The Acupuncture Facelift?? Now I've Heard Everything!

An interesting article in Yahoo News describes a facelift being performed by acupuncture. Practitioners claim that it stimulates collagen production, lifts sagging skin, and is as effective as Botox.

Hahahahahahahahaha!!!

But seriously, I know very little about this, although my mother has been trained in acupuncture and acupressure. She's used it on me on more than one occasion with variable results. I do believe there is real validity to some of its benefits which cannot be explained by science. That being said, I've never seen actual results from Acupuncture Facelifts, and would be interested to see some before-and-after photos. In the meantime, I will stick with actually putting something into the needles I poke a person with. If any readers have anecdotal stories about this, feel free to share.

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

The Acupuncture Facelift?? Now I've Heard Everything!

An interesting article in Yahoo News describes a facelift being performed by acupuncture. Practitioners claim that it stimulates collagen production, lifts sagging skin, and is as effective as Botox.

Hahahahahahahahaha!!!

But seriously, I know very little about this, although my mother has been trained in acupuncture and acupressure. She's used it on me on more than one occasion with variable results. I do believe there is real validity to some of its benefits which cannot be explained by science. That being said, I've never seen actual results from Acupuncture Facelifts, and would be interested to see some before-and-after photos. In the meantime, I will stick with actually putting something into the needles I poke a person with. If any readers have anecdotal stories about this, feel free to share.

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

Will the last medical dermatologist please turn off the lights? Access issues for dermatology patients

The trend of Dermatologists becoming more and more unavailable for actually treating dermatological conditions is in the news again in the front page of the New York Times. The article, "As Doctors Cater to Looks, Skin Patients Wait" discusses the discrepancy in how patients are catered to for cosmetic versus medical dermatologic conditions. I blogged about this same issue last September in "How Botox affects your access to a Dermatologist"

There's a few dermatologists quoted who really come off poorly in the language they use justifying their practice choices. You can bet they'd like a mulligan about now in their 'on the record' interview.

Peppered in the comments section to the article are the predictable griping like,

• "Doctors should not get rich off their patients. Period. End of story. Society has greatly subsidized every doctor's education. If a doctor wants to supplement his or her income with cosmetic procedures, this should be strictly evenings and weekends."



• "Why on earth should a 10-minute botox injection be worth $500?"



• "...clinics will not take patients without referrals, and unless a matter is urgent, it can take 4 - 5 months to get an appointment (which they keep as short as possible). However, if a patient wants a cosmetic procedure, it takes only 1 - 2 weeks for an appointment. The dermatology profession needs to examine its ethics, or the lack thereof."



• "The rest of the medical system will follow. Once health care becomes a one-payer system, there will be a second tier for the moneyed. This is how medicine works in Europe."



• "This is a perfect example of market forces at work, and proof the market works perfectly. Money talks. In this case, however, market forces pervert the delivery of good health care. The solution is to reimburse doctors for actually taking care of patients, not doing procedures or ordering expensive tests. With a regime change in Washington on the horizon, we will hopefully have a complete overhaul of our decrepit and wasteful health care-industrial complex."



• "Disgusting example of the growing scummy side of medicine. A terrific example of how the wrong people gain admission to medical school, sociopath sales persons, "I've always wanted to help people, blah, blah blah..." while only interested in the cash. We need a new health care system with salaried physicians"



• "These comments are scary. Most are uniformed, ignorant and miss the point. Physicans can't meet their overhead and are responding to "managed care" in the only way they can. It is the root cause of most of the ills we see today. We will never able to administer quality healthcare in this type of system. How is it possible for a small practice to negotiate equitable reimbursements from a market giant such as Cigna?"



• "The idea that patients with potential skin cancer have to literally beg to be seen by a doctor is absolutely horrifying. This is one area where civil suits can be an effective weapon. Drs. who refuse to deal with a skin cancer should be sued out of practice. And/or heavily regulated by the government or their own "Professional" organization (the AMA). Does this behavior actually conform to the AMA's code of conduct?"



• "Any doctor who will not see a patient who suspects a mole cancerous, or has a chronic skin disease, for longer than 72 hours, should be sued and forced to explain his negligence in a court of law. "


Reading the comment sections of articles in "the nation's newspaper" is always really illustrative to me. There's alot of frustration and hostility about healthcare in the public which gets (mis)directed at physicians. (Don't forget poor Dr. Zenn who was sniped by the breast implant nutters in June.) It's really a systemic issue, but it's easier to blame "greedy" doctors then actually recognize the costs of administering and delivering healthcare is affecting this. Commenter's also usually fail to understand that this issue with dermatologists is actually going to get worse rather then better with whatever "universal healthcare" system we end up with. Unless you pay physicians market wages for their services, they're going to look for opportunities to realize it elsewhere.

Reading this article I also kept thinking, why the hell would you feel like you absolutely have to go to a dermatologist (or Plastic Surgeon) to have a skin lesion or rash looked at? While I appreciate patient's opinion of our skills, evaluation and biopsy of lesions/rashes is simple enough that it logically should be largely the province of primary care providers or the nurse practitioners and physician assistants that affiliate with them in practice IMO. A lot of wound care clinics have such a set up, and I think wound care is much trickier then skin lesions!



Rob

Is something wrong with Janice Dickinson?

The Drunken Stepfather blog (NSFW) showed this photo of Janice Dickinson with a crooked mouth. While this is most likely just the expression she was making, it also resembles the appearance of a person who suffered a nerve injury during a facelift or liposuction of the jawline. In these situations, the nerve that causes the lip to pull down can become damaged, creating a crooked smile or frown. In 99% of cases this spontaneously resolves, usually within a few months, but can be permanent in extremely rare cases. This type of nerve injury is one of the most dreaded complications of a facelift. (Knock on wood) I've never seen one that was permanent, and am always vigilant to do everything I can to avoid it.

Hopefully, for Janice's and her surgeon's sake she's just looking silly for the paparazzi...

Thanks to the CosmeticSurgeryTruth blog for the link.

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

Is something wrong with Janice Dickinson?

The Drunken Stepfather blog (NSFW) showed this photo of Janice Dickinson with a crooked mouth. While this is most likely just the expression she was making, it also resembles the appearance of a person who suffered a nerve injury during a facelift or liposuction of the jawline. In these situations, the nerve that causes the lip to pull down can become damaged, creating a crooked smile or frown. In 99% of cases this spontaneously resolves, usually within a few months, but can be permanent in extremely rare cases. This type of nerve injury is one of the most dreaded complications of a facelift. (Knock on wood) I've never seen one that was permanent, and am always vigilant to do everything I can to avoid it.

Hopefully, for Janice's and her surgeon's sake she's just looking silly for the paparazzi...

Thanks to the CosmeticSurgeryTruth blog for the link.

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

Brigitte Nielsen Looks Better After Plastic Surgery

Brigitte Nielsen has re-emerged onto the scene after undergoing plastic surgery for a German reality television show. She underwent liposuction on her thighs, Botox, and a breast reduction. The 'after' photos show that the 44 year old ex-wife of Sly Stallone looks great. I wonder if she also underwent other facial plastic surgeries, such as a browlift, facelift, and eyelid lifts? It appears that way to me.

Why did a 44 year old age so prematurely in the first place? It's a possible combination of the California sun, smoking, drinking, and possibly a just plain unhealthy lifestyle.

As an aside, I am finding more and more that people who take really good care of themselves seem to heal from plastic surgery with considerably less swelling, less bruising, and even less discomfort than the average patient. I have a handful of patients in my practice who strictly avoid the Southeast Michigan diet of Coney dogs, deep dish pizza, and Better Made potato chips who have astounded me with their speedy recoveries from plastic surgery. For some reason, I doubt that Brigitte Nielsen would fit into that group. But maybe Flavor Flav...

Note: photo on the left is pre-surgery, right is post-surgery.
Photo and story credit: The Daily Mail

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

Brigitte Nielsen Looks Better After Plastic Surgery

Brigitte Nielsen has re-emerged onto the scene after undergoing plastic surgery for a German reality television show. She underwent liposuction on her thighs, Botox, and a breast reduction. The 'after' photos show that the 44 year old ex-wife of Sly Stallone looks great. I wonder if she also underwent other facial plastic surgeries, such as a browlift, facelift, and eyelid lifts? It appears that way to me.

Why did a 44 year old age so prematurely in the first place? It's a possible combination of the California sun, smoking, drinking, and possibly a just plain unhealthy lifestyle.

As an aside, I am finding more and more that people who take really good care of themselves seem to heal from plastic surgery with considerably less swelling, less bruising, and even less discomfort than the average patient. I have a handful of patients in my practice who strictly avoid the Southeast Michigan diet of Coney dogs, deep dish pizza, and Better Made potato chips who have astounded me with their speedy recoveries from plastic surgery. For some reason, I doubt that Brigitte Nielsen would fit into that group. But maybe Flavor Flav...

Note: photo on the left is pre-surgery, right is post-surgery.
Photo and story credit: The Daily Mail

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

Plastic Surgery 101 officially endorses Index Funds. Bogleheads of the world unite!

There's been kind of a truism in contemporary Plastic Surgery practice that our business is kind of like "stocks and bonds". Cosmetic surgery has been more and more like "stocks" - high growth with lots of dividends, while reconstructive surgery has been more like a "bond" - steady, boring, and losing ground to inflation. Cosmetic surgery tends to have it's own cycle in that it's busy 3-4 months of the year (late winter - early spring), slows during the summer, and grinds to a halt in August/September when school is back in and women in school or with children can't take the time off to recover.

As we're teetering in the brink of a recession from the real-estate and credit bubbles, there's a lot of stories about how many predominately cosmetic surgery practices are feeling the pinch. A cosmetic practice is usually higher overhead and when things slow, they can get hit hard. Much like the DOW Jones index, these "stocks" are stagnant.

Common sense says, "it must be a good time to be a bond holder (or reconstructive surgeon in this instance)" which usually zig when stocks zag in terms of value.
Unfortunately this isn't true either. We've just narrowly avoided a showdown in Washington over an immediate 10% cut (and planned additional 5% next quarter) in Medicare reimbursement to physicians, which has the effect of actually reducing inflation adjusted compensation up to 30%(!). Private insurers, never one to leave money on the table, will quickly index their rates to the new Medicare scale and there will be significant disruptions potentially in access to care.

As I've been poised to assume custodianship of our office's 401K plan, I've tried to take it upon myself to learn more about investments. Since last October, the American stock exchange value is down something like 20% and has been hammered by fuel costs, the subprime mortgage meltdown, soaring costs of commodities, and a general lack of consumer confidence.

Recently I've been reading two books which have really been transformative in how I think about the stock market. William Bernstein's "The Four Pillars of Investing" & John Bogle's "The Little Book of Common Sense Investing". Both books advocate a strategy called Index Investing which is an extraordinarily boring but productive way to conduct your finances.

A few common concepts to this school of thought:

Trying to accurately time peaks and valleys of the market is impossible

Routinely beating the market return after expenses is (nearly) impossible

"Cost is King"- low overhead funds (like Index Funds) offer extraordinary advantage over time due to compounding interest versus actively managed mutual funds or hedge funds

Index funds and the related Exchange Traded Funds (ETF's) are increasingly the investment vehicle of choice for the multi billion dollar pension plans, large endowment vehicles, and investment industry professionals personal portfolios. (If their unlimited access to the best minds and research teams has driven them to indexing, don't you think you should consider it too?)

Whatever insight you may think you have into a mutual fund or stock's prospects, you're going to get crushed competing and trading against the resources and insight of large investment organizations. They already know and have responded to any information you have before you even have that information.

Consider carefully the added costs of advice (in fees) and beware of stars (as in, star mutual fund managers)

Do not overrate past fund performance. Bull markets mask underperformance of funds compared to benchmarks

Don’t own too many funds. Buy your fund portfolio – and hold it!

What's a "Boglehead"?

"They are a bunch of diehard fans of John C Bogle, the founder of Vanguard, one of the most successful and largest mutual funds in the US. Started in 1975, the company is the pioneer of index funds. Its value proposition of low fees is well known to mutual fund investors all over.

The low fees give Vanguard an edge when it comes to returns. According to a recent article in smartmoney.com, Vanguard’s equity funds have returned 14.48% annualized over the last three years, compared to the company’s two closest rivals, American Funds (14.02%) and Fidelity (13.87%). The average equity fund in America returned 12.43%.

Vanguard’s largest fund, the S&P 500 Index fund has an expense ratio of below 0.20% per annum. "

Rob

Jenny Lee- Plastic Surgery "Enthusiast"

After Jocelyn Wildenstein, model /actress Jenny Lee may be the person most well-known primarily for her plastic surgery. It's rumored that she's had over 30 plastic surgery procedures performed on her, and she is planning many more in the future. She really does look like a human Barbie doll. She has an interesting "About Me" page on her website, where she explains her thoughts on plastic surgery.

She does not reveal who her plastic surgeon is. No, it's not me. I wouldn't do this much work on someone, even if it paid for my house (and my car and my son's college education). Maybe it's my friend Dr. Steve Svehlak (just kidding Steve!).

photo credit: thejennylee.com , Maria Bernal Photography

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

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Jenny Lee- Plastic Surgery "Enthusiast"

After Jocelyn Wildenstein, model /actress Jenny Lee may be the person most well-known primarily for her plastic surgery. It's rumored that she's had over 30 plastic surgery procedures performed on her, and she is planning many more in the future. She really does look like a human Barbie doll. She has an interesting "About Me" page on her website, where she explains her thoughts on plastic surgery.

She does not reveal who her plastic surgeon is. No, it's not me. I wouldn't do this much work on someone, even if it paid for my house (and my car and my son's college education). Maybe it's my friend Dr. Steve Svehlak (just kidding Steve!).

photo credit: thejennylee.com , Maria Bernal Photography

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

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Getting Ready for Bathing Suit Season

There's not much new in the world of celebrity plastic surgery today, so I thought I'd give you some links to a series of TV segments I did for the local Fox 2 Detroit affiliate. We did a week of "Getting Ready for Bathing Suit Season" segments, focusing on minimally invasive ways to get your body ready for the beach. If you are bored and want to take up a few minutes, here you go:

Laser Hair Removal
Anti-Cellulite Treatments
Laser Spider Vein Treatments
Clay Peel for the Back (Back-ne)

Thanks to the crew at Fox 2 Detroit for including me in these segments!

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

Getting Ready for Bathing Suit Season

There's not much new in the world of celebrity plastic surgery today, so I thought I'd give you some links to a series of TV segments I did for the local Fox 2 Detroit affiliate. We did a week of "Getting Ready for Bathing Suit Season" segments, focusing on minimally invasive ways to get your body ready for the beach. If you are bored and want to take up a few minutes, here you go:

Laser Hair Removal
Anti-Cellulite Treatments
Laser Spider Vein Treatments
Clay Peel for the Back (Back-ne)

Thanks to the crew at Fox 2 Detroit for including me in these segments!

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

Sarah Jessica Parker - What's the Big Deal?

For some reason, the removal of Sarah Jessica Parker's chin mole has actually made news. Apparently she showed up to Yankee stadium without a nevus on her chin and the media has made a big deal out of it.

Ho hum, I take moles off all the time. Usually insurance actually pays for it, although not very much. Moles are rarely cancerous. Check out my post on John McCain if you want to know how to spot a dangerous mole. However, if you have any concern about a mole, have your dermatologist or plastic surgeon take a peek at it.

This would be bigger news if it was Cindy Crawford's signature mole.

Photo credit: eonline.com

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

Sarah Jessica Parker - What's the Big Deal?

For some reason, the removal of Sarah Jessica Parker's chin mole has actually made news. Apparently she showed up to Yankee stadium without a nevus on her chin and the media has made a big deal out of it.

Ho hum, I take moles off all the time. Usually insurance actually pays for it, although not very much. Moles are rarely cancerous. Check out my post on John McCain if you want to know how to spot a dangerous mole. However, if you have any concern about a mole, have your dermatologist or plastic surgeon take a peek at it.

This would be bigger news if it was Cindy Crawford's signature mole.

Photo credit: eonline.com

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

Aja Rock's Breasts - What's Going On Here?

Aja Rock is a famous New Zealand model and music artist. Here is a photo fo her with rocker Tommy Lee. What's going on with her breasts?

It appears to me to be a capsular contracture. Capsular contracture is the result of excess scar developing around a breast implant, making the breast appear hard and round. If severe, the scar tissue can develop a separation from the normal tissue of the breast, which is what I think may be happening here.

Check out more of my comments in NZrealitytv.com.
For more on Aja Rock, click here.

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

Aja Rock's Breasts - What's Going On Here?

Aja Rock is a famous New Zealand model and music artist. Here is a photo fo her with rocker Tommy Lee. What's going on with her breasts?

It appears to me to be a capsular contracture. Capsular contracture is the result of excess scar developing around a breast implant, making the breast appear hard and round. If severe, the scar tissue can develop a separation from the normal tissue of the breast, which is what I think may be happening here.

Check out more of my comments in NZrealitytv.com.
For more on Aja Rock, click here.

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

Alex Rodriguez - Do All His Women Have Plastic Surgery?

Do all of pro baseball player A-Rod's women have plastic surgery? A recent article in Make Me Heal.com says so. Check it out here.

I was interviewed this week by In Touch Weekly magazine regarding Madonna's possible plastic surgery. Check it out in the upcoming issue.

Maybe A-Rod doesn't mind his women having some plastic parts? If that is the case, then maybe his next girlfriend will be Jocelyn Wildenstein!

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

Alex Rodriguez - Do All His Women Have Plastic Surgery?

Do all of pro baseball player A-Rod's women have plastic surgery? A recent article in Make Me Heal.com says so. Check it out here.

I was interviewed this week by In Touch Weekly magazine regarding Madonna's possible plastic surgery. Check it out in the upcoming issue.

Maybe A-Rod doesn't mind his women having some plastic parts? If that is the case, then maybe his next girlfriend will be Jocelyn Wildenstein!

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

Prevelle - Today for Tonight?

Mentor, a company best known for their outstanding breast implants, has recently released a new hyaluronic acid filler here in the United States. It's called Prevelle 'Silk,' and is the only hyaluronic acid filler available which also incorporates lidocaine (an anesthetic) into the product. The idea is that most patients who have it for enhancing the lips or filling in wrinkles do not need painful dental blocks to numb the area prior to injecting it. They also advertise that the product has little swelling and downtime, hence the slogan "Today for Tonight."

What's the drawback? Mainly the longevity of the product. Prevelle appears to last around 90 days or so, whereas the two most popular hyaluronic acid fillers (Restylane and Juvederm) can last 6 months or more. Prevelle is cheaper, however, and with the minimal discomfort associated with its injections, does seem to have a nice niche.

I would recommend it for people who want the following: Less reaction and swelling, less discomfort with injection, a cheaper price, and don't mind a shorter-lasting result.

To learn more about Prevelle, click here.

Thanks for reading.

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

Prevelle - Today for Tonight?

Mentor, a company best known for their outstanding breast implants, has recently released a new hyaluronic acid filler here in the United States. It's called Prevelle 'Silk,' and is the only hyaluronic acid filler available which also incorporates lidocaine (an anesthetic) into the product. The idea is that most patients who have it for enhancing the lips or filling in wrinkles do not need painful dental blocks to numb the area prior to injecting it. They also advertise that the product has little swelling and downtime, hence the slogan "Today for Tonight."

What's the drawback? Mainly the longevity of the product. Prevelle appears to last around 90 days or so, whereas the two most popular hyaluronic acid fillers (Restylane and Juvederm) can last 6 months or more. Prevelle is cheaper, however, and with the minimal discomfort associated with its injections, does seem to have a nice niche.

I would recommend it for people who want the following: Less reaction and swelling, less discomfort with injection, a cheaper price, and don't mind a shorter-lasting result.

To learn more about Prevelle, click here.

Thanks for reading.

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

Copping a feel - now a civic virtue in Russian town of Bataisk

The tiny town of Bataisk in southern Russia has established a hands on tradition on a new shrine to the female form.

There is a new bas-relief silhouette of a woman's chest in the town square, on whose breasts a man’s hand is lying. It is being touted by locals that if a man touches this bust he is going to attain "family happiness".

tacky de chez tacky!

Rob

Pharrell Williams and a New Way to Remove Tattoos?

According to Plasmetic.com, rapper and producer Pharrell Williams is planning on undergoing a new way to remove tattoos without scars. Here are some details:

a. This is an invasive procedure that requires skin grafting.
b. The patient has to give a sample of his skin.
c. This skin is then replicated in a laboratory.
d. Once this is done, the new skin is stitched over the tattooed one.
e. It does not leave any scars.
f. Once the skin is healed, new tattoos can be done on it.
g. This is a faster and less painful alternative.

Now, this sounds to me that they are planning to remove the old tattooed skin and replace it with a skin graft that was grown in a laboratory. The statement "It does not leave any scars" is the one I really question here. I have performed skin grafts many times before (such as on burn patients) but any skin graft patient will tell you there are scars involved. Just because the skin is grown in a laboratory doesn't mean that it won't create scars. Furthermore, one cannot place a skin graft over intact skin because it will just slough off if the underlying skin isn't removed first.

This whole thing sounds like a crock to me. Lasers are very effective with tattoo removal nowadays, just ask Angelina Jolie or Johnny Depp (remember when he changed Winona Forever to Wino Forever? Doh!).

We don't do laser tattoo removal at my office, by the way.

Photo credit: prphotos.com

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

Pharrell Williams and a New Way to Remove Tattoos?

According to Plasmetic.com, rapper and producer Pharrell Williams is planning on undergoing a new way to remove tattoos without scars. Here are some details:

a. This is an invasive procedure that requires skin grafting.
b. The patient has to give a sample of his skin.
c. This skin is then replicated in a laboratory.
d. Once this is done, the new skin is stitched over the tattooed one.
e. It does not leave any scars.
f. Once the skin is healed, new tattoos can be done on it.
g. This is a faster and less painful alternative.

Now, this sounds to me that they are planning to remove the old tattooed skin and replace it with a skin graft that was grown in a laboratory. The statement "It does not leave any scars" is the one I really question here. I have performed skin grafts many times before (such as on burn patients) but any skin graft patient will tell you there are scars involved. Just because the skin is grown in a laboratory doesn't mean that it won't create scars. Furthermore, one cannot place a skin graft over intact skin because it will just slough off if the underlying skin isn't removed first.

This whole thing sounds like a crock to me. Lasers are very effective with tattoo removal nowadays, just ask Angelina Jolie or Johnny Depp (remember when he changed Winona Forever to Wino Forever? Doh!).

We don't do laser tattoo removal at my office, by the way.

Photo credit: prphotos.com

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

Plastic Surgery 101 welcomes Dr. Jason Jack to our sandbox. Roll Tide!

I like to take this opportunity to welcome Dr. Jason Jack to my clinical practice and to Plastic Surgery 101. Jason is both a peer and friend of mine who was starting a new practice, and I was tickled to death to offer him a place in my office while he gets settled. Dr. Jack was a scholarship quarterback at the University of Alabama during their 1993 NCAA football championship before being an honors medical student and outstanding plastic surgery resident at the University of Kentucky.

Rob

Breast implants and observed breast cancer rates. Could they actually be protective? Let's ask the rats.

* Image at right spoofed from The Onion

One of the most serious claims in the class action lawsuits against Dow Corning Corp. during the "silicone crisis" involving breast implants in the late 1980's was that silicone breast implants caused breast cancer and/or delays in diagnosis of breast cancer. Despite there being no evidence for it actually happening, these were reasonable questions to ask. Over the last 20 years, we've been flooded with data that has been reassuring on these issues.

Implants do make conventional mammograms harder to interpret by their "shadow", but the increased ease of doing manual exams by having the implant to push against to feel lesions compensates a great degree. An MRI mammogram can be used to supplement mammograms when needed for better imaging for screening.

One of the more interesting findings in several of the large series of women with implants was the observation of significantly lower (almost 40%) rates of breast cancer in the implant group versus a control population of women without implants. The intuitive reason for this has been that these women with implants were a self-selected (rather then "randomly selected") group who were likely to be healthier and have less breast tissue, which both should lowered their expected rates.

To really sort out a true "expected rate" for breast cancer, you'd have to do some herculean effort of better characterizing the individual risks with a tool like one of the "Gail Model's" of the study participants, which is almost impossible in such large trials. The suggestion that the presence of implants themselves was protective wasn't really taken seriously. There could however, be something that makes us look at this issue a little closer.

I came across a pre-publication in the journal Aesthetic Plastic Surgery entitled, "Breast Implants as a Preventive Factor" describing the differential temperature seen on thermography (a imaging technique that shows temperature) from experimental rats with silicone implants placed and the resultant affect that had on local circulating hormone levels and cellular abnormalities (both of which were decreased in the implant group). Now this was only an animal model mind you, but it immediately occurred to me that maybe part of that effect we were seeing was from this phenomena. Interesting stuff!

rob

Anna Kournikova does not have breast implants

Here's a quote from tennis star Anna Kournikova, responding to the same lame questions all the reporters ask her:

“I’m not married, not pregnant, didn’t have a boob job, no Botox. What else?”




I'm not surprised. She's 27 and been blessed with great genes. While she is pretty attractive, I was always partial to Mary Joe Fernandez and Chris Evert. I guess this shows my age.

Quote credit: celebritysmackblog.com
Photo credit: prphotos.com

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

Share |

Anna Kournikova does not have breast implants

Here's a quote from tennis star Anna Kournikova, responding to the same lame questions all the reporters ask her:

“I’m not married, not pregnant, didn’t have a boob job, no Botox. What else?”




I'm not surprised. She's 27 and been blessed with great genes. While she is pretty attractive, I was always partial to Mary Joe Fernandez and Chris Evert. I guess this shows my age.

Quote credit: celebritysmackblog.com
Photo credit: prphotos.com

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

Share |

Guess the Chest!

Ayyyy.com has a fun little "Guess the Celebrity Breasts" quiz. Can you name any of the celebrities whose chest is featured? I am embarrassed to say that I only got 4 right!
Doh!

Click here to go to Ayyyy.com for the answers!

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

Guess the Chest!

Ayyyy.com has a fun little "Guess the Celebrity Breasts" quiz. Can you name any of the celebrities whose chest is featured? I am embarrassed to say that I only got 4 right!
Doh!

Click here to go to Ayyyy.com for the answers!

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

What's oncoplastic surgery?

The Wall Street Journal profiled the concept of "Oncoplastic Breast Surgery". This is conceptually just lumpectomy or mastectomy done better. The concept uses rotating breast tissue to fill defects at the time of lumpectomy or larger "quadrantectomy" procedures. These are maneuvers we use with breast reduction and mastopexy procedures adapted to some of the cancer surgery procedures.



It's a nice concept, but the rate-limiting step here is getting general surgeons to change how they think about breast surgery. Trying to coordinate someone else during the resection with a reconstruction is difficult, as they don't "think" like plastic surgeons do. I'm skeptical that short courses to surgeons can teach much beyond the most simple techniques. It's like putting someone in front of Guitar Hero on the Wii or Playstation and expecting them to play guitar professionally afterwards.

I'm constantly evaluating blood supply, tension, and tissue quality in a way that you just don't get taught in other specialties. Weekend courses in this discipline just aren't the same as having doing hundreds of different possible reconstructive techniques all over the body and bringing that to bear on a given case. I had the pleasure of working with two of the leaders in this field during my breast surgery fellowship, in Plastic Surgeon Dr. Pat Maxwell and (an occasional basis) Breast Cancer Surgeon, Dr. Pat Whitworth in Nashville. I though I knew how to do mastectomies and whatnot before I saw these guys do their thing. They're incredible! Both do such anatomically sound breast procedures with no superfluous steps that it's really beautiful (for lack of a better word) to watch. Dr. Whitworth is quoted in the article BTW.

Rob

Meryl Streep and Heidi Klum Not Fond of Plastic Surgery

Both Meryl Streep and Heidi Klum have recently gone on record as being anti-plastic surgery. According to thecelebritycafe.com:

“You'd be amazed how many men in the industry have gone down that road,” Meryl Streep observed. "I don't get it.” Streep revealed that true actors should realize that often more interesting roles come to the older set anyway. “The good thing about getting older is that when they do cast you it's often something interesting - you're no longer asked to be the beautiful leading lady,” she said. When actors aren’t hired just for their matinee looks they are given the chance to play roles that “examine all the idiosyncrasies people have.” Streep remained refreshingly free of believing in unattainable standards of youth and beauty. “I think you have to embrace getting older and celebrate life,” she advised.

According to tob.hollywood.com, Heidi Klum stated:

There’s something odd when you’re 35 or 40 and ironed to the max. You change with time, and it’s fine. Everywhere there are these stand-up cards saying, ‘Have a little silicone while you get your roots done.’ I want to be the opposite of that.

It's easy for them to say that. One is arguably one of the greatest actresses of all time, and the other is a supermodel. I say, to each their own!

Photo credit: prphotos.com

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

Meryl Streep and Heidi Klum Not Fond of Plastic Surgery

Both Meryl Streep and Heidi Klum have recently gone on record as being anti-plastic surgery. According to thecelebritycafe.com:

“You'd be amazed how many men in the industry have gone down that road,” Meryl Streep observed. "I don't get it.” Streep revealed that true actors should realize that often more interesting roles come to the older set anyway. “The good thing about getting older is that when they do cast you it's often something interesting - you're no longer asked to be the beautiful leading lady,” she said. When actors aren’t hired just for their matinee looks they are given the chance to play roles that “examine all the idiosyncrasies people have.” Streep remained refreshingly free of believing in unattainable standards of youth and beauty. “I think you have to embrace getting older and celebrate life,” she advised.

According to tob.hollywood.com, Heidi Klum stated:

There’s something odd when you’re 35 or 40 and ironed to the max. You change with time, and it’s fine. Everywhere there are these stand-up cards saying, ‘Have a little silicone while you get your roots done.’ I want to be the opposite of that.

It's easy for them to say that. One is arguably one of the greatest actresses of all time, and the other is a supermodel. I say, to each their own!

Photo credit: prphotos.com

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

Quick links

I hope you have enjoyed your July 4th holiday weekend. I've had a great time with my wife and kids. Here are a few quick links for you to check out:

1. It looks like Australia has problems with phony plastic surgeons too. Click here.
2. Plastic Surgery Products magazine (of which I am on the Editorial Advisory Board) has a nice editorial about the current state of plastic surgery blogs. Click here.
3. For those of you unfamiliar with MTV's True Life television series, it is a documentary show which follows youths through various turning points in their lives. One recent episode featured two 20 year olds who had multiple plastic surgeries. According to the LA Times:

Yet when Rachael, her nose bandaged from the latest operation, softly said, "Hopefully I'll have the confidence to maybe complete the other goals in my life now, like being in Playboy and maybe finding a boyfriend," the show revealed the pathos lurking inside her synthetic nose-jobbed and implanted shell.

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

Quick links

I hope you have enjoyed your July 4th holiday weekend. I've had a great time with my wife and kids. Here are a few quick links for you to check out:

1. It looks like Australia has problems with phony plastic surgeons too. Click here.
2. Plastic Surgery Products magazine (of which I am on the Editorial Advisory Board) has a nice editorial about the current state of plastic surgery blogs. Click here.
3. For those of you unfamiliar with MTV's True Life television series, it is a documentary show which follows youths through various turning points in their lives. One recent episode featured two 20 year olds who had multiple plastic surgeries. According to the LA Times:

Yet when Rachael, her nose bandaged from the latest operation, softly said, "Hopefully I'll have the confidence to maybe complete the other goals in my life now, like being in Playboy and maybe finding a boyfriend," the show revealed the pathos lurking inside her synthetic nose-jobbed and implanted shell.

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

Who Has the Best Breasts in the Biz?

There is a great article on Colin Stewart's In Your Face blog which focuses on In Touch Weekly's Top 10 "Best Breasts" Poll. He analyzes each celebrity and whether or not they have breast implants. It's a nice read, and not just because he quotes me several times. Here's my opinion of whether each person in the top 10 have real or fake breasts.
1. Jessica Simpson - fake
2. Tyra Banks - real
3. Scarlett Johansson - real
4. Carmen Electra - fake
5. Lindsay Lohan - fake... I think.
6. Katherine Heigl - not sure
7. Audrina Patridge - who is she?
8. Jennifer Aniston - real
9. Megan Fox - tough call, but I think I know who may have done her rhinoplasty (good friend of mine)...
10. Beyonce Knowles - fake

For more in-depth analysis, click here for the article.

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

Photo credit: prphotos.com

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

Who Has the Best Breasts in the Biz?

There is a great article on Colin Stewart's In Your Face blog which focuses on In Touch Weekly's Top 10 "Best Breasts" Poll. He analyzes each celebrity and whether or not they have breast implants. It's a nice read, and not just because he quotes me several times. Here's my opinion of whether each person in the top 10 have real or fake breasts.
1. Jessica Simpson - fake
2. Tyra Banks - real
3. Scarlett Johansson - real
4. Carmen Electra - fake
5. Lindsay Lohan - fake... I think.
6. Katherine Heigl - not sure
7. Audrina Patridge - who is she?
8. Jennifer Aniston - real
9. Megan Fox - tough call, but I think I know who may have done her rhinoplasty (good friend of mine)...
10. Beyonce Knowles - fake

For more in-depth analysis, click here for the article.

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

Photo credit: prphotos.com

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

Is it worth it to operate on celebrities?

There is an interesting post from the Scalpel or Sword blog regarding the dangers of operating on celebrities such as Tiger Woods:

When a 32 year old soon-to-be billionaire superstar seeks medical treatment, I doubt he has to get a referral from his PCP or approval from an HMO pencil-pusher. But as the John Ritter case revealed, when a rich celebrity suffers a disastrous medical outcome, the potential liability far exceeds any insurance coverage or assets of the treating physicians.

Sure, the Orthopedist will get to prominently display a signed picture in his office waiting room of Tiger shaking his hand, and he will likely benefit from the prestige of having such a high-profile patient. And I'm sure Tiger will pay his bill in full. But what is a reasonable fee for taking on the enormous liability risk of treating such a patient?

This is even more true when the surgery being performed on the celebrity is plastic surgery. The Donda West case is an excellent example of that. Sure, her surgeon may have gotten some kudos for doing a nice job had things gone well, but since the situation ended poorly, his practice has now been devastated. Obviously other factors are in play in that situation as well. That being said, would I operate on celebrities? Yes.

Story credit: scalpelorsword.blogspot.com by way of KevinMD.com

Photo credit: prphotos.com

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

Is it worth it to operate on celebrities?

There is an interesting post from the Scalpel or Sword blog regarding the dangers of operating on celebrities such as Tiger Woods:

When a 32 year old soon-to-be billionaire superstar seeks medical treatment, I doubt he has to get a referral from his PCP or approval from an HMO pencil-pusher. But as the John Ritter case revealed, when a rich celebrity suffers a disastrous medical outcome, the potential liability far exceeds any insurance coverage or assets of the treating physicians.

Sure, the Orthopedist will get to prominently display a signed picture in his office waiting room of Tiger shaking his hand, and he will likely benefit from the prestige of having such a high-profile patient. And I'm sure Tiger will pay his bill in full. But what is a reasonable fee for taking on the enormous liability risk of treating such a patient?

This is even more true when the surgery being performed on the celebrity is plastic surgery. The Donda West case is an excellent example of that. Sure, her surgeon may have gotten some kudos for doing a nice job had things gone well, but since the situation ended poorly, his practice has now been devastated. Obviously other factors are in play in that situation as well. That being said, would I operate on celebrities? Yes.

Story credit: scalpelorsword.blogspot.com by way of KevinMD.com

Photo credit: prphotos.com

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