Sarah Palin, Smart and Beautiful

Congrats to Sarah Palin, John McCain's VP pick and first female nominee for the GOP. As Makemeheal.com reports: "Sarah Palin is the surprise pick of John McCain for Republican Vice President nominee, but that is not the only surprise. A former runner-up at the 1984 Miss Alaska beauty pageant, the 44-year old Palin is strikingly attractive and smart to boot".

Palin is a hunting, hockey-playing, intelligent mother of five who makes working mothers heads spin at the prospect of her meteoric rise in the past decade. Regardless of partisan politics, she serves as a strong inspiration to women who are trying to juggle home, career, kids, and significant other and become leaders at their trade. I expect she will be criticized just because of the way she looks despite her intelligence, accessibility, and broad approval from her constituency. She is a great and forward-thinking pick for McCain who is breaking the glass ceiling with the reality of being a working woman and Washington outsider. No matter what the outcome of the election is, it will be a historic moment in November for America!

Surgeons and Video Games

Recent studies show that video game playing can be associated with surgery skills. Certain types of video games can truly have beneficial effects, improving a surgeon�s ability to problem solve as well as to finish the surgery more quickly than a surgeon who has not played video games before. Some people say that playing video games can even make a surgeon smarter by enhancing their ability to be more precise in the actions they take and help them to perform with lesser errors.
One study found that gamers who participate in the very popular multiplayer online game, World of Warcraft used their problem solving skills, such as testing, modeling and they found that these gamers even used math improving their scientific thinking.
In one article, I found that that one study involving thirty-three laparoscopic surgeons who had played video games before were actually 27% faster during the surgeries they performed and they made 37% fewer mistakes than those surgeons who had not played video games. (Source link: American Psychological Association).

Who knew video games could help a surgeon�s performance? Not that I think there should be a mandatory video game course in medical school, but perhaps something similar to a virtual testing skill course will be available sometime in the near future. BTW, plastic surgeons use endoscopic skills in breast augmentation using the transaxillary (armpit) technique, in browlifting, and in mini-tummy tucks. Guess all that Pac-Man and Donkey Kong as a kid pays off.

Who thinks Chelsea Clinton had plastic surgery?

All those who made fun of the President's daughter during the Clinton administration are eating their words now! It seems as if Chelsea Clinton got a make-over -- perhaps a rhinoplasty and chin augmentation. Chelsea introduced "my mother and my hero" on Monday night at the Democratic National Convention (see story in People.com). She looks great with her new look. She straightened and lightened her hair and lost her gummy smile (Source: goodplasticsurgery.com). Dermal fillers such as Restylane and Juvederm can help disguise a gummy smile by plumping up the top lip. She may have had help from her dentist as well.

The rhinoplasty procedure can improve and refine the aesthetics of your nose with surgical techniques that improve a drooping tip, a bulbous tip or a dorsal bump. It also can narrow the bridge of the nose when osteotomies (or breaking the bones) are done. A septoplasty can correct and improve breathing problems which are caused by a condition known as a deviated septum. Chin augmentation is a small change that makes a world of difference. These procedures have helped Chelsea Clinton improve her look and most likely give her more confidence than ever! Now it's Hillary's turn...

Importance of the PAP Smear--The Case of Jade Goody

According to the The National Cancer Institute women who do not regularly have a Pap smear to detect HPV or abnormal cells in the cervix are at increased risk of cervical cancer. The new poster child for cancer prevention would be Jade Goody from TV's reality show "Big Brother". She recently was diagnosed with invasive cervical cancer. She had previously undergone 3 procedures to remove the abnormal cells and when she once again was told she had an abnormal smear test she decided to ignore it (usually it's called dysplasia, but we don't know the specifics of her case). The abnormal cells are sometimes caused by HPV (human papillomavirus)--I'm sure you've seen the recent commercials on TV for the vaccine called Gardasil.

Although there is no early warning signs, PAP smears do help detect cervical cancer. She's quoted as saying she was scared and believed once the cells have been removed that it should not come back. And even though Jade ignored letters from doctors telling her to get another procedure she couldn't ignore much longer. After collapsing, Jade now has to have an urgent hysterectomy to remove her womb and an intensive course of radiotherapy and chemotherapy. Scary.

Read the story on thedailygoss.com!

Did Britney Spears get SmartLipo?

With all of the attention turned to Britney Spears' (recent) fabulous physique has come the obligatory question whenever celebs lose weight: "How did she do it?"

Sure enough, the pop tart reveals just that in the latest issue of OK! magazine courtesy of E!Online, talking about how she's cut out sugar and that her meals consist of things like chicken, salmon, rice, avocados, egg whites and turkey burgers.

"I try to do just 1,200 calories a day," says Brit, who also happens to work out five days a week. "It may sound like it's not much, but it's actually a lot of food if you eat the right things."

12oo calories a day is a tough diet, and is likely similar (but not necessarily the same) as one that is often prescribed to diabetics by docs as recommended by the ADA (American Diabetic Association).

Just looking at the photo to the left of Britney's tuned up abdomen, it leads one to wonder if she also had a quick fix like SmartLipo or some type of traditional liposuction procedure. I haven't examined or treated her, but I wouldn't be surprised if at some point after having kids she had something like that. SmartLipo is awesome because it can be done on defined, isolated fat pockets under local anesthesia, and the patient can literally walk out the door and go home afterward with very little downtime (except for some bruising and swelling typical of any lipo procedure). SmartLipo utilizes a laser to melt the fat first, which then gets suctioned away with small cannulas. The lasering beforehand purportedly helps over the next few months with skin retraction or tightening. And Britney's abdominal and outer and inner thigh skin looks kind of tight here, reminiscent of young women who have had such a procedure done. (I say young because younger women have more elasticity in their skin and more of an ability for the skin to tighten smoothly). Exercise and diet of course help, and should be first line when trying to shed pounds.

How Michael Phelps Shaves off the last Millisecond

Congrats to Michael Phelps for his eight gold medals at the Beijing Olympics! He is such a fish; it has been so impressive just watching him fly past everyone else in the swimming pool. He has such an incredibly fit and finely tuned body with his hardcore exercise and diet regimen to be discussed in his new book entitled, "Built to Succeed". His 12,000 calorie/ day diet is detailed in a recent Wall Street Journal article.

He is the consummate athlete. But, wait....just one small comment. If he were ever interested in shaving off another .001 seconds from that score, he should think about otoplasty. Otoplasty, or ear pinning, involves resection of some of the cartilage of the bowl of the ear, pinning the ear back with sutures, and several other maneuvers to help downplay their prominence.

Just a thought :) Actually, in all reality, the swimcap holds the hair and ears pressed down to the scalp for swimmers. Phelps is flawless.

Tennis Star Lindsay Davenport gets Botox and Juvederm

Lindsay Davenport, the 32 year-old tennis star, has admitted to receiving Botox and Juvederm injections. She states in her interview with makemeheal.com, "No one should have to feel like their skin is aging faster than their body. Thanks to JUV�DERM I just look my age. And my theory is, when I find something that works, I want to share it. That�s why I�m talking freely about my JUV�DERM treatments. I want to help educate women and men about safe and effective aesthetic treatment options they have available to them and stress the importance of seeing a trained physician for treatment."
I am glad to see this professional athlete speaking freely about her experience with plastic surgery. Dermal fillers and Botox injections are great ways for women to enhance their appearance and feel better about themselves. It definitely appears that she has some Botox in this photo! :) She looks great and she loves her results.
As a Registered Nurse who performs injections, I really enjoy the immediate results that my patients see with dermal fillers.

Christina Applegate bravely undergoes bilateral mastectomies for breast cancer and BRCA + gene

Christina Applegate's choice to bravely undergo a double mastectomy puts her in the company of a growing number of women taking aggressive steps to avoid dying of breast cancer. A recent article in USA Today states that studies show more patients are choosing mastectomies, even though women are just as likely to survive if they have smaller, breast-conserving surgeries.
Some of this growing trend has been spurred by technology: MRI scans that can detect smaller, earlier cancers; sophisticated genetic tests that can warn women of their inherited risks like the one Applegate was positive for. Newer techniques in plastic surgery for that makes more aggressive surgery more appealing (we are now able to do free flap reconstruction with the patients' own tissues to rebuild the breast, or use newer generation silicone gel implants after tissue expansion for reconstruction). There is no doubt that some women are opting for mastectomy because their fear of cancer and mortality looms larger than the immediate appearance of their breasts postoperatively. Federal legislation mandates insurance coverage of breast reconstruction after cancer so this is good for patients too.

Applegate, 36, was at high risk for breast cancer, both because her mother had the disease and because she carries a rare genetic mutation in a gene called BRCA-1, which increases the risk of developing aggressive disease at a young age--women with this gene have up to an 84% risk of breast cancer. Applegate told Good Morning America Tuesday that she had early-stage cancer in only one breast and underwent two lumpectomies, and she that opted for a double mastectomy after learning of the genetic mutation. Only about 5% to 7% of breast cancers carry these mutations.

Some women with the mutations opt to have preventive mastectomies even if they haven't been diagnosed with cancer given their high liklihood of developing breast cancer in one or both breasts in the future. A recent study in the International Journal of Cancer, for example, found 18% of women with the mutations took this approach. Applause for Christina Applegate for bringing public awareness to a disease that is diagnosed in 1 in 8 women. I wish her all the best in her recovery.

Every woman should remember to do monthly self-breast exams, mammogram starting at 40 or even earlier or with an MRI with a positive family history, and to consult with their doctor with any abnormal findings.

Has Paris Hilton had a breast augmentation or is this a new bra line?

More photos of Paris Hilton's increased bust got people talking at the opening of club Apple last week. (Source: X17 Online) But despite seemingly going from an A-Cup to a C-Cup, a Paris insider assures them that it's not the work of a good plastic surgeon, just an extremely effective push-up bra. A quote in the article says,

"Paris has never had plastic surgery and has been wearing a prototype from her bra line she has been developing. At Apple she looked amazing and everyone was asking where they could get that Bra."

I agree, she probably has a great padded push-up bra (or perhaps a small submuscular breast enhancement that gives her a little "extra" in the right bikinis and low-cut shirts). In any case, its a great idea to market it as a new type of push-up bra! Paris is always reinventing herself in such an entrepreneurial fashion.

A Beauty Obsessed Culture Affecting Young Women?

A new report on Reuter's today says that America's obsession with beauty is posing serious problems for the health and economic well-being of women and young girls.

The report is based upon a study done by the nonprofit YWCA in the United States which said that women and girls are spending more and more money in their quest to look like idealized, air-brushed magazine models. The report, Beauty at any Cost, noted U.S. women spent some $7 billion a year, or an average of about $100 each, on cosmetics and beauty products. They mention that $100 a month, if saved and invested for five years, would pay for a full year of tuition and fees at a public college, the report calculated.

The report also cited that nearly 11.7 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2007 -- a 446 percent increase in 10 years, according to the American Society for Aesthetic Plastic Surgery. Botox injections as well as liposuction and breast augmentation are the most popular nonsurgical and surgical procedures.

It mentioned that weight loss and smoking are big issues among young women (as they have always been). I think that young women should try to put everything in perspective, and not spend all of their money on beauty treatments, and not start at such an early age. Once you start it can become a slippery slope, with the cost of upkeep as you go along...just think about highlighting your hair. But, I also think a lot of women get plastic surgery to address a certain issue about their anatomy like breast asymmetry or flatness, or a bump on a crooked nose, that has always been an area of concern to them. They are not all junkies or addicts, and sometimes the public has a skewed vision of what's going on because of reality shows like Extreme Makeover and Hollywood. I am glad the YWCA is shedding light on the issue.

New State Law in California sets Welcomed Precedent for Patient Safety after Donda West's Death

The California Senate has approved new laws relating to plastic surgery following the untimely death of Donda West. The Senate announced on Thursday that the new laws require patients to undergo a physical examination before any surgery takes place (we as plastic surgeons call this a "medical clearance" and it is obtained in order to assess the medical status of patients undergoing elective surgery; seems pretty basic and common sense, huh?).

Senator Mark Ridley Thomas admitted that the new legislation was in direct response to West's postoperative death in November last year. Ridley-Thomas told the Los Angeles Times: "Many of us are concerned about the quality of care extended to those who receive elective surgery.� Source: Taletela.com

West was undergoing a tummytuck, or abdominoplasty, and liposuction combined with a breast reduction shortly before the time of her death. Here is the story as it broke on FoxNewsLive when I was interviewed about it.

I hope this will inspire similar legislation all over the United States for the sake of patient safety. Board certification by the American Board of Plastic Surgery, credentialing in local hospitals, and verification of licensure and any disciplinary action are all important things for consumers to research when picking a plastic surgeon these days.

Jennifer Aniston and Lip Augmentation

Questions are always being raised as to whether or not Jennifer Aniston has had "work" done. Lately people have questioned whether she's had lip augmentation with soft tissue fillers. As you can see in the photo, if she did it was actually done well and very conservatively along the upper border of the lip. Lip injectables are soft tissue fillers (usually Restylane or Juvederm these days, a naturally occuring hyaluronic acid which is not permanent, and very "forgiving" or soft). She may have just used a different lipliner and gloss to give her lips a little perk--also the shots are taken from different angles so that could have something to do with the mildly different look to her lips.

She looks awesome. Whatever she's having, I'll have some too. And she's got a cute boyfriend, too.
Check it out in Daily Mail (photo credit).

Has Ali Lohan had a Breast Augmentation?

Rumor has it that 14- year old Ali Lohan had a breast augmentation. That would be really weird, seeing as breast enhancement for cosmetic purposes is not recommended or approved by the FDA of the United States as well as plastic surgery specialty societies like ASPS (American Society of Plastic Surgery) and ASAPS (American Society for Aesthetic Plastic Surgery) for girls under the age of 18. Hmmm, could it just be a regular growth spurt? Probably. She has such a cute figure, and I can't imagine a surgeon implanting a 14- year old girl, especially one of such notoriety and fame since he or she would automatically be scrutinized for that choice. (She looks like she has on a good padded push-up bra too in the picture on the right).

Of note, reputable plastic surgeons and the FDA do approve of using breast implants for the reconstruction of abnormal breasts in women of any age, including those under 18. Certain developmental deformities such as tuberous breast syndrome and severe congenital breast asymmetry give a good reason for breast implants in women of younger ages given the embarrassment and difficulty finding clothes that fit growing up. Photo credit of Us Weekly Magazine.

Good luck defending yourself among the paparazzi, Ali!

Without Breasts There Is No Paradise

My assistant, Janie, brought to my attention a soap opera in Latin America that has become wildly popular. The soap opera "Sin Senos no Hay Paraiso" is on NBC's Telemundo and is based on a book inspired by a true story about a group of young women that have decided to do whatever it takes to escape their humble town where poverty reigns. The story takes place in two locations: Colombia and Mexico. and The story is mostly revolved around Catalina, a beautiful young high school girl obsessed about getting breast augmentation in order to become a high class prostitute in order to get her family (her mother and her brother) out of poverty. Her schoolmates and best friend Yesica have breast implants and tell Catalina that the only way to really make money is to get the operation and get the biggest breasts possible. They remind her daily that men only care about breasts in the business. Along with her school mates and the help of Yesica she is able to "book" jobs in order to try to raise money for her operation. She believes breast implants is a short cut to easy money hence happiness.

However since she is inexperienced and naive she has relations with other men, all with fruitless jobs and bad intentions. She now encounters Lorena from Mexico and she promises Catalina and other pre-op girls modeling contracts in Mexico with the condition that they be operated by her surgeon. Little do they know that she is working for a narcotrafficker, Martinez, and the shady surgeon plan to fill the implants with bags of heroin in order to sneak the drugs out of Colombia to Mexico. (Crazy!?) So Catalina is then tricked into going through the augmentation and she has no idea that she is carrying a significant amount of drugs in her chest. Although she thought that once she had breasts she would be happier and life would be better, she is realizing that she is now being humiliated and mistreated and further away from happiness which ironically she thought breasts would bring her.

Amazing how in our culture and in other cultures breasts are praised and "sought after" for various reasons. The storyline is a little out there, but its interesting to see what becomes a hit in different places all over the world. Hey, we've got All my Children and Days of Our Lives.

The Truth About "The NewNewFace"

Madonna has been getting a lot of press lately. Her Madgesty has always had such a great body, finely toned and trim. I have watched her as I grew up belting out hit after hit. Lately many are speculating on what she has done to her face. New York Magazine did a feature this month on the "NewNewFace", and described what we as plastic surgeons have been doing for a while: adding volume instead of taking it away (remember the thin and bony faces that look too tight on Madison Avenue circa 1990?), tightening the foundation of the face instead of the skin itself in facelifting so that there's no excessive tension leading to that wind-tunnel look. We've also seen an uptick of women getting injectable fillers and Botox as an earlier or as an alternative to surgery. Let's see how they stand the test of time.

Looking at the photos, it looks like Madonna may have had some fillers to the cheeks, nasolabial folds, and lips (can't tell which one--could be one of the hyaluronic acid fillers like Restylane or Juvederm for lips or folds, Sculptra or Radiesse to the cheekbones, or even her own fat taken from elsewhere on her body. She also may have had a mid-facelift (or some variant of a "mini" or short-scar facelift) and upper and lower lid blepharoplasty to give the eyelids a little lift and give her upper lids a clean sulcus and a more rested appearance. Also, Botox can lead to her brows elevating and arching a bit (a "chemical" browlift as some call it) and smoothening the forehead by selectively paralyzing the muscles there.

Altogether an interesting article, good to see my hospital Manhattan Eye and Ear mentioned in it!

Plastic Surgery, The Celebrity

Welcome to this new blog about plastic surgery. In this world, cosmetic plastic surgery itself has become the celebrity. I am constantly bombarded with images, blogs, websites, TV shows, and radio talk about the subject. I am asked to comment by media on who has done what and when, what works and doesn't, and the latest trends in the industry. It's become crazy! When I went to medical school I had no idea what the future would behold.

On the other hand, my practice is largely made up of young and middle-aged women seeking surgical treatment of some problem or anatomic area of aesthetic concern that has been bothering them for some time. They are normal people. They come to me with legit concerns, and do not want to look overstretched, overstuffed and overdone; in fact, often they don't even want anyone to notice. So for my first post I thought it appropriate to bring to light a news story I saw today on MSNBC.com. The title was "'Ugly' is the New Beautiful".

The article said that one talent agency in New York City (where I live and practice) goes out of its way to look for unique models who are not considered traditionally beautiful. It said, "According to agency founder Simon Rogers, "beauty really does come in all shapes and sizes," and in the modeling industry, there's room for all. "We now represent a really candid cross-section of what America is," he said." So step aside, supermodels, because at this agency, "Ugly" looks for people who are from every walk of life!

As a plastic surgeon I agree with appreciating beauty (and "ugly") in all its forms. Although a lot of people would say plastic surgery makes everyone look a certain way, I would argue that it absolutely does not... and good plastic surgery ideally is designed and individualized based upon one person's anatomy and desires. Good cosmetic surgery may even go undetected. We'll see if celebrities seek that willingly (or unwillingly) as we go forward here.

So on that note, enjoy, and thanks for stopping by!