Surgical Roulette - Risks of Surgery with a Phony Plastic Surgeon

The Times Publication has an outstanding article chronicling the story of Dr. Peter Normann, an Arizona-based Internal Medicine and Emergency Room specialist who masqueraded as a plastic surgeon. In a span of seven months three unsuspecting patients died under his care. The article highlights the unfortunate and shocking stores of several of his victims. It's a fascinating read. From the article:

While the cosmetic horror stories described by the patients of Peter Normann represent some of the most egregious in the state's history, research shows they are part of a larger and growing danger of ill-equipped and inadequately trained plastic surgeons performing invasive cosmetic procedures.Normann, an emergency room and internal medical physician, was never certified as a plastic surgeon. In other cases, some Valley physicians certified to practice as gynecologists or even ear, nose and throat doctors have been found to be practicing cosmetic surgery, many with little more experience than a weekend training course.
The results are patients being left scarred, disfigured, and in three of Peter Normann's cases, dead.

In response to the growing number of phony plastic surgeons, the Arizona Medical Board released a Guide to Choosing a Cosmetic Surgeon. You can find it here.

Even here in Metro Detroit there are numerous physicians who are performing plastic surgery with little more than a weekend course's training. If you are thinking of having plastic surgery, make sure your surgeon is certified by the American Board of Plastic Surgery. All members of the American Society of Plastic Surgeons are certified by the American Board of Plastic Surgery, so this is a good place to find a plastic surgeon for you.

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

Surgical Roulette - Risks of Surgery with a Phony Plastic Surgeon

The Times Publication has an outstanding article chronicling the story of Dr. Peter Normann, an Arizona-based Internal Medicine and Emergency Room specialist who masqueraded as a plastic surgeon. In a span of seven months three unsuspecting patients died under his care. The article highlights the unfortunate and shocking stores of several of his victims. It's a fascinating read. From the article:

While the cosmetic horror stories described by the patients of Peter Normann represent some of the most egregious in the state's history, research shows they are part of a larger and growing danger of ill-equipped and inadequately trained plastic surgeons performing invasive cosmetic procedures.Normann, an emergency room and internal medical physician, was never certified as a plastic surgeon. In other cases, some Valley physicians certified to practice as gynecologists or even ear, nose and throat doctors have been found to be practicing cosmetic surgery, many with little more experience than a weekend training course.
The results are patients being left scarred, disfigured, and in three of Peter Normann's cases, dead.

In response to the growing number of phony plastic surgeons, the Arizona Medical Board released a Guide to Choosing a Cosmetic Surgeon. You can find it here.

Even here in Metro Detroit there are numerous physicians who are performing plastic surgery with little more than a weekend course's training. If you are thinking of having plastic surgery, make sure your surgeon is certified by the American Board of Plastic Surgery. All members of the American Society of Plastic Surgeons are certified by the American Board of Plastic Surgery, so this is a good place to find a plastic surgeon for you.

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

Haylie Duff - Plastic Surgery?

Has Haylie Duff had plastic surgery recently? It appears so. Check out the new photo on Celebrity Smack, and compare it to the photo here. She appears to have had a reduction genioplasty, or surgery to reduce the projection of the chin. Her nose also appears to have been tweaked via a rhinoplasty. Overall I think the nose looks great, but the chin may have ended up a bit on the smaller side. I'll be interested to see how she looks when more photos come out. Hopefully it won't be a PR disaster like her sister Hillary Duff's veneers.

For the Celebrity Smack article, click here.
Photo credit: prphotos (from 2007)

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

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Haylie Duff - Plastic Surgery?

Has Haylie Duff had plastic surgery recently? It appears so. Check out the new photo on Celebrity Smack, and compare it to the photo here. She appears to have had a reduction genioplasty, or surgery to reduce the projection of the chin. Her nose also appears to have been tweaked via a rhinoplasty. Overall I think the nose looks great, but the chin may have ended up a bit on the smaller side. I'll be interested to see how she looks when more photos come out. Hopefully it won't be a PR disaster like her sister Hillary Duff's veneers.

For the Celebrity Smack article, click here.
Photo credit: prphotos (from 2007)

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

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An aspirin a day may not keep the doctor away after all

Sudden shifts in medical advice can cause both patients and doctors confusion. In recent years the benefits of breast self exam for cancer, checking PSA (prostate specific antigen) levels for prostate cancer screening, vitamin supplements of any sort, and chest x-rays for lung cancer screening have all been reported to be ineffective and sometimes harmful to patients.

Add one more to the list - the routine use of low dose 81mg aspirin in the general population to decrease heart attack and stroke risk. This had been pushed such that most adults should consider taking a "baby" (81mg dose) aspirin a day. This seemingly harmless recommendation actually seems to be causing more problems then it's worth according to a new review of the literature.

Analysis of data from over 100,000 clinical trial participants found the risk of harm largely cancelled out the benefits of taking the drug. Use of aspirin in the lower-risk group was found to reduce non-fatal heart attacks by about 20%, with no difference in the risk of stroke or deaths from vascular causes. But it also increased the risk of internal bleeding by around 30%, a potentially life threatening complication. This is summarized here.


Only those who have already had a heart attack or stroke should be advised to take a daily aspirin is the new suggestion, at least for this week.

Click below to hear an audio summary:



Rob

Reese Witherspoon Eats Cookies to Look Younger - Nutricosmetics

According to an interview with In Touch Weekly magazine, Reese Witherspoon has been eating cookies which claim to have anti-aging properties. According to Pop Crunch:

The Walk The Line star is rumored a huge fan of beauty giant BORBA’s DeLuscious Vitamin Enhanced Cookies, which claim to combat fine lines and wrinkles.
The tasty treats come in different flavors including Oatmeal Raisin and Chocolate Toffee White Chocolate, and boast more than nine minerals and vitamins.

These cookies are commonly known as nutricosmetics, or foods believed by some to have anti-aging properties. Many of them have anti-oxidants and are packed with vitamins and minerals. Some examples include Borba's skin balance gummy bears and age-defying water. While it's big business overseas, nutricosmetics (or nutriceuticals) have not become as big a hit here in the U.S., although some high end stores do carry these types of foods.

What's my opinion? I think that virtually anything you eat that is good for you (fruit and veggies=good, fat fried salty foods=bad) will help keep you looking younger. That's common sense. I once worked with a plastic surgeon who loved Burger King. He ate Whoppers all the time and his face was a greasy mess. I bet if he changed his diet he'd look much better. I often see this in my patients. The ones who don't drink, don't smoke, stay out of the sun, and eat good foods look younger than the ones who do all of the above.

It's just that they might not have as much fun in life...

Photo credit: prphotos.com

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

Reese Witherspoon Eats Cookies to Look Younger - Nutricosmetics

According to an interview with In Touch Weekly magazine, Reese Witherspoon has been eating cookies which claim to have anti-aging properties. According to Pop Crunch:

The Walk The Line star is rumored a huge fan of beauty giant BORBA’s DeLuscious Vitamin Enhanced Cookies, which claim to combat fine lines and wrinkles.
The tasty treats come in different flavors including Oatmeal Raisin and Chocolate Toffee White Chocolate, and boast more than nine minerals and vitamins.

These cookies are commonly known as nutricosmetics, or foods believed by some to have anti-aging properties. Many of them have anti-oxidants and are packed with vitamins and minerals. Some examples include Borba's skin balance gummy bears and age-defying water. While it's big business overseas, nutricosmetics (or nutriceuticals) have not become as big a hit here in the U.S., although some high end stores do carry these types of foods.

What's my opinion? I think that virtually anything you eat that is good for you (fruit and veggies=good, fat fried salty foods=bad) will help keep you looking younger. That's common sense. I once worked with a plastic surgeon who loved Burger King. He ate Whoppers all the time and his face was a greasy mess. I bet if he changed his diet he'd look much better. I often see this in my patients. The ones who don't drink, don't smoke, stay out of the sun, and eat good foods look younger than the ones who do all of the above.

It's just that they might not have as much fun in life...

Photo credit: prphotos.com

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

Youth Knows No Pain - Plastic Surgery Documentary

Set your TiVo's folks! Filmmaker Mitch McCabe has created a documentary on the current state of plastic surgery, premiering at 9pm EST August 31st on HBO. Screenings before this premiere include:

Cinevegas Film Festival : Saturday June 13, 6:30pm, and Sunday June 14, 10am.

Silverdocs Film Festival, D.C. area. Friday June 19, 3:30pm, Sunday June 21, 6:30pm.

Los Angeles: Sunset Gower Studios, June 30th, 7pm

Here's the lowdown:

In YOUTH KNOWS NO PAIN, an age-obsessed daughter of a plastic surgeon (filmmaker Mitch McCabe) takes a journey through America's $60 billion a year anti-aging world. In this Alice-in-Wonderland tale, McCabe spends 2 years traveling across America visiting doctors, experts and lives with a cross-section of characters from Minnesota to Texas who've gone to varying lengths to "beat the clock", to paint a funny but troubling portrait of a country that desperately needs to stay forever young. Along the way, one wonders if the filmmaker herself hasn't been pulled in by the seduction of youth.

"Youth Knows No Pain" is an alternately wry and unsettling journey across that grey zone where physical appearance meets self-esteem. Mitch McCabe has assembled for the film a remarkable group of individuals who collectively reveal that there's a deep discomfort running through the heart (and body) of contemporary America."
-Richard Peña, Program Director, Film Society of Lincoln Center

For more information on Youth Knows No Pain, click here for their Facebook page.

Special thanks to Mitch McCabe.

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

Youth Knows No Pain - Plastic Surgery Documentary

Set your TiVo's folks! Filmmaker Mitch McCabe has created a documentary on the current state of plastic surgery, premiering at 9pm EST August 31st on HBO. Screenings before this premiere include:

Cinevegas Film Festival : Saturday June 13, 6:30pm, and Sunday June 14, 10am.

Silverdocs Film Festival, D.C. area. Friday June 19, 3:30pm, Sunday June 21, 6:30pm.

Los Angeles: Sunset Gower Studios, June 30th, 7pm

Here's the lowdown:

In YOUTH KNOWS NO PAIN, an age-obsessed daughter of a plastic surgeon (filmmaker Mitch McCabe) takes a journey through America's $60 billion a year anti-aging world. In this Alice-in-Wonderland tale, McCabe spends 2 years traveling across America visiting doctors, experts and lives with a cross-section of characters from Minnesota to Texas who've gone to varying lengths to "beat the clock", to paint a funny but troubling portrait of a country that desperately needs to stay forever young. Along the way, one wonders if the filmmaker herself hasn't been pulled in by the seduction of youth.

"Youth Knows No Pain" is an alternately wry and unsettling journey across that grey zone where physical appearance meets self-esteem. Mitch McCabe has assembled for the film a remarkable group of individuals who collectively reveal that there's a deep discomfort running through the heart (and body) of contemporary America."
-Richard Peña, Program Director, Film Society of Lincoln Center

For more information on Youth Knows No Pain, click here for their Facebook page.

Special thanks to Mitch McCabe.

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

Michael Jackson - Does He Have Skin Cancer?

The newest Michael Jackson rumor circulating on the internet is that he may be getting treated for skin cancer. According to the Sun:

A source said: “Michael’s tests showed spots of skin cancer on his body, and cells which could turn to skin cancer on his face... He was at first very concerned, but says he has been assured by the doctors that they can treat this and he will recover... Michael is really looking forward to his concerts and is determined to wow his fans at each and every gig... He said he’s insisted that any treatment must fit around the concerts, and the show will go on.”

Jacko, who has been seen making regular visits to his Beverly Hills dermatologist wearing a mask and surgical cap, received the shock diagnosis last month.

The most common skin cancer is basal cell carcinoma, which almost never spreads to other organs or kills people. If left untreated, it just tends to get larger and larger. Pre-cancerous cells can often be treated without surgery.

For all you MJ fans, I bet that he'll be just fine.

Photo credit: prphotos.com

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

Michael Jackson - Does He Have Skin Cancer?

The newest Michael Jackson rumor circulating on the internet is that he may be getting treated for skin cancer. According to the Sun:

A source said: “Michael’s tests showed spots of skin cancer on his body, and cells which could turn to skin cancer on his face... He was at first very concerned, but says he has been assured by the doctors that they can treat this and he will recover... Michael is really looking forward to his concerts and is determined to wow his fans at each and every gig... He said he’s insisted that any treatment must fit around the concerts, and the show will go on.”

Jacko, who has been seen making regular visits to his Beverly Hills dermatologist wearing a mask and surgical cap, received the shock diagnosis last month.

The most common skin cancer is basal cell carcinoma, which almost never spreads to other organs or kills people. If left untreated, it just tends to get larger and larger. Pre-cancerous cells can often be treated without surgery.

For all you MJ fans, I bet that he'll be just fine.

Photo credit: prphotos.com

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

New Study Reveals that Thread Lifts Don't Work

A new study published in the Archives of Facial Plastic Surgery comes to the conclusion that Thread Lifts, a popular type of lunchtime facelift, just don't work. Here are some details:

- 33 patients who underwent thread lifts were compared to 10 patients who underwent other surgical procedures.
- Follow-up averaged 21 months.
- On a scale of 0 (no improvement) to 3 (considerable improvement), those patients undergoing thread lifts scored lowest, showing only 0.3-0.5 degrees of improvement.
- For those patients who underwent traditional surgical procedures, their scores ranged from 1.5-2.3.
- The authors conclude that the improvement seen by thread lifts at 1 month were likely due to swelling and inflammation.
- The authors conclude that thread-lifts carry a high risk of complications, while extensive scarring may make it difficult to remove the threads, which is problematic because studies have found up to 20% of patients need a repeat surgery.

I do not perform thread lifts because the results I've seen from even the most respected plastic surgeons have been unimpressive. Most physicians who perform thread lifts are not real plastic surgeons, but cosmetic surgeons who learn the procedure in a course. There is no real substitute for a well-done facelift or mini facelift (in selected patients).

For more information on the threadlift study, click here.

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

New Study Reveals that Thread Lifts Don't Work

A new study published in the Archives of Facial Plastic Surgery comes to the conclusion that Thread Lifts, a popular type of lunchtime facelift, just don't work. Here are some details:

- 33 patients who underwent thread lifts were compared to 10 patients who underwent other surgical procedures.
- Follow-up averaged 21 months.
- On a scale of 0 (no improvement) to 3 (considerable improvement), those patients undergoing thread lifts scored lowest, showing only 0.3-0.5 degrees of improvement.
- For those patients who underwent traditional surgical procedures, their scores ranged from 1.5-2.3.
- The authors conclude that the improvement seen by thread lifts at 1 month were likely due to swelling and inflammation.
- The authors conclude that thread-lifts carry a high risk of complications, while extensive scarring may make it difficult to remove the threads, which is problematic because studies have found up to 20% of patients need a repeat surgery.

I do not perform thread lifts because the results I've seen from even the most respected plastic surgeons have been unimpressive. Most physicians who perform thread lifts are not real plastic surgeons, but cosmetic surgeons who learn the procedure in a course. There is no real substitute for a well-done facelift or mini facelift (in selected patients).

For more information on the threadlift study, click here.

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

Lisa Rinna Opens Up About Her Plastic Surgery

In a very frank, revealing interview on the Today Show, actress Lisa Rinna has admitted to silicone injections in her upper lip. She admits to having it done 23 years ago during the time of the movie Beaches. Like injectable silicone often does, it got hard and she's had to have steroid injections to the upper lip to soften it up. She also admits to having Botox and Juvederm injections. The Juvederm is especially evident in the obliteration of her nasolabial folds - the lines between the corners of the mouth and sides of the nose- and her plumped up cheeks. Finally, she admits to having had a breast lift, which she really feels she benefitted from.

It's always nice to see a celebrity be frank and open about his or her plastic surgery, whether good or bad. I speculated that she had a Gortex implant in her upper lip, which is another type of permanent implant like silicone. Unfortunately, the only way to remove liquid silicone is to cut it out. Ouch.

For streaming video of the Lisa Rinna Today Show interview, click here.

Photo credit: prphotos.com
Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share |

Lisa Rinna Opens Up About Her Plastic Surgery

In a very frank, revealing interview on the Today Show, actress Lisa Rinna has admitted to silicone injections in her upper lip. She admits to having it done 23 years ago during the time of the movie Beaches. Like injectable silicone often does, it got hard and she's had to have steroid injections to the upper lip to soften it up. She also admits to having Botox and Juvederm injections. The Juvederm is especially evident in the obliteration of her nasolabial folds - the lines between the corners of the mouth and sides of the nose- and her plumped up cheeks. Finally, she admits to having had a breast lift, which she really feels she benefitted from.

It's always nice to see a celebrity be frank and open about his or her plastic surgery, whether good or bad. I speculated that she had a Gortex implant in her upper lip, which is another type of permanent implant like silicone. Unfortunately, the only way to remove liquid silicone is to cut it out. Ouch.

For streaming video of the Lisa Rinna Today Show interview, click here.

Photo credit: prphotos.com
Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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The Hottest and Newest in Plastic Surgery... From the Las Vegas Strip

Last week I attended the annual Aesthetic Plastic Surgery meeting in Las Vegas. Here are some highlights of the newest and hottest things you may soon see (or are seeing) in plastic surgery:

1. Fractional Lasers are everywhere. It seems that nearly every laser company is plugging its fractionated laser. These are basically lasers which are similar to the old CO2 lasers, but instead of focusing on all the skin, they only focus on tiny spots at a time. This causes less downtime and discomfort, but does it create similar results? Time will tell.
2. Will we someday be able to apply Botox as a cream? A company is working on a cream containing a botulinum-type toxin which may work similarly to Botox when applied. This is technically not Botox, but a botulinum-like cream. It is still in the development phase.
3. BodyJet - Water-assisted liposuction. The maker claims that it is less invasive and has less discomfort. Only a handful of surgeons currently have this machine. Is it a flash-in-the-pan or a new device with legs?
4. Removing fat without surgery - I covered this at length on the Rachael Ray Show. Two big players are Liposonix and Ultrashape. Neither is FDA-approved, and likely won't be for some time. There is one other device I am looking into however...
5. Smoothshapes - This is a new anti-cellulite treatment which combines laser with mechanical massage. I don't have any experience with this machine, because I own a Dermosonic anti-cellulite machine instead. I think there are many effective ways to treat cellulite, and these are two of the most prominent. Click here to see a segment I did with the local Fox News affiliate on treating cellulite.
6. Ulthera - This is an ultrasound machine that can target its energy to heat up the platysma (neck muscle) in order to tighten it and therefore create a nicer neckline. The results look promising, but it is still under investigation.
7. Cosmetic Gynecology - There was some interesting discussion on this topic, since many plastic surgeons and gynecologists are entering this new "field." I have absolutely no desire to perform cosmetic gynecologic procedures. A prominent gynecologist weighs in on this subject on his blog here.
8. Rumored to be coming to plastic surgeons' offices soon: Gummy bear implants! This is both a good (great implant for a select group of patients) and bad (hopefully quack cosmetic surgeons won't try to put these difficult-to-place implants in). If they are placed poorly, they can turn upside down and slide around, causing major cosmetic problems.

Much of the meeting focuses on how to improve our plastic surgery techniques, which would be boring for most of the readers of this blog. I always find it a great learning experience to see how other plastic surgeons perform similar surgeries, as I strive to continually improve my technique and results. Thanks to the ASAPS for putting on a great meeting.

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

The Hottest and Newest in Plastic Surgery... From the Las Vegas Strip

Last week I attended the annual Aesthetic Plastic Surgery meeting in Las Vegas. Here are some highlights of the newest and hottest things you may soon see (or are seeing) in plastic surgery:

1. Fractional Lasers are everywhere. It seems that nearly every laser company is plugging its fractionated laser. These are basically lasers which are similar to the old CO2 lasers, but instead of focusing on all the skin, they only focus on tiny spots at a time. This causes less downtime and discomfort, but does it create similar results? Time will tell.
2. Will we someday be able to apply Botox as a cream? A company is working on a cream containing a botulinum-type toxin which may work similarly to Botox when applied. This is technically not Botox, but a botulinum-like cream. It is still in the development phase.
3. BodyJet - Water-assisted liposuction. The maker claims that it is less invasive and has less discomfort. Only a handful of surgeons currently have this machine. Is it a flash-in-the-pan or a new device with legs?
4. Removing fat without surgery - I covered this at length on the Rachael Ray Show. Two big players are Liposonix and Ultrashape. Neither is FDA-approved, and likely won't be for some time. There is one other device I am looking into however...
5. Smoothshapes - This is a new anti-cellulite treatment which combines laser with mechanical massage. I don't have any experience with this machine, because I own a Dermosonic anti-cellulite machine instead. I think there are many effective ways to treat cellulite, and these are two of the most prominent. Click here to see a segment I did with the local Fox News affiliate on treating cellulite.
6. Ulthera - This is an ultrasound machine that can target its energy to heat up the platysma (neck muscle) in order to tighten it and therefore create a nicer neckline. The results look promising, but it is still under investigation.
7. Cosmetic Gynecology - There was some interesting discussion on this topic, since many plastic surgeons and gynecologists are entering this new "field." I have absolutely no desire to perform cosmetic gynecologic procedures. A prominent gynecologist weighs in on this subject on his blog here.
8. Rumored to be coming to plastic surgeons' offices soon: Gummy bear implants! This is both a good (great implant for a select group of patients) and bad (hopefully quack cosmetic surgeons won't try to put these difficult-to-place implants in). If they are placed poorly, they can turn upside down and slide around, causing major cosmetic problems.

Much of the meeting focuses on how to improve our plastic surgery techniques, which would be boring for most of the readers of this blog. I always find it a great learning experience to see how other plastic surgeons perform similar surgeries, as I strive to continually improve my technique and results. Thanks to the ASAPS for putting on a great meeting.

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

Bruce Jenner Has Another Facelift

Kim Kardashian has confirmed that her step-dad Bruce Jenner has had his second facelift. According to USmagazine.com:

"Twenty five years ago, Bruce was ill-advised by a doctor to have a partial facelift and a nose job," Kim writes. "Unfortunately, the result wasn't what Bruce had hoped for and for years since then he has been the victim of cruel taunts from the media."

"Since he's turning 60 in October, Bruce felt it was time to correct the mistakes made by the previous doctor so he went to a new doctor for a second facelift," she continues. "The results are amazing! Bruce looks better than ever and he is extremely happy with the result. Make sure you watch Keeping Up with the Kardashians next Sunday to see what Bruce went through for his new look!"

I always thought he'd had his nose whittled down too much. Hopefully the corrective work will make him look less 'operated on' and more masculine. Bruce does seem like the most sane one of the bunch in that reality show. Unfortunately, in the above picture he looks like he was just ridden hard and put away wet!

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

Share |

Bruce Jenner Has Another Facelift

Kim Kardashian has confirmed that her step-dad Bruce Jenner has had his second facelift. According to USmagazine.com:

"Twenty five years ago, Bruce was ill-advised by a doctor to have a partial facelift and a nose job," Kim writes. "Unfortunately, the result wasn't what Bruce had hoped for and for years since then he has been the victim of cruel taunts from the media."

"Since he's turning 60 in October, Bruce felt it was time to correct the mistakes made by the previous doctor so he went to a new doctor for a second facelift," she continues. "The results are amazing! Bruce looks better than ever and he is extremely happy with the result. Make sure you watch Keeping Up with the Kardashians next Sunday to see what Bruce went through for his new look!"

I always thought he'd had his nose whittled down too much. Hopefully the corrective work will make him look less 'operated on' and more masculine. Bruce does seem like the most sane one of the bunch in that reality show. Unfortunately, in the above picture he looks like he was just ridden hard and put away wet!

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

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Ireland and others on board with regulating cosmetic surgery providers - The end for Tom's Rhinoplasty, et. al?

The United States is not alone in trying to come up with a way to ensure quality and standards among providers of cosmetic surgery and related procedures. The Independent (UK) wrote about this problem in Ireland and the U.K. last fall (see here) saying,

"Once you have a basic medical degree you need no specialist qualification in order to perform plastic surgery. A GP could do a breast augmentation in the morning, even though he had never seen it done or performed one -- and that is perfectly legal. The International Association of Plastic Surgeons (IAPS) members are trained in plastic, reconstructive and aesthetic surgery. Other people carry out procedures despite having no formal qualifications." One major concern of the IAPS is that of surgeons being flown in from abroad by private clinics and simply flying home after performing a procedure. "You would expect any other surgeon to be resident in the country in which he is practising," says Mr David O'Donovan, Secretary of the IAPS.

"Yet private clinics are shipping in surgeons who are not around when the patient needs aftercare, or complications arise. Some say their doctors are specialists, but they don't say what they're specialists in. For instance, a doctor performing breast surgery could, in fact, be a bowel specialist."

Similar stories can can found around the world from the United States, Australia, and other western countries. It certainly seems likely to get worse here as reimbursements for physicians are poised to take a big hit with whatever happens with American health care reform. There will be even more pressure for many doctors to encroach outside of their areas of expertise and become self-styled "Cosmetic Surgeons" or "Aesthetic Medicine" specialists.

Catering to this trend is the ever proliferating alphabet of organizations seeking to give some fig leaf of authenticity for doctor's credentials who have little or no formal training in some of the services they're now offering. (WTF is laser "vaginal rejuvenation" by the way?). One of the "cosmetic surgery boards" here in the United States has even had the nerve to suggest that their members are more qualified then Plastic Surgeons to perform cosmetic procedures and has railed against hospital medical staffs who have (quite rightly) not granted their hodge podge of members surgical privileges outside the scope of their accredited training.

For a Gynecologist's take on some of his colleagues trying to peddle themselves off as reinvented cosmetic surgeons, read this great post at "David's waste of bandwidth".

"Cosmetic surgery can kill people. It can maim and disfigure people. Just as I think surgeons should respect the procedures we do as gynecologists, we should respect the things they do, and only do them when we really have the training and judgment to proceed. No weekend course on ”cosmetic gynecology“ (whatever the f that is) is going to provide skills and judgment comparable to someone who is boarded in cosmetic surgery and plastic/reconstructive surgery. As it is, the folks who are boarded in cosmetic surgery are rightfully pissed at those cosmetic surgeons who are doing this without board certification or a decent background in plastic and reconstructive surgery. Why are we adding to this nonsense?

As an example in terms of judgment, you're mentioning the possibility of doing ”gspot injections“ (sic). This is inappropriate and has no place in modern practice, cosmetic surgery, gynecology or otherwise.

To my point exactly. We have no business doing this crap. I sympathize with those who do, and understand their motivation in terms of a cash business. But we're surgeons and professionals, NOT car dealers trying to make a fast buck. Or are we?"

It's not so far fetched to imagine a proverbial "Tom's Rhinoplasty Clinic" (an olde school South Park season 1 reference) popping up every block stamped with the seal of approval by ____________. (fill in the blank with bogus board certification du jour)

Rob

Angelique from I Love Money 2 - Go Away!

Continuing with the theme of over-the-top reality show contestants... VH1 just ended its series I Love Money 2, which has as one of its stars a French stripper named Angelique. With her idiotic statements, overinflated trout pout, and watermelon-sized breast implants, she singlehandedly sets the women's lib movement back thirty years. Hopefully Americans will never have to see her ever again!

Yes, I know this is harsh, but I'm partial to Metro Detroit's own Prancer, whom Angelique verbally assaulted on the program. Unlike Angelique, Prancer's quite down-to-earth, fun, and personable. Check out her MySpace here.

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

Angelique from I Love Money 2 - Go Away!

Continuing with the theme of over-the-top reality show contestants... VH1 just ended its series I Love Money 2, which has as one of its stars a French stripper named Angelique. With her idiotic statements, overinflated trout pout, and watermelon-sized breast implants, she singlehandedly sets the women's lib movement back thirty years. Hopefully Americans will never have to see her ever again!

Yes, I know this is harsh, but I'm partial to Metro Detroit's own Prancer, whom Angelique verbally assaulted on the program. Unlike Angelique, Prancer's quite down-to-earth, fun, and personable. Check out her MySpace here.

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

Annina from Big Brother UK

This is a photo of Annina, a participant in television program Big Brother in the UK. As you can see, her breast implants are excessively large, and her skin even looks a bit mottled in her breasts and chest. Sometimes skin that is this color can signify poor blood supply to the tissues and can increase her risk for implant and skin-related problems. My advice to her would be to downsize her breast implants, have a breast lift, and avoid smoking and tanning.

Or she could just leave well enough alone.

Photo credit

For an even more shocking photo on Awful Plastic Surgery, click here.

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

Annina from Big Brother UK

This is a photo of Annina, a participant in television program Big Brother in the UK. As you can see, her breast implants are excessively large, and her skin even looks a bit mottled in her breasts and chest. Sometimes skin that is this color can signify poor blood supply to the tissues and can increase her risk for implant and skin-related problems. My advice to her would be to downsize her breast implants, have a breast lift, and avoid smoking and tanning.

Or she could just leave well enough alone.

Photo credit

For an even more shocking photo on Awful Plastic Surgery, click here.

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

Carrot Top, Vegas, and Meetings

I've just returned from the American Society for Aesthetic Plastic Surgery annual conference in Las Vegas. It was held at Mandalay Bay, and was chock full of the newest in the field of cosmetic plastic surgery. I'll post some of the 'hottest' and 'newest' trends in a future post.

I had the pleasure of spending some time with two plastic surgeons whom I went to residency with, Dr. Sanjiv Kayastha and Dr. Terry Higgins. Dr. Kayastha practices outside Albany, New York, and Dr. Higgins (who has been mentioned on this site once before) practices in Vegas. Both are outstanding surgeons, and if you live in their area they would definitely be the people to see!

In between attending meetings and seminars, I did spot one celebrity dining at the table next to us Monday night: Carrot Top. He was there with a couple friends and kept to himself. Wow, is he striking. That red fro combined with muscles galore makes him a sight to behold!

Photo credit: prphotos.com

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

Carrot Top, Vegas, and Meetings

I've just returned from the American Society for Aesthetic Plastic Surgery annual conference in Las Vegas. It was held at Mandalay Bay, and was chock full of the newest in the field of cosmetic plastic surgery. I'll post some of the 'hottest' and 'newest' trends in a future post.

I had the pleasure of spending some time with two plastic surgeons whom I went to residency with, Dr. Sanjiv Kayastha and Dr. Terry Higgins. Dr. Kayastha practices outside Albany, New York, and Dr. Higgins (who has been mentioned on this site once before) practices in Vegas. Both are outstanding surgeons, and if you live in their area they would definitely be the people to see!

In between attending meetings and seminars, I did spot one celebrity dining at the table next to us Monday night: Carrot Top. He was there with a couple friends and kept to himself. Wow, is he striking. That red fro combined with muscles galore makes him a sight to behold!

Photo credit: prphotos.com

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

(smart) Skin Care for Dummies..... keep it simple stupid

There is an overwhelming amount of skin care products on the market, and it can get kind of confusing to patients and doctors about sorting out hype from substance. At the end of the day I think you've got to keep it simple and try to minimize the number of steps and products that people use.

At a basic level you need to consider 3 things to be essential

• a gentle daily cleanser (which can be something cheap)
• a restorative agent(s) to improve or maintain your skin
• protection from the sun

There's a whole bunch of peripheral products addressing pigmentation (toners, hydroquinone products, etc...) that serve niche roles as well.

I've become a fan of the Neo Cutis line of products for two reasons
1. it's reasonably priced for medical grade skin products
2. you can do a lot with a very simplified regimen

The gimmick with NeoCutis is a substance called "PSP" which is a proprietary protein derivative of sorts derived from fetal skin cells. This PSP ingredient is common to their different product lines in different concentrations and with some other additives. For men, their gel-based, "Biogel"
is a very easy single product that men can use without overwhelming our simple brain or making us feel overly metrosexual. Highly recommended and one tube will last 3 months or so, pretty reasonable for $120-150 dollars. Neocutis makes a more concentrated PSP product eye cream which is also great. As I understand it, a lot of people just use it for their whole face. It seems to work well and be very tolerant to people even with sensitive skin.

I'm not here to pimp for that particular company, but I think they make a value-based product line that is very simple. If you combine one of their PSP products with an OTC gentle cleanser, Retin A (or another retinoid-like product), and some sunscreen you suddenly have a fairly formidable combination for less then $200-250.

rob

A Little Botox for Paula?

For all of you American Idol watchers out there, this photo of Paula Abdul from Dlisted.com does appear to show some Botox working well to prevent wrinkles between her eyebrows (the glabella). It looks like she's trying to grimace but can't. This is exactly what Botox (or Dysport) can do to prevent the "11" sign between the eyebrows.

Go Adam Lambert!

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

A Little Botox for Paula?

For all of you American Idol watchers out there, this photo of Paula Abdul from Dlisted.com does appear to show some Botox working well to prevent wrinkles between her eyebrows (the glabella). It looks like she's trying to grimace but can't. This is exactly what Botox (or Dysport) can do to prevent the "11" sign between the eyebrows.

Go Adam Lambert!

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

Daryl Hannah - Plastic Surgery?

MakeMeHeal.com has a post on Daryl Hannah's possible plastic surgery. She looks puffy and completely unlike herself. What a shame. Unless she used permanent fillers like Artefill (bad) or Silicone (worse), most of the changes should get better with time. I've always considered her to be very attractive, especially when she starred in one of my all-time favorite movies Roxanne.

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

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Daryl Hannah - Plastic Surgery?

MakeMeHeal.com has a post on Daryl Hannah's possible plastic surgery. She looks puffy and completely unlike herself. What a shame. Unless she used permanent fillers like Artefill (bad) or Silicone (worse), most of the changes should get better with time. I've always considered her to be very attractive, especially when she starred in one of my all-time favorite movies Roxanne.

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

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"Going Dutch" for ideas on healthcare reform

There's a real lovely article in the NY Times Sunday magazine about the Netherlands. The ostensible focus is on the social welfare network of the state, and contrasting an American expat's experience there. One of the issues discussed is health care, a very timely topic as it relates to the United States.

Since I started writing Plastic Surgery 101 in December 2004, I've periodically touched on medical economics as it's something that's fascinating both personally and professionally. It's been clear for several decades that we're creeping towards some type of state funded system ("Universal healthcare"), and the time table has sped up due to a couple of factors

the coming retirement of the bulk of the baby boomers. A demographic who has always been described as somewhat self-entitled. Their clout and collective zeitgeist are proving a potent voice in this.

the economic incentives of employers and unions coming into alignment on this. Someone wrote a few years ago that when Wal Mart decided it was time for universal health care, then discussions would happen in earnest.

a liberal president has a aggressively liberal congress and slight liberal majority senate

the real estate and stock market crisis have made not having both a job and health insurance a reality for a lot of middle, upper-middle, and white-collar classes.

I've been convinced that we're going to end up with a public-private system where basic care is covered and people with more money will be able to purchase higher levels of care or convenience to care. It's what actually exists in most of the world. There will still be moaning and gnashing of teeth about unequal access, quality, etc... but we'll be better off then we are on the whole.

Anyway, there's a great descriptor of this in the article I was referring to, "Going Dutch"

"The Dutch health care system was drastically revamped in 2006, and its new incarnation has come in for a lot of international scrutiny. “The previous system was actually introduced in 1944 by the Germans, while they were paying our country a visit,” said Hans Hoogervorst, the former minister of public health who developed and implemented the new system three years ago. The old system involved a vast patchwork of insurers and depended on heavy government regulation to keep costs down. Hoogervorst — a conservative economist and devout believer in the powers of the free market — wanted to streamline and privatize the system, to offer consumers their choice of insurers and plans but also to ensure that certain conditions were maintained via regulation and oversight. It is illegal in the current system for an insurance company to refuse to accept a client, or to charge more for a client based on age or health. Where in the United States insurance companies try to wriggle out of covering chronically ill patients, in the Dutch system the government oversees a fund from which insurers that take on more high-cost clients can be compensated. It seems to work. A study by the Commonwealth Fund found that 54 percent of chronically ill patients in the United States avoided some form of medical attention in 2008 because of costs, while only 7 percent of chronically ill people in the Netherlands did so for financial reasons.

The Dutch are free-marketers, but they also have a keen sense of fairness. As Hoogervorst noted, “The average Dutch person finds it completely unacceptable that people with more money would get better health care.” The solution to balancing these opposing tendencies was to have one guaranteed base level of coverage in the new health scheme, to which people can add supplemental coverage that they pay extra for. Each insurance company offers its own packages of supplements.

Nobody thinks the Dutch health care system is perfect. Many people complain that the new insurance costs more than the old. “That’s true, but that’s because the old system just didn’t charge enough, so society ended up paying for it in other ways,” said Anais Rubingh, who works as a general practitioner in Amsterdam. The complaint I hear from some expat Americans is that while the Dutch system covers everyone, and does a good job with broken bones and ruptured appendixes, it falls behind American care when it comes to conditions that involve complicated procedures. Hoogervorst acknowledged this — to a point. “There is no doubt the U.S. has the best medical care in the world — for those who can pay the top prices,” he said. “I’m sure the top 5 percent of hospitals there are better than the top 5 percent here. But with that exception, I would say overall quality is the same in the two countries.”

While free associating on things Dutch, Sasha Cohen's Borat paid Amsterdam a visit a few years back. Good stuff!

Rob

Miss California Carrie Prejean's Breast Implants

Miss California, Carrie Prejean, supposedly had her breast implants paid for by the Miss California USA pagaent. This is according to Shanna Moakler, co-executive director of Miss California USA.

In an interview with "Access Hollywood," Billy Bush asked Moakler, "Did you guys pay for it?"
"Yes," Moakler responded. "We did."
"It was something that we all spoke about together," Moakler said referring to herself, Prejean and Keith Lewis, Moakler's co-executive director. "It was an option and she wanted it. And we supported that decision."

Moakler, a former Miss USA herself, defended the organization's decision to pay for the implants, telling "Access" that it's a common practice in beauty competitions.
"Breast implants in pageants is not a rarity. It's definitely not taboo. It's very common. Breast implants today among young women today is very common. I don't personally have them, but you know — they are," she said.

The above photo appears to show a pair of breast implants which create a round look in someone with little breast tissue to cover them. They are very tasteful in size, though.

Source

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

Miss California Carrie Prejean's Breast Implants

Miss California, Carrie Prejean, supposedly had her breast implants paid for by the Miss California USA pagaent. This is according to Shanna Moakler, co-executive director of Miss California USA.

In an interview with "Access Hollywood," Billy Bush asked Moakler, "Did you guys pay for it?"
"Yes," Moakler responded. "We did."
"It was something that we all spoke about together," Moakler said referring to herself, Prejean and Keith Lewis, Moakler's co-executive director. "It was an option and she wanted it. And we supported that decision."

Moakler, a former Miss USA herself, defended the organization's decision to pay for the implants, telling "Access" that it's a common practice in beauty competitions.
"Breast implants in pageants is not a rarity. It's definitely not taboo. It's very common. Breast implants today among young women today is very common. I don't personally have them, but you know — they are," she said.

The above photo appears to show a pair of breast implants which create a round look in someone with little breast tissue to cover them. They are very tasteful in size, though.

Source

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