Tuesday, August 25, 2015

Gynecomastia, how to get rid of it

The five things you need to know about fixing gynecomastia:

Gynecomastia or man boobs is a condition where the male breast tissue develops into a benign growth of breast development, similar to a female breast.  It can be on one breast or both.

There are many potential causes of gyencomastia and for a complete list of medications please check out this article.

When surgery is the solution, it can be performed very simply with little to no scarring.  Please check out this video for more information.

Saturday, March 28, 2015

Laser lipo reviews: a summary of all surgical and non surgical options

Each week we get questions about different non surgical options for fat reduction. Every machine claims to be THE BEST, in this video Dr. B reviews the newest devices and which ones DO and DO NOT work! Please WATCH and LIKE (on YouTube)!!!! Thanks
631 232 2636


Tuesday, February 17, 2015

Liposuction of the thighs: fixing plastic surgery gone bad

http://ift.tt/1v08zxA Thigh liposuction, the inner thigh, outer thigh or anterior (front) thigh are the areas with the highest chance of a getting a poor result. The fat in the front and outer thighs is located very superficially and if done incorrectly will create a poor contour and 'dents' in the skin. The surgeon treating this area must be patient and use very thin suction cannulas to give the best result. The inner thigh if performed too aggressively can leave a patient with loose skin. The outer thigh can look different when the patient is laying flat on the table and standing. When I perform liposuction of the outer thigh I use specially made positioning pillows to simulate the standing position while the patient is laying down. There is a fine balance that must be considered by the performing surgeon. The patient in this video had a very bad result after liposuction of her thighs by another surgeon. She was left with dents and irregularities that I Was able to repair by liposhifting and fat transfer. I demonstrate this technique in this video. To see our before and afters of liposuction please check out http://ift.tt/1ACW7pR Dr. Scott M Blyer CAMEO Surgical Center 3750 Expressway Drive South Islandia, NY 11749 631 232 2636 drblyer@cameosurgery.com http://ift.tt/1v08zxA Subscribe with this link: http://ift.tt/1Bl77CB



Wednesday, February 11, 2015

Lip injections or other choices?

http://ift.tt/1v08zxA Lip injections are amongst the most popular non surgical requests in our office. Patients often ask for a lip with more pout, a natural look, or a lip with more definition. Resytlane, Perlane, Juvederm, or Belotero are the most popular lip fillers. A lip filler is not the only option for lip enhancement. There are times where a lip implant is better, or a lip lift or a V-Y advancement. Knowing what kind of lip a patient has and what they want to accomplish will help determine what is best for that particular lip. For more filler information check out http://ift.tt/1DGaHMv Check out http://ift.tt/1z8pKct for more lip enhancement procedures Dr. Scott M Blyer CAMEO Surgical Center 3750 Expressway Drive South Islandia, NY 11749 631 232 2636 drblyer@cameosurgery.com http://ift.tt/1v08zxA Subscribe with this link: http://ift.tt/1Bl77CB



Tuesday, January 27, 2015

Check out our new YouTube page. You won't be disappointed.

Cosmetic surgery, injectibles, skincare, nutrition, and weight loss continues to increase in popularity as surgeries become more affordable, nonsurgical options are improving, and recovery and associated downtime becomes less. On this YouTube channel we will be reviewing the best options for common complaints, whether they are time tested procedures or relatively new. There is a lot of bad information: people misrepresenting outcomes, recovery, and expectations driven by financial gain. This channel will serve as a beacon of truth where we will provide honest answers to your questions or concerns. We will cover interesting things from our office, news, and your emails and comments below. By subscribing to our channel, you will not miss anything and be eligible for different special offers and free demonstrations that CAMEO Surgical Center may be offering. CAMEO Surgical Center 3750 Expressway Drive South Islandia, NY 11749 631 232 2636 drblyer@cameosurgery.com http://ift.tt/1v08zxA Subscribe with this link: http://ift.tt/1Bl77CB



Wednesday, November 21, 2012

Mens' Night Dec 14, 2012

No matter what kind of man you are...

This night is for you

CAMEO Surgery Mens' Night 

Friday December 14, 2012
6 pm
3750 Expressway Dr S
Islandia, NY 11749

The line up:
short and sweet 
each talk will be kept around 10 minutes
Grab a beer and a seat 
  • Dr. Blyer "The turkey neck, facial wrinkles, man boobs, ab sculpting, and having a face like a sexy beast"
  • Dr. Calapai "Safe Testosterone and Human Growth Hormone, the Man’s Fountain of Youth”
  • Chris Maranzino "Building muscle like you are freakin King Kong"
  • Kathy RoccoGrande "Your face should not double as sandpaper.  It's sexy to have nice man skin along with laser hair removal of the back and chest. "
  • Ms. Jeanna Campo, "Losing ½ -2 pounds per day and increasing your testosterone through HCG”
  • Ms. Anastassia Nikonorova "5 super foods to maintain your mojo" 
 Come for a beer, wings, and a good time
Bring some business cards.  You never know who you meet.  
Please RSVP 631 232 2636 by Dec 7  

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Tuesday, April 10, 2012

Buttock augmentation at CAMEO Surgery

Columbus may have been the first to claim the world is round, but Kim Kardashian was probably the first to claim the perfect buttocks is round. Buttocks augmentation is quickly becoming one of the fasting growing procedures in cosmetic surgery. It is a procedure that is safe and the results can be gorgeous. The only bad news, you can’t see it without using a mirror.

Fat grafting, (aka the Brazilian Butt Lift) is taking fat from unwanted areas and injecting into the buttocks. I often refer to it as the Robin Hood procedure. Taking from the rich and giving to the poor. When done correctly, the graft looks and feels natural and the results are long lasting.
Harvesting fat from around the buttocks allows for a more sculpted shape in addition to the added volume. In anticipation of a shrinkage of the initial graft, I overfill the buttocks by 30-40%. There are people that do not have adequate amounts of fat for an optimal result. If weight cannot be gained prior to the surgery, you may not be a good candidate for the procedure. In that case, I will remove as much fat available and use that with your understanding that the result may be less than what we consider ideal.

Buttocks implants are another option for placement, although this is not a procedure I perform. It is typically fraught with complications. Among these are:
1. Infection- in a normal wound it requires 1,000,000 bacteria to create an infection, on an implant that number is 10,000. This is substantially less. The buttocks is inherently not the cleanest area and therefore subject to an increased chance of infection.
2. Wound breakdown- placing pressure on any part of your body results in a transient decrease in blood flow. We see this when we press our skin and it turns white. Placing an implant in the buttocks compromises the blood supply to the skin and then sitting on the implant can cause the blood supply to this skin to be insulted resulting in wound breakdown.
3.Scarring- the incision size to fit a large stock (preformed) implant may be large to fit it in.
In other countries silicone has been used as an injectible option in the buttocks. I would
The track record for buttock enhancement with fat has been marvelous. It is a procedure that we definitely not recommend this as I have seen disasters from this including, skin damage, nerve damage, migration of the silicone, deformity, terrible scars, treatments requiring amputation of a leg and even a few deaths. This has been infamous in hotel rooms and in the back alley ‘doctor shops’ on the news every few months.
have excelled at and have down to a science. Using the most state of the art equipment to assure optimal fat viability and your safety we can sculpt and create your desired derriere.

The Nalgas King of Neuva York
Dr. Blyer

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Saturday, February 25, 2012

Restylane: new news or old snooze?

Stop the press! The FDA clears Restylane as the first filler approved for lip augmentation. We can all sleep better tonight. After 1000s of lip enhancement injections without any hiccups, I do not think this will change the market at all. Is it good to know? Perhaps you will be on Jeopardy?
As we age there are changes we see in the lip. The aged lip loses volume and it becomes thinner. The cupid’s bow (philtrum) becomes flatter, and the lip will actually lengthen and show less upper teeth at rest. The lip liner area becomes less defined and woman often complain that their lipstick bleeds. Vertical lines in the white portion of the lip also are a common complaint. Many young people alike, just want a fuller lip as a result of the growing trend in beauty thanks to our idols like Angelina.
Hyaluronic acid fillers are the most common filler used to correct these changes in the lip. This is a natural substance found in skin and works to trap water and plump skin, thus while you’ll often find it in your everyday moisturizer. Such fillers include Restylane®, Perlane, and Juvederm®. These are all FDA approved fillers for wrinkles and creases, but only Restylane® is FDA approved for the lip. Comparing these three products, Restylane is a jello like consistency that typically lasts for 6 months. Perlane is a larger molecule that lasts longer than Restylane® but can be prone to lumpiness as a result of its size. Juvederm® is typically my go to filler for lips as the results are smooth and it is a concentrated form of hyaluronic acid that can last up to a year.
Lip enhancement is an easy procedure that yields beautiful results. The treatment is painless after getting the area numb and there is little to no downtime. Should the recent FDA approval lean you, the patient, more towards the path of Restylane? How many of you have had Botox injections? Did you know it is only FDA approved for frown lines?

Monday, February 13, 2012

Going green using fat?

In today’s world, so many of us are trying to ‘go green’. Recycling is the processing of waste into new products, to prevent the waste of potentially useful materials. Recycling is an integral part of this movement. Does this trend apply to cosmetic surgery?

The ultimate ‘green’ procedure which has gained tremendous popularity over the past few years are fat transfers. Years ago, the final destination of fat from liposuction was the trash. We now are learning of the wonderful properties of fat that make it an ideal filler. Fat as a filler lasts between 8 and 10 years, longer than any other temporary filler commercially on the market. There are 500 times more stem cells in fat than in bone marrow. When used in the face, the skin not only looks improved from the volume enhancement, but the skin looks richer, more radiant, and the number of wrinkles diminish. Fat is a natural filler from your own body, eliminating the fear of rejection or reaction. Excess fat is kept in storage to be used in the future for touch ups.

The face is not the only destination for our soft yellow friend. We use fat to enhance the buttocks (Brazilian Butt Lift), the breast, and even the genitals! It is amongst one of the most popular cosmetic procedures, and I am performing a few of these surgeries each week.

Perhaps the concept originated in Robin Hood-taking from the rich and giving to the poor? Whatever the case may be, taking unwanted areas of fat and using it as a filler is not only a fiscally sound investment but an intuitively genius idea. Its popularity and applications are only growing by the hour.

Wednesday, October 12, 2011

Kenny Rodgers didn't know when to hold 'em

There has been a epidemic of poor celebrity cosmetic surgery. Poor Kenny Rodgers and Burt Reynolds. These two gentlemen are a result of a doctor thinking in a vacuum. Although they had multiple procedures done, the upper third of the face may be the most telling. The position of the brow varies by culture, fashion age and gender.

In Mediterranean, Hispanic, and Latin origins a high arched brow is usually desirable.
In Caucasian females the lateral (side closest to the ears) 1/3 should be elevated. In men the brow is low, level in symmetry with the boney orbital rim.

Actors or any patient who we are accustomed to seeing a certain way cannot stray from their norm without looking awkward. Doctors cannot think and react always what the textbook tells you. That separates doctors from technicians. Technically the procedures may have been done correctly, but it certainly does not fit their faces

Can it be fixed? Of course. Almost every week I have a patient present with a 'botched surgery" . Sometimes the corrections are in multiple stages and takes creative thinking but most things can be fixed. In these cases, relaxing incisions under the skin are needed and sometimes skin grafts or tissue expansion is needed as well.

Tuesday, October 11, 2011

What's your butt type?

Humans are the only primates that mate face to face. In other specices males approach females from the rear and use her swollen red buttocks as a signal that she is ready for mating. A plump butt in the face of some men can signal the subconscious that she is ready for mating.

In 1968 scientists looked at the the type of people that liked different types of butts...

Men who prefer big butts are characterized by a need for order: neatness, organization, and orderliness. Men who prefer very large butts tend to be business majors or accountants. These people tend to quickly think of people by stereotypes. In social situations they like to be the center of attention and their values are strong in nature. Type A politicians and businessmen fit this profile.

Men who prefer little butts tend to work hard to see things through. In social situations they do not feel the need to be the center of attention. They are often education majors and they do not read sports magazines.

Thursday, October 6, 2011

Medical Tourism: getting surgery overseas to save $

In the current state of the economy, we have noticed an increasing trend in the interest of having cosmetic surgery abroad, also known as “medical tourism”. There are many qualified doctors overseas, but is it worth the risk. Below, please see my 10 biggest concerns about this issue.

1. Standards of care
The United States Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) warns that the quality of health care in overseas facilities may not be on par with the United States, and that foreign facilities are not always subject to the same health standards and regulations. Few overseas health facilities are accredited by the Joint Commission International (JCI), an organization that accredits overseas hospitals according to quality and safety standards similar to those in the United States.

2. Infection
The largest percentage (31%) of complications from surgeries overseas was infections. Many countries have infectious diseases such as; influenza, tuberculosis and some transmitted by mosquitoes that Americans and Europeans would not have built up a natural immunity to.

3. Other common surgical Complications needed intervention
Other common complications reported by patients were dehiscence (where the wound opens up), contour abnormality, and hematoma (collections of blood in the site). These issues can happen or appear at any point during the healing process; not just immediately after surgery.

4. I have a post operative surgical problem, now what?
Personal medical insurance most likely will not cover a patient while out of the country, if a medical complication should arise, additional costs could be out of pocket. “Medical tourism” is typically excluded from travel insurance coverage. If a complication arises at home there will be a need to find a local doctor willing to take on a case with complications which can be very expensive, or travel back to the foreign country.

5. Checks and balances
The standards of care in the US are much greater than other countries. Medical errors can happen overseas or even in the US. The fact that the local physician out of the country may be unfamiliar with your case may pose additional challenges.

6. FDA regulations
Sometimes inferior medical devices can be used such as breast implants for popular surgeries as breast augmentation. This would not be the case in the United States where implants are closely monitored by the FDA.

7. Traveling after surgery
One of the most popular cosmetic procedures today is the "Mommy Makeover", a combination of a tummy tuck with breast surgery. It is a long procedure and follow up care is very important. In most cases drains are used for 7 to 10 days. The patient must avoid strenuous activity, lifting and bending, making traveling through an airport with luggage difficult.

Preventing blood clots the day of surgery and throughout the recovery period is of extreme importance, and if missed can be potentially lethal. After any surgery you are at an increased risk of blood clotting in your legs, known as a DVT (deep vein thrombosis). Traveling on an airplane greatly increases this risk due to the many hours of immobility.

The chance of acquiring an airborne infection on a plane after the stress of surgery is greater than that at home in your bed.

8. Recovery
Recovering on a tropical beach is not a good option; the patient needs to stay out of the sun and out of the water is necessary to avoid scarring and infection. Being close to home with the support of family or friends is optimal. Having your surgeon nearby is the safest situation. Enjoying a trip to a far off destination after healing is the best plan.

9. Why is the surgery cheaper?
There are excellent surgeons all over the world but many are able to have lower fees because they do not provide protection for patients such as medical malpractice or hospitals do not have liability insurance. Additionally, medical supplies, drugs, sutures, and implants are more expensive in the US with the added costs of FDA regulations.

10. Is the surgery actually cheaper?
Estimated price for a simple tummy tuck
Flights $1,000/person x 2 $1000-2000
Hotel $800 for 1 week $800
3 Meals x 7 days $500
Surgery cost $3000-6000

Total $6300-9300

(It is not advised to travel on a plane 7 days after surgery, but with the above scenario, the cost is essentially the same as the average tummy tuck in the US.)

The most important question and the most commonly ignored, is your health worth the risk?

Thursday, September 29, 2011

Skin Tyte on The Doctors

Skin tightening without surgery!

Skin Tyte

What is Skin Tyte?

Sciton's Skin Tyte offers of a non-invasive treatment for skin laxity which is safer and more effective than ever before. By delivering 100% safe infrared light energy with advanced surface cooling technology heat is delivered below the skin's surface to increase tissue tightening and reduce skin laxity.

This ground-breaking new technology is used to selectively heat the dermal collagen deep in your skin while at the same time cooling the epidermis (outer layer of skin) prior-to, during, and after treatment, reducing pain and minimizing internal thermal injury to adjacent skin structures. The result is partial coagulation and contraction of collagen which tightens the skin.

What can Skin Tyte do for my skin?

A Skin Tyte procedure is a series of full face or body, gentle uses of pulsed infrared light energy treatments aimed to improve the appearance of sun damaged and aged skin, as well as decrease patches of facial and neck redness and flushing. Skin Tyte treatment results in a much younger looking skin.

Skin Tyte Treatments were developed to consistently and predictably improve the visible appearance of the skin with no down time. Skin Tyte treatments may be used over any areas of the body that present aged, photo damaged skin such as neck, chest, hands and arms.

Which area of the body can be treated with Skin Tyte?

SkinTyte treatment is safe for all skin types and can be performed on any area of the body where an improvement in your skin firmness is desired. Popular areas include the face, neck, abdomen and arms

How does the Skin Tyte work?

The SkinTyte process selectively photocoagulates soft tissue in combination with an integral thermo-electric cooler for use in cooling the epidermis at the treatment site prior to, during and after treatment to reduce pain and minimize heat injury to the adjacent skin structures.

By utilizing a broadband of light energy to heat dermal collagen, this process promotes the partial denaturation and contraction of collagen. The heat also stimulates the body's natural healing process which generates a renewed firmer collagen base that leads to skin tightening.

Most individuals requires 2-5 sessions. Each session is spaced at an interval of 3-4 weeks.

This treatment takes about 45 minutes per area. The most commonly treated areas are the face, neck, belly and upper chest.

Most patients feel that their skin is tighter after just one treatment, but visible improvements in skin laxity generally take place over three to six months. This exciting new technology is perfect for those who wish to tighten and firm up their skin, with virtually no down-time. This is outstanding for the patient who wants to avoid surgery but still "tighten up".

Check out the video on the doctors in other posting!

Thursday, September 22, 2011

USA Today misleads the public about cosmetic surgery

What Patients Should Know About Cosmetic Surgery and Their Cosmetic Surgeons

Jayne O’Donnell’s articles of September 14-15, 2011 entitled "These Women died after having liposuction" and "Cosmetic surgery gets cheaper, faster, scarier: Commoditization opens door to dubious practices" (collectively "Article") jeopardize the safety of your readers considering cosmetic surgery. The Article is filled with false information, and misleads patients regarding how to choose a cosmetic surgeon placing patients at risk.

In order to protect cosmetic surgery patients who read your Article, the American Academy of Cosmetic Surgery ("AACS"), American Board of Cosmetic Surgery ("ABCS"), the Cosmetic Surgery Foundation for Education, Research and Patient Safety ("CSF"), and the cosmetic surgeons who represent the specialty of cosmetic surgery on the American Medical Association ("AMA") House of Delegates, respectfully urge USA Today to correct the false and misleading statements contained in the Article. The authors hereof, and the groups they represent, share the goal of patient safety through education. We were disturbed to learn of the tragedies subject to the Article, and it reminded us why we tirelessly advocate to ensure that only physicians who obtain the necessary education, training, and experience perform cosmetic surgery. Unfortunately, Ms. O’Donnell was misinformed, and the Article relies on anecdotal information rather than peer reviewed articles and fact based evidence.

It is our goal to provide cosmetic surgery patients with valuable and credible information regarding cosmetic surgery, and the education, training, and experience necessary to perform it. To help USA Today correct the misinformation included in the Articles, below is fact-based information regarding cosmetic surgery and who is qualified to perform it:

Plastic Surgery and Cosmetic Surgery Are Not the Same Thing.

Cosmetic surgery and plastic surgery are different specialties requiring different education, training, and experience. Cosmetic surgery involves procedures designed to enhance appearance (Common procedures include breast implants; chemical peels; chin, cheek, and nose augmentation; face lifts; hair transplants; liposuction, and tummy-tucks). Cosmetic surgery was developed, and is practiced, by dermatologists, facial plastic surgeons, general surgeons, gynecologists, oral and maxillofacial surgeons, ophthalmologists, otolaryngologists, plastic surgeons, and doctors from other fields. Unlike cosmetic surgery, plastic surgery is dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease.

There are currently no residency programs in the U.S. devoted exclusively to cosmetic surgery. And, residency programs in dermatology, general surgery, obstetrics and gynecology, oral and maxillofacial surgery, ophthalmology, otolaryngology, and plastic surgery do not include training on every cosmetic procedure. Therefore, doctors seeking to learn the vast array of cosmetic surgery procedures must do so after completing their residency training. Understanding this fact is necessary to understanding the difference between "cosmetic surgery" and "plastic surgery."

Residency training required to become board certified in plastic surgery may not include training with respect to many common cosmetic procedures. Therefore, while the title "board certified plastic surgeon" tells you the doctor has received certain training and experience with respect to "plastic surgery," it does not tell you the same thing with respect to "cosmetic surgery," and it does not tell you the doctor has more or less "cosmetic surgery" training than a board certified dermatologist, facial plastic and reconstructive surgeon, general surgeon, gynecologist, oral and maxillofacial surgeon, ophthalmologist, otolaryngologist, or other doctor. Therefore, to find the most qualified doctor for a specific cosmetic procedure, patients must compare doctors’ overall (residency and post-residency) training and experience with respect to that procedure.

Cosmetic surgery patients need to understand that the education, training, and experience required for a doctor to become competent in cosmetic surgery is not the same as that required to become competent in plastic surgery. The Article’s suggestion to the contrary is simply false. See Diagram A.

False Premises

Diagram A

Diagram A illustrates the Article’s false premises that all board certified plastic surgeons, and only board certified plastic surgeons, are qualified to perform all cosmetic procedures. Cosmetic surgery patients who believe these false premises are misled into relying on incomplete and inaccurate information when choosing their physician. As a result, patients fail to consider many well-qualified cosmetic surgeons, and fail to properly evaluate physicians’ education, training, and experience regarding their cosmetic procedure. As a result, their safety is jeopardized by: (1) having their choice of qualified cosmetic surgeons arbitrarily reduced;1 and (2) potentially being directed to physicians with little or no cosmetic surgery experience.

1The total number of physicians board certified in the named specialties since the Boards’ inceptions (dermatology, general surgery, gynecology, ophthalmology, otolaryngology, oral and maxillofacial surgery, and plastic surgery) exceeds 176,840; with approximately the following breakdown among specialties: Dermatology: 14,330; General Surgery: 57,810; Gynecology: 49,110; Ophthalmology: 24,800; Otolaryngology: 15,960; Oral and Maxillofacial Surgery: 7,060; and Plastic Surgery: 7,770. Board certified plastic surgeons make up only 4.4% of the total number of board certified physicians shown. (ABMS 2010 Certificate Statistics; and Report of the ADA-Recognized Specialty Certifying Boards April 2011).

The fact is that there are physicians in various specialties who obtain the necessary post-residency education, experience and training to become qualified to perform cosmetic surgery, and there are others who do not. Therefore, a physician’s competence, skill, and ability with respect to a cosmetic surgery procedure depends on their education, training, and experience regarding that procedure, and not on their particular board certification. See Diagram B.

Diagram B correctly illustrates that within each discipline there are physicians who received specialized education, training, and experience in cosmetic surgery (inner circle - "Qualified Cosmetic Surgeons") as well as physicians who have not and are, therefore, not qualified to perform cosmetic surgery. Whether physicians from among the various disciplines are qualified to perform cosmetic surgery is determined by their education, training, experience, and proven competence with respect to the contemplated cosmetic procedure, and not by their underlying board certification. It is imperative that cosmetic surgery patients understand this fact. Those who only consider a physician’s underlying board certification when choosing their doctor base their decision on incomplete information and reduce their choice of qualified cosmetic surgeons. See Diagram A.

Cosmetic surgery patients who believe that all board certified plastic surgeons, and only board certified plastic surgeons, are competent in cosmetic surgery may choose an unqualified physician (i.e., board certified plastic surgeon with inadequate or no training with respect to the given cosmetic procedure) and are, therefore, at risk. Compare Diagrams A and B.

Criteria for Evaluating Physicians.

The Article falsely suggests that hospitals evaluate doctors based on their board certification, and therefore patients should do the same. On the contrary, the criteria hospitals use to evaluate physicians specifically opposes relying on a doctor’s board certification. Instead, the criteria for evaluating physicians applied by national healthcare organizations requires an assessment of the physician’s education, training, experience, and proven competence. This criteria is consistently published by the American Medical Association ("AMA"), American Osteopathic Association’s Healthcare Facilities Accreditation Program (HFAP), the Joint Commission, which accredits hospitals in the U.S., and the Federal Government. In fact, the U.S. Department of Health and Human Services expressly prohibits the granting of staff membership or hospital privileges solely on certification or membership in a specialty body or society.

Recognizing the potential abuse of specialty certification, AMA’s House of Delegates adopted Substitute Resolution 88 regarding the delineation of clinical privileges:

Resolved that it is the American Medical Association policy that individual character, training, competence, experience, and judgment be the criteria for granting privileges in hospitals; and be it further resolved, that the physicians representing several specialties can and should be permitted to perform same procedures if they meet this criteria.

AMA’s policy on "Board Certification and Discrimination" specifically opposes discrimination against physicians based solely on lack of ABMS or equivalent American Osteopathic Board certification. Importantly, all of these authorities agree the use of a single criterion, including board certification, in evaluating a physician is inappropriate and inconsistent with providing quality patient care

Board Certification in Cosmetic Surgery.

Contrary to the Article’s false information, there are multiple valid certifying boards that are not members of the American Board of Medical Specialties ("ABMS"), and, importantly, none of the ABMS member boards certify physicians in cosmetic surgery.

ABMS is only one of several private organizations that recognize medical specialty certifying boards that meet their membership requirements. Today, the three largest organizations that provide medical specialty board recognition include the ABMS (recognizing 24 specialty boards), the American Osteopathic Association’s Bureau of Osteopathic Specialists (recognizing 18 specialty boards), and the American Board of Physician Specialties (recognizing 18 specialty boards). All three organizations assist their member boards in developing educational and professional standards to evaluate and certify physicians in their respective specialties. And, all three are private membership organizations that must consider, address, and foster the interests of their members. What a board’s certification evidences about the education, training, and experience of those it certifies depends on its certification requirements; not on the membership association to which it belongs.

The American Board of Cosmetic Surgery ("ABCS") certifies physicians exclusively in cosmetic surgery.

In addition to other certification requirements, all applicants for certification by ABCS must first be certified by one of the following ABMS or AOA member boards:

American Board of Dermatology

American Board of Oral and Maxillofacial Surgery

American Board of Surgery;

American Board of Obstetrics and Gynecology;

American Board of Ophthalmology (with completion of an American Society of Ophthalmic Plastic and Reconstructive Surgery approved Oculoplastic Fellowship);

American Board of Otolaryngology;

American Board of Plastic Surgery;

or be recognized by the American Board of Oral and Maxillofacial Surgery (ABOMS) and have an MD degree. In determining certification, ABCS considers only eligible candidates who, by definition, have completed certain general surgical training and specific additional cosmetic surgery training. The residency and post-residency training required by an ABMS candidate’s core board coupled with the additional training required by ABCS for certification meets or exceeds that which eligible candidates to any ABMS board (including plastic surgery) must obtain with respect to any certified cosmetic procedure. Without substantial post-residency training in cosmetic surgery, many if not most board certified plastic surgeons do not qualify for certification by ABCS.

Liposuction and the Tumescent Technique.

Importantly, the Article misrepresents facts about liposuction suggesting it is safer if performed under general anesthesia rather than local anesthesia when, in fact, the opposite is true. From the pioneering liposuction techniques introduced in Europe in the 1970s through the time it was introduced in the U.S. in the early 1980s, liposuction procedures were performed under general anesthesia. This changed in the mid-1980s when dermatologist, Jeffrey A. Klein, M.D., developed the tumescent technique. The tumescent technique, which involves local anesthesia, revolutionized liposuction and is much safer than liposuction under general anesthesia.

As confirmed in an article published in the Journal of Clinical Anesthesia (Liposuction: contemporary issues for the anesthesiologist), many physicians who perform liposuction have not made the effort to learn the new, safer procedure:

Unfortunately, many physicians and anesthesiologists, due to their limited training in tumescent anesthesia, still believe that modern general anesthesia is the safest route for liposuction. Consequently, many do not make the effort to learn the new technique that allows liposuction totally by local anesthesia. Although modern general anesthesia is considered safe, it may expose the patient to unnecessary risk given that a safer alternative is available. Now that liposuction can be performed totally by local anesthesia, it might be considered that general anesthesia is often abused in the world of cosmetic surgery. Kucera, M.D., Ian J., Liposuction: contemporary issues for the anesthesiologist. Journal of Clinical Anesthesia, 2006, 18: 380).

Most importantly, and as further confirmed by multiple fact based studies and articles over the past decade, liposuction patients of board certified plastic surgeons experienced a significantly higher death rate, insurance claims, and malpractice complaints, compared to other specialties performing cosmetic procedures.

How to Choose Your Cosmetic Surgeon

Cosmetic surgery patients should ask their cosmetic surgeon the following:

1. How long have you been performing the specific cosmetic procedure?

2. What are the risks and possible complications? Before the surgery, your doctor should explain to you the risks and possible complications, and potential side effects, including the pros and cons of the procedure.

3. Where did you receive your training with respect to the procedure?

4. How much experience do you have performing the procedure? How many have you performed in total? How many have you performed over the past year?

5. How do you define success with regard to the procedure? What is your success rate performing the procedure? How many of your patients have returned for revisions or corrections with respect to the procedure? How many of your patients have returned for revisions or corrections in general?

6. May I review "before and after" pictures of those who have had the procedure performed by you?

7. Where will you perform my procedure? Is the facility accredited? Cosmetic surgery is performed in various facilities such as hospitals, surgical centers, and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation. Some certifying organizations include the Joint Commission (formerly "JCAHO"), the Accreditation Association for Ambulatory Health Care ("AAAHC"), and the American Association for Accreditation of Ambulatory Surgery Facilities ("AAAASF").

8. Are there any alternatives to the procedure that may exist considering my desired result?

The Article was based on false and misleading information. Accordingly, we respectfully urge USA Today to correct the misinformation before cosmetic surgery patients rely on the Article and are harmed.

Respectfully Submitted on behalf of:

American Academy of Cosmetic Surgery, Angelo Cuzalina, MD, DDS, President

American Board of Cosmetic Surgery, Michael Will, MD, DDS, President

Cosmetic Surgery Foundation for Education,

Research and Patient Safety, Suzan Obagi, MD, President; Jane Petro, MD, FACS, Executive Director

Robert Jackson, MD, AMA House of Delegates Cosmetic Surgery Representative

Fore more information please check out the website for The American Board of Cosmetic Surgery

Wednesday, August 31, 2011

ICD-9 code for being UGLY!

Should there be a medical code for being beaten with the ugly stick? Apparently researchers believe so. Recent research from University of Texas showed that ugly people will make

$230,000 less in their lifetime than attractive people. There is a group now claiming that ugly people should get disability for their inherited ailment. This is a cool article and worth looking at in today's NY Times. Similarly, I wrote an article in July. Here it is....

Sunday, July 27, 2008

Are prettier people more successful?

Are attractive people more successful than unattractive people? Most research to date points to an answer of yes.

We were all told, what is "on the inside" counts more. Was that all a hoax created by an ugly person? You make the call.

CNN reported the following:
Attractive students get more attention and higher evaluations from their teachers
Attractive patients get more personalized care from their doctors
Attractive criminals get lighter sentences than less attractive convicts

Attractive people make 5% more in their pay.

In a collaborative study by Michigan State University and University of Texas, financial earnings were examined:
Good-looking people made the most money
Average looking people made 3-8% less
Plain looking people earned 8-18% less

Similarly, a London Guildhall University survey of 11,000 33 year olds showed unattractive men earned 15% less than attractive men. Plain women earned 11% less than their attractive counterparts.

Even studies of babies show that children look and study more intently at an attractive face than unattractive one.

Do I think everyone should run out to have cosmetic surgery to save their careers? Obviously not. But you should feel comfortable in your own skin. Confidence is so important to creating an attractive aura.

I have seen shy introverted women who had very low self esteem transform themselves to totally confident women after a breast augmentation or abdominoplasty (tummy tuck). Sometimes all it takes is that little fix that you need to take that next step. Most importantly do it for yourself.

Tuesday, August 16, 2011

Plastic ≠ Fake; How to look natural after cosmetic surgery

The Michael Jackson nose, the Kenny Rodgers facelift, Lindsey Lohan lips, the Heidi Montag boob job; famous people are becoming infamous for cosmetic surgeries that have gone awry. What went wrong? Who is to blame, the doctor, the patient or the public’s demand of perfection from their idols or simply the fear of aging gracefully?

Although there are many reasons and factors that go into one’s reason for undergoing a cosmetic procedure it is ultimately the doctor’s responsibility to inform and educate the patient on what is right and do what is ethical. Imaging software is an excellent tool, to create a shared vision and allow the patient and doctor to express their concerns. Too often I believe it is misused as a selling tool to show a patient “perfection” after surgery. Anyone well versed in Photoshop can turn Roseanne Arnold to Paris Hilton. Instead, this tool should be used to show the limitations and set realistic expectations of surgery.

Many times a patient will tell me “I need my eyes done”, when the problem is their brow position. Oftentimes someone comes in for a neck lift when instead they need a chin enhancement. Patient’s don’t always know the answer. The most well executed surgery is useless if it was the wrong procedure. It is important to get multiple opinions from well qualified doctors and see what makes sense to you. It truly is an art to look at someone’s face and tell them what needs to be enhanced or made more subtle. Many doctors simply have that knack, while others just don’t, independent of age or experience. Some doctors are very gifted salesmen, some are great technically, but do not have that “eye”. It falls on the patient to find this out. Patient referrals, testimonials and reviews, looking at their before and after results and ultimately visiting that doctor and following your gut is the answer.

Many doctors produce cookie cutter results. My personal belief is to make a feature fit the face, and enhance other beautiful features that person possesses.

Like the song we sang as children “the hip bone’s connected to the...thigh bone”, every anatomical portion of our face is connected. The face is made up of 14 bones and 50+ muscles all working together as a dynamic system. To think that “fixing my nose” in a vacuum is wrong. Moving one thing has an impact on neighboring structures functionally and aesthetically. It is important for the doctor to take this into account.

Every surgery is challenging and could potentially change a person’s life. Your surgeon should treat you as such. Do you feel rushed at your consultation, are your questions and concerns taken seriously, do you feel like you are just another number? These are all “red flags”. Listen to that little voice inside your head. Bringing a friend or family member can help you and may notice cues you may have missed. Surgery is a shared responsibility between patient and doctor, and when working as a team success is the only option.
Always with patient care first,
Dr. B

CAMEO Surgery