The real Botox bottle and box have many security features to prevent counterfeiting.
Botulinum Toxin remains the number one non-surgical cosmetic treatment year after year. In 2014, 3,588,218 neuromodulating wrinkle treatments were reported by the American Society for Aesthetic Plastic Surgery alone. Botulinum Toxin Treatments were more popular than the next four nonsurgical beauty treatments combined:
The latest counterfeit Botox bottles look a lot like the old Botox bottles. They are taller, thinner, lack holograms, lack unique lot numbers, lot numbers on bottle and box may not match and they have “Botulinum Toxin Type A” instead of “Botox Cosmetic OnabotulinumtoxinA.”
When I say, “Counterfeit Botox,” I am not talking about competitive brands of FDA approved Botulinum Toxin. Botox was the first to market in the US, while Dysport was the first to market in Europe. Both are FDA approved, as are two others:
FDA Approved Botulinum Toxin – What’s The Difference?
Dysport was the first to market in Europe, second in the US and is also FDA approved.
There is a big difference between FDA approved Botulinum Toxin and everything else fraudulently making the claim. The approved drugs are deemed safe and effective when administered in the prescribed fashion by a qualified and experienced injector. These drugs have been tested, and are manufactured under the supervision of the FDA. Their factories are open to surprise inspection at any time, and the distribution can be stopped when problems are found.
Counterfeit Botulinum Toxin on the other hand, is not manufactured with the same quality controls. It may not contain any Botulinum Toxin, and when it does, the dosing can range from ineffective to lethal.
How to Avoid Counterfeit Botox
You get what you pay for, and beauty is not cheap. If an offer seems too good to be true, it’s most likely false. It takes experience to become a good injector, so look for an established practice with experienced injectors. Ask questions:
How many Botox injections do you do a month?
How long have you been performing Botox injections?
What is your training?
Can I see the bottle? (for Botox look for the Allergan hologram)
How long between mixing the Botox and Administration?
Reputable doctors will be happy to explain. Grumpy or evasive responses are a red flag.
Wrinkle Ridding Consultations
As a Board Certified Plastic Surgeon, I perform everything from Botox to Facelifts. Botox is usually performed in the office on the third Wednesday of each month. It’s a busy day, but it allows me to use Botox or Dysport within a few hours of mixing, so nothing gets stale. If you are interested in Botox, Fillers or Surgical Correction of Facial Wrinkles, give me call at (925) 943-6353. More Plastic Surgery Information is available on our newly revamped and mobile friendly web site: DrMele.com.
Today, Lip Augmentation is dominated by injectables. Fillers like Restylane, Juvederm and Perlane, were used a few million times last year to plump the American’s lips and the treat facial wrinkles. Fillers are second only to Botox in number of non-surgical cosmetic procedures performed.
With the advent of improved dermal fillers, Lip Augmentation has become one of the most popular facial procedures. Lips are very important in defining facial beauty. In fact, the lips and the eyes together are the most important features in facial aesthetics. Lipstick and eye makeup are used to enhance their appearance and to focus our attention on these areas.
Large Lips are sexy and are associated with youth and fertility. Did you know the lips are largest when a woman is pregnant? While tout pouts, duck lips and some well known Lip Tragedies occur, modern lip fillers are safe, effective and FDA approved. Injectable HA fillers most often give a natural, soft enhancement that lasts for months.
Lips begin decreasing in size in the late twenties and early thirties. The loss of volume is natural, so Thin Lips are associated with advancing age.
While the perception of age is important, there are other practical considerations too. Thin lips begin to wrinkle around the edges, causing lipstick to bleed, defeating lipstick’s enhancing ability.
Dermal grafting offers a longer lasting Lip Augmentation. This type of Lip Enhancement is frequently combined with the Facelift.
Lip enhancement is one of the most popular procedures at my San Francisco Bay Area Plastic Surgery office. In terms of the non-surgical procedures offered, the fillers used for Lip Augmentation, Restylane, Juvederm and Perlane, are second only to Botulinum Toxin, Botox and Dysport, in terms of demand. Since the later inhibit motion, they are not often used for Lip Enhancement.
The Lip Augmentation Video segment below was taken from the Bay Area’s News Station, KRON 4’s, Body Beautiful. Host Janelle Marie and I recently discussed the non-surgical and the surgical methods currently available for Lip Enhancement. While fillers are quick and convenient, they do require maintenance and periodic touch-ups. Surgical alternatives can provide longer lasting results; however, the recovery is longer.
The pro’s and con’s of Non-Surgical and Surgical Lip Augmentation are discussed further on the Lip Enhancement Video below. Before and After Pictures are also included to help illustrate what is possible.
Lip Augmentation and Enhancement Video
Lip Enhancement Options
If you are considering Lip Enhancement, give us a call at (925) 943-6353. Only an in-person consultation can offer you the full scope of your options. Whether it’s the quick plumping afforded by the latest in modern lip fillers, or the longer lasting results of surgical lip augmentation, Dr. Mele’s office in East San Francisco Bay Area city if Walnut Creek, CA, can get you the information you need for a safe and predictable result.
Prominent ears, and other ear deformities, are usually present at birth. About 30% correct themselves with normal aging, but the majority will require treatment for correction. There are many variations, but protruding ears are the ear deformity that is corrected most frequently with Otoplasty.
Ear Pinning Video – Otoplasty for Prominent Ears
The television segment below is from the San Francisco Bay Area News Station KRON 4’s Body Beautiful. In this Otoplasty Video, I discuss the Correction of Prominent Ears, and include a few examples of Otoplasty Before and After Pictures. Any advice offered in this video is true in general; however, individual treatment recommendations can only be made after a consultation, which includes a medical history and physical examination.
Cosmetic Ear Surgery (Otoplasty) Video
Treatment Right After Birth
For the first few days of life, the ears can be molded. The mother’s estrogen, makes the ear’s cartilage soft, allowing a brief window of time in which to actively reshape the ear. According to research from the Department of Plastic Surgery University of Texas Southwestern Medical Center, treatment started within the first few weeks after birth can be as high as 90% effective, and avoid the need for surgery. If you notice your newborn has an irregular shape to their ear, be certain to mention this to your doctor and see if Ear Molding is an option.
Treatment Before Elementary School
The five-year-old’s ear is already 85% of its adult size. Otoplasty is often performed at this age, prior to Elementary School, to decrease teasing about prominent ears.
A common time for treatment of Prominent Ears is age five of six. By this age, the ear is about 85% of its adult size, and if it was going to spontaneously correct, it should have. Otoplasty, or ear changing surgery, is performed as an outpatient procedure under anesthesia with good long-term results. The head is often wrapped for a week, and a head band worn for a few months at night, can help protect the results while the ear shape becomes set.
Treatment Later in Life
Young Adulthood is another common time for the correction of prominent ears. Otoplasty can improve the appearance of the ears, and remove the anxiety associated with them.
Otoplasty can be performed at any age. A common time for Otoplasty is young adulthood. The ear re-shaping surgery is performed in much the same way as it is in childhood, though it can often be performed under local with light sedation for the properly selected patient. If the idea of being awake causes anxiety, anesthesia may be the better option for you.
What is Otoplasty?
Otoplasty can be performed in adults too. Even the follicly challenged can feel confident that the surgical evidence will be hidden behind their ears.
The most common reasons for a prominent ear are:
Incomplete folding – leaving the rim sticking out
A large central bell of the ear (the concha)
Anterior rotation of the ear
Each of these deformities can be addressed during Otoplasty. Incomplete folding is corrected with sutures, or by scoring the ear cartilage. A large concha can be surgically reduced, and an anteriorly rotated ear can be set back. Most these corrections are done through an incision hidden in the fold behind the ears, so that it remains hidden, even with short hair-cuts.
If you or your child has prominent ears, a Board Certified Plastic Surgeon can help. A careful examination and medical history will determine the best course of treatment. To schedule a consultation in our San Francisco Bay Area Plastic Surgery Office call (925) 943-6353 today.
Breast buds can lead to “puffy nipples,” really the enlargement of the areolae rather than the nipple proper. Gynecomastia reduction surgery can remove the disproportionate breast tissue and masculinize the chest.
Gynecomastia Reduction Surgery on the Bay Area’s KRON 4’s Body Beautiful
A couple of months ago, I had the opportunity to discuss Gynecomastia Reduction Surgery on the San Francisco Bay Area’s News Station, KRON 4. Body Beautiful, was the first live show broadcast from the new KRON 4 studios, and what a beautiful facility it is. It was my privilege to discuss the various forms of Gynecomastia and the many Breast Reduction treatments available.
Types of Gynecomastia Reduction Treatments
Liposuction, direct excision of the gland, removal of excess skin and combinations of all these methods were reviewed and illustrated with Gynecomastia Reduction Before and After Pictures. Excision of the skin is not usually necessary, unless there is a large amount of loose skin. This type of skin redundancy is seen in older patients and after large weight loss, like with Post Bariatric Plastic Surgery.
Gynecomastia and Male Breast Reduction Surgery Video
Breast Buds – The First Wave Effects Us All But Doesn’t Last
Gynecomastia effects every man at some point in his life. Every infant is born with it. The mother’s female hormones cross the placenta and cause the development of breast tissue. Infants will quickly lose the breast buds as their mother’s hormones gradually metabolize in the infant’s circulation.
Breast Buds – The Second Wave Effects Most of Us and Often Stays
The second wave of Gynecomastia might not go quietly. The breasts experience a second surge of hormones during puberty. This can be a problem for young men. Approximately 65% of boys experience the recurrence of Breast Buds during the pre-teen to teen years. In about half those affected, the enlarged breast tissue again decreases as the hormone levels drop. Since this can take several years, it is recommended that early Gynecomastia be observed for 1-2 years. If it persists, and it remains a cosmetic concern, there are surgical options that are safe and effective.
The chances of Gynecomastia can go up with certain behaviors, too. Many medications can promote breast development in men. While young men do not often require water pills (diuretics) or blood pressure medicine (antihypertensives); however, steroid use and smoking Marijuana both promote abnormal growth of breast tissue. There are no medications known to reliably decrease the size of gynecomastia, once it develops.
Breast Buds – The Third Wave Comes Later
The third wave of Gynecomastia is in middle age and later in life. It can be Pseudogynecomastia, fat from weight gain, or True Gynecomastia, often secondary effects of medications, like the diuretics and antihypertensives mentioned above. Gynecomastia can also be a significant side effect of prostate cancer treatments. After puberty, once Gynecomastia develops, it rarely leaves without surgical intervention.
Breast Buds – Outside the Waves Could be Dangerous
While the vast majority of Gynecomastia is benign, certain signs and symptoms, including abnormal timing at presentation, may be a warning, and further investigation may be warranted. Men account for 1% of all Breast Cancer cases, and other tumors, like testicular and pituitary cancer, can produce hormones that promote breast development. Gynecomastia associated with bleeding or discharge from the nipple may also require additional testing.
If you have problems with disproportionately large breasts, areolae or nipples, whether you are a man or a woman, you have options. Explore your options with a private and personalized consultation appointment. Give my San Francisco Bay Area Plastic Surgery office a call today at (925) 943-6353. The San Francisco Plastic Surgery Blog, and my other web sites provide accurate information; however, the best results are obtained by tailoring your surgical plan to your situation.
I repeat this often: when it comes to getting the best results, there is no substitute for an in-person consultation with a qualified, experienced, Board Certified Plastic Surgeon.
Body Dysmorphic Disorder (BDD) is a socially isolating belief that one’s body is unusually defective. It effects 1-2% of the population, and is equally prevalent in women and men. BDD is defined as a preoccupation with an imagined or trivial defect in appearance, causing clinically significant distress or impairment in social, occupational, or other functioning. BDD can manifest as a strong desire to hide, or fix the defect.
Body Dysmorphic and Plastic Surgery Patients
Most people with Body Dysmorphic Syndrome become socially isolated, but some seek the care of a Plastic Surgeon for correction of their problem. Unlike most plastic surgery patients; however, BDD patients do not always have a physical flaw, and those who do tend to have exaggerated concern about what seems to be a minor flaw. Even if the defect can be corrected with Plastic Surgery, BDD patients do not get the usual relief that most Plastic Surgery patients get. This can lead to continued distress, repeated operations and, as confirmed in a new study, more surgical complications. More on this below.
Body Dysmorphic Disorder Research
BDD was described by Enrico Morselli in 1886, as dysmorphophobia. One hundred years later, it made its way into the DSM-III-R, and last month an article published by Austin J. Woolley and Julian D. Perry in the American Journal of Ophthalmology confirmed what Plastic Surgeons have know about the disorder. The article entitled Body Dysmorphic Disorder: Prevalence and Outcomes in an Oculofacial Plastic Surgery Practice confirmed the important aspects of how BDD affects, and can complicate, plastic surgery.
Picasso – Tete de Femme – Jacqueline
BDD and Eyelid Surgery (Blepharoplasty)
The article focused on a consecutive series of 728 Blepharoplasty patients who were screened with the Dysmorphic Concern Questionnaire. 50 patients (6.9%) scored greater than 9, and were classified as positive for BDD. While this is higher than the percentage expected in the general population, it is not unusually high for patients seeking cosmetic surgery. The BDD group was then compared to a group of 150 control patients (who scored less than or equal to 8).
Characteristics of Body Dysmorphic Patients
Significant differences (confidence interval of 95%) were demonstrated. Patients in the positive questionnaire screening group were:
Significantly younger (P = .004)
Had more eyelid surgeries (P = .007)
Experienced higher rates of complications after surgery (P = .002)
Had a higher technician word count compared to the control group (P = .003)
While you might expect these types of findings, the magnitude of the differences always surprises me.
For example, the reoperation rate for BDD patients was 22.7% compared to 6.9% in the control group. Perhaps this is understandable, given the subjective nature of reasons for reoperations, coupled with the BDD patient’s strong desire to fix a problem, even if it is slight or imaginary. Moreover, the complication rate for BDD patients was 19.1% compared to 0% in the control group. Complications are much more objective. Was there a component of sabotage in the BDD group? Because how one feels about the outcome of eyelid surgery, should not lead to such a significant increase in outcomes like infections or bleeding.
Patients with BDD are prone to compulsive or repetitive behavior, and solutions often give only momentary relief. Typical patterns of behavior include:
Camouflaging (clothing, makeup, hair, hats)
Comparing themselves to others in terms of appearance
Seeking plastic surgery
Constantly checking the mirror
Plastic Surgery is not the Cure
Picasso – Tete de Femme Same painter, same woman, a more connected view of the world.
While the physical deformity in BDD may be minor or absent, the distress experienced is real. Seeking Cosmetic Plastic Surgery may be a symptom, but Plastic Surgery is not the cure. Cognitive behavior therapy seems more effective than medication, but both modalities are used. Interestingly, patient improvement is associated with an increase in the number and quality of connections between the orbitofrontal cortex and the amygdala. Both these areas of the brain are involved in decision making, while the amygdala also helps with emotional reactions and processing memory. More connected inside. More connected to the outside, and less Body Dysmorphia.
This month, I had the unique opportunity to tape the latest installment of Body Beautiful in the newest TV studio in San Francisco. KRON 4’s new studios are bright, shiny and in high definition. The show is still live, and has a new set, new cameras, a new control room and everything worked perfectly. A big thank you to KRON for trusting me with live launch, and to the cast and behind the scenes crew who made it work seamlessly.
Breast Augmentation Revision Surgery
Over the next few weeks, I will be posting segments from the show. This week, we start with Breast Augmentation Revision Surgery. The FDA requires plastic surgeons to notify their patients that Breast Implants, like most implanted medical devices, are not “lifetime devices.” This means your Breast Augmentation may wear out before you do. On the other hand, there is no expiration date on a Breast Implant. Despite what you may read on the Internet, Breast Implants do not need to be replaced every ten years, though about a fourth of women with Breast Implants will have Breast Implant Revision Surgery in the ten years after their Breast Augmentation.
Breast Implant Revision Surgery Video
The above Breast Augmentation Revision Video reviews the most common reasons for Breast Implant Revision. The preview above shows Pictures of Before and After Symmastia (Uni-Boob) Repair. Watch the video to see treatment of many of the most common revision surgeries with Before and After Pictures of Breast Implant Revision Surgery.
Reasons for Breast Implant Revision Surgery
There are many reasons for Breast Augmentation Revision Surgery. The most common reason is to replace perfectly good breast implants with larger perfectly good breast implants. Many of the most common reasons for Breast Revision Surgery are discussed in the Breast Augmentation Video featured above. To learn more about the common reasons for breast revision surgery, just click on any of the following links:
If you have problems with your Breast Implants, and are considering upsizing, upgrading or revision surgery, give my San Francisco Bay Area Plastic Surgery office a call. While I try to supply you with the most up-to-date and accurate Breast Implant Information possible on the San Francisco Plastic Surgery Blog, there is no substitute for an in-person consultation. Call (925) 943-6353 today, to arrange your personal, private consultation appointment.
The American Society for Aesthetic Plastic Surgery (ASAPS) has released its 2014 Cosmetic Plastic Surgery statistics. The United State’s premier professional society dedicated to the advancement of Aesthetic (Cosmetic) Plastic Surgery has compiled the procedures performed by its members and others last year, and here are the results:
The ASAPS has released last year’s plastic surgery statistics.
Plastic Surgery Procedures- Who had What?
More than ten million surgical and nonsurgical cosmetic procedures were performed in the United States last year.
Nonsurgical cosmetic procedures are easier, simpler and more frequently performed than surgical procedures.
As expected, nonsurgical procedures accounted for the majority of the total with 8.8 million procedures:
Americans have spent more than 12 billion dollars during each of the last two calendar years on surgical and nonsurgical cosmetic plastic surgery procedures. While nonsurgical procedures outnumbered surgical procedures in frequency, surgical procedures accounted for 60% of the total expenditures.
The Fastest Growing Procedure in 2014
Liposuction, Breast Augmentation and Tummy Tucks have increased dramatically since I started my Walnut Creek Plastic Surgery practice in 1997, while Cosmetic Eyelid and Nasal Surgery have remained steady.
Since starting my San Francisco Bay Area Plastic Surgery practice in 1997, there has been a 274% increase in the total number of cosmetic procedures. Surgical procedures have increased by 82% and nonsurgical procedures increased by 508%. The fastest growing procedure in 2014 was Buttock Augmentation, aka the Brazilian Butt Lift (BBL). While the totals are still less than 10% of the number of breast augmentations, the growth was an impressive 86% last year. The BBL, with over 21,000 procedure performed in 2014, moved up steadily from 20th in 2004, and 18th in 2009 to 15th in 2014.
Breast Augmentation Trends
Breast Augmentation was passed by Liposuction again this year for the most popular procedure. The two are usually neck-and-neck for the top spot each year. With the introduction of breast implants 5.0, form-stable, high-strength, cohesive silicone gel, gummy bear or whatever the latest catch phrase is, 80% of breast implants used in 2014 were silicone and 20% were saline. Breast Implant Revision Surgery increased 30% last year, and may be the result of both the improved alternatives in breast implants currently available and the recognition that breast implants are not life-time devices.
The Ladies Have It
Since 1997, the number of cosmetic procedures for women increased over 429%. Women account for 90% of all cosmetic plastic surgery patients. With breast procedures, excluding breast reconstruction, accounting for over one-third of all cosmetic surgery, this is no surprise. 605,987 female breast procedures (breast augmentation, breast lift, breast reduction, breast revision) were performed in 2014. Comparing this with 24,234 male breast procedures (gynecomastia reduction), women account for over 96% of all cosmetic breast surgery.
Cosmetic Plastic Surgery Consultations
If you are considering Cosmetic Plastic Surgery, be certain to find a Board Certified Plastic Surgeon with experience in the procedure you are considering. If you are in the San Francisco Bay Area, give my office a call at (925) 943-6353. My friendly Plastic Surgery staff in Walnut Creek, CA, is available to take your call, and arrange your private consultation.
This Wednesday’s Body Beautiful on the San Francisco Bay Area’s News Station, KRON 4, will cover both Facial Plastic Surgery procedures and Body Sculpting.
Facial Plastic Surgery
One of the most frequently augmented parts of the body are the lips. Lip Augmentation with dermal fillers like Restylane, Juvederm and Perlane, offer instant gratification, minimal recovery and virtually no down-time. There is a day or two of swelling, and the volume needs to be maintained periodically, but these hyaluronic acid based fillers are softer, and last longer than the previous lip plumper: Collagen.
Surgical Lip Enhancement Before and After Pictures
Vermilion Advancement is a Surgical Lip Enhancement that permanently advances the red vermilion of the lip out of the mouth and onto the lips.
Surgical Lip Enhancement
Surgical Lip Enhancement is also an option. Dermal grafts and local tissue rearrangement can add volume and change the lip shape with longer lasting results. Unlike fillers, these procedures do require some down-time for recovery. The surgical options for Lip Enlargement with be discussed on KRON 4’s Body Beautiful this week.
Otoplasty (Ear Pinning) Before and After Pictures
Otoplasty, sometimes called Ear Pinning, is a facial plastic surgery procedure that corrects prominent ears.
Prominent Ear Correction (Otoplasty)
Otoplasty is the cure for prominent ears. It is one of the few Cosmetic Plastic Surgery procedures which is performed on both children and adults. Ears are usually prominent at birth. There is evidence that immediate molding, within a few days of birth, can bring the ears in closer to the head, but after a few weeks, the ear cartilage is unbending in its prominence.
The ear reaches 85% of its adult size by age five, making this is a common time for Otoplasty. It is important that both the parents and the child feel the ears are too prominent. A second peak in the age of correction is in young adults. Usually, their prominent ears have been bothering them for quite some time, and as young adults, they now have the means to fix it.
Breast Implant Revision Surgery Before and After Pictures
A common reason for Breast Implant Revision is to correct Capsular Contracture. Before, the breast implant is firm, squeezed and pushed up out of the breast by a tight capsule, leaving the breast tissue hanging. The after picture shows the improved breast shape and support.
Breast Augmentation Revision Surgery
Breast Augmentation remains the most popular of all the cosmetic plastic surgery procedures. While Breast Implants can add volume to small or deflated breasts, the results can change with age.
Breast Implant Revision has almost become a specialty unto itself. The reasons for revision and the methods are reviewed on my SanFranciscoBreast.com web site. Some of the most common breast revision surgeries, and the results, will be discussed this week on Body Beautiful.
Gynecomastia (Male Breast Reduction) Before and After Pictures
Gynecomastia is Male Breast Enlargement, and not in a good way. The problem can occur at any age, but is most common during puberty, and in one-third of cases, lasts a lifetime. Gynecomastia Reduction can help masculinize the chest again.
Male Breast Reduction (Gynecomastia Reduction Surgery)
Gynecomastia Reduction Surgery is one of the most common male cosmetic plastic surgery procedures. Removing disproportionate breast tissue can help smooth out the chest both in and out of clothing. I practice Plastic Surgery in the San Francisco East Bay Area city of Walnut Creek. It’s been warm here all winter, and gets hot in the summer. I know I have done a good job when my patients ditch the bulky hot sweatshirts they wear during their initial consultation, for a t-shirt after their Gynecomastia Reduction. Wearing a sweatshirt in Walnut Creek during the summer is no fun.
Body Beautiful Wednesday at 11 AM
This Wednesday, March 11, at 11 AM, host Janelle Marie and I will be discussing Lip Augmentation, Otoplasty, Breast Implant Revision Surgery and Male Breast (Gynecomastia) Reduction in the new KRON 4 studios. If you have questions about these, or any plastic surgery procedures, that you would like answered on the air, use the contact form in the margin to drop me a note.
If you would like to schedule a consultation, call (925) 943-6353 to arrange a personal, in-person review of your options.
Thirty-five-year-old Marcus Kemeter let doctors amputate his hand and replace it with a bionic hand. It’s not because he is a touched Star Wars fan who dreams Darth Vader is his father and wanted a new hand like Luke Skywalker. It’s not because he wants to selflessly volunteer to advance the knowledge of man like those signing-up for a one-way trip to Mars.
The Michelangelo Hand by Ottobock has a flexible wrist, seven hand positions, an independent thumb… and Captain Hook’s ire.
The Decision Took Time
Seventeen years before making the decision to replace his hand, Marcus injured his shoulder in a motorcycle accident. He lost function of the nerves that controlled his arm. The medical term for this type of injury is a brachial plexus injury. The brachial plexus is a collection of nerve “cables” that connect the spinal cord to the arm.
Brachial plexus injuries are as common as they are devastating. Any strong blow to the shoulder can stretch and injure the nerves causing changes in sensation, weakness and even paralysis. While motor vehicle accidents are a common cause, falls and sports are too. The nerves can be repaired, to restore function. However, while motion of the upper arm is often improved, function of the hand is not.
Nerve Injuries Recover Slowly
Even the best results, leave a patient with the dexterity of wearing boxing gloves. The hand can be used as an assist, but grasping and fine motor skills are lost. Without sensation, the ability to protect the hand from further injury is lost. Even minor cuts are more likely to become life and limb threatening, because a numb limb does not heal as well. The extremity becomes a liability.
In His Own Words
In his case, Marcus’s brachial plexus was repaired in 1996, helping his shoulder and elbow, but the forearm and hand never recovered. When questioned about his decision to exchange his injured hand for a bionic one Mr. Kemeter stated:
“I could feel everything but I couldn’t do anything with the hand. It wasn’t hard for me to decide to do the operation,” said Kemeter. “I couldn’t do anything with my hand. The prosthesis doesn’t replace a full hand, but I can do a lot of stuff.”
In 2011, Dr. Oskar C. Aszmann, Plastic Surgeon at the Medical University of Vienna’s Center for Extremity Reconstruction and Rehabilitation, transplanted nerves from Marcus’s leg to his forearm.
Bionic Hand Training: Marcus’s forearm is attached to sensors that pick-up the commands his brain sends to the transplanted nerves in his forearm. A computer interprets the neuro-transmissions and translates them into motion of the prosthesis.
After three months, the nerve grafts had matured to the point where they could be connected to a computer for practice moving the prosthetic hand. With brain retrained, the point-of-no-return is negotiated. According to Dr. Aszmann:
“When it’s obvious this mechatronic hand can be of great use to them, then the decision to have the hand amputated is a very easy one,” he said. “If I have to convince someone, they’re not a good [candidate].”
Thanks to all the preconditioning, once the amputation was healed and the prosthesis fitted, it took only a few days for Mr. Kemeter to adjust to his new bionic hand:
“I can do much more than before,” Kemeter said. “Carrying big things, for example, wasn’t possible with only one hand. Now I can do it.”
Anything is Possible
As our understanding of the human body increases, and better materials are found, anything is possible. Notice the boy’s right arm? Someday, you won’t be able to.
As a Board Certified Plastic Surgeon and an Electrical, Computer Engineering major, these devices fascinate me. I blogged before on the subject about the diversity encompassed by Plastic Surgery. While plastic surgeons are better known for Breast Augmentation, more reconstructive plastic surgery is performed than cosmetic. Stories like the replacement of Marcus’s hand reveal the benefit of both sides of the profession. The restoration of form and function is the ultimate goal, and it is happening now. It’s not a fantasy like Star Wars, and will only get better in the future, like round-trips to Mars.
My wife sent me an article this week about a woman who tragically lost her life in the pursuit of larger buttocks. The article entitled “Michelangelo of Buttock Injections Charged With Murder,” tells a story that has been told before, and unfortunately, will likely be told again. The latest story wasn’t about a woman traveling from the UK to Thailand for Plastic Surgery, but about a woman traveling from the UK to the US for Plastic Surgery, and about a home-grown US scam artist preying on naive 20-year-olds who lack the funds or the foundation to know why you should choose a Board Certified Plastic Surgeon who uses a Certified Surgical Facility.
Buttock’s created by the real Michelangelo. Coincidentally, David’s backside is also as hard as a rock.
Medical Tourism has many problems, especially if you live in the United States. The United States has the most regulated system of medical care in the world. Many of the protections we enjoy here in the US are not available in other countries.
In Thailand for example, the head of the regulatory Medical Council of Thailand, Dr Samphan Komkrit, told the World News Blog that “historically (in Thailand), breast implants, eyelid surgery, rhinoplasty – these jobs were not done by plastic surgeons… we don’t want to discriminate against doctors who are not plastic surgeons. This is about self-interest and business interest.” This was in response to a woman dying at the hands of a Thai General Practitioner who was operating on a woman, in his office, at 11 PM, to remove infected Buttock Implants he had placed the week before, presumably also in his office. To save money, an accredited surgery center was not used, nor was an anesthesiologist. The GP was acting not only as a Plastic Surgeon, but at the same time was administering general anesthesia, by himself. More frightening than the head of the county’s medical council’s defense of the current standard of care, is the fact that in Thailand, short of a conviction, there is nothing Dr. Komkrit, or any other medical society on Thailand can do to suspend the offending doctor’s license.
There are no FDA approved fillers to enlarge the Buttocks
To date, the FDA has not approved any buttock fillers.
Despite the large volume of information available on the Internet, and the recommendations from the American Society for Aesthetic Plastic Surgery and the International Society of Aesthetic Plastic Surgeons, these types of problems continue to occur. I saw a young woman yesterday who had silicone injected into her buttocks in Mexico 10 years ago by an anesthesiologist. Sadly, there is little I can offer that will not lead to further disfigurement. There is no way to just suck it back out.
The Brazilian Butt Lift
Last week’s Brazilian Butt Lift article provides information on fat grafting to the buttocks as a method for enlarging the buttocks. It is a procedure that will only work for a selected group of patients, and I only perform it in an accredited surgical facility with the help of a real anesthesiologist. This is the safest way I know of to perform the operation.
Why Plastic Surgery Society Memberships Matter
Belonging to our State, National and International Plastic Surgery Societies is not cheap. While each provides an attractive membership document suitable for framing, the main reason I maintain active membership is to keep abreast of the latest in plastic surgery patient safety and plastic surgery procedures. These societies have stricter criteria for membership than those required to have a medical license. So as a consumer, you can be assured that members of these societies are being held to a higher standard.
A Few of the ways I make certain I am qualified to take care of my Plastic Surgery patients.
Two requirements are that members operate in accredited facilities, and that we have hospital privileges for these procedures. This means a hospital has independently checked our qualifications, and that the facilities we use are also inspected by an independent organization to be certain that everything is up to medical standards. The advantage of an accredited surgery center has been reaffirmed most recently with decreased infection rates.
The advantage of having an anesthesiologist present during surgery should be obvious. Yes, it cost more, but you’re comfort and safety are worth it. The anesthesiologists only job is to make certain that you are both comfortable and safe. This allows me to concentrate of what you are really interested in – results.
How to Choose Your Plastic Surgeon
I have written posts before about How to Choose a Plastic Surgeon. The article is as true today as the day it was posted. It includes links to check you doctors qualifications. If you are considering Plastic Surgery, and would like to make a personalized consultation appointment, call (925) 943-6353 and see what a Board Certified Plastic Surgeon can do for you.