasts.
2. In the US, the major hyaluronic acid fillers are extremely expensive. They typically cost the surgeon upwards of $250 per 1 cc syringe. When one considers that the smallest breast implants are typically about 200cc, this can really add up in cost.
3. When massive amounts of a foreign substance are injected into the body, the body can react by creating a shell of inflammatory tissue around it, called a granuloma. This can even get infected in certain instances and create large wounds as the substance is expelled from the body.
4. With 1 in 9 women getting breast cancer in the United States, it is important to make sure that this treatment doesn't interfere with cancer-detecting mammograms.
5. Hyaluronic acid products have been proven to last 6-12 months in the face. How is it that it lasts up to 18 months in a breast?
6. Who wants to spend $4000-7000 each 18 months for a single added cup size?

With the amount of fake plastic surgeons in this country, I would not be surprised if some of them tried to use this procedure to promote themselves as being new and innovative. The whole thing sounds like a crock to me.

Story credit: marieclaire.co.uk, dailymail.co.uk

Click here for a clip from my appearance on Fox News discussing this procedure.

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

Boob Jab or Bust?

The Boob Jab is a new procedure which is gaining popularity outside the United States. Apparently it is a nonsurgical method of breast augmentation, where a hyaluronic acid injectable filler called Macrolane is injected via a 20 cm needle into the breast to augment it. The procedure costs $4000-7000 and lasts approximately 12-18 months.

What do I think of this? There are some very important questions to consider with it:
1. To my knowledge, hyaluronic acid is not FDA approved for injection into the breasts.
2. In the US, the major hyaluronic acid fillers are extremely expensive. They typically cost the surgeon upwards of $250 per 1 cc syringe. When one considers that the smallest breast implants are typically about 200cc, this can really add up in cost.
3. When massive amounts of a foreign substance are injected into the body, the body can react by creating a shell of inflammatory tissue around it, called a granuloma. This can even get infected in certain instances and create large wounds as the substance is expelled from the body.
4. With 1 in 9 women getting breast cancer in the United States, it is important to make sure that this treatment doesn't interfere with cancer-detecting mammograms.
5. Hyaluronic acid products have been proven to last 6-12 months in the face. How is it that it lasts up to 18 months in a breast?
6. Who wants to spend $4000-7000 each 18 months for a single added cup size?

With the amount of fake plastic surgeons in this country, I would not be surprised if some of them tried to use this procedure to promote themselves as being new and innovative. The whole thing sounds like a crock to me.

Story credit: marieclaire.co.uk, dailymail.co.uk

Click here for a clip from my appearance on Fox News discussing this procedure.

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

Ashlee Simpson Comments on Her Rhinoplasty

Ashlee Simpson has recently commented to
US Magazine on her previous rhinoplasty. She stated:

"(Plastic surgery) is something that everybody should think about for a really long time. Once you know it's something you really feel comfortable with, then to each their own.
I was never really unhappy with how I looked, (and) I don't think I am more beautiful than I was (before). I just see the same old goofy girl I see every day."

I agree with her first statement, however I do believe her rhinoplasty helped bring out the more attractive features of her face, including her eyes, cheeks, and lips. This is a sign of a good rhinoplasty. It's nice that she sees herself as the same person. Good plastic surgery should not make a person look TOO different, only like a better version of themselves.

Now if only she could sing...

Photo credit: prphotos.com

Thanks for reading.

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

Ashlee Simpson Comments on Her Rhinoplasty

Ashlee Simpson has recently commented to
US Magazine on her previous rhinoplasty. She stated:

"(Plastic surgery) is something that everybody should think about for a really long time. Once you know it's something you really feel comfortable with, then to each their own.
I was never really unhappy with how I looked, (and) I don't think I am more beautiful than I was (before). I just see the same old goofy girl I see every day."

I agree with her first statement, however I do believe her rhinoplasty helped bring out the more attractive features of her face, including her eyes, cheeks, and lips. This is a sign of a good rhinoplasty. It's nice that she sees herself as the same person. Good plastic surgery should not make a person look TOO different, only like a better version of themselves.

Now if only she could sing...

Photo credit: prphotos.com

Thanks for reading.

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

Dumb laws and smart laws re. plastic surgery

Tragic events have a way of stimulating bad legislation.

Co-conspirator in Plastic Surgery blogging, "Dr. 48307", Tony Youn had a very insightful retort a few weeks backto a bill ("the Donde West law") introduced in the California legislature (read here) to mandate medical clearance on all patients undergoing cosmetic surgery. Something similar is now being mentioned in Illinois. Dr Youn writes:

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?

Keep in mind that California is also the state where a judge ruled in 2006 that a certificate from a non-recognized cosmetic surgery "board" organization was equivalent (or better!) to the American Board of Plastic Surgery for accreditation proposes over the objections of the state medical board for California, the American Medical Association (AMA), the American Society of Plastic Surgeons (ASPS), the American Board of Facial Plastic Surgery, the American Board of Medical Specialties (ABMS), and others. This ruling ignored the existing state law that allowed physicians to advertise board certification only if the certifying board or association is recognized by ABMS or deemed equivalent by the state medical board.

BACK TO THE "DONDE WEST" LAW

Broad non-directed medical screening by 3rd parties would be an extremely inefficient and unnecessarily expensive way to clear patients for surgery. Besides, this process already takes part as part of a patients' surgery evaluation. Now your doctor can be a tool, and adopt the blanket position that "I send all my patients for medical clearance before surgery", but that's just punting the ball and practicing defensive medicine to the extreme.

The scale we commonly use to characterize surgery patients' anesthesia risk, called the ASA system, is a pretty good screening tool. The overwhelming amount of patients undergoing cosmetic surgery are low risk, and ASA class I or II patients should not need "medical clearance". In addition, many primary care doctors have absolutely no idea what "medical clearance" means anyway, and get a little peeved when patients show up for non-reimbursable office visits.

When we talk about medical clearance, it's usually in the context of chronic medical issues or asking whether the patient needs provocative testing for coronary artery disease. Patients who may need to be "tuned up" prior to surgery are those with:

• diabetes - Are there blood sugars under control?


• significant hypertension


• morbid obesity


• sleep apnea


• symptoms of (or strong risk factors for) coronary disease

Many of those conditions might be exclusionary for elective cosmetic surgery in the first place, particularly when combined. Keep in mind that the patient involved in the event triggering this reactionary bill, Donde West's, had undergone coronary testing earlier in the year (which was reportedly normal) and died over 24 hours postop from what sounds like a probable aspiration event. No amount of screening would prevent something like that.

"Smart Laws" relating to cosmetic surgery seem to be a little more difficult to implement. A more practical way to address the whole issue of office based surgery procedures would be to standardize the accreditation of facilities and remove the loopholes in some states that still exist. My state, Alabama, for instance has set a timetable for requiring accreditation for office an ambulatory surgery centers (ASC) over the next 18 months. The ASPS already makes it a requirement for membership that you will pledge to only operate in accredited (or planned accredited) office facilities. A common sense regulatory step would be to require hospital privileges for any surgery you'd propose to do in your office requiring sedation or general anesthesia, which would have the de facto effect of an additional level of credentialing applied by hospital medical staff offices. It's so common sense that it will be violently opposed by many "cosmetic surgeons" who would see their ability to practice cut off at the knees. Something to think about!

Thanks again Tony for your wonderfully entertaining blog!

Rob

Crazy Self-Liposuctioning Surgeon in Japan

The surgeon in this video is nuts. I can barely stick a contact lens into my eye, much less liposuction myself. Check it out at your own risk.
Thanks to cosmeticsurgerytruth.blogspot.com for the link.

Crazy Self-Liposuctioning Surgeon in Japan

The surgeon in this video is nuts. I can barely stick a contact lens into my eye, much less liposuction myself. Check it out at your own risk.
Thanks to cosmeticsurgerytruth.blogspot.com for the link.

George Clooney Has Plastic Surgery...Down There??

Ever the jokester, George Clooney has stated he's has some plastic surgery work done...in a very private place:

The Ocean's Eleven star denied reports he had surgery to remove lines from his face, but jokingly teased journalists at Esquire magazine with a story about another type of procedure.
He says, "I did get my balls done though, I got them unwrinkled. It's the new thing in Hollywood - ball ironing."

Okayyy... I actually met George Clooney, albeit briefly, while in L.A. at the Hamburger Hamlet on Sunset and Doheny (the location of my previous office). He was a very friendly guy. I wouldn't think of him as the 'ball ironing' type.

Story credit: starpulse.com

Photo credit: prphotos.com

Thanks for reading.

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

George Clooney Has Plastic Surgery...Down There??

Ever the jokester, George Clooney has stated he's has some plastic surgery work done...in a very private place:

The Ocean's Eleven star denied reports he had surgery to remove lines from his face, but jokingly teased journalists at Esquire magazine with a story about another type of procedure.
He says, "I did get my balls done though, I got them unwrinkled. It's the new thing in Hollywood - ball ironing."

Okayyy... I actually met George Clooney, albeit briefly, while in L.A. at the Hamburger Hamlet on Sunset and Doheny (the location of my previous office). He was a very friendly guy. I wouldn't think of him as the 'ball ironing' type.

Story credit: starpulse.com

Photo credit: prphotos.com

Thanks for reading.

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

The worst star trout pouts ever... In the Sun

I was recently interviewed by The Sun, a U.K. Paper, on overplumped celebrity lips. They have a quiz to see if you can determine which overplumped lips belong to which celeb. For the article...click here.

Thanks to Toni Jones for including me in the piece.

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

The worst star trout pouts ever... In the Sun

I was recently interviewed by The Sun, a U.K. Paper, on overplumped celebrity lips. They have a quiz to see if you can determine which overplumped lips belong to which celeb. For the article...click here.

Thanks to Toni Jones for including me in the piece.

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

Gimme Jolie Lips and a Beyonce Booty!

I was recently interviewed by Orato.com on celebrity plastic surgery, how to choose a plastic surgeon, and this very blog. The interview, entitled Gimme Jolie Lips and a Beyonce Booty! was turned into a 1st person piece. Check it out here if you are interested.

Doesn't Beyonce look great?

Thanks to Robyn Stubbs and Orato.com for their kind interest.

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

Gimme Jolie Lips and a Beyonce Booty!

I was recently interviewed by Orato.com on celebrity plastic surgery, how to choose a plastic surgeon, and this very blog. The interview, entitled Gimme Jolie Lips and a Beyonce Booty! was turned into a 1st person piece. Check it out here if you are interested.

Doesn't Beyonce look great?

Thanks to Robyn Stubbs and Orato.com for their kind interest.

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

Lara Flynn Boyle

Lara Flynn Boyle is making an appearance on Law and Order (my wife's favorite show, which I can't stand!). Her lips look large (they have for years) but her face appears a bit more filled out. Take a peek at the NBC trailer here.
It's possible she may have had fat grafting or Sculptra injections to volumize her face, but she may also have gained a few pounds. She was dreadfully thin when she dated Jack Nicholson.

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

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Lara Flynn Boyle

Lara Flynn Boyle is making an appearance on Law and Order (my wife's favorite show, which I can't stand!). Her lips look large (they have for years) but her face appears a bit more filled out. Take a peek at the NBC trailer here.
It's possible she may have had fat grafting or Sculptra injections to volumize her face, but she may also have gained a few pounds. She was dreadfully thin when she dated Jack Nicholson.

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

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The charity business as (un)usual - Operation Smile

There's a nice story on featuring Operation Smile in the New York Time's magazine. Operation Smile is an organization that organizes and performs cleft lip and palate surgery in developing countries. The story is not really about the altruism of Operation Smile, but rather it focuses on how it became an effective organization only after operating more like a business and less like a traditional charity.


3rd world missions by plastic surgeons, where a team flys in for a few days, does a lot of pediatric plastic surgery (cleft lip/palate) and leaves would seem like a hard thing to be criticized, but it has been increasingly done. The appropriateness of these kinds of surgeries performed by surgeons who didn't do them in their state side practice and by loosely-supervised residents (as was often the case on these trips) has been questioned for years. Groups like operation smile have addressed this, and require active practices in pediatric plastic surgery among volunteers. More importantly IMO has been the change in philosophy to where we're now increasingly training local physicians in these countries to do simple and reproducible operations to correct these defects recognizing the limitations of resources they may face in terms of speech therapy and orthodontics post operatively.


Rob

Kelly Rowland - Breast Implants

Destiny's Child singer Kelly Rowland has admitted to having a breast augmentation, boosting her bust from an A cup to a very tasteful B cup:

"I was sick of not fitting into my tops," she revealed in an interview. "There was this one really hot House of Dereon top — I just wanted to fill that out!"

She looks great. The breasts fit her tiny frame well. Breast augmentation is the most common surgery that I do, with the most popular size jump from an A to a C. Next most common is B --> C, followed by A --> B, then B/C --> D.

I wonder if the glamorous Beyonce will come out of the plastic surgery closet next?

Story credit: Starmagazine.com

Photo credit: Prphotos.com

Thanks for reading.

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

Share |

Kelly Rowland - Breast Implants

Destiny's Child singer Kelly Rowland has admitted to having a breast augmentation, boosting her bust from an A cup to a very tasteful B cup:

"I was sick of not fitting into my tops," she revealed in an interview. "There was this one really hot House of Dereon top — I just wanted to fill that out!"

She looks great. The breasts fit her tiny frame well. Breast augmentation is the most common surgery that I do, with the most popular size jump from an A to a C. Next most common is B --> C, followed by A --> B, then B/C --> D.

I wonder if the glamorous Beyonce will come out of the plastic surgery closet next?

Story credit: Starmagazine.com

Photo credit: Prphotos.com

Thanks for reading.

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

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Update on The Lifestyl- Lift

Some new articles focusing on the Lifestyl- Lift present further information for any of you considering these procedures:

1. Lifestyl- Lift Website Sues Vendor for Negative Reviews (From PSP E Report) :
Santa Clara University School of Law professor Eric Goldman, who has advised RealSelf on the case, posts about the issue on his personal blog:
"No matter how many times I see it -- and in the Internet era, I see it all too frequently -- I always shake my head in disappointment and frustration when a company uses trademark law to lash out against unflattering consumer reviews. To these companies, trademark law is a cure-all tonic for their marketplace travails, and trademark doctrine is so plastic and amorphous that defendants have some difficulty mounting a proper defense. As a result, all too frequently, the threat of a trademark lawsuit causes the intermediary to capitulate and excise valuable content from the Internet."


I do not perform the Lifestyl- Lift. I disagree with how this procedure is often advertised. If it sounds too good to be true, it probably is.

Note: I am spelling it Lifestyl- Lift on purpose...

Thanks for reading,

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

Update on The Lifestyl- Lift

Some new articles focusing on the Lifestyl- Lift present further information for any of you considering these procedures:

1. Lifestyl- Lift Website Sues Vendor for Negative Reviews (From PSP E Report) :
Santa Clara University School of Law professor Eric Goldman, who has advised RealSelf on the case, posts about the issue on his personal blog:
"No matter how many times I see it -- and in the Internet era, I see it all too frequently -- I always shake my head in disappointment and frustration when a company uses trademark law to lash out against unflattering consumer reviews. To these companies, trademark law is a cure-all tonic for their marketplace travails, and trademark doctrine is so plastic and amorphous that defendants have some difficulty mounting a proper defense. As a result, all too frequently, the threat of a trademark lawsuit causes the intermediary to capitulate and excise valuable content from the Internet."


I do not perform the Lifestyl- Lift. I disagree with how this procedure is often advertised. If it sounds too good to be true, it probably is.

Note: I am spelling it Lifestyl- Lift on purpose...

Thanks for reading,

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

Wall Street Journal on SmartLipo - I scooped 'em!

A visitor to the site pointed out to me that today's Wall Street Journal also featured a profile of Cynosure's SmartLipo platform highlighting some of the same thoughts I had in my post yesterday.

If you're interested, you can read it here.

Mariah Carey Comments on my Plastic Surgery Speculation

On a recent interview on E! Radio, Mariah Carey commented on my recent speculation that she's had plastic surgery:

"One of the rumors I just heard about was that I spent $150,000 in plastic surgery. What in the ham sandwich do they think I did? It's very annoying."

Oops. I think I annoyed her.
The much-disputed $150,000 figure was asked of me by the magazine, and my thought was that it is possible she could have spent this much to look so good. Not all of it would be attributed to plastic surgery, but also to skin care products, gym memberships and/or equipment, personal training, facials, chemical peels, body skin treatments, and even specialty foods and vitamins. When these things are taken into account, $150,000 for an A-list star like her is not outside the realm of possibility.

I am actually a fan of hers. In fact, the first CD I ever bought was her Vision of Love album when I was a freshman in college. I think she is a major talent and have enjoyed her music over the years, so I hope my comments haven't caused her any hurt. I do think she looks fantastic.

Story credit: The Celebrity Truth
Photo credit: prphotos.com

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

Mariah Carey Comments on my Plastic Surgery Speculation

On a recent interview on E! Radio, Mariah Carey commented on my recent speculation that she's had plastic surgery:

"One of the rumors I just heard about was that I spent $150,000 in plastic surgery. What in the ham sandwich do they think I did? It's very annoying."

Oops. I think I annoyed her.
The much-disputed $150,000 figure was asked of me by the magazine, and my thought was that it is possible she could have spent this much to look so good. Not all of it would be attributed to plastic surgery, but also to skin care products, gym memberships and/or equipment, personal training, facials, chemical peels, body skin treatments, and even specialty foods and vitamins. When these things are taken into account, $150,000 for an A-list star like her is not outside the realm of possibility.

I am actually a fan of hers. In fact, the first CD I ever bought was her Vision of Love album when I was a freshman in college. I think she is a major talent and have enjoyed her music over the years, so I hope my comments haven't caused her any hurt. I do think she looks fantastic.

Story credit: The Celebrity Truth
Photo credit: prphotos.com

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

Plastic Surgery 101 - Iceland's most popular plastic surgery blog :)

I'm constantly amazed at the ability of the internet to put like minded people in touch from around the world. I can still remember the thrill I got from Napster's heyday where I was able to communicate in real time with fans of artists I liked (Richard Thompson, Bruce Cockburn, Chris Whitley, among others) around the world.

While I may only be the 281st most popular health care blog this week according to Healthcare100.com (I demand a recount!) , like many under appreciated rock bands I'm now "big in Europe". I'd like to give a shout out to American ex-pat, Ms. Erika Wolfe, who took the time to send some beautiful postcards from her adopted home in Kopavogur, Iceland telling me how much she enjoys Plastic Surgery 101. I wish I had some "PS 101 brand" swag I could mail you back! My Icelandic is kind of "rusty" but via the magic of web-translator programs - Ericka, þakka þú fyrir the póstkort

Ericka sent me stunning images from:

Waterfall Dettifoss, north Iceland

Iceland's famous "Blue Lagoon"

Rob

Plastic Surgery at the Oscars on Make Me Heal.com

Make Me Heal.com has several articles on plastic surgery at the Oscars this year. I watched most of the telecast and did not see a lot of obvious new work. Nicole Kidman looked the best I've seen her in a while, possibly due to the lack of Botox in her forehead. For more speculation, visit Make Me Heal.com news.

Photo credit: MakeMeHeal.com

Thanks for reading.

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