What Christina Applegate's looking at with her breast cancer reconstruction

Earlier this month, actress, Christina Applegate announced she'd undergone bilateral mastectomies for breast cancer. She reportedly possess one of the better characterized "breast cancer genes", BRCA1, which puts her at extraordinary high lifetime risks for developing breast or ovarian cancers. From the wire reports, she deferred reconstruction and plans on becoming pregnant after planned chemotherapy.

It sounds like she's received very mainstream advice for treating a younger breast cancer patient, particularly for a BRCA1 carrier. IMO these patients are excluded from consideration for lumpectomy procedures for treatment and should be strongly advised to consider prophylactic surgery on the other breast to maximally reduce lifetime risk of subsequent breast cancers. It's important to make sure patients understand that the highest risk factor for breast cancer is a personal history of breast cancer in the contra lateral breast. In young patients like Ms. Applegate, the math is even more persuasive for aggressive surgery as they have longer life expectancies during which breast cancers can develop. These patients are also frequently recommended to have the ovaries removed, both to suppress native estrogen production (which can stimulate some breast cancers) and to decrease the 40%+ increase in risk of ovarian cancer that brca1 confers.

I'm a little confused why they would not have proceeded with any part of her reconstruction at this point. She's trim enough that I do not believe she has enough bulk to do her reconstruction using her own tissues alone (probably using some microsurgical technique). I'd have strongly advised placing tissue expanders at the time of mastectomy to maintain the skin elasticity and you could later decide if you needed silicone gel implants or you could find an acceptable donor site for some autologous tissue to use. In a low risk patient, you really don't lose much by expander placement, while you realize an easier expansion process.




Rob

Breast Augmentation Using Stem Cells? Not Yet...

An interesting article claims that plastic surgeons in Europe and Japan are using stem cells for breast augmentation. It also states that some surgeons in the United States are also performing stem cell breast augmentation.

The closest thing to stem cell breast augmentation that I have experience with is fat grafting to the breast. Fat actually does contain a large amount of stem cells, and the procedure does work. However, due to significant controversy regarding its possible effects on mammography and breast cancer detection, I don't recommend it except in those situations where breast implants are not able to be used. The standard of care for breast augmentation is still the breast implant, and I expect that this will not change for a long time.

I know of no plastic surgeons in the U.S. who actually experiment with stem cells for breast augmentation.

Story credit: upi.com
Photo credit: The Soap Box

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

Breast Augmentation Using Stem Cells? Not Yet...

An interesting article claims that plastic surgeons in Europe and Japan are using stem cells for breast augmentation. It also states that some surgeons in the United States are also performing stem cell breast augmentation.

The closest thing to stem cell breast augmentation that I have experience with is fat grafting to the breast. Fat actually does contain a large amount of stem cells, and the procedure does work. However, due to significant controversy regarding its possible effects on mammography and breast cancer detection, I don't recommend it except in those situations where breast implants are not able to be used. The standard of care for breast augmentation is still the breast implant, and I expect that this will not change for a long time.

I know of no plastic surgeons in the U.S. who actually experiment with stem cells for breast augmentation.

Story credit: upi.com
Photo credit: The Soap Box

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

actor Gabriel Olds on women who've had plastic surgery -Put your asshat on, Gabe!

So B-list actor Gabriel Olds pens this piece for the August 2008 Glamour magazine titled, "Why men crave real (not perfect) bodies". It's funny when Jerry Seinfeld breaks up with a woman for having "man hands" in a classic Seinfeld episode, but you it's tacky when you're that frank in a print column.





Fine. You certainly can make thoughtful and plausible arguments why we all should ignore contemporary ideals of female beauty (real and imagined) and realize inner beauty for what it is. You do NOT have to do it in a dickhead tone of voice which alienates said women. Monsieur Olds quickly falls off the cliff quickly in that regard with his narcissistic article.

The women commenting to the article certainly had their fangs out over this:

I have breasts implants, and before I got them I spent my entire life being ridiculed by both men and women. I had absolutely no breasts. I was nothing but a nipple and I always felt like less of a woman. I couldn't find clothes that fit well, bathing suits were a nightmare, and shopping for bras was nearly impossible. I made the decision to undergo breast augmentation not because I wanted to be "perfect," it was because I wanted to be "normal".

I would like to say first, how presumptuous of Mr. Oldnutsack to assume that we should reveal our own medical history before we have even had the opportunity to see the size of his dick.(OUCH!)

I mean really, to dump someone/doubt their honesty because they didn't immediately tell you about a surgery?! I highly doubt you would go around telling first dates or third dates even, "I have ED. I have a dangling penis, so I take Viagra to make it perkier."

this author is SHALLOW. He had one superficial date with a women he is PHYSICALLY attracted to and he is writing her off! He is obviously not interested in getting to know her on the inside. I am a psychotherapist. People like him need to take a good LONG look at them selves and be honest about why they are afraid of intimacy. It is clear to any one reading this article that his motive was purely sexual. If the author wants perfection then he will need to accept that perfection is achieved by alteration and that anything natural has flaws. A word of advice: Try to shake your narcissism, mister. It's unattractive to women. Hey, are you sure she didn't dump you after she felt YOU up!

Rob

Pam Anderson - No to Botox but Yes to Juvederm?

Here is a photograph of Pam Anderson during a recent press tour in Australia to promote her new reality show on E!. As you can see, there is no sign of any Botox in her forehead, but her lips look pretty plump, possibly due to Juvederm injections. The cupid's bow of her upper lip looks obliterated, which can happen when a good amount of injectable filler is placed there. This is one of the few photos that I've seen where Pam looks all of her 41 years. Maybe the jet lag hasn't been kind. I always look (and feel) like hell after a long plane flight.

Juvederm lasts around 6-12 months, and I find it works very well in the lips when injected conservatively.

Photo credit: dlisted.com

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

Pam Anderson - No to Botox but Yes to Juvederm?

Here is a photograph of Pam Anderson during a recent press tour in Australia to promote her new reality show on E!. As you can see, there is no sign of any Botox in her forehead, but her lips look pretty plump, possibly due to Juvederm injections. The cupid's bow of her upper lip looks obliterated, which can happen when a good amount of injectable filler is placed there. This is one of the few photos that I've seen where Pam looks all of her 41 years. Maybe the jet lag hasn't been kind. I always look (and feel) like hell after a long plane flight.

Juvederm lasts around 6-12 months, and I find it works very well in the lips when injected conservatively.

Photo credit: dlisted.com

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

Has Jennifer Aniston Had Her Lips Plumped?

Photos of Jennifer Aniston have recently surfaced, showing a possible lip augmentation. If she's had it done, it is a subtle job, possibly with Restylane. Some may argue that her lips look the same, but if you compare the 'then' to the 'now,' you can see that the lip proportions have changed. In the 'then' photo, her upper lip is slightly smaller than her lower lip. In the 'now' photo, the upper lip is actually larger than the lower lip.

I have stated many times on this blog that the natural lip proportions (with some exceptions) have the lower lip 1.5 times the size of the upper lip. Quite often plastic surgeons become overzealous in augmenting the upper lip, making it appear larger than the lower lip. This creates the all-too-common 'trout pout.' Whether Jennifer Aniston has had her lips done or not, I'm sure John Mayer would agree that her "Body is a Wonderland."

Photo credit: Daily Mail

Thanks for reading.

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

Share |

Has Jennifer Aniston Had Her Lips Plumped?

Photos of Jennifer Aniston have recently surfaced, showing a possible lip augmentation. If she's had it done, it is a subtle job, possibly with Restylane. Some may argue that her lips look the same, but if you compare the 'then' to the 'now,' you can see that the lip proportions have changed. In the 'then' photo, her upper lip is slightly smaller than her lower lip. In the 'now' photo, the upper lip is actually larger than the lower lip.

I have stated many times on this blog that the natural lip proportions (with some exceptions) have the lower lip 1.5 times the size of the upper lip. Quite often plastic surgeons become overzealous in augmenting the upper lip, making it appear larger than the lower lip. This creates the all-too-common 'trout pout.' Whether Jennifer Aniston has had her lips done or not, I'm sure John Mayer would agree that her "Body is a Wonderland."

Photo credit: Daily Mail

Thanks for reading.

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

Share |

Good Doctor of the Day Award - Dr. Paul Offit on autism and vaccines

I've mentioned in a 2007 post, "Mad Science", about the political issue of autism's and their alleged link to childhood vaccinations in the past as a metaphor for what we went thru with the debunked tort driven silicone breast implant (SBI) scare in the late 1980's. Unlike SBI's which are a cosmetic product, vaccines save lives. Lots of them!

A wrong headed attempt to blame first a preservative in some vaccines (thimerosol) and later the vaccines themselves for new diagnosis of autism has led to a dangerous public health situation. Pockets of non-immunized children can clearly serve the role of "typhoid mary" for pandemics of illness if history is any guide.

The number of new measles cases in the U.S. is at its highest level since 1997, and nearly half of those involve children whose parents rejected vaccination. According to the Las Vegas Sun,

It is no longer endemic to the United States, but every year some Americans pick it up while traveling abroad and bring it home. Measles epidemics have exploded in Israel, Switzerland and some other countries. But high U.S. childhood vaccination rates have prevented major outbreaks here.

In a typical year, only one outbreak occurs in the United States, infecting perhaps 10 to 20 people. So far this year through July 30 the country has seen seven outbreaks, including one in Illinois with 30 cases, said Seward, deputy director of the CDC's Division of Viral Diseases.

....The nation once routinely saw hundreds of thousands of measles cases each year, and hundreds of deaths. But immunization campaigns were credited with dramatically reducing the numbers. The last time health officials saw this many cases was 1997, when 138 were reported. Last year, there were only 42 U.S. cases."

Leading the voices of reason and evidence-based medicine is Dr. Paul Offit, who has a great new book coming out this whole controversy and breaks it down for a lay audience as to what the issues are and what the evidence shows. Linked below is a nice clip of Dr. Offit summarizing this.




Rob

The Top 10 Worst Female Celeb Body Parts?

CelebSlam has named their Top 10 Worst Female Celeb Body Parts. Here they are:

10. Jennifer Love Hewitt's Hips
9. Jennifer Garner's Toes
8. Paris Hilton's Wonky Eye
7. Jennifer Lopez's Buttocks
6. Tori Spelling's Breasts
5. Sarah Jessica Parker's Hands
4. Mischa Barton's Thighs
3. Jenna Jameson's Lips
2. Tara Reid's Stomach
1. Amy Winehouse's...Pick Something

I would definitely disagree with a number of their choices, especially Jennifer Love Hewitt and Jennifer Lopez. I wonder what a list of the Top 10 Worst Male Celeb Body Parts would include? Maybe Kenny Rogers' eyelids, Fred Thompson's neck, Mickey Rourke's cheeks, and Brad Pitt's face? ;)
To see photos of the 'offending' body parts from Celeb Slam, click here for their post.

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

The Top 10 Worst Female Celeb Body Parts?

CelebSlam has named their Top 10 Worst Female Celeb Body Parts. Here they are:

10. Jennifer Love Hewitt's Hips
9. Jennifer Garner's Toes
8. Paris Hilton's Wonky Eye
7. Jennifer Lopez's Buttocks
6. Tori Spelling's Breasts
5. Sarah Jessica Parker's Hands
4. Mischa Barton's Thighs
3. Jenna Jameson's Lips
2. Tara Reid's Stomach
1. Amy Winehouse's...Pick Something

I would definitely disagree with a number of their choices, especially Jennifer Love Hewitt and Jennifer Lopez. I wonder what a list of the Top 10 Worst Male Celeb Body Parts would include? Maybe Kenny Rogers' eyelids, Fred Thompson's neck, Mickey Rourke's cheeks, and Brad Pitt's face? ;)
To see photos of the 'offending' body parts from Celeb Slam, click here for their post.

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

Christina Applegate Breast Cancer and Reconstruction

As you may know by now, Christina Applegate has undergone a double mastectomy for possible breast cancer. She has the BRCA1 gene, which is a marker for high breast cancer risk. Ms. Applegate elected to undergo a prophylactic mastectomy, essentially removing all her breast tissue in order to prevent a potentially deadly cancer from appearing. In an interview, she stated that the next eight months would be spent undergoing breast reconstruction surgery.

What reconstructive surgery may she be having? It sounds to me that she is probably going to undergo breast reconstruction using breast implants. This process can take several surgeries. Most commonly, temporary breast implant expanders are placed at the time of the mastectomy. These implants are gradually filled over several months to expand the remaining skin and muscle. When they are the desired size, then another surgery is performed where the expander implants are replaced with permanent breast implants. Usually a few months later the nipples are recreated during a third surgery. The final step is often tattooing of the nipples and areola, in order to get the darker color of the real thing.

I wish her the best in her recovery and future treatments. I thought she was great in Married with Children.

Photo credit: prphotos.com

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

Christina Applegate Breast Cancer and Reconstruction

As you may know by now, Christina Applegate has undergone a double mastectomy for possible breast cancer. She has the BRCA1 gene, which is a marker for high breast cancer risk. Ms. Applegate elected to undergo a prophylactic mastectomy, essentially removing all her breast tissue in order to prevent a potentially deadly cancer from appearing. In an interview, she stated that the next eight months would be spent undergoing breast reconstruction surgery.

What reconstructive surgery may she be having? It sounds to me that she is probably going to undergo breast reconstruction using breast implants. This process can take several surgeries. Most commonly, temporary breast implant expanders are placed at the time of the mastectomy. These implants are gradually filled over several months to expand the remaining skin and muscle. When they are the desired size, then another surgery is performed where the expander implants are replaced with permanent breast implants. Usually a few months later the nipples are recreated during a third surgery. The final step is often tattooing of the nipples and areola, in order to get the darker color of the real thing.

I wish her the best in her recovery and future treatments. I thought she was great in Married with Children.

Photo credit: prphotos.com

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

California Senate Approves "Donda West Law"

The California Senate has approved, by a margin of 37-1 the Donda West law, named after Kanye West's late mother. This law makes it mandatory for anyone undergoing a cosmetic surgery to have a history and physical performed prior to surgery.

Ho hum. Most plastic surgeons already do this. Instead of enacting unnecessary laws, why not limit plastic surgery to those who are actually trained at it? The California legislature has recently approved a bill allowing oral surgeons (DDS dentists) to perform all sorts of facial plastic surgery. How ridiculous! You wouldn't want me performing your root canal, so why have an oral surgeon do your facelift?

Photo credit: prphotos.com

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

California Senate Approves "Donda West Law"

The California Senate has approved, by a margin of 37-1 the Donda West law, named after Kanye West's late mother. This law makes it mandatory for anyone undergoing a cosmetic surgery to have a history and physical performed prior to surgery.

Ho hum. Most plastic surgeons already do this. Instead of enacting unnecessary laws, why not limit plastic surgery to those who are actually trained at it? The California legislature has recently approved a bill allowing oral surgeons (DDS dentists) to perform all sorts of facial plastic surgery. How ridiculous! You wouldn't want me performing your root canal, so why have an oral surgeon do your facelift?

Photo credit: prphotos.com

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

What is the Most Nipped and Tucked City?

Men's Health Magazine has recently released its list of the most nipped and tucked cities in the United States. Guess what's number one? San Francisco!

Do you think this may have to do with Senator Nancy Pelosi's influence? She does look mighty good for her age.

Here is the remainder of the top 10:
2: Honolulu
3: Sacramento
4: Miami
5: Tucson
6: San Diego
7: Richmond, VA
8: Washington, DC
9: Rochester, NY (not Rochester, MI)
10: Seattle

Other notables:
34: Grand Rapids, MI
48: Los Angeles, CA

Which are the least nipped and tucked?
Lincoln, NE
Fort Wayne, IN
Montgomery, AL
Toledo, OH
Madison, WI

I actually get quite a few patients who come from Toledo to have plastic surgery here in Metro Detroit...

For the full list from Men's Health, click here.




Thanks for reading.

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

What is the Most Nipped and Tucked City?

Men's Health Magazine has recently released its list of the most nipped and tucked cities in the United States. Guess what's number one? San Francisco!

Do you think this may have to do with Senator Nancy Pelosi's influence? She does look mighty good for her age.

Here is the remainder of the top 10:
2: Honolulu
3: Sacramento
4: Miami
5: Tucson
6: San Diego
7: Richmond, VA
8: Washington, DC
9: Rochester, NY (not Rochester, MI)
10: Seattle

Other notables:
34: Grand Rapids, MI
48: Los Angeles, CA

Which are the least nipped and tucked?
Lincoln, NE
Fort Wayne, IN
Montgomery, AL
Toledo, OH
Madison, WI

I actually get quite a few patients who come from Toledo to have plastic surgery here in Metro Detroit...

For the full list from Men's Health, click here.




Thanks for reading.

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

Plastic Surgery 101's Olympic Update - It's sunny side up on the beach volleyball coverage!

If you've ever watched professional sports events, you'll notice the cameramen have this habit of doing random crowd shots where they zoom in on pretty women pretty shamelessly. Women's beach volleyball coverage takes this to a whole new level.

Under the guise of "explaining the importance hand signals" during the match, NBC has about the most gratuitous photo gallery of women's backsides in teeny-weenie bikinis this side of Sports Illustrated's swimsuit issue. The whole idea of buttock aesthetics has received some attention in plastic surgery literature, and one of these days I'll write about it.

If you think I'm exaggerating about how blatant a T&A show the coverage is, please check NBC's gallery on the web which as far as I can tell was likely compliled by a 12 year old male NBC staffer!

Usually, in doubles competition, you have a server and you have his/her partner near the net. Crucial to a successful game play is a good line of communication between the players on a team as the court is a wide area for two players to cover. A lack of coordination between players will likely result in wide open spaces and a disjoint defense. It is up to the person nearest the net to call the shots and signal clandestinely to his/her partner what the intended game play is. In essence, the person nearest the net is the quarterback of the team.

There are 4 basic "modes" for each hand which is held behind the back to signal the other player. 'One finger' signals that the net player will block the opponent's spike down the line on the corresponding side of the hand. 'Two fingers' signals that the net player will block the opponent's spike at an angle cross-court on the corresponding side of the hand. A 'closed fist' signals that the net player will not block on the corresponding side of the hand. And finally an 'open hand' signals that the net player will block "ball," i.e. block according to how and where the opponent sets and swings.

I think this athlete's signaling she's wedging! :)




Rob

Do You Want to Be on TV?

Sorry for the lack of updates. It's been a whirlwind past couple days. Tuesday afternoon I flew to L.A. to film a television pilot, returning Wednesday evening. I've been in surgery all day today, so I just haven't had time to post anything!

Speaking of TV, I was contacted by the producer of a well-known television program that is looking for people who lighten their skin to look "better." The title of the segment is "Bleaching for Beauty" and they want to find people who believe they are more attractive after using skin lightening creams. If this applies to you, email your information to me at: miplasticsurgeon@yahoo.com. I will forward your information to the producer.

If you have an interesting plastic surgery-related story and would like to be featured on television, feel free to email me. I often get calls from producers who are looking for an interesting story to tell. Who knows, maybe you can get a free trip to New York out of it!

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

Do You Want to Be on TV?

Sorry for the lack of updates. It's been a whirlwind past couple days. Tuesday afternoon I flew to L.A. to film a television pilot, returning Wednesday evening. I've been in surgery all day today, so I just haven't had time to post anything!

Speaking of TV, I was contacted by the producer of a well-known television program that is looking for people who lighten their skin to look "better." The title of the segment is "Bleaching for Beauty" and they want to find people who believe they are more attractive after using skin lightening creams. If this applies to you, email your information to me at: miplasticsurgeon@yahoo.com. I will forward your information to the producer.

If you have an interesting plastic surgery-related story and would like to be featured on television, feel free to email me. I often get calls from producers who are looking for an interesting story to tell. Who knows, maybe you can get a free trip to New York out of it!

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

Plastic Surgery 101 suggests look before you leap (in logic) on hospital infections

There's an op-ed piece in today's Wall Street Journal by one Betsy McCaughey which has my blood pressure up. The article titled, "Hospital Infections: Preventable and Unacceptable" implies that any hospital acquired infection was preventable and should be remedied with class action lawsuits.

For someone who's bright like Ms. McCaughey, she shows little insight and understanding apparently into what drives and perpetuates many different types of infections. Nobody disagrees that common sense steps like hand washing and protocols for invasive intravenous (IV) access maintenance are important in limiting infections, it is both a dangerous and disingenuous idea to suggest that a goal of ZERO is attainable. It is impossible to achieve a failure rate of 0% for system or process, particularly one with infinite numbers of variables (as with a human population of patients). Unlike a Toyota, no two models of the human assembly line are exactly alike (even identical twins gradual accumulate differences due to environmental exposure).

Patients with more comorbities are going to have higher infection rates PERIOD. An overweight, diabetic, smoker (a frequent demographic for vascular disease patients in my neck of the woods) who has open heart surgery has more problems then others and an increased infection rate is more attributable to the patient's behavior rather then the hospital. Obese patients and smokers have higher rates of problems after elective plastic surgery (like breast reconstruction or reduction for instance)as well for that matter. You can be sure at some point, hospitals (and doctors) will be looking at patient demographic data to exclude higher risk patients from treatment at their facility whatsoever.

In referring to a list of "never events" recently laid out by Medicare for which they will not cover the cost of complications she blithely writes

"No wonder Medicare calls these infections "never events" Why should jurors reach a different conclusion in a lawsuit."

This coming from a bureaucrat and politician is hard to take. While we should always strive to be perfect, it's important to realize that there are processes which we can all agree on to attain low and reproducible rates of infection.

For a related writing here on Plastic Surgery 101 see the post "Medicare announces they won't pay for complications - How the F*** is this going to work?" that I wrote last year.


Cheers!
Rob

Beware! Entering a no spin zone: Predictable pullback on Smart-Lipo and other laser assisted liposuction systems

It was so predictable as to be boring!

So I'm reading a particularly shameless trade journal this week who's cover story promised updates on laser liposuction. This monthly glossy magazine is essentially a series of (not so) stealth ads with physicians shilling for lasers and other products for which they're paid spokesmen. As the topic turned to laser liposuction systems (like Cynosure's SmartLipo) you saw a lot of pullback on exactly how enthusiastic a number of surgeons are.

"In reality, the degree of fat melting attained with laser lipolysis has not met the high expectations of some practitioners"

When you see comments like that in a fluff trade journal which routinely celebrates every device/technology (whether it deserves it or not) you know this issue is understated significantly. When you take mostly non plastic surgeons and hand them a "magic wand" like SmartLipo while promising great body contouring results, it's a set up for under delivering. There still is no shortcut on mechanically removing tissue for most patients. An exception might be some one's neck which has almost no fat to speak of.

This is kind of like the thread lift fiasco all over again. It's become clear that these laser platforms are much less revolutionary, but are more likely modestly complementary (if that) to the 30 year old tumescent liposuction techniques introduced to the west by a French surgeon named Illouz.

The general "off the record" feelings of most experienced plastic surgeons experimenting with this is that these types of devices are safe but offer no clear advantage. Repeatedly it's described more as a succesful marketing phenomena rather than a real improvement. It's still not established that delivering thermal energy below the skin affects "tightening" whatsoever, which is the whole gimmick of the laser. If it does, it doesn't appear to do it without still having to do most of the heavy lifting with traditional lipo.

In contrast to this unnamed aforementioned trade journal which is lame, I'd like to give a nod to editor Jeff Frentzen and Plastic Surgery Products magazine which frequently has good articles - like mine for instance


Cheers,
Rob

Update of the Acupuncture Facelift from the Beauty Brains

A fantastic site, The Beauty Brains, has a good post on the facts behind the Acupuncture Facelift. Their bottom line:



If you’re going to get a cosmetic procedure done, don’t waste money on acupuncture. Save up for a full blown face lift. At least that will be done by a reputable doctor and has been proven to work. And if surgery isn’t something you want to do, stick to the high quality facial products you can buy at your local drug store. They’re just as good as the department store products.



I would agree with just about everything they state in the article, except for one thing. I strongly believe that physician-prescribed skin care products, such as Obagi Nuderm, are much more effective and powerful in reversing aging than local drug store or department store products. Otherwise, like all their posts, I find the article extremely well-written. Check it out here.


Thanks for reading.

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

Update of the Acupuncture Facelift from the Beauty Brains

A fantastic site, The Beauty Brains, has a good post on the facts behind the Acupuncture Facelift. Their bottom line:



If you’re going to get a cosmetic procedure done, don’t waste money on acupuncture. Save up for a full blown face lift. At least that will be done by a reputable doctor and has been proven to work. And if surgery isn’t something you want to do, stick to the high quality facial products you can buy at your local drug store. They’re just as good as the department store products.



I would agree with just about everything they state in the article, except for one thing. I strongly believe that physician-prescribed skin care products, such as Obagi Nuderm, are much more effective and powerful in reversing aging than local drug store or department store products. Otherwise, like all their posts, I find the article extremely well-written. Check it out here.


Thanks for reading.

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

Lindsay Davenport Uses Juvederm and Botox

In an exclusive interview with Make Me Heal.com, new Juvederm spokesperson and professional tennis player Lindsay Davenport admits to having both Juvederm and Botox injections...and loving them:

No one should have to feel like their skin is aging faster than their body. Thanks to JUVÉDERM I just look my age. And my theory is, when I find something that works, I want to share it. That’s why I’m talking freely about my JUVÉDERM treatments....I love the results of Juvederm. I’ve also used Botox Cosmetic which has provided great results as well!

We perform Juvederm injections in my practice quite often. It injects very nicely, and some studies have shown longevity of the product for a year. Overall, my only complaint about Juvederm is that the syringe size is 0.8 cc, and not 1.0 cc like Restylane. There are so many other fillers on the market nowadays (including Perlane, Prevelle, Artifill, Radiesse, and several others) that it's easy for a patient to be confused about what to use. An easy recommendation for patients is that you can't go wrong starting out with Restylane or Juvederm, as these are the two 'workhorses' of filler products, in my opinion. Some of the other fillers are more 'niche' players (kind of like a doubles specialist in tennis).


Photo credit: prphotos.com (Photo taken before her Juvederm treatment)


Thanks for reading.

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

Lindsay Davenport Uses Juvederm and Botox

In an exclusive interview with Make Me Heal.com, new Juvederm spokesperson and professional tennis player Lindsay Davenport admits to having both Juvederm and Botox injections...and loving them:

No one should have to feel like their skin is aging faster than their body. Thanks to JUVÉDERM I just look my age. And my theory is, when I find something that works, I want to share it. That’s why I’m talking freely about my JUVÉDERM treatments....I love the results of Juvederm. I’ve also used Botox Cosmetic which has provided great results as well!

We perform Juvederm injections in my practice quite often. It injects very nicely, and some studies have shown longevity of the product for a year. Overall, my only complaint about Juvederm is that the syringe size is 0.8 cc, and not 1.0 cc like Restylane. There are so many other fillers on the market nowadays (including Perlane, Prevelle, Artifill, Radiesse, and several others) that it's easy for a patient to be confused about what to use. An easy recommendation for patients is that you can't go wrong starting out with Restylane or Juvederm, as these are the two 'workhorses' of filler products, in my opinion. Some of the other fillers are more 'niche' players (kind of like a doubles specialist in tennis).


Photo credit: prphotos.com (Photo taken before her Juvederm treatment)


Thanks for reading.

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

Fullness In, Tautness Out - Old News?

The Early Show on CBS had a segment this morning explaining the "new" trend in plastic surgery: Adding volume instead of just lifting. They explained that adding fullness to the cheeks is a key component of reversing aging and creating the most naturally youthful look possible.

Is this old news? When I did my aesthetic surgery fellowship with Dr. Richard Ellenbogen five years ago, the importance of volume enhancement in facial rejuvenation was the most important thing he taught me. We even published an article in the Aesthetic Surgery Journal about it, entitled the Volumetric Facelift. Click here for the article.

I strongly agree that adding fullness into a face is an extremely important part of reversing aging. I teach my patients that aging is a 3-Dimensional process. The best methods for volume addition are surgical facial fat grafting or nonsurgical Sculptra injections (not approved by the FDA for general cosmetic use). These are some of my favorite procedures to perform, as the results can be very natural and very powerful.

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

Fullness In, Tautness Out - Old News?

The Early Show on CBS had a segment this morning explaining the "new" trend in plastic surgery: Adding volume instead of just lifting. They explained that adding fullness to the cheeks is a key component of reversing aging and creating the most naturally youthful look possible.

Is this old news? When I did my aesthetic surgery fellowship with Dr. Richard Ellenbogen five years ago, the importance of volume enhancement in facial rejuvenation was the most important thing he taught me. We even published an article in the Aesthetic Surgery Journal about it, entitled the Volumetric Facelift. Click here for the article.

I strongly agree that adding fullness into a face is an extremely important part of reversing aging. I teach my patients that aging is a 3-Dimensional process. The best methods for volume addition are surgical facial fat grafting or nonsurgical Sculptra injections (not approved by the FDA for general cosmetic use). These are some of my favorite procedures to perform, as the results can be very natural and very powerful.

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

Note to self - Never tell a woman she has a witch's chin deformity

Doh!

Sometimes our terminology and analysis comes out of our mouth without thinking about how people may internalize it. So I'm at this event the other night celebrating my new partner's addition to the practice, and I made the innocent mistake of telling someone I thought they had a little bit of a "witch's chin" when they were asking me about what they didn't like about their own chin.




Big mistake!I think I've now scarred that girl for life as she's now fixated on it! While I was implying a subtle chin feature that only someone like me is going to pick up on, she's imagining I've called her the wicked witch of the west. That awkward moment has inspired today's sermon on chins.

Cartoons characters such as Andy Gump and Broom Hilda the Witch are best known for their exaggerated facial features. In Plastic Surgery we have borrowed these characterization helping us to describe features with the “Andy Gump Syndrome” or the “Witches Chin Deformity.”




An Andy Gump deformity is produced from not reconstructing the jaw bone (mandible), most commonly when cancer surgeries in that area require removal. In 2008, such mandible problems are treated by taking a piece of your fibula (a lower leg bone) and doing microsurgical reconstruction to transplant it to the jaw. I did about a dozen of those in my training and it's an elegant surgery. As I don't do microsurgery in practice or work at a hospital where such large ENT cancer surgeries are performed, I hopefully will never be asked to do something like that again!

A "witch's chin" deformity describes either an excess of fat and/or drooping of said fat on the projecting part of you chin. The surgical correction involves removing the bulk and suspending it to the bony part of your chin. Seen below is a representative picture of the condition and a graphic of one of the operations to fix it.















For all you ever wanted to know about witch's appearences in pop culture throught history, check out the neat "Sexy Witch Blog" from Australia.

G'day mates!
Rob

Madonna and Madamism?

Is Madonna turning into a Madame puppet-face? Cityrag.com has coined (or propagated) the term "Madamism," which is a process some stars undergo as they have too much plastic surgery. They begin to look more and more like Madame the puppet. Other stars who may be undergoing Madamism include Priscilla Presley, Faye Dunaway, Cher, and maybe even Lara Flynn Boyle.

Check out cityrag.com for more details.

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

Madonna and Madamism?

Is Madonna turning into a Madame puppet-face? Cityrag.com has coined (or propagated) the term "Madamism," which is a process some stars undergo as they have too much plastic surgery. They begin to look more and more like Madame the puppet. Other stars who may be undergoing Madamism include Priscilla Presley, Faye Dunaway, Cher, and maybe even Lara Flynn Boyle.

Check out cityrag.com for more details.

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

Paris Hilton Denies Plastic Surgery

Paris Hilton is currently filming Repo! The Genetic Opera portraying a person addicted to plastic surgery. Naturally, she's been asked whether she's had some work done. Her response:

Well, I've never had any plastic surgery, so doing a character like that — it was a lot of fun to change because every scene I have a different nose, I have different eyes, different hair. We were using a lot of prosthetics, so every scene you can't really tell that it's me, so that was a lot of fun.

I enjoy movies, but something tells me I'm going to miss this one...

For my previous posts on Paris Hilton, click here.

Story source: mtv.com

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

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Paris Hilton Denies Plastic Surgery

Paris Hilton is currently filming Repo! The Genetic Opera portraying a person addicted to plastic surgery. Naturally, she's been asked whether she's had some work done. Her response:

Well, I've never had any plastic surgery, so doing a character like that — it was a lot of fun to change because every scene I have a different nose, I have different eyes, different hair. We were using a lot of prosthetics, so every scene you can't really tell that it's me, so that was a lot of fun.

I enjoy movies, but something tells me I'm going to miss this one...

For my previous posts on Paris Hilton, click here.

Story source: mtv.com

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

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What's Happening to Madonna?

What's the story with Madonna's appearance? She seems to be getting thinner and thinner (check out her arms) yet her cheeks remain full and soft. Can this be due to plastic surgery?

I think it is. There are three ways to effectively add volume to the face. The first is facial fat grafting. This is one of my favorite plastic surgeries to perform because it is minimally invasive and can really return a nice, youthful softness to the face. The second way to add volume to the face is via solid implants. With the exception of a chin implant, I am not a fan of these types of facial implants. Some of them require screws to keep them in place. Due to their hard nature, they also do not achieve the softer look of facial fat grafting, or the third technique: Sculptra injections. I believe Madonna may have had Sculptra injections to her face over the last several years to retain volume and softness. Sculptra is FDA approved for HIV-related facial wasting, but is often used for general cosmetic reasons. I think it is a very effective way to enhance the face.

So why do I think Madonna has had Sculptra and not facial fat grafting? Since it appears the fat in the rest of her body has all but disappeared, I would expect the same to occur in her face. However, even with an extremely thin body, her cheeks remain full. Sculptra-enhanced cheeks should not deflate quite as much as fat-enhanced cheeks.

For more of my thoughts on Madonna's possible $100,000 worth of plastic surgery, check out last week's issue of In Touch Weekly.

Photo credit: IDontLikeYouInThatWay.com

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

What's Happening to Madonna?

What's the story with Madonna's appearance? She seems to be getting thinner and thinner (check out her arms) yet her cheeks remain full and soft. Can this be due to plastic surgery?

I think it is. There are three ways to effectively add volume to the face. The first is facial fat grafting. This is one of my favorite plastic surgeries to perform because it is minimally invasive and can really return a nice, youthful softness to the face. The second way to add volume to the face is via solid implants. With the exception of a chin implant, I am not a fan of these types of facial implants. Some of them require screws to keep them in place. Due to their hard nature, they also do not achieve the softer look of facial fat grafting, or the third technique: Sculptra injections. I believe Madonna may have had Sculptra injections to her face over the last several years to retain volume and softness. Sculptra is FDA approved for HIV-related facial wasting, but is often used for general cosmetic reasons. I think it is a very effective way to enhance the face.

So why do I think Madonna has had Sculptra and not facial fat grafting? Since it appears the fat in the rest of her body has all but disappeared, I would expect the same to occur in her face. However, even with an extremely thin body, her cheeks remain full. Sculptra-enhanced cheeks should not deflate quite as much as fat-enhanced cheeks.

For more of my thoughts on Madonna's possible $100,000 worth of plastic surgery, check out last week's issue of In Touch Weekly.

Photo credit: IDontLikeYouInThatWay.com

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