The topic of cosmetic surgery seems to be a fertile playing ground for fun and interactive blogging. That was my thinking when this site was initially created; however, I have fallen short of actually posting. So… I now publicly (although to few if any readers for now) challenge myself to jump start what I feel could be a platform for entertaining and informative plastic surgery discussion- the Denver Cosmetic Surgery Blog.com. Ideally, I’d like to create enough interest and hopefully spark a forum-like on-line dialogue. My plan is to share some of my thoughts and experiences that occur during my work as a Plastic Surgeon and see what questions and responses people may have. I vow to be responsive, creating an opportunity for those interested to engage in an honest dialogue about the world of plastic surgery.
Today, I had a consultation with a woman who is interested in breast augmentation. But she has a bit of a different situation. Her chest bones developed in such a way that she has a depression between her breasts that causes her breasts to be somewhat different in shape, position, and posture. She is a wonderfully self-aware woman and understands the changes that her bone development caused to her breast appearance. Her expectations of being fuller with a more womanly shape are easily obtainable and I have no doubt that she would be pleased with her surgery results. I bring this up because a valuable point came up during our consultation that I discuss with many people who are considering surgery. When patients try to develop reasonable expectations of what a surgical procedure will do for them, it is critical that they first understand where they are starting. Most people don’t actually see their true appearance when they look in the mirror due to some brain phenomenon that develops over our lives warping our mirror image into something different in our minds. So, I often recommend that people take pictures of themselves and evaluate the pictures rather than the mirror reflection. People are generally amazed (sometimes in a good way, sometimes not) at what they really look like. Then, they can truly understand where they are starting and better grasp where plastic surgery will take them. Also, by placing those pictures in front of the computer, people can then do their internet research and identify what really works for their “before” situation, and what doesn’t. If everyone did this little trick, they’d be able to figure out most of the truths and myths in my field and have a great idea if cosmetic surgery can achieve what they want. The woman I met today had done this and she will undoubtedly benefit from her awareness.
Dr. Steven Vath
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Earlier this week I spent a half hour with one of those interesting, confident, has-her-act-together patients who help make my job fun. She was seeing me for concerns she had with her abdomen and thighs, which were somewhat fuller than she would have preferred, and she had a PLAN.
“I have a trainer, I have talked with a friend who is a dietician, and I intend to lose 25 lbs. in the next 3 months.”
Fair enough, I thought.
“You”, she said to me plainly, “are Plan B.”
Which got me thinking — this is really how the cosmetic surgery thing should work. In an ideal world, potential patients would exhaust all of their non-surgical options for improvement of whatever body part troubles them, and come to someone like me when these options prove insufficient. For many body parts, their are no non-surgical options. Your breasts aren’t going to get bigger or perkier, no matter how hard you work out. But for body contouring, a bit of effort in the diet and exercise departments can have great benefits. Should surgery ultimately be necessary (for lose abdominal skin after weight loss or pregnancy, for example) a fitter patient will be healthier, less complication-prone, and more likely to get a great result. For facial rejuvenation, it makes sense to start with less aggressive measures like skin care, Botox, and fillers before moving forward with a facelift.
In short, the more patients do before I get to them, the more I am often able to do for them when surgery becomes their best option for improvement, when Plan B becomes Plan A.
Dr. Wolfe
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There continues to be confusion surrounding the different types of silicone implants, specifically regarding what is and what is not a “cohesive” or “gummy” implant. I believe that some of this confusion is, unfortunately, being caused by other Plastic surgeons who, either through ignorance or intentional misdirection, are misinforming patients. I have seen a number of breast augmentation consults who have been told by other surgeons in the Denver community that the silicone implants currently approved by the FDA are “gummy” implants and won’t leak if they rupture. As has been stated elsewhere in this blog, this is simply untrue. All of the implants approved for first-time augmentation patients are NOT what should be correctly known as “form-stable, cohesive” implants. If they rupture, they will leak, despite the aggressive marketing campaigns of certain companies that suggest otherwise. (I am an investigator in the Inamed 410 trial, and so I am allowed to use form-stable, cohesive implants for some types of revision patients.)
Why the misdirection? I can only think that some surgeons simply don’t know what they’re talking about, or are being less than honest in an effort to convince patients of the safety of the current silicone implants. Either way, it’s inexcusable. Patients cannot make a fully informed decision unless they know what the real risks and rewards of various choices are. There is a new website created by several of the country’s foremost experts on breast implants which contains a wealth of information surrounding cohesive implants. I would encourage anyone interested in the topic to peruse its content, patients and surgeons alike-
Dr. Wolfe
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Liposuction can create wonderful body transformations. Localized areas of fat excess can be reduced, leaving behind a person’s natural, more attractive body contours undisturbed by these bulges. BUT… as I was reminded this morning during a consultation with a patient that had previous liposuction, it has it’s limitations. A 43 year old woman had lost about 50 pounds leaving her skin a bit more lax than others her age. She had previous liposuction of her tummy and hoped to have more performed in that area. Unfortunately, her prior procedure created an unnatural appearance with some contour waviness and over-flattening of her lower abdomen. Nonetheless, when she grabbed her tummy, she could create a roll of skin and fat, so she reasoned that more liposuction was the answer. I discussed with her that further liposuction would not be advisable because it does not tighten skin and would only worsen any contour irregularities that she already has. In all likelihood, I would probably not have recommended liposuction of her abdomen in the first place.
This is a common scenario that I see daily in consultations: women that get a “muffin top” over their pants and understandably determine that liposuction is the answer to their problem. Unfortunately, when the jeans are released, no localized bulge exists! In these situations, liposuction is not the solution.
So how do you figure out what to do when frustrated with your body contour in the mirror? If you look hard enough, you’ll find the answer you want to hear. The internet will surely provide content that supports any desired conclusion. If you want to hear that liposuction will tighten skin, you’ll find it. If you want to hear that liposuction will carve out a waste, you’ll find it. If you want to hear that liposuction can chisel out six-pack abs, you’ll find it. But if you want to really find out the truth about the benefits of liposuction, it’s all in the pictures. Before and after pictures taken of real patients shows what can truly be achieved. Perform an honest evaluation of your bothersome areas in the mirror and then go online to find pictures of women with similar situations. If you can’t find the results you want, it may not exist.
Liposuction must be used properly. In my opinion, most bad results or unhappy patients after liposuction are the result of poor patient selection. In other words, usually the problem isn’t a poorly performed procedure, but a poor choice in performing the procedure! I tell everyone that I meet during a consultation that liposuction is the most over-hyped, over-marketed, and over-performed procedure in plastic surgery. But when it’s used correctly on the right person, liposuction can be fantastic.
Dr. Vath
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A patient I recently saw in consultation for a Mini-facelift asked an interesting question: “Do facelift patients have a hard time adjusting to their new, younger appearance?” Without hesitation, my answer was “No”. As I thought about it, I realized why, and a quick internet search confirmed my suspicion. A common comment from patients is, ”I’m here for a consult because how I look doesn’t match how I feel. This study indicates that most people, and baby boomers in particular, feel younger than they look. In effect, then, a facial rejuvenation procedure actually improves the balance between how patients feel and what they see in the mirror. It’s always nice when science confirms something I’ve seen for years-
Dr. Wolfe
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